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Yet another plague panic


Case #3 from the 1976 Ebola outbreak in Zaire; picture by Dr. Lyle Conrad, Centers for Disease Control – Centers for Disease Control and Prevention’s Public Health Image Library (PHIL), with identification number #7042.

This image is in the public domain and thus free of any copyright restrictions. As a matter of courtesy the CDC requests that the content provider be credited and notified in any public or private usage of this image. Taken from the Wikimedia Commons.

Thirty plus years in medicine has given me some perspective as has infectious diseases (ID). One of the almost TNTC cool things about ID is that infections, unlike the diseases of modernity, have been plaguing humans since before we were humans.

There is a sense, a usually unvoiced assumption, on the part of many people that we are supposed to be healthy, that our default mode is good health and that with the proper diet and attitude we could obtain the health that was ours before the fall.

I think not. I see no perfection in any human, except maybe my wife who would achieve perfection if only she liked beer and steak.

We are a hodgepodge of anatomic and physiologic compromises that allowed us to spread across the world. But if you like to read history, you realize that most of the time we died like flies from infections, trauma and other medical problems. The variations that allowed us to survive malaria or tuberculosis led to sickle crises and the metabolic syndrome. Even with evolution no good mutation ever goes unpunished.

And, immunologically, we are perhaps as individual as snowflakes. We currently lack the cost-effective technology to check for the many polymorphisms that increase or decrease our odds for infection. Just have the wrong form of snot and it increases your risk for meningitis. Who knows what genetic variations are lurking to increase (or decrease) the risk of disease?

So I do not see the baseline for animals as healthy, just healthy enough to survive and reproduce and there is not a lot that can be done to be healthy beyond the simple basics: don’t be fat, eat a reasonable diet, exercise, avoid too much alcohol and any tobacco. No matter what you do you will get old and sick and die, but if you were lucky enough to get the right genes (please, let me have my mother’s not my father’s) you may get a reasonably healthy life.

Men at some time are masters of their fates:
The fault, dear Brutus, is not in our stars,
But in ourselves

I also expect infections, new and old, to sweep across the world. It happens all the time. There was no AIDS when I started medical school. West Nile Virus was not in the US until about 1999. Since then West Nile has spread across the US to all lower 48 except Oregon. We still have had very little local transmission of West Nile in Oregon. I credit the hops. H1N1 influenza had not been seen for 50 years but it came back like gangbusters in 2009.

Infections spread across the world all the time. It may be birds (West Nile) or planes (SARS) or boats. Bubonic plague was unknown in the West until steam ships brought to San Francisco in 1900, and then plague spread across the west.

There are many factors that can contribute to outbreaks and the spread of infectious diseases. You need susceptible hosts, you need an infectious organism, and you need an efficient mode of transmission.

The best ways for infections to spread are coughing and sex. Avoid sex with someone who is coughing I always say. The nice thing about sex as method of spread is that the organism does not have to be present in high amounts or be very infectious since sex appears to be a past time that people enjoy repeating. Most people with herpes, as an example, are never symptomatic and secrete small amounts of virus all the time.

HIV has been interesting. In the old days, before we knew about HTLV-3, we only knew the risks for HIV, one of which was having many sexual partners. It was not uncommon for patients to report Wilt Chamberlin numbers for their sexual contacts. That has changed and there is some suggestion that as the number of partners has declined along with an increase safer sex, HIV may have become more virulent. With less opportunity to be passed on, only the more infectious/virulent strains survive, although HIV maintains the same mode of transmission.

Every couple of years there is a new infection that gets everyone worried. HIV, SARS, West Nile, Legionella, MERS –CoV have been the worries in my time.

Now Ebola is the current infection most in the news with 1,700 cases and 930 deaths as of today. It took six months to cause that many cases in an area with a population of around 20,000,000. And this in an area with a horrible infrastructure for both health care and infection control. While a ghastly outbreak, Ebola does not appear to be particularly infectious or pose much of a pandemic risk.

Compare that with H1N1:

From 12 April 2009 to 10 April 2010, we estimate that approximately 60.8 million cases (range: 43.3-89.3 million), 274,304 hospitalizations (195,086-402,719), and 12,469 deaths (8868-18,306) occurred in the United States due to pH1N1.

and perhaps 250,000 deaths worldwide. Ebola, from an epidemic potential viewpoint, appears to be trivial. It looks to be one of many localized outbreaks of awful diseases in the world that are common and may be increasing in the future.

Ebola is spread by direct contact with blood or secretions from the infected person and as such should, in areas with resources, be controlled with aggressive infection control procedures. Based on what is known to date, I do not worry overmuch about the spread of Ebola in the US. Direct contact is not a very efficient way to transmit infections, especially infections that are rapidly fatal. Most infections routinely spread by direct contact are relatively indolent. Maybe I am overly sanguine, but I do not see much to worry about with Ebola from either an epidemic potential or having patients brought to the US.

Thirty year of following infection control procedures and I have yet to catch an infection from a patient. I remember at the start of the AIDS epidemic there were those who refused to care for AIDS patients due to worries of catching the disease. It never worried me since I knew the modes of transmission and I did not partake of those behaviors. That said, I still remember the first AIDS patient I took care of, before we knew about HTLV-3, offering me a chocolate from the box at his bedside while declaring he would have to “spit in my mouth” to pass on AIDS. While I had no problem touching the patient, shaking hands and doing an exam, I politely declined the chocolate. I would eat one today however, as long as it didn’t have walnuts.

It is curious that people worry about Ebola, yet little is said about Dengue, another very common hemorrhagic fever that is at our doorstep.

The World Health Organization (WHO) estimates that 50 to 100 million infections occur yearly including 500,000 DHF cases and 22,000 deaths.

Dengue has the most efficient mechanism for infection spread known: mosquitos. I have seen it estimated that half of all human deaths are due to infections spread by mosquitos. Dengue is present throughout Central and South America and the mosquitos that spread the infection, Aedes aegypti and Aedes albopictus are ubiquitous in the Southern half of the US (and, sadly, Oregon). 40% of people who have never left Brownsville Texas (and who would not want to leave Brownsville Texas?), have serologic evidence of Dengue. There has been an outbreak in the Florida Keys and where there is Dengue, there follows Yellow fever.

Both diseases have the potential to spread (or re-occur as in the case of Yellow fever, which caused considerable morbidity and mortality in the 17th and 18th century US) with global warming and the potential northern spread of the mosquito vector. No one seems worried about these two infections, but instead fret about Ebola, some of it totally wackaloon.

There are many infections to worry about, with potential for local outbreaks, epidemics and pandemics. But that has always has been the case. The best we can do for most infections is a holding action, keeping them at bay with public health measures such as vaccines and potable water. Unfortunately, I doubt we will ever repeat the successes such as the eradication of smallpox and rinderpest and many of the predicted short term changes (the next 1,000 years or so) would likely increase the spread of many infections.

These infections do offer opportunities for those in the world of pseudo-medicine. For some, like the Natural News, perhaps alternative medicine is preferred term, because it suggests the alternate universe, the one where Spock has a goatee, and not the real world in which I live.

Although homeopaths have weighed in on the appropriate magic water to be used to treat Ebola, evidently homeopaths are not heading for Africa to prove the efficacy of their therapy and there will be scant opportunity for them to use their magic in the US or Europe to treat Ebola.

Homeopaths love to credit the proof their superior therapeutics to the cholera outbreaks in London in the 19th Century. Given the purging and bleeding that were the standard medical therapy at the time, the nothing of homeopathy was likely better than the dangerous interventions of the time.

There have not been many epidemics this century for which homeopathy could test their mettle. H1N1 hit hard and fast and to judge from the few papers on homeopathic treatment, it can be judged as hit or miss. Or perhaps miss and miss, give the quality of homeopathic research that resulted from the H1N1 epidemic.

We may be primed for a new epidemic in the US: chikungunya. It is in the Caribbean where it is going gangbusters: in 8 months over 500,000 cases.

Six out of 10 cases have been reported from the Dominican Republic, which tallied 307,933 cases in Epidemiological Week 31, up 26,000 cases from last week. In addition to the DR, Guadaloupe reported 71,000 cases, Haiti reported nearly 65,000 and Martinique recorded 54,000. The French side of St. Martin, where the epidemic began has reported 4,500 cases.

Now that is an epidemic. Spread by mosquitos, almost everyone who gets the virus has symptoms: fevers, muscle and joint pain, rash and headache, often quite severe. Death is rare.

There are now a few cases of chikungunya transmitted in the US, and once it gains a toehold it should spread fast. It took West Nile less than a decade to cross the US, although it had help from birds. Perhaps it will hit the poor disproportionately since they do not have air conditioning to keep themselves cool and away from mosquitos.

Homeopaths have treatments for chikungunya, although they retain their usual inability to understand the difficulties in assigning causality to events when treating a process that by its nature is self-limited.

We are probably on the cusp of millions of cases of chikungunya in the US. Given that there is no specific treatment or prevention (besides avoiding mosquito bites) for chikungunya and 70-90% of those infected will become ill, it is perfect opportunity for homeopathy, and the other pseudo-medicines, to put up or shut up. An epidemic is probably coming for which medicine only has supportive care, the perfect opportunity for pseudo-medicines to demonstrate their superior effectiveness with modern methods.

Somehow I suspect it will not happen.

P.S.
Idle thoughts. I have asked psychiatrists why practicing homeopathy does not meet the criteria for delusional disorder. I always get a blank look. I am not a fan of the DSM, mostly as one past girlfriend or another has used it in attempt to classify me and I am well aware of the sordid history of using psychiatry as a means to suppress those whose opinions are unpopular. The latter is certainly not appropriate.

It seems to fit and homeopaths are a danger to others, since they act on their delusions. Probably a weakness in the DSM rather than homeopaths.

It remains one of the curiosities of human culture and medicine. People can believe in and practice medical systems that are totally divorced from reality with an acceptance found in no other profession. Weird.

Posted in: Homeopathy

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267 thoughts on “Yet another plague panic

  1. Preston Garrison says:

    I’m not an M.D., although I did spend 2 years in med school in the ’70s before going off to become a biochemist. I spent about 20 minutes this morning thinking about what to do if I was a doc on the scene in the Ebola outbreak. What I came to was passive immunity – use plasma from patients who’ve recovered. I went looking around to see if this had been tried and stumbled on the fact that a paper was published back in the ’90s where 8 Ebola patients were treated with transfusions from recovered patients. Seven survived. Dr. Brantly, who was returned to the U.S. the other day, got a transfusion from a boy that he had previously treated, in addition to the investigational mix of humanized mouse Abs against Ebola.

    It seems to me that while the high-tech vaccines and monoclonal Abs expressed in tobacco are the things to shoot for on the scale of 6 months to years, clinicians on the the scene of a deadly epidemic need to think about things that can be done simply and quickly. We’re accustomed to accepting trials that take years to come and years to complete. I think if I was one of those people who had Ebola right now, I would like to see less patient research protocol following and more fast creativity. When the mortality rate is 60-90%, how much is there to lose?

    1. Angora Rabbit says:

      Your suggestion is spot-on, and antibodies from previously infected individuals has been a front-line treatment for years – the Hot Zone talks about this. I would quibble with the description of passive immunity; the plasma would be rich with IgGs made to fight the infection, definitely an active immunity product. The strategy isn’t really different from the current therapy (did I hear it was grown in tobacco?), which also supplements with antibody. There are pros and cons to both – monoclonals give you a known epitope with defined efficacy, whereas polyclonal (like the serum) can target multiple epitopes. But a person’s blood will have variable potency and may or not have been titered to estimate efficacy, so it’s a bit of a crap shoot. Plus you run the risk of transferring other infective agents in the blood, parasites, other microbes and viruses, etc. A bigger problem might be cultural barriers for the donors, recipients, and families; a defined protein might get around that.

  2. Windriven says:

    “we died like flies from infections, trauma and” drowned in seas of testosterone unleashed in the service of one or another imaginary deity. As Yakov Smirnoff should say: “what a species.”

    “Now Ebola is the current infection most in the news with 1700 cases and 930 death as of today. It took 6 months to cause that many cases in an area with a population of around 20,000,000. And this in a area with a horrible infrastructure for both health care and infection control. While a ghastly outbreak, Ebola does not appear to be particularly infectious or pose much of pandemic risk.”

    This is without question the single most cogent and coherent paragraph on Ebola that I have ever read. Its inclusion should be be mandatory in every newspaper and magazine article, every radio and television report. But not nearly as titillating as, “Ebola’s coming and you’re going to bleed out like road kill and die in writhing agony. Probably tomorrow or certainly the day after.” ID medicine and epidemiology are important. So is managing the perceptions of a public, half of whom still believe in ghosts.

    “Unfortunately, I doubt we will ever repeat the successes such as the eradication of smallpox and rinderpest…”

    I wish you’d expounded further on this. Why were those achievements singular? What now prevents us from eradicating, say, polio?

    1. goodnightirene says:

      What now prevents us from eradicating, say, polio?

      Religion and conspiracy theory thinking (some of which is justified considering that the US used vaccination to get to Bin Laden).

      1. Windriven says:

        “Religion and conspiracy theory thinking”

        Sure, but weren’t those things around when we eradicated smallpox?

        1. mouse says:

          Yup, This is an interesting report on barriers to polio irradiation in the three remaining countries where polio is endemic.

          http://www.plosmedicine.org/article/info%3Adoi%2F10.1371%2Fjournal.pmed.1001529

          Here’s a money quote “In our view, the ambition of the global health community to eradicate polio appears to be blinding it to lessons learned about health systems over the past 30 years. Polio eradication will only be achieved with stronger health systems and bottom-up community engagement, which is likely to require more time and more investment than is currently available in Pakistan, Nigeria, and Afghanistan because of their political fragility. The routine immunisation program is weak in Pakistan and Nigeria, in part because during polio immunisation campaigns many other programs stall [11]. “

        2. KayMarie says:

          They were around, but I don’t think they were as organized or quite as able to start a panic.

          I also think that in the last few decades there have been enough things that have eroded trust that it is also easier to spread the “of course they are up to something devious” meme.

          No hard data follows, just my impressions and anecdotes. When I was young (and maybe naive) it seemed most people were wanting progress, going to the moon, equal rights, eradicating disease. It felt like the progress would just continue on and on. Feels to me now like we are very entrenched in push back mode with more fundamentalism, nostalgia for what was lost, etc. I assume at some point the pendulum swings back but so far it feels to me like it is still going to get more anti-progress, anti-science, return to the past for awhile. Probably until something major happens and our only way out is returning to science. What that would be, I dunno. I just know it always swings back.

          What gives me hope is how much the push back seems to rely on the jargon of progress. We want to seem scientific and progressive even when we are regressive and myth-based. Like they know the genie is out of the bottle and it is only a matter of time before they lose the battle.

          1. Windriven says:

            “What gives me hope is how much the push back seems to rely on the jargon of progress. We want to seem scientific and progressive even when we are regressive and myth-based. Like they know the genie is out of the bottle and it is only a matter of time before they lose the battle.”

            I think you’re on to something here. I live in the PNW where Seattle is home to “The Discovery Institute”, the epicenter of so-called intelligent design, successor delusion to nearly defunct creationism. Your comment struck a chord as Discovery Institute couches everything in a film of pseudo-scientific jargon, often dribbled from the lips of religious nuts who have somehow managed to earn degrees in scientific disciplines.

          2. Calli Arcale says:

            With smallpox, you also have to remember that first of all, it has a much higher mortality rate than measles or polio (so it’s more obviously a threat) and secondly the vaccination campaign against it goes back centuries. Polio we’ve only been fighting for about sixty years. We’re almost there, but a combination of very region-specific fearmongering and social unrest (it’s difficult to conduct an adequate vaccination campaign in the middle of an incredibly bloody civil war) are preserving pockets of the disease.

            Rinderpest is different; it’s a livestock disease, and since eradication has clear dollar benefits, it’s much easier to gain acceptance. Also much easier to mandate it, since the patients themselves are animals with absolutely no say in the matter, and destined for butchering in any case.

            1. KayMarie says:

              And since most cattle aren’t pets you probably don’t have many anti-vaxxers mooing over the poor early demise of their Bossy from some disease that you expect in animals of a certain age (even if it seems way too young).

              Don’t know if they are anti-vaxxers or not, but a family in my county had to put down their dogs after a fight with a rabid raccoon. If more cows were pets we’d probably never get rid of a disease in them.

              1. Windriven says:

                “a family in my county had to put down their dogs after a fight with a rabid raccoon.”

                They hadn’t vaccinated their dogs for rabies? Most counties require that don’t they?

              2. KayMarie says:

                Oh yeah, it is required. And several times a year the local animal welfare groups have vaccination drives where it costs something like $5 per animal.

                I’m not sure how much enforcement there is. I don’t think there is much other than a lot of places won’t do services on your dog if you haven’t had it vaccinated, and you probably can’t take it on a plane with you.

              3. mouse says:

                Kinda hard to know if the precious pet phenomenon is helping or hurting rabies vaccine rates. Many people who think of their pets as family take them in for regular vet visits with the needed vaccines. Many of the domestic animals particularly at risk for non-vaccination are cats which are taken to vets less and dogs who are low priority in the family or just outright neglected or abandoned. I’m sure there are some precious pets that are not vaccinated due to antivax views, but my guess (I could certainly be wrong here) is that low prioritization and neglect account for more non-vaccinated cases.

                I’m kinda curious on statistics now, but I doubt there are accurate ones available.

          3. Thor says:

            The sad part is that so much precious time is lost and wasted as the pendulum swings away. Gone forever. We are held back as a species.
            I often wonder what it would be like if human progress would have developed completely unhindered by religion, etc. At my age, I’ll never get to witness that world. That shouldn’t have to be. It’s wrong and I’m angry and cranky about it. It will be (I hope) a dramatically different place in, say, 300 years (or 1000, if you’d like), as mental processes keep refining, science and technology keep advancing, children get better education. We’ve already come a long way.

          4. Stephen H says:

            An immense amount of trust has been lost in the last 20-30 years. I’m not sure the West was ever fully trusted by the rest of the world, but its actions lately have been so obviously self-serving that one should not be surprised when community leaders in African and Asian countries say “vaccination is a US plot”.

            Short term decisions can sometimes make for extremely long term consequences (think Constantine), and the reasons behind current mistrust, while going both ways, have been strengthened by all sorts of racist behaviours by “civilised” countries.

            1. WilliamLawrenceUtridge says:

              Part of the problem is that the West and even the US is treated as a block, a monolith of actors who all support the same goals and methods. The reality is that the West and the US are made up of competing interests – while I wouldn’t trust Lockheed-Martin or Karl Rove to do anything nice for Africa, I would trust Bill Gates and the WHO. It’s tarring everyone with the same brush.

              Not, of course, that the West and US (to tar everyone with the same brush) is any better. Sikhs and Saudis are lumped into the same group as “potential islamofascist terrorists” because they both wear headgear that isn’t part of the Western tradition – never mind Sikhs aren’t even Muslim.

              Humans are monkeys, and monkeys love to hate the the other tribe of monkeys.

      2. Sean Duggan says:

        I’d be more inclined to blame efficient transportation networks. Plagues tended to be somewhat self-limiting in that they either didn’t kill that many people or they killed off a town before they could spread. Now, travelling to the other side of the globe can be done in less than a day’s time, meaning that vectors can spread before people even get symptomatic.

    2. Sarah A says:

      I remember reading about the eradication of smallpox in Richard Preston’s book Demon in the Freezer. One of the things that struck me forcibly was how many corners were cut in terms of informed consent and how impossible it would be to get away with that sort of thing in the modern world where the internet is so ubiquitous that even people who don’t have flush toilets still have cell phones. As we’re seeing with the current attempt to eradicate polio, it only takes a few refusers to sabotage an enormous public health undertaking.

    3. WilliamLawrenceUtridge says:

      Polio doesn’t have an animal reservoir, Ebola does (bats).

      1. Emily68 says:

        I think polio does have an animal reservoir–apes and (maybe) monkeys. Jane Goodall talks about a polio epidemic among the chimps at the Gombe Stream Reserve.

        1. Windriven says:

          I’d forgotten about that; she mentioned it in her autobiography, didn’t she? Anyway, I looked it up and you are quite correct: humans, chimpanzees and gorillas.

          1. Sawyer says:

            Now I’m puzzled. Every time polio eradication is mentioned on This Week in Virology, Dr. Racaniello stresses that the reason we can eliminate polio is because of the lack of a reservoir host. Are the viruses in chimps really polio, or another enterovirus with a similar structure?

            1. Windriven says:

              Wa-a-ay beyond my competence to address, Sawyer. But I join you in hoping that someone who knows what they’re talking about to weigh in.

              When I was young, polio could still strike fear into the hearts of parents. Childhood friends referred to still puddles and ponds as ‘polio water’. The oral vaccine arrived when I was an adolescent and the dream of eradicating polio seemed attainable.

              I suspect, as Irene (I think it was) pointed out, political instability is more to blame than non-human reservoirs. It would be enough for me to see it eliminated in humans, even if that meant vaccination forever. But it is hard to sell vaccination as a priority in a country like Syria or Somalia where the notion of legitimate government is more theoretical than actual.

            2. WilliamLawrenceUtridge says:

              My guess would be that the apes and chimps get proto polio, or something similar. The deep-dark ancestor of smallpox still lurks in Egyptian naked mole rats; it infects them, but is harmless to humans – but was the progenitor of what ultimately became smallpox after it went through hundreds of cycles of augmented lethality in cities. It may also be a matter of susceptibility, apparently humans are more vulnerable through poop than chimps are, so once we eliminate it in humans it might vanish in chimps; humans might be the ones giving it to chimps through repeated dumps in African rivers. In addition, it appears that when monkeys and chimps get polio, they excrete less of it, for a shorter time (same source).

              1. n brownlee says:

                Hmm- my memory is that Goodall witnessed, and wrote about, a polio outbreak in a human settlement that was then carried downstream in human waste- which then led to infection, and death and permanent disability, in some of the chimpanzees she was observing.

                I don’t think she observed the infection moving from chimps to humans. I was a shameless Goodall fan in my 20s- but I no longer have her books.

                I’m going to keep looking for the reference.

        2. JD says:

          I think polio does have an animal reservoir–apes and (maybe) monkeys. Jane Goodall talks about a polio epidemic among the chimps at the Gombe Stream Reserve.

          There is no doubt that non-human primates can be infected by and transmit picornaviruses, this may be what was witnessed. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3536375/

          What has never been shown, to my knowledge, is natural poliovirus (1,2, or 3) infection among these primates that would be able to infect humans. Wikipedia tells me they have been infected in laboratory settings, but not really sure what this means. If chimpanzees etc. were carrying transmittable polio to a degree that would make them a meaningful reservoir, I would have to assume that working with bush meat would be reported as a potential risk factor, and Nigeria (plus surrounding countries) wouldn’t be the only hot zones in Africa.

          My take is inline with what has been mentioned above. Political instability and inability to reach certain areas with vaccines (due to security threats or refusal) would explain what we are seeing. I have to suspect that distrust of humanitarian efforts to vaccinate (going so far as killing relief workers) is an important problem in Nigeria.

          Seems like everyone references back to the Dowdle 1997 paper regarding the reservoir. (Dowdle WR, Birmingham ME: The biologic principles of poliovirus eradication.
          J Infect Dis 1997, 175:S286-S292.)

          Here’s a decent commentary on the issues of eradication (nothing mind blowing): http://www.biomedcentral.com/1741-7015/12/116

          1. Sawyer says:

            Excellent work JD. Thanks for the info.

  3. Windriven says:

    For any reader who hasn’t been to Mike Adams’ Natural News site, it is worthwhile to follow Dr. Crislip’s link to the “Health Ranger’s” Ebola story which enumerates “Twenty-one questions about Ebola: government propaganda, medical corruption and bioweapons experiments.”

    I will refrain from further comments on the content, all of which would be too easy. But while you’re there, soaking in your daily dose of batsh!t, check out the number of advertisements. The Health Ranger may not know jack about science, medicine, or coherent thought but he clearly has mastered marketing.

    1. WilliamLawrenceUtridge says:

      The Health Ranger, for all that he’s basically evil, is primarily a master of marketing and populism. He is a deity at selling people what they think they need. His first career was in spam marketing!

  4. goodnightirene says:

    Ewwww, Dr. C, you made me click on “Natural News”–I feel really yukky.

    I think it’s the word itself with Ebola–sounds way more terrifying than yellow fever and there’s a cool band (well, I think it’s a cool band, anyway) called Dengue Fever. Plague sounds pretty bad and stirs up the masses too. I wonder if the anti-vaxxers well get an Ebola shot if and when it becomes available?

    1. Koffi Babone says:

      Other posters have down played how contagious Ebola is and have compared its transmission and infection rate to HIV and Hepatitis which is wrong.

      You can live with an HIV or hepatitis positive person and not catch those diseases, you cannot do the same with Ebola. If you live with an Ebola symptomatic patient, chances are you will get it.

      1. Andrey Pavlov says:

        You can live with an HIV or hepatitis positive person and not catch those diseases, you cannot do the same with Ebola. If you live with an Ebola symptomatic patient, chances are you will get it.

        Oh really? How about this study on what is actually infective?

        Other than in samples grossly contaminated with blood, EBOV was not found by any method on environmental surfaces and by RT-PCR on the skin of only 1 patient. These results suggest that environmental contamination and fomites are not frequent modes of transmission, at least in an isolation ward… Taken together, our results support the conventional assumptions and field observations that most EBOV transmission comes from direct contact with blood or bodily fluids of an infected patient during the acute phase of illness. The risk of casual contacts with the skin, such as shaking hands, is likely to be low. Environmental contamination and fomites do not appear to pose a significant risk when currently recommended infection control guidelines for the viral hemorrhagic fevers are followed.

        Or you can compare it on epidemiological terms (though of course there will be some variability depending on exactly your population) using the basic reproduction number to compare them.

        For Hepatitis C the BRN comes out to 1.49. And that is for the highest risk group – IV drug users and at the peak of HepC in the 90′s.

        Also HCV incidence among IDU’s was high in the 1990′s (10-35%), but appears to have declined over the last decade. We used a recent estimate… of 34%… this yields a basic reproduction number R0 of 1.49… [which is] similar to other estimates in the literature.

        Well then. Let’s see what the BRN is for Ebola, shall we?

        Our study allowed quantifying transmission in different settings during the two epidemics. According to our estimates, the term of R0 concerning the transmission during traditional burial was estimated at 1·8 (95% CI 0·0–2·3) for the DRC epidemic and at 0·1 (95% CI 0·0–3·2) for the Uganda epidemic

        So in one active epidemic the BRN was slightly higher than HepC. In the other it was vastly lower. The study goes on to talk about how the higher BRN was likely due to burial practices since that is the most at-risk time for transmission.

        So once again, comparing the infectivity of Ebola at the absolute most at-risk times yields a value not that different from Hepatitis C in intravenous drug users. And it is explicitly noted that casual contact like skin is low risk, as is the risk from fomite based transmission.

        So not only can you indeed live in the same house with someone and not get Ebola, but it is overall probably just about as risky for infection (and perhaps in less risky) than HepC.

        You may want to actually look at the relevant literature before you start making proclamations.

      2. KayMarie says:

        Of 173 household contacts of the primary cases, 28 (16%) developed EHF.

        None of the 78 household members who had no physical contact with the case during the clinical illness were infected

        http://www.ncbi.nlm.nih.gov/pubmed/9988169

        Doesn’t sound like 100% in the same house always get it.

        What makes Ebola different than HIV and Hepatitis is how fast you die. Just because you die fast doesn’t mean it is much easier to catch. Now that it does make you leak infectious fluids, means you need to take more care with patients than things where you have to deliberately introduce the infected fluids into someone else. Also that people infected with Ebola are so sick they need people to do close contact care does also increase the risk to care givers. Most people for most of their HIV infection are quite capable of performing basic self care/activities of daily living.

        Is it a scary disease, yes. Is it a particularly horrific disease, yes. The reality of it is really bad enough, it doesn’t need any additional hype of the most deadly or most infectious disease in all the world. If it were really as unstoppable as the fear dictates we’d all be dead already.

      3. Koffi Babone says:

        “So not only can you indeed live in the same house with someone and not get Ebola, but it is overall probably just about as risky for infection (and perhaps in less risky) than HepC.
        You may want to actually look at the relevant literature before you start making proclamations.”

        OK, I’ll bite.

        From your own reference:

        1) http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2870608/ :

        we estimated the R0 at 2·7 (95% CI 1·9–2·8) for the 1995 DRC epidemic and at 2·7 (95% CI 2·5–4·1) for the 2000 Uganda epidemic. Our study allowed quantifying transmission in different settings during the two epidemics. According to our estimates, the term of R0 concerning the transmission during traditional burial was estimated at 1·8 (95% CI 0·0–2·3) for the DRC epidemic and at 0·1 (95% CI 0·0–3·2) for the Uganda epidemic. For the Uganda epidemic, transmission in the community seems to have played an important role. Although confidence intervals are wide, these results suggest different roles of community, hospital and burial-related transmission in the two epidemics studied here. The term of R0 associated with traditional burial increases with the CFR (see Appendix). This may explain a slightly more important role of funerals in the spread of the disease during the 1995 DRC epidemic, as the CFR was greater in this epidemic. However, a higher reproduction rate during burial may also indicate less precautions or increased contacts with cadavers at this time.

        2) http://jid.oxfordjournals.org/content/196/Supplement_2/S142.full :

        “Other than in samples grossly contaminated with blood, EBOV was not found by any method on environmental surfaces and by RT-PCR on the skin of only 1 patient. These results suggest that environmental contamination and fomites are not frequent modes of transmission, at least in an isolation ward. However, the infectious dose of EBOV is thought to be low, and neither cell culture nor the RT-PCR assay used for EBOV in this study have not been extensively validated for use in environmental detection. Hence, the sensitivity and specificity are unknown. It is possible that EBOV was present in the environment below the threshold of detection or that environmental surfaces in the isolation ward were, at times, initially contaminated by EBOV but then decontaminated through the daily cleaning routine. However, many of the inanimate objects tested, such as bed frames and bedside chairs, would not routinely be specifically decontaminated with bleach solutions under existing guidelines unless they happened to be visibly contaminated [3], suggesting that environmental contamination did not occur. Taken together with empirical epidemiological observations during outbreaks, our results suggest that current recommendations for the decontamination of filoviruses in isolation wards [3] are effective. The risk from environmental contamination and fomites might vary in the household or other settings where decontamination would be less frequent and thorough, especially if linens or other household materials were to become visibly soiled by blood.

        In other words, special precautions should be taken to make sure Ebola is not spread. Do family members of HIV or hepatitis positive patients need to take special precautions if they do not have open sores?

        3) https://www.aimsciences.org/journals/pdfs.jsp?paperID=8693&mode=full
        “For Hepatitis C the BRN comes out to
        1.49. And that is for the highest risk group – IV drug users and at the peak of HepC in the 90′s.
        Also HCV incidence among IDU’s was high in the 1990′s (10-35%), but appears to have declined over the last decade. We used a recent estimate… of 34%… this yields a basic reproduction number R0 of 1.49… [which is] similar to other estimates in the literature.”

        You are comparing apples to oranges in this example. A BRN of 1.49 is for IV drug users. If I understand correctly, all family members must be IV drugs users to have a BRN of 1.49, therefore if you are living with a hepatitis positive person and are not a drug user, the risk is presumably lower. In addition, (I am guessing here since it is not documented) I am assuming that not all Ebola victims are IV drug users.

        In any case, you are cherry picking the conclusions. You should not forget to look at the whole picture (your BRN stats for Ebola are not mentionned in the abstract). If you only look at the trees, you will miss the forest. From your own references, it is stated that dealing with Ebola requires special measures and is implied that the risk is higher for household members.

        1. KayMarie says:

          But certainly not the 100% can’t avoid it death sentence you predicted.

          As I said the main issue as I see it is Ebola victims are likely to shed more viruses than some of the other blood borne illnesses. So, yeah you need to take precautions, just like I take a lot of precautions when someone at work has a cold or norovirus because they are likely to get the virus all over everything.

  5. Cervantes says:

    I think one reason for the disproportionate attention being paid to Ebola is that the symptoms are particularly nasty. But I’ve found that when I point out on one or another blog that other infectious diseases — malaria, TB, diarrheal diseases, etc. — kill more Africans by orders of magnitude, and that assertions that Ebola is “highly contagious” are misleading because it requires direct contact with bodily fluids, people freak out and accuse me of trying to downplay the crisis, not caring about the victims, etc. I’m just trying to put it into perspective, of course.

    BTW, the H1N1 flu season was statistically a perfectly normal flu season. That number of deaths and hospitalizations is not at all unusual.

    1. Young CC Prof says:

      The total number wasn’t abnormal, in fact it was on the low end, but the demographics of the victims was. Most of the H1N1 deaths occurred in adults of working age, and there were a confirmed 350 children and 50 pregnant women.

      Normal flu epidemics kill the elderly or very frail, H1N1 killed or hospitalized people who were perfectly healthy a few days earlier.

      1. Kathy says:

        If there’s anything that scares people, it’s going fishing with someone one weekend and going to his funeral a few weeks later.

  6. mouse says:

    People practicing homeopathy are not considered delusional because the definition of delusion usually excludes beliefs that are common within the person’s culture or subculture. It seems pretty well established that these beliefs are common within certain sub cultures (if not our general U.S. culture).

    A second reason is that the definition of delusion excludes a mistaken belief. It’s talked about quite often here on SBM how our typical cognitive bias lead people to believe certain ineffective therapies are effective. So, in many cases the belief in homeopathy can be considered a mistaken belief.

    Regardless, the point of identifying delusions is to establish possible effective treatments. Even setting aside the sizable practicality or ethics concerns, I have my doubts that treating large groups of health practitioners who believe in homeopathy with psychiatric medications or CBT would be helpful.

    Yeah – okay, I know it was a joke and I’m being a tight-a*#, I got no sleep last night, so I am experiencing a sense of humor deficit. I clearly should have waited for a less sleep deprived day to read MC.

    1. PMoran says:

      MTR: “A second reason is that the definition of delusion excludes a mistaken belief. It’s talked about quite often here on SBM how our typical cognitive bias lead people to believe certain ineffective therapies are effective. So, in many cases the belief in homeopathy can be considered a mistaken belief.”

      Yes, many are surely misled by the illusion that homeopathic remedies have intrinsic therapeutic effectiveness, for reasons that are well-understood, such as the rapidly self-limiting nature of many medical conditions and some factors less easy to pin down such as placebo responsiveness and patient reporting biases. While in these times we might expect most “healers” to have some awareness of these matters, mainstream doctors have historically and even to some degree contemporaneously proved no less prone to such illusions.

      Perhaps the mental flaw, if there is something to be regarded as outside the range of “normality”, is the inability to see how implausible homeopathic practice is. That should be the antidote to hasty judgements as to its efficacy.

      Yet, why can some not see this? I don’t know. Plenty of homeopaths have been well-educated.

  7. Msrk Crislip says:

    when belief is common in a subculture; that is what makes it a subculture

    so we just need to get all the people who think Jodie foster loves them in one room, they elect a mayor, and they are now a subculture with no delusions?

    it is the spectrum of the human condition that remains interesting. at what point does denial of reality and substituting your own become pathologic? When does a cult become a religion? I do not really know, but someone suggests homeopathy for Ebola they can’t be playing with a full deck.

    and I am thinking of those who are providers not patients.

    BTW: I do not not think they are mentally ill nor should they get treated.

    1. mouse says:

      “BTW: I do not not think they are mentally ill nor should they get treated.”

      Well, I did get that it was humor, I did not think you were actually suggesting treatment, but the DSM comment got me on this thought process, so there it is.

      “it is the spectrum of the human condition that remains interesting. at what point does denial of reality and substituting your own become pathologic? When does a cult become a religion?”

      Or one could ask at what point does denial of reality and substitution of your own become beneficial? Hard to say, although always interesting to think about. Possibly different points for different environments and cultures.

      Anyway, I guess I am more focused on the mechanism of delusion. Which was why I responded as I did.

      I would suggest that in a true psychiatric delusion there is often not a denial of reality and substitution. The persons perception and cognitions are atypical which leads to a different interpretation of reality. I suspect this is what the DSM is attempting to describe, in which case it’s helpful to exclude subculture beliefs and mistaken beliefs.

      Perhaps if one is talking about social forms of pathological beliefs it’s helpful to come up with a different term that excludes individual psychiatric delusions and focuses on social pressures, group think, common cognitive bias, etc? Dogma, perhaps? Probably already defined in sociology or anthropology. I’d have to look it up.

      Also, one can clearly be experiencing a psychiatric delusion that is acceptable within a particular sub culture, Yes? psychiatric delusions (from schizophrenia, bipolar, etc) are common enough that it’s expected that some homeopathic practitioners, religious people, SBM proponents, will also be delusional.

      I’ve often wondered how often the more extreme forms of dogma in some individuals (such as treating Ebola with homeopathy or avoiding the use of standard medical care) maybe due to an actual psychiatric condition.

      So maybe that is all you were saying and I misinterpreted the first time around.

      1. Kathy says:

        It’s an interesting topic Mouse – and part of a bigger subject: where do you draw the boundaries for anything? As a lifelong taxonomist (of plants not diseases) I’ve seen how tough it is to do this – is it a species or not? Subspecies? Variety? Hybrid? Your imagination? They say taxonomists reach their peak when most people are thinking of retiring, perhaps because by then they know ALL lines are drawn in the sand. Or perhaps they just develop sufficient grumpiness to override all the nonsense they hear.

        All taxonomies are dependent on what characters are chosen to define a group, and which are rejected. There have been various attempts to overcome this bias, but they (imho!) haven’t worked.

        So, without attempting to draw a line in this discussion of DSM, I’d suggest that it might be useful to take, as one character, how much the mistaken belief interferes with daily life and relationships. A lot of mistaken beliefs are maintained and reinforced by changing one’s society, by joining a different church or changing one’s blog site to one where people agree with you. If this isn’t possible, then the resulting dislocation leads to unhappiness and hopefully, to seeking out help. But not often.

        Another (I’m joking, but not entirely) is loss of sense of humour, in general and w.r.t. the cherished belief. Do creationists make jokes about Noah’s Ark? Unlikely.

        A character I’d reject is educational level, or scientific education vs. some other variety. My evidence for this is purely anecdotal though, If data showed me I was mistaken, then I’d retract this.

        1. mouse says:

          “All taxonomies are dependent on what characters are chosen to define a group, and which are rejected. There have been various attempts to overcome this bias, but they (imho!) haven’t worked.

          So, without attempting to draw a line in this discussion of DSM, I’d suggest that it might be useful to take, as one character, how much the mistaken belief interferes with daily life and relationships.”

          Maybe it might also be important to define WHY one is formulating a criteria? Does one want a standard criteria for use in research? Is for diagnostic/treatment purposes? Is it so that one can avoid being taken in by another’s delusions? Or avoid trusting a person who is delusional with non-related tasks? Or is it a form of self examination into one’s owns beliefs?

          Weirdly enough, I could imagine that a commitment to the truth or accuracy on a particular topic may cause the same levels of dysfunction as delusions. It can interfere with daily life and relationships, it may even cause one to delay important decisions due to discomfort with uncertainty or fear of inaccurate information. Some even lose their sense of humor in their commitment to accuracy or the truth (not that this would ever happen to me {irony alert}.

          As an aside – I thought this RadioLab episode called Lying to Ourselves, made some interesting observations to are a bit related.
          http://www.radiolab.org/story/91618-lying-to-ourselves/

    2. WilliamLawrenceUtridge says:

      BTW: I do not not think they are mentally ill nor should they get treated.

      Well, they are homeopaths, so chances are they are already not being treated.

      1. DW says:

        Hahahaha!!

  8. Nicholas Jankowski says:

    Regarding homeopathy and cholera: It could actually be the one of the two conditions homeopathy can actually cure (the other being dehydration). My knowledge of the matter is limited to the description given in “The Ghost Map” of the last major London cholera outbreak, but it was described how one of the most effective treatments is excessive hydration. The human gut will eventually flush the contaminant, and if you don’t die from dehydration first you have a good chance of survival. I recall the book saying that people have ‘deliberately contracted cholera’ and survived it via excessive hydration.

    1. Nicholas Jankowski says:

      now that I re-read my comment, I realize that would just make it ‘one’ condition treatable by homeopathy, as both are treating dehydration.

      1. Chris says:

        The trick is to have electrolyte replacement. There is a recipe posted by World Health Organization. It definitely does not have homeopathic quantities of salts and sugars.

        Plus it is much more current than Iqbal’s 1850s story.

        Iqbal, where is the evidence that homeopathy has progressed at all during the last two hundred years? Where is that evidence it is effective for preventing and/or treating real viral diseases like rabies and measles?

        1. Iqbal says:

          Chris

          …where is the evidence that homeopathy has progressed at all during the last two hundred years? Where is that evidence it is effective for preventing and/or treating real viral diseases —?

          In homeopathy, a patient is treated not the name of a disease. What progress do you look for in homeopathy medicine?

          Let us look at ebola virus.

          Check this site:
          https://www.google.com/search?q=pictures+of+ebola+blisters&hl=en-IN&gl=in&authuser=0&tbm=isch&imgil=66VzaOLDIzFYPM%253A%253BviEWf5gdaLBZ8M%253Bhttp%25253A%25252F%25252Fwww.mimentum.com%25252F&source=iu&usg=__1xQCWAl0v8i9P4DwBGZt_yn24-4%3D&sa=X&ei=UQ3nU6r1GMTt8AWi_YHYCw&ved=0CDAQ9QEwCQ&biw=1366&bih=657#facrc=_&imgdii=_&imgrc=66VzaOLDIzFYPM%253A%3BviEWf5gdaLBZ8M%3Bhttp%253A%252F%252Fwww.mimenta.com%252Fmimentum%252Fwp-content%252Fuploads%252F2014%252F07%252FEbola-lesions.jpg%3Bhttp%253A%252F%252Fwww.mimentum.com%252F%3B413%3B265

          Photograph 2.

          Check http://www.quackometer.net/blog/2012/05/the-swizz-report-on-homeopathy.html

          On May 25, 2012 I wrote about the problem faced by my son in 1997. It seems he had a virus problem. The doctor prescribed Variolenum (made from small pox) and then Crotalus because the blisters that developed on my son’s skin were similar to photograph 2. The basis of my son’s problem was not ebola. Present homeopathic doctors have also defined Crotalus as the main remedy for the epidemic – the symptoms are similar.

          Crotalus as a medicine would have been developed over a 100 years ago (a lecture appears in 1904 regarding the medicine). If it worked then, it worked in 1997 what change in the name of development should be made?

          1. Chris says:

            Sorry, I do not see any PubMed citations in that list.

            “Crotalus as a medicine would have been developed over a 100 years ago (a lecture appears in 1904 regarding the medicine). If it worked then, it worked in 1997 what change in the name of development should be made?”

            Viruses were just being discovered a century ago, so how would you know it worked on rabies, measles, etc? Please provide just PubMed indexed studies by reputable researchers that homeopathy treated or prevented verified viral infections. Not “It seems he had a virus problem.”

            Andre Sainte claims homeopathy works for rabies better than the present vaccine. A vaccine that has been improved much over a century (it is no longer made from dried rabbit spines). So just provide studies showing homeopathy works for rabies better than the modern rabies vaccine.

            1. Chris says:

              “Sainte” should be “Saine”

            2. Iqbal says:

              Chris

              …….Viruses were just being discovered a century ago,..

              Before 100 years, virus had no effect on humans – just because these were not discovered?

              Homeopaths cure the patients not the name of disease or the virus.

              1. Chris says:

                What color is the sky in your world? Since it is a fantasy world it must be any color you like.

                What level of really bad education do you have to make an idiot statement like “Before 100 years, virus had no effect on humans – just because these were not discovered?”

                They had an effect, and there were a few actual effective treatments done with science. They were actually thought to be something akin to “miasms.” Actual science started to separate the miasmic fantasy into reality by discovering the actual properties of the infectious agents. With that new information they discovered better ways to prevent and treat viral infections (yellow fever, polio, measles, etc), and even bacterial infections (diphtheria, tetanus, pertussis, etc.)

                Homeopathy has yet provide any similar progress.

                Try reading a book on medical history, that explains the work that went into separating fantasy from reality. I am presently reading Rabies by Bill Wasik and Monica Murphy. Another good book is The Great Influenza by John Barry, which has a history of the work to learn the differences between filterable and non-filterable infectious agents (bacteria versus virus).

                Then come back and provide the PubMed indexed studies by reputable qualified researchers proving Andre Saine’s contention that homeopathy works better for rabies than the modern rabies vaccine. There should be animal tests showing that homeopathy cures rabies. They should be similar to the tests done by Louis Pasteur when he developed the first rabies vaccine. Where are those tests proving homeopathy?

              2. n brownlee says:

                People get well on their own, and homeopaths take the credit.

          2. Chris says:

            By the way, the second link is not a photograph. It is a very good article on how homeopaths do their version of “science.” The article concludes with:

            There is much more in the so-called Swiss Report. All of it is special pleading, attempts to lower the standards of evidence, exclude contradictory evidence and cherry pick studies that suit. I shall leave other, if they have the strength, to look at other chapters.

            But for me, this dismal appeal to superstitious ways of knowing, the blatant disregard for facts and the attempts to muddy the water of evidence based medicine, are all I need to ignore this advert for homeopathic medicine.

          3. Kathy says:

            “In homeopathy, a patient is treated not the name of a disease. ”

            If my child is dying horribly of rabies or tetanus … or dying of ANYthing … I wouldn’t give a f@rt about this being treated holistically if the treatment didn’t cure her. This is just wimpish philosophy, playing pretty games with words. I want real-life results when I’m sick, not pabulum promises of pie in the sky, jam tomorrow.

            Homeopathy is fairy gold and you know what happens to that when the sun comes up and dreamtime is over? It returns to the dust that it always was.

          4. Calli Arcale says:

            “In homeopathy, a patient is treated not the name of a disease.”

            Fine, you can hide behind that semantic argument. So then, how many patients with rabies has homeopathy successfully treated?

            1. Chris says:

              “So then, how many patients with rabies has homeopathy successfully treated?”

              This should be qualified to be within the last half century, and verified by standard medical care practitioners. Andre Saine tends to point to 19th century anecdotes as his “proof.”

            2. KayMarie says:

              And I don’t see where dumping all people in the same bucket based on a symptom no matter what caused that symptom is really any different from dumping all people in the same bucket based on a disease regardless of which symptoms of that disease they are having.

              And it is erroneous to say doctors give all patient the same thing at the same dose for the same disease as if there was only one treatment per disease. One of the reasons for several different similar drugs is science is 100% certain that there are genetic variants, differences in how the body activates or detoxifies medications, etc.

              I think this “only treat the disease” trope is a bit dangerous and doesn’t acknowledge that one disease may have many treatments and your doctor will work through the available ones to find which one works for you as an individual based on your symptoms and your tolerances. Too many people never follow up (but in CAM world they all get counted as treatment successes who are now totally cured of all maladies).

          5. WilliamLawrenceUtridge says:

            In homeopathy, a patient is treated not the name of a disease. What progress do you look for in homeopathy medicine?

            That’s not progress, that’s regression. Pre-modern forms of medicine categorized illness along a variety of lines, primarily by symptoms – all fevers were treated the same, irrespective cause. Homeopathy is a prime example, but it also “refines” the classifications to an absurd degree, since it looks at more and more trivial symptoms. “Patient is afraid of the color red. Patient dreams of rabid sheep. Patient exhibits mild tremor in the left hand while holding an umbrella and licking a battery.”

            Treating someone according to etiology was one of the major advances of medicine and is responsible for a considerable amoutn of its success.

            Crotalus as a medicine would have been developed over a 100 years ago (a lecture appears in 1904 regarding the medicine). If it worked then, it worked in 1997 what change in the name of development should be made?

            I’ve highlighted the key flaw in your argument, specifically an assumption.

            Homeopathy doesn’t work.

    2. DW says:

      That’s a great book by the way.

  9. Mark Crislip says:

    Cholera patients often need 10, 20 even up to a 100 liters of replacement fluid. I doubt homeopaths were giving that much (that would be a homoepathic overdose) esp before we knew the right formulation for oral rehydration.

    1. Windriven says:

      “(that would be a homoepathic overdose”

      (Steven Wright voice: )So … Like cures like, right? So would the homeopathic remedy for drowning be … water? If so, how many dilutions? Same with alcoholism, right? Like cures like? I mean, I’d go to meetings and everything.

      1. Iqbal says:

        Mark Crislip

        ……Cholera patients often need 10, 20 even up to a 100 liters of replacement fluid. I doubt homeopaths were giving that much (that would be a homeopathic overdose) …

        And still the treatment at LHH in 1854 with little drops of homeopathic camphor, copper, hellebore, arsenic, and other medicine saved many lives.

        Then the treatment was defined as : “That by introducing the returns of homeopathic practitioners they (the Treatment Committee) would not only compromise the value and utility of their averages of Cure, as deduced from the operation of known remedies, but they would give an unjustifiable sanction to an empirical practice, alike opposed to the maintenance of truth and to the progress of science.”

        Not very different to what you write.

        1. Chris says:

          No. It is very different. Look at the World Health Organization recipe I linked to. It is not just drops of electrolytes.

          1. Iqbal says:

            Chris

            ….WHO – does anyone care for their reports?

            Read this and check with your doctor to find out if he even bothers to read what WHO circulates.

            http://www.who.int/bulletin/volumes/81/5/Russell0503.pdf

            I am positive he would be merrily prescribing paracetamol for every child with fever.

            1. Chris says:

              Many people do. One article on acetaminophen does not negate the recipe that provides electrolytes for dehydration due to diarrhea from cholera, rotavirus, etc.

              The WHO recipe is not the only one around, there are several others. All of them have nonhomeopathic quantities of salts and sugars.

        2. Sawyer says:

          LQ this is truly pathetic. You keep harping on this issue without even realizing the central conclusion – that homeopathy is only 160 years behind modern medicine.

          When scientists and doctors talk about the early research on cholera, their key focus is the development of the germ theory of disease and the underlying methodology that enabled that theory to come into its own. The actual cure rates from the 1850s are essentially trivial from a scientific perspective. Any doctor bragging about their ability to cure cancer today is better than it was in the 19th century would be rightfully ridiculed by their colleagues.

          I’m starting to wonder if you are a Poe, because even homeopaths should have the sense not to make such silly defenses of their practice.

          1. Iqbal says:

            Sawyer

            ……You keep harping on this issue without even realizing the central conclusion – that homeopathy is only 160 years behind modern medicine…

            You have to use the data with – sign: Homeopaths are years ahead. They had the ability to cure cholera 160 years ago when scientific drugs were helping kill patients!!!

            …When scientists and doctors talk about the early research on cholera, their key focus is the development of the germ theory of disease and the underlying methodology that enabled that theory to come into its own…

            You are way behind time. Germ theory is the most stupid concept ever defined in the medical field. You have a few billion germs between your mouth and the other end. How are you alive?

            1. Chris says:

              “Germ theory is the most stupid concept ever defined in the medical field.”

              And precisely why you are over a century behind in science, medical knowledge, and reality.

              This is the comment I will now refer others to whenever you dump your fantasy based retrograde anti-science nuttery in a comment thread.

              1. Sawyer says:

                Right before I posted this morning I wondered if it was a mistake to give iqbal any more attention than he deserves, but now I’m glad I did. I presented a a shovel and he brought in a freaking backhoe, digging his hole even deeper than I thought possible

                It also reminds me that if I ever decided to become a science fiction writer I could fall back on homeopathy, as the two careers seem to require identical skill sets. Although most good science fiction writers tend to have internally consistent story arcs.

            2. JD says:

              You are way behind time. Germ theory is the most stupid concept ever defined in the medical field.

              Says the jack*ss pushing homeopathy. Good one.

              We could go through each of Koch’s postulates and demonstrate how painfully wrong you are, but I’m assuming that is not worth my time. So please, do tell me why we can visualize pathogens and have achieved so deep an understanding of viral, bacterial, and fungal pathogenesis? http://www.utmb.edu/virusimages/

              I am just supposed to ignore these entire fields because you claim to have magic potions? That you would suggest treating ebola and cholera with placebo water may just be the most ridiculous line of thinking that I have ever encountered. Congratulations.

              You have a few billion germs between your mouth and the other end. How are you alive?

              You know nothing of biology. It’s called symbiosis. Please spend about a minute on google and look it up. Actually, that seems to be just too much effort, so here you go: http://en.wikipedia.org/wiki/Gut_flora

              You know what happens when this symbiosis is disrupted? Clostridium difficile infection. Endomicrobial symbiosis is a well-developed and thoroughly studied phenomenon. Try again.

              1. Iqbal says:

                JD

                ….So please, do tell me why we can visualize pathogens and have achieved so deep an understanding of viral, bacterial, and fungal pathogenesis?……..

                If germs are so important to human disease, how is it that ebola is not able to kill 100% humans it infects? Scientists are not even aware of which of the “germs” in the human gut are good, bad or ugly.

                Europeans traveling to Asia generally end up with upset stomachs. This after eating the same food and drinking the same water as their Asian counterpart. Where is the error?

              2. KayMarie says:

                @Iqbal

                Have you heard of the immune system? Usually takes a few days to kick in.

                Some pathogens (not all non-human germs are pathogens) are better at hiding from the immune system than others.

                For Ebola takes something like 7-10 days for the immune system to kick in really good, and if you kill it off before you go into organ failure (where supportive modern medical helps, it delays the organ failure) you live.

                If (because each human has a slightly different set of genes for their immune system) you aren’t able to fight it off in that time frame, you die.

                Why if I suddenly change my dog’s food does it get GI upset? Why do cows get severely gassy (to the point of death sometimes) if you change them from grass feed to grain feed too fast? When the system (you + your germs) are calibrated for one environment a radical change in that environment may cause distress until you adjust for the new environmental conditions.

                As for the gut germs, part of that is many gut germs cannot be cultured in the lab, yet. Many do not grow out in the oxygen, some may need media to grown on we haven’t invented yet. What beliefs do you have about the ocean because we haven’t explored all of it? Do you claim all marine science is wrong and some woo is right because well we haven’t been to the bottom of all those trenches, yet.

              3. AdamG says:

                KayMarie, Iqbal’s schtick is pretty old hat around here. He’s really not worth your time.

              4. JD says:

                Responding was against my better judgement, I am done with this nonsense from here on out.

                @Germ-Theory Denier – please educate yourself.

                Scientists are not even aware of which of the “germs” in the human gut are good, bad or ugly.

                We have a good idea: http://genome.wustl.edu/projects/detail/human-gut-microbiome/

                Europeans traveling to Asia generally end up with upset stomachs. This after eating the same food and drinking the same water as their Asian counterpart.

                Thank you for proving my point about the microbiome of the GI tract: http://www.scientificamerican.com/article/the-guts-microbiome-changes-diet/

              5. Chris says:

                Iqbal: “If germs are so important to human disease, how is it that ebola is not able to kill 100% humans it infects?”

                Did you ever graduate from grade school? Did you even take a basic biology class? Because your grasp of the subject is less than what my kids knew before entering high school.

              6. WilliamLawrenceUtridge says:

                If germs are so important to human disease, how is it that ebola is not able to kill 100% humans it infects?

                Why would it? That’s like asking “if lions are predators, why don’t they just eat all of the zebras?” Ebola hasn’t evolved to be 100% lethal to humans (and such an approach would be evolutionarily counter-productive anyway) so you wouldn’t expect 100% lethality no matter what. Part of it is the virus itself, part of it is the genetic susceptiblity of the human host, and part of it is the random nature of the immune system when it reacts to infection.

                Scientists are not even aware of which of the “germs” in the human gut are good, bad or ugly.

                Sure…that’s why they just throw anything into yogurt these days, and not specific, purified strains of certain bacteria. That’s why they aren’t doing specific clinical trials on specific bacteria to treat specific diseases.

                At this point it’s rather clear you are simply making stuff up, or perhaps just unaware of the reality of scientific findings. Is it because you do no independent research, and just repeat whatever your homeopath tells you? Will you believe anything they say and buy anything they sell?

                Europeans traveling to Asia generally end up with upset stomachs. This after eating the same food and drinking the same water as their Asian counterpart. Where is the error?

                Asians coming to Europe and North America will also experience a disruption in their GI tract, eating the same food and drinking the same water. It’s because the GI tract must adjust, immunologically and as an ecosystem, to a new species. There’s no magic. It’s much like how eating broccoli gives you the farts if you do it once in a while, but eat it regularly and you’re much better able to digest it gas-free.

                Again, you’re asking questions as if you were scoring points – but they’re questions we know the answer to. What do you hope to accomplish besides demonstrating your lack of understanding of the field?

            3. WilliamLawrenceUtridge says:

              You have to use the data with – sign: Homeopaths are years ahead. They had the ability to cure cholera 160 years ago when scientific drugs were helping kill patients!!!

              160 years ago there were no scientific drugs. At that time, science was just beginning to disprove all of the beliefs about medicine inherited untested from Galen, it hadn’t yet adopted scientific treatments because they ddin’t yet exist.

              Are you sure homeopaths were curing cholera by the way? Are you sure they weren’t merely recording those who survived while under their care? How many patients went to homeopathic doctors and died of cholera?

              You are way behind time. Germ theory is the most stupid concept ever defined in the medical field. You have a few billion germs between your mouth and the other end. How are you alive?

              Because not all germs are infective in humans, and very, very few are lethal. The idea that all germs are infectious and deadly is a false one – of the millions of viruses and bacteria that exist in the world, only a few dozen are actually dangerous to humans. Most of those are only dangerous to humans in specific circumstances of reduced immunity. There are perhaps 20 that are actually dangerous and contagious enough to present a significant health concern to the general population, and maybe only six that cause significant numbers of deaths – and we vaccinate against all of them. And most of those six have evolved specifically within human population centers over the centuries to specifically infect humans by developing ways of hiding from or deactivating branches of the immune system.

              “Germs” (i.e. viruses, bacteria and fungi) aren’t generally dangerous, particularly now given public health efforts have specifically controlled the truly deadly ones.

              You don’t seem to really understand the field you are criticizing.

              1. Iqbal says:

                KayMarie

                ….Have you heard of the immune system? Usually takes a few days to kick in.If (because each human has a slightly different set of genes for their immune system) you aren’t able to fight it off in that time frame, you die. Why if I suddenly change my dog’s food does it get GI upset? ….

                My message was to differentiate between the importance of immune system and germs. Germs are irrelevant if the immune system functions well.

                A little off beat – but is interesting reading in business today:

                http://businesstoday.intoday.in/story/india-best-ceo-automobiles-rajiv-bajaj-leadership/1/201398.html

                The change of food theory is missing data. A check for period 2006 – 2013 on travel between Europe and Asia in our company: From Asia to Europe – 836 visits (duration 4 days – 8 weeks) – no health claim from food – not even cold or cough.

                From Europe to Asia – 512 visits (duration 2 days – 4 weeks) – 211 cases of food poisoning, 18 hospitalizations. 103 cases were from persons travelling out of Europe for the first time. This is when Europeans are more careful about food.

                The sudden change of food works in one direction?

                ….As for the gut germs, part of that is many gut germs cannot be cultured in the lab, yet. Many do not grow out in the oxygen, some may need media to grown on we haven’t invented yet….

                Ever try to visualize an ecosystem that works as a balance –especially if there are millions of different constituents (germs ?) and effects not known. Lions and Zebras may look important but if all snakes are killed humans will stop dying of bites but will have some difficulty in living with rats.

              2. KayMarie says:

                My message was to differentiate between the importance of immune system and germs. Germs are irrelevant if the immune system functions well.

                So no human on the planet has a properly functioning immune system? I’ve yet to meet someone who has never been sick.

                Also by what mechanism do you propose an immune system makes all antibodies to all potential infectious agents without “seeing” any of them?

                I know there are defenses that work prior to the antibodies being made for the first time, but they don’t seem to be 100% totally effective for all infections.

                So I’m confused. Unless everything in my Immunology class about how the immune system works was totally wrong. :-)

              3. Iqbal says:

                WilliamLawrenceUtridge

                ………..160 years ago there were no scientific drugs…..

                When did drugs start to be scientific ?

                ……… The idea that all germs are infectious and deadly is a false one – of the millions of viruses and bacteria that exist in the world, only a few dozen are actually dangerous to humans. … and maybe only six that cause significant numbers of deaths……And most of those six have evolved..

                We know of FLU – from different birds and animals would be different and mutations in itself would be , HIV (from monkeys), Ebola (from bats), Dengue (mosquito) . Which are to follow? The animal world is rather big and world of birds even bigger. So what is lurking round the corner?

              4. Chris says:

                “My message was to differentiate between the importance of immune system and germs. Germs are irrelevant if the immune system functions well. ”

                This is exactly why you need to be ignored. You have absolutely no idea about the interaction between the microbes and any kind of mammal.

              5. Harriet Hall says:

                “Germs are irrelevant if the immune system functions well”

                By the No True Scotsman argument, he would probably say that if someone gets an infection that constitutes proof that his immune system was not functioning well. :-)

                This reminds me of the chiropractor who told me you couldn’t get an infection if your spine was in alignment. He went on to say “Germs don’t cause disease; if they did, we’d all be dead.”

              6. WilliamLawrenceUtridge says:

                My message was to differentiate between the importance of immune system and germs. Germs are irrelevant if the immune system functions well.

                Well that’s untrue. While nutrition, stress and other factors can certainly modulate the functioning of the immune system, and thus susceptibility to disease (as well as it’s severity), being healthy is not a guarantee of immunity to disease. The wealthy and well-fed died in plagues as well as the poor, and the poor and starving also survived disease. One will note that cholera and dysentery was common in sailors suffering from scurvy, but sailors still survived their voyages. Further, Native Americans were often taller, and better-fed than their European counterparts in 1492, but still died in massive numbers, sometimes as high as 95% of a population, when introduced to European diseases. Yes, a strong immune system is important (except for autoimmunity and allergies), but it’s not everything.

                A little off beat – but is interesting reading in business today:

                Interesting indeed. Do you get your automobile advice from the New England Journal of Medicine?

              7. Iqbal says:

                KayMarie:

                … I’ve yet to meet someone who has never been sick…

                Falling sick is a good way to find if the immune system works and a great way to improve it. Avoid drugs.

                “Studies have shown in the USA that it is the rich kids that suffer more from ear infections and other common childhood infections. Since antibiotics are very expensive the poor parents do not bother to give their children antibiotics for minor illnesses. This helps the child to fight the infection with the help of its own immune system and, in the bargain; the child develops immunity against major infections. This has another very dangerous ramification to it. Antibiotics given to minor viral illnesses of childhood make the immune system change its response to infection in such a way that the cytokine response to infections, based on their genes, changes from TH1 to TH2. The latter is the most important trigger for asthma in later life.” (http://bmhegde.com/bmh/useartdetail1.php?aid=27)

                ….Also by what mechanism do you propose an immune system makes all antibodies to all potential infectious agents without “seeing” any of them?…..

                The immune system has a great memory and understanding. It remembers each illness a person comes out if it is not compromised by drugs.

                …I know there are defenses that work prior to the antibodies being made for the first time, but they don’t seem to be 100% totally effective for all infections. So I’m confused. Unless everything in my Immunology class about how the immune system works was totally wrong…

                This is the requirement from the medical system. The medicine should strengthen the immune system, not destroy it.

              8. KayMarie says:

                But what do you think causes the illnesses?

                You said it isn’t germs (they are irrelevant), so what would the immune system have to react to or remember about the illness.

                What no human got ill before modern medicine? Drugs cause illness? Please to enlighten.

              9. WilliamLawrenceUtridge says:

                When did drugs start to be scientific ?

                The term “scientific drugs” comes from your comment. Don’t blame me because your original terminology is sloppy. Scientific investigation of drugs started a couple centuries ago, but didn’t really hit it’s stride until the 19th century – which is about the period of history homeopathy considers to be cutting-edge.

                We know of FLU – from different birds and animals would be different and mutations in itself would be , HIV (from monkeys), Ebola (from bats), Dengue (mosquito) . Which are to follow? The animal world is rather big and world of birds even bigger. So what is lurking round the corner?

                I’m not sure what your point is – that we should carpet-bomb nature in case of zoonotic infections? Meh, I can get on board with that, nature basically hates people. Incidentally, mosquitos transmit Dengue, they aren’t the original host. And you aren’t really refuting my point – these diseases are only considered “serious” because the truly serious ones are mostly controlled. None of the diseases you cite have any of the transmissability and lethality of the diseases we currently vaccinate for – polio, pertussis, diptheria, and formerly smallpox until we drove it extinct (yay people!) Influenza is a bit of an exception, but it mostly makes you miserable (and we’d all be better off if we got the seasonal vaccine). In fact, we only really worry about these diseases because we’ve controlled the really bad ones. And if the contries where these diseases are endemic were first-world, with advanced economies and infrastructure, they would probably have vaccines for most (HIV being an exception). Have you ever even met someone Dengue? Ebola? Even HIV?

                In none of these cases does homeopathy help, bar fluids and electrolytes.

              10. n brownlee says:

                @Iqbal

                “Since antibiotics are very expensive the poor parents do not bother to give their children antibiotics for minor illnesses. This helps the child to fight the infection with the help of its own immune system and, in the bargain; the child develops immunity against major infections. ”

                If this is true, they why do the children of the more affluent social classes consistently live longer, healthier lives than those of the poor? On EVERY continent, in EVERY country, by EVERY statistics-gathering group, national, international, political or not.

              11. WilliamLawrenceUtridge says:

                Falling sick is a good way to find if the immune system works and a great way to improve it. Avoid drugs.

                Before the advent of scientific medicine, drugs, antibiotics, vaccines, etc. what was the average lifespan? Now differentiate that figure according to whether or not childhood mortality is factored in.

                In the past, people did avoid drugs, and died because of it.

                Your link to a paper discussing antibiotics and ear infections merely points to mainstream recommendations to avoid giving antibiotics for ear infections. Whether the preclinical markers highlighted as changing has any health relevance is another question, one that is still being researched.

                The immune system has a great memory and understanding. It remembers each illness a person comes out if it is not compromised by drugs.

                Um, [citation needed] there champ. What drugs compromise acquired immunity? And how does the immune system “understand”, lacking as it does a nervous system.

                Also, not all diseases are remembered by the acquired immune system; you can get sick with some diseases multiple times and previous infection is not protective.

                This is the requirement from the medical system. The medicine should strengthen the immune system, not destroy it.

                Great, how do we “strengthen the immune system”? What does that mean? Does vaccination count, because it’s been responsible for the death of a child being tragic rather than inevitable. Oh, and what are the implications of your statement for someone with an autoimmune condition?

                Cite your sources!

              12. Iqbal says:

                n brownlee

                ……If this is true, they why do the children of the more affluent social classes consistently live longer, healthier lives than those of the poor? On EVERY continent, in EVERY country, by EVERY statistics-gathering group, national, international, political or not…

                I did not write the complete paragraph as I referred the article.

                ” The slum dwellers kids, when they have enough to eat, have very robust health and have very low incidence of asthma and many other common illnesses. Whenever they do not thrive, it is only because they do not get enough nutrition in their diet.”

                Please read the article.
                http://bmhegde.com/bmh/useartdetail1.php?aid=27

                Affluent can live longer with asthma and good nutrition.

                Why do you require to think linear? Health does not depend on only one variable.

              13. WilliamLawrenceUtridge says:

                The idea that the rich have more autoimmune diseases than the poor is an interesting observation, known for a very long time, that is currently under investigation. Real research is looking into it, but it is too preliminary to have good answers yet. Only quacks claim they can cure asthma on the basis of this observation.

                Affluent can live longer with asthma and good nutrition.

                Why do you require to think linear? Health does not depend on only one variable.

                I’m not sure what your point is – I doubt most commentors here think health is linear and dependent on a single variable. That’s the kind of naivete that homeopaths, with their theories of miasmas and vital forces, tend to believe in.

              14. Iqbal says:

                JD

                “We have a good idea: http://genome.wustl.edu/projects/detail/human-gut-microbiome/

                Did you even read before posting the link? “Without understanding the interactions between our human and microbial genomes, it is impossible to obtain a complete picture of our biology. Our microbiome is largely unexplored.”

                “Thank you for proving my point about the microbiome of the GI tract: http://www.scientificamerican.com/article/the-guts-microbiome-changes-diet/

                So how does it explain the sickness of the Europeans in Asia and not vice-versa.

              15. WilliamLawrenceUtridge says:

                So how does it explain the sickness of the Europeans in Asia and not vice-versa.

                Well maybe the reporting venue (a business journal) got it wrong, or maybe the European food and water supply is much cleaner than the Asian?

        3. WilliamLawrenceUtridge says:

          And still the treatment at LHH in 1854 with little drops of homeopathic camphor, copper, hellebore, arsenic, and other medicine saved many lives.

          How do you know this? Where are the carefully-recorded comparisons of groups receiving and not receiving homeopathy?

          Then the treatment was defined as : “That by introducing the returns of homeopathic practitioners they (the Treatment Committee) would not only compromise the value and utility of their averages of Cure, as deduced from the operation of known remedies, but they would give an unjustifiable sanction to an empirical practice, alike opposed to the maintenance of truth and to the progress of science.”

          I can’t even understand this, and it’s apparently from the 19th century. If you are such a fan of 19th century cures, you should go to a barber the next time you break your leg.

          1. Iqbal says:

            WilliamLawrenceUtridge

            ….How do you know this? Where are the carefully-recorded comparisons of groups receiving and not receiving homeopathy?….

            This is reported as part of British Parliament proceedings. All details are present in the report. The LHH article is a summary.

            1. Windriven says:

              lowball, that’s not exactly how science is done. Any treatment is judged against either placebo or against existing therapy.

              The British Parliament has been home to all sorts of inanity and that is just counting politics. As a venue for assessing science it fails to rise to the level of absurdity.

              You are clearly beyond the reach of science and reason so I’m sure I’m wasting my breath. But if you’d like to be taken seriously here, bring some authoritative evidence that homeopathy works. That means quality studies published in a serious, peer reviewed journals. Anecdotes from 50 or 100 years ago don’t meet that criterion.

            2. Harriet Hall says:

              As far back as 1830 there have been controlled studies of homeopathy showing that it doesn’t work. See http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1484568/ A hospital in Russia was divided into 3 wards: one got conventional medical treatment (bloodletting and medication), one got homeopathic treatment by homeopaths, and one got no treatment but placebo pills.The no-treatment ward had better outcomes than either of the other two. Up until about 1900 patients were as likely to be harmed as to be helped by conventional medical treatment; science-based medicine has made great advances since that time, but homeopathy has not. If the experiment were repeated today, the conventional treatment ward would have had much better outcomes; the homeopathic ward would not. Of course, it would be unethical to do such a study today and deny effective treatment to patients with serious illnesses.

            3. WilliamLawrenceUtridge says:

              This is reported as part of British Parliament proceedings. All details are present in the report. The LHH article is a summary.

              You mean this report, that ultimately concluded “By providing homeopathy on the NHS and allowing MHRA licensing of products which subsequently appear on pharmacy shelves, the Government runs the risk of endorsing homeopathy as an efficacious system of medicine. To maintain patient trust, choice and safety, the Government should not endorse the use of placebo treatments, including homeopathy. Homeopathy should not be funded on the NHS and the MHRA should stop licensing homeopathic products.”? I’m sure the proponents of homeopathy consider the evidence they provded as part of that report to be convincing. But they obviously failed to convince the British Parliament.

              Maybe you should read the entire Committee report, rather than just the parts you already agree with.

              1. Iqbal says:

                WilliamLawrenceUtridge

                ……..You mean this report, that ultimately concluded …

                No. I meant this: http://books.google.co.uk/books?id=0qgSAAAAYAAJ&printsec=frontcover&source=gbs_ge_summary_r&cad=0#v=onepage&q&f=false

              2. Chris says:

                Sorry, the 2010 report takes precedence over one that is more than 150 years old. Time has moved on, real medicine has changes, unlike homeopathy, which is stuck in the 19th century.

              3. WilliamLawrenceUtridge says:

                Yeah, I prefer my information to come from the most recent millennia. I’ll even settle for the two most recent centuries. I don’t even like fiction that is more than 30 years old, let alone fiction that’s 160.

                Also, don’t you think that maybe, just maybe, a Parliamentary inquiry that is newer, and in fact based on a body of scientific knowledge that included the germ theory of disease, might be a better starting point? You’ll notice that most countries don’t have cholera epidemics these days, and it’s not because of homeopathy.

                Of course, none of this matters to you iqy, because you’ve got it backwards. You don’t care what the evidence is, because you’re all about the conclusion. Anything that doesn’t support your belief in homeopathy, like, for instance, a four-year-old parliamentary report, is discarded and ignored. Anything that does, like a 164-year-old parliamentary report, is kept.

                Because who needs the tedious effort of understanding how the world works, when you’ve got a fairy story that does the heavy lifting for you.

              4. Iqbal says:

                WilliamLawrenceUtridge

                ……Before the advent of scientific medicine, drugs, antibiotics, vaccines, etc. what was the average lifespan? Now differentiate that figure according to whether or not childhood mortality is factored in…

                Incorrect. Improve sanitation and nutrition, remove drugs and life spans would be longer and better. Dr. Hall write “Babies in the US routinely get antibiotics on the first day of life to prevent devastating gonorrheal eye infections, but the risk is low today. In Sweden, they are not treated, and there is no effect on the rate of infection. Perhaps we should reconsider.” (This is the evidence based practice Dr. Novella likes to write about – what was the % ).

                ……In the past, people did avoid drugs, and died because of it…..

                You contradict yourself and all those who write on behalf of SBM. In the past people took drugs and died because of them, left alone they would have been ok. Recall the cholera and the flu epidemics of the 19th and 20th century.

                …….. What drugs compromise acquired immunity?

                Most drugs compromise immunity. Read “ Antibiotics vs. the Microbiome” carefully, “and the possibility that antibiotics may have a causal role in several of the so-called diseases of civilization.” Which names of diseases would you like to take out and which names would you include in this list?

              5. Chris says:

                The fact there are problems with real medicine does not prove homeopathy works. In fact, real medicine changes as more is known, this has not happened in homeopathy. Which exactly why the more recent parliament proceedings cancel those of a 160 years ago.

                Now where is that real verifiable evidence proving Andre Saine’s contention that homeopathy works better for rabies? And also the evidence homeopathy works better for malaria?

              6. Sawyer says:

                Most drugs compromise immunity. Read “ Antibiotics vs. the Microbiome” carefully, “and the possibility that antibiotics may have a causal role in several of the so-called diseases of civilization.”

                Wow what a revelation. I can’t believe this topic has never been covered on this very website, or in a book endorsed by this website. /sarcasm

                Indiscriminate use of anti-biotics was foreseen as a problem from the first years of sulfonamide and penicillin, and has been a serious topic of research for over 40 years. You are hopelessly behind in your understanding this problem, all while arrogantly pretending you’re years ahead of everyone else.

                I can’t decide which is more entertaining – your terrible strawman arguments about modern medicine, or the fact you essentially believe there were wizards preventing flu and cholera outbreaks at the turn of the century.

              7. WilliamLawrenceUtridge says:

                Reply below.

  10. Thor says:

    What great writing, thanks wholeheartedly. Best introduction to a topic ever.
    You demolished the naturalistic fallacy. “Any questions”?

  11. Stephane Northon says:

    That naturalnews’s ebola page has attracted some scary comments. I must say I am balancing on the edge of “this is funny, where’s my popcorn” and straight out “where do these wackos come out from?”

    I think my favorite section of a rather long, conspiracy-driven comment, is this one…

    “Unless we turn this nonsense around, the human race could become extinct like the dinosaurs from the treatments of modern medicine to kill a non- threatening or phantom germ or virus.”

    And I’m not even cherry-picking on the bad parts – this general message is along those lines of logical fallacies, false dilemmas, etc…

  12. Max says:

    “Ebola is spread by direct contact with blood or secretions from the infected person”

    You sure about that?
    The WHO’s page on Ebola says, “Ebola then spreads in the community through human-to-human transmission, with infection resulting from direct contact with the blood, secretions, organs or other bodily fluids of infected people, and INDIRECT CONTACT WITH ENVIRONMENTS contaminated with such fluids.” Emphasis mine.

    The Public Health Agency of Canada says, “In the laboratory, infection through small-particle aerosols has been demonstrated in primates, and airborne spread among humans is strongly suspected, although it has not yet been conclusively demonstrated.”
    It also says, “SURVIVAL OUTSIDE HOST: The virus can survive in liquid or dried material for a number of days. Infectivity is found to be stable at room temperature or at 4°C for several days…”

    Armand Sprecher, the medical adviser to Doctors Without Borders for hemorrhagic fevers, told NPR that Ebola can be caught by touching the protective suit (PPE): “Where we see health care worker infections when the PPE is in place, [the worker] did something to override the PPE: They didn’t wear it appropriately or contaminated their hands in the process of getting [the suit] off.”

    I bet that’s how Nancy Writebol was infected, since her job was to disinfect health workers leaving the Ebola treatment area.

    So if Ebola can be transmitted INDIRECTLY via the suit, why not via a doorknob?
    Isn’t that one of the ways the cold and flu is spread? Isn’t that why the CDC says to wash your hands to avoid catching a cold or flu?

    The Ebola-containing bodily fluids include mucus and sweat, which gets on anything the sick person touches. And what if someone with Ebola has a cold or allergies, and sneezes on you?

    Lastly, the Cardiff Common Cold Center’s page on the common cold says, “Common cold viruses are not very contagious. Despite the fact that very few of us escape from at least a couple of common cold infections each year, common cold viruses are not very contagious. Under laboratory conditions when healthy volunteers are kept with others who are suffering from common cold infections it has proven remarkably difficult to spread infection from one person to another.”

    Well that’s reassuring. Next they’ll be saying that Ebola is not very contagious despite the fact that everyone catches it.

    1. JD says:

      I appreciate the point that infection can spread in the form of fomites that have been covered in bodily fluid. That is a legitimate concern for those dealing closely with ebola patients. This is made pretty clear by the problems observed with body cleansing rituals.

      “Common cold viruses are not very contagious. Despite the fact that very few of us escape from at least a couple of common cold infections each year, common cold viruses are not very contagious. Under laboratory conditions when healthy volunteers are kept with others who are suffering from common cold infections it has proven remarkably difficult to spread infection from one person to another.”

      This is absolutely true. It’s actually pretty hard to recreate environments like classrooms, offices, public restrooms, and commercial airplanes that facilitate transmission of pathogens spread by aerosol. They are just that good at bringing people into close contact and fostering spread.

      The good news is that **in humans** ebola has not been shown to be transmitted by aerosol. If it did, think about how much worse this epidemic could be. More importantly, the virus is not shed in the asymptomatic (as you aren’t vomiting and bleeding all over the place). This would likely prevent many people who could transmit the virus from boarding planes (much more likely for someone with the sniffles or a low-grade fever). I will give you one thing, if the virus does persist in dried fluids, it could be dangerous for loved ones to carry-on items (clothes etc) of someone who died of ebola.

      You reference primates, but remember that not everything that is demonstrated is clinically relevant. Also, as far as I can tell, in well-conducted studies, this myth has been pretty well-debunked. http://www.iflscience.com/health-and-medicine/study-confirms-ebola-not-transmitted-through-air

    2. JD says:

      Infection resulting from direct contact with the blood, secretions, organs or other bodily fluids of infected people, and INDIRECT CONTACT WITH ENVIRONMENTS contaminated with such fluids.

      This is well known and one of the problems with preventing spread in Africa. Look at the body cleansing rituals. Although infection via fomites is a large problem for those treating ebola patients, the protocols take this into account. I could see such protocols being difficult to follow in low-resource situations though.

      In the laboratory, infection through small-particle aerosols has been demonstrated in primates, and airborne spread among humans is strongly suspected, although it has not yet been conclusively demonstrated.

      Not everything demonstrated in primates is clinically relevant. Besides, this myth has been pretty well-debunked by studies with better contamination control. http://www.iflscience.com/health-and-medicine/study-confirms-ebola-not-transmitted-through-air

      The Ebola-containing bodily fluids include mucus and sweat, which gets on anything the sick person touches. And what if someone with Ebola has a cold or allergies, and sneezes on you?

      Despite the fact that very few of us escape from at least a couple of common cold infections each year, common cold viruses are not very contagious. Under laboratory conditions when healthy volunteers are kept with others who are suffering from common cold infections it has proven remarkably difficult to spread infection from one person to another.

      Several issues that make this an ill-formed comparison.

      1) there is not solid evidence that asymptomatic individuals spread the virus. Sweat and mucus can be concerns, but the titer generally isn’t large enough to do nearly as much damage as blood or vomit. Although not a perfect comparison, think about how HIV is secreted in sweat and mucus, but not in sufficient quantities to infect.

      2) the point about rhinovirus communicability is absolutely true. It is very difficult to recreate in lab the perfect conditions for transmission of diseases spread by aerosol that classrooms, offices, public restrooms, and commercial airplanes create. We generally meander our way through a rhinovirus petri dish all day long. But, it is much more likely for someone with the sniffles or a low-grade fever to get on a plane (or come into work, in the extremely unlikely event it spreads to the US) than it would be for someone bleeding or vomiting all over the place (aka individuals capable of spreading ebola).

      I will give you one thing though, that I have thought about. If the virus can remain viable in dried vomit or blood, there could be a small concern over loved ones bringing the personal items of ebola victims on the plane. Not sure if measures to prevent this in places like Monrovia have been put in place or not.

    3. WilliamLawrenceUtridge says:

      Ebola can be spread through means other than blood, semen or feces. It’s just much less likely. It doesn’t have an optimized dispersal mechanism like influenza. The fact that it can be spread through casual contact doesn’t mean it will be spread. History demonstrates that ebola doesn’t spread nearly as well as influenza and basic procedures used against HIV work well with ebola. That’s not 100%, but it’s good enough to not be overly concerned about ongoing spread in a country with decent public health systems and no tradition of lengthy and widespread contact with corpses.

      1. Max says:

        Is it less contagious than norovirus, which easily spreads through vomit and feces, especially on cruise ships?
        Is it less contagious in hospitals than hospital-acquired infections like MRSA, which are contracted by over a million Americans each year?

        1. KayMarie says:

          There are so many factors involved, but for those who need to believe Ebola is uniquely and by orders of magnitude more contagious than anything else in the world, I doubt any statistic will persuade them.

          On the one hand, it does live on surfaces for a while so you are more cautious than something that needs mucous membrane to mucous membrane contact as it dies seconds after leaving a body.

          It doesn’t seem to take many copies of the virus to get into trouble so you need more care than something that you really need to get a big dose of it. Why you can get it taking off your protective gear.

          Sure we have the biggest outbreak ever going on, but generally these outbreaks are pretty small compared to other diseases so it can’t be all that easy to catch and spread. I’m more worried about catching something when millions catch it in the first few months than when a thousand or so caught it in the first few months.

          People aren’t contagious for extended periods of time while still apparently healthy, which lowers the worry compared to some things where you are very contagious for up to a week before you see any signs of illness so no one avoids contact with you.

          There doesn’t seem to be any insects or such that carry it around between bites, so that lowers the worry compared to other diseases that are easily spread by mosquitoes or fleas.

          Basically things that have been adapted to spread in humans for most of human history tend to spread more easily (but tend to be less lethal as that is how they kept being spread). These things that normally are in other critters (like fruit bats) but changed a tiny bit so they can now infect a human tend to be harder to pass from person to person even though they sometimes have pretty high death rates.

          1. Max says:

            I would like to believe that Ebola is less contagious than anything else in the world, but I haven’t seen much evidence of that. Like, what makes it less contagious than norovirus?

            Previous outbreaks of Ebola were contained in African villages because people didn’t travel outside, but that doesn’t mean it’s not contagious.

            The fact that this outbreak is so much bigger than previous ones suggests that generalities based on previous outbreaks may not apply to this one.

            1. Windriven says:

              “I would like to believe that Ebola is less contagious than anything else in the world,”

              It isn’t less contagious than anything in the world. But it is not wildfire contagious either.

              “Ebola is the current infection most in the news with 1,700 cases and 930 deaths as of today. It took six months to cause that many cases in an area with a population of around 20,000,000. And this in an area with a horrible infrastructure for both health care and infection control.” – Mark Crislip

              The point is that careful adherence to long established infection control procedures is the solution to 90% of the problem. Isolation, cleanliness, sanitation. Those are almost trivial in Des Moines. Not so much in Freetown.

            2. KayMarie says:

              I never said least infectious, either. It isn’t black or white either the most or least infectious.

              Yes, if you are in the same room as someone with Ebola you will want to be taking precautions. Especially if you are taking care of them so are cleaning up their blood, vomit, diarrhea, etc. Any area those touch needs to be disinfected completely. Usually people that sick don’t move around much so you can avoid them completely. You may want to take more precautions that other things transmitted in a similar way at a similar rate because it is more deadly than they are with fewer treatments.

              At least people with Ebola don’t throw off thousands of viral particles in the breath for several days before you even know they are sick like some other diseases. It isn’t transmitted by mosquito so you can be infected by someone across town.

              There are a lot of things I’d worry about before being certain Ebola is gonna get me. Not that I want to give you any additional worries.

              1. Andrey Pavlov says:

                I actually wrote a comment in response to Kofi Babone wherein I demonstrated that the infectivity and transmissibility of Ebola is demonstrably less than that of HepC. But the comment got lost somewhere in the ether. I am checking to see if the SBM wordpress gods and recover it.

            3. WilliamLawrenceUtridge says:

              One of the main reasons that Ebola is more contagious in Africa is because of burial and grieving rituals which involve extensive contact with a dead person, including kissing the (still bleeding) corpse.

              Perhaps this outbreak is different, but so far it seems to be so only in magnitude, not the basic characteristics of the virus. Looking at the wikipedia page (which has a lot of references, so is reaonsably trustworthy), it suggests that travel, in particular reaching a large city of two million (most of whom, one notes, are still alive), might be a factor.

              1. Max says:

                And in industrialized countries it may be more contagious because of crowded subways and air travel.
                That’s why the statistics from one area may not apply to another area, but the basic properties of the virus should be the same.

              2. Max says:

                And now the WHO says, “Staff at the outbreak sites see evidence that the numbers of reported cases and deaths vastly underestimate the magnitude of the outbreak.”
                Reminiscent of the 2009 H1N1 swine flu pandemic, which turned out to be more widespread but less deadly than first estimated. But I doubt that Ebola Zaire will turn out to be less deadly.

              3. WilliamLawrenceUtridge says:

                And in industrialized countries it may be more contagious because of crowded subways and air travel.

                But in African cities of over two million, they don’t have busses, or intersections, or schools, or movie theatres, or shopping malls?

                That’s why the statistics from one area may not apply to another area, but the basic properties of the virus should be the same.

                Problematic for a couple reasons – viruses evolve in response to selective pressure, and the basic properties strongly suggest that Ebola currently isn’t very good at spreading in humans without sustained contact

                You seem to be arguing that Ebola could be more deadly and infectious than anticipated. Sure, it could be. But so far it’s not.

                Reminiscent of the 2009 H1N1 swine flu pandemic, which turned out to be more widespread but less deadly than first estimated. But I doubt that Ebola Zaire will turn out to be less deadly.

                2009 was more deadly with specific populations, it killed disproportionate numbers of healthy adults, which was always the concern.

                You may doubt all you want, but Ebola isn’t spread like influenza, even as it may be more deadly. Merely because you worry about something doesn’t mean you get to ignore the evidence.

              4. KayMarie says:

                But in African cities of over two million, they don’t have busses, or intersections, or schools, or movie theatres, or shopping malls?

                But apparently one thing they do not really have in those cities in Africa is fully equipped isolation wards. Saw a report from Doctors without Borders that was trying to get a new tent-based isolation ward up and running especially since it sounded like the Samaritan’s Purse one shut down after the doctors got sick and airlifted to Atlanta.

                Just because they have some hospitals and we see some people with some equipment on the news doesn’t mean they have nearly enough. The reporters probably don’t hang out in the areas that have the least amount of infection control. I wouldn’t.

              5. KayMarie says:

                Oh, and it may pay to check out a list of most densely populated cities in the world. Most of the densely packed ones are not in industrialized Europe or USA.

        2. WilliamLawrenceUtridge says:

          Is it less contagious than norovirus, which easily spreads through vomit and feces, especially on cruise ships?

          Yes, because norovirus promotes vicious, watery vomiting and diarrhea that aerosolizes the viral particles. Ebola does not.

          Is it less contagious in hospitals than hospital-acquired infections like MRSA, which are contracted by over a million Americans each year?

          Yes, very much so. Particularly given MRSA is innocuous in healthy humans with functioning immune systems.

          If Ebola were as contagious as you appear to be JAQing-off towards, it would be a serious public health problem. It is not, not even in Africa.

          1. Andrey Pavlov says:

            Is it less contagious in hospitals than hospital-acquired infections like MRSA, which are contracted by over a million Americans each year?

            LOL. Yes, of course. You need to look at rates of infection and the base replication rate to make an accurate comparison. Looking at absolute numbers is pointless – a really poorly contagious disease can have huge numbers because of large numbers of people getting exposed and a really contagious disease can have low numbers because few people are exposed.

            1. Max says:

              Andrey, are you saying that few people would be exposed to Ebola? Why, because it makes people very sick? So does norovirus and influenza. In the first three days, Ebola symptoms are flu-like.

              1. KayMarie says:

                Norovirus you are contagious before you get sick and sometimes for a long time after you are well.

                http://www.medicinenet.com/norovirus_infection/page3.htm

                Again contagious before you get sick with influenza
                http://www.flu.gov/about_the_flu/seasonal/

                Ebola is contagious after you get sick. If it were contagious for a day or two before you get sick we wouldn’t be talking a couple thousand people in an urban area in 6 months, we’d be talking a couple thousand people every couple of days.

              2. WilliamLawrenceUtridge says:

                Andrey, are you saying that few people would be exposed to Ebola?

                I can’t speak for Andrey, but part of the answer would have to be an acknowledgement of how incomparable the mechanisms of transmission are for these three diseases. Ebola is spread primarily through bodily fluids, you have to work really hard to get the viral particles in someone at a distance. Norovirus is aerosolized through vomiting and explosive diarrhea. Influenza is transmitted through respiration including sneezing, a symptom that influenza itself actually causes, both in and out of infected people. Further, the viral particles are vastly different sizes; norovirus is about 40nm across, influenza is about 100nm and Ebola is 800nm long and for lack of a better word, “tangly”.

                Look, there’s a reason why epidemiologists and public health officials aren’t too worried about Ebola. Maybe just trust them to know what they are doing? Your fear may be due more to your ignorance than anything inherent to Ebola.

              3. Max says:

                Tuberculosis is transmitted through respiration, and it’s caused by Mycobacterium tuberculosis, which is 2000-4000nm long.

                Maybe your complacency is due to your ignorance.

              4. KayMarie says:

                Your fear may be due more to your ignorance than anything inherent to Ebola.

                Or as some sociologists reported when discussing risk assessment.

                It really doesn’t matter what numbers the scientists come up with to assess the risk. It is going to be how human beings respond to risk that determines the vast majority of policy.

                My understanding, as limited as it is, is our brain has ways to turn on the fear or damp down the fear of a risk.

                For example we don’t, generally, walk out side see our car and run away screaming about how it is going to kill us today. We are used to that risk and we become complacent about the risk and will generally not take action on the data that says you are more likely to die in your car than other ways of dying.

                But when something is new or different our brain has a tendency to ramp up the fear. So a new disease will be much more feared than something that has been killing us for years.

                You see this in some NIMBY cases where there is already something toxic in the area, and the new thing is much less toxic than the old thing. It is easy to get the community up in arms to keep the new thing blocked, but no one cares to fight to get the old thing out of the neighborhood. Sometimes you can’t convince people it is OK to replace the more toxic thing with the less toxic thing.

                Some of us are probably more likely than others to really need to ramp up that fear of new risks than others.

                That is why there are a lot of things I’m more concerned about than Ebola. But my fear of some new diseases that I think are more likely to get me is also going to be effected by the same human biases.

                Not all viruses are spread the exact same way, even more so when you start saying well this bacteria is spread like this so any and all viruses must all be spread the same way, or whatever that oh yeah but what about this bacterial disease over here. {inappropriate cross threading} Next thing you’ll be comparing Ebola to how plant diseases spread and wanting something done about aphids.

              5. Max says:

                William didn’t explain why the bigger size of Ebola viruses makes any difference, but in context it’s clear that he insinuated that bigger size means less airborne.
                It sounded bogus to me because the virus is still much smaller that the droplets that carry it. My suspicion was validated by the fact that the much larger Mycobacterium tuberculosis is airborne.
                So why would large size prevent the Ebola virus from being airborne but not the larger Mycobacterium tuberculosis? Makes no sense.

                And spare me the psychobabble, Doctor Kay. If I lived on a desert island, I’d still want to make sense of the contradictory information about Ebola, because I like to make sense of things and I’m annoyed by bullshit.

              6. WilliamLawrenceUtridge says:

                Tuberculosis is transmitted through respiration, and it’s caused by Mycobacterium tuberculosis, which is 2000-4000nm long.

                Sure, but tuberculosis is optimized to be spread through aerosolization. That’s how it has evolved to spread. Your argument is about as meaningful as saying “look, a bike is way smaller and lighter than a plane, it must be better at flying”. Specifics are important. Design is important, transmission methods are important. There’s a reason that (obviously) smarter and better-informed people than you aren’t worried about this – and I’m not talking about myself. I’m talking about the CDC, the WHO, DWB, etc.

                William didn’t explain why the bigger size of Ebola viruses makes any difference, but in context it’s clear that he insinuated that bigger size means less airborne.
                It sounded bogus to me because the virus is still much smaller that the droplets that carry it. My suspicion was validated by the fact that the much larger Mycobacterium tuberculosis is airborne.

                That’s great and all, but I wouldn’t suggest running screaming through the streets because one person on the internet had one analogy that failed or was inaccurate. Perhaps instead of listening to me, you could read up on what the CDC or other experts have to say. This Week In Virology is made up of actual experts on infectious diseases, and viruses specifically, and from what I understand they’ve been discussing Ebola extensively.

                Winning an argument with me about Ebola (which you haven’t done by the way, at best you’ve shown that one premise used in one analogy might be false – and your point about the particles being smaller than the droplets they are embedded in is a good one that I hadn’t thought of, thanks) isn’t the same thing as being right. Even if you are right about this one aspect of Ebola, you’re still wrong about it’s overall transmissability because empirically – it just doesn’t spread very well.

                So why would large size prevent the Ebola virus from being airborne but not the larger Mycobacterium tuberculosis? Makes no sense.

                Sure, I’ll concede the point that I, as a nonspecialist, am probably wrong about the size and shape of Ebola being an aspect of its infectivity. Doesn’t change the fact that at best if it can spread via aerosol, it doesn’t do so very well.

                And spare me the psychobabble, Doctor Kay. If I lived on a desert island, I’d still want to make sense of the contradictory information about Ebola, because I like to make sense of things and I’m annoyed by bullshit.

                The thing is, what you see as “bullshit” might really be a measure of your lack of knowledge of the topic. I’ll spare you the psychobabble and instead point to two logical fallacies that are at play – Dunning-Kruger, and cognitive dissonance. DK is here because you don’t know that much about Ebola but assume the small amount you do know is enough to discount the opinion of actual experts. And cognitive dissonance is at play because you have had several facts pointed out to you repeatedly that are contrary to your beliefs and rather than admitting these facts undercut your argument, you have hyperfocussed on irrelevant tangents or the few facts (actually assumptions really) that you feel you can comfortably refute.

                It’s no Freud, but that just makes it more likely to be correct.

            2. Jopari says:

              Therefore? Does that mean that just because a person raises a variable that must be the only variable involved?

              Different diseases transmit differently and also cause different symptoms, if you can prove that it actually happens through aerosol, then slam dunk case. Yet, research has already been done to determine this and come out negative.

              Your response reminds me of the myth that bees defy all aerodynamic properties and fly. So, according to your logic, does that mean worms are also capable of flight?

              1. Jopari says:

                Reply to wrong comment, it was a comment to Max’s comparison of tubercolosis.

          2. Max says:

            “Norovirus promotes vicious, watery vomiting and diarrhea that aerosolizes the viral particles. Ebola does not.”

            Ok, that would be one reason if it’s true. How do you know the vomit caused by Ebola doesn’t aerosolize?
            On the other hand, I can think of reasons why Ebola would be harder to stop than norovirus, like its longer incubation period.

            “MRSA is innocuous in healthy humans with functioning immune systems.”
            Ok, but hospitals are full of sick people. You mean hospitals don’t test for MRSA or isolate MRSA carriers because most of them won’t die from it, even though they spread it to others who die from it.

            1. WilliamLawrenceUtridge says:

              How do you know the vomit caused by Ebola doesn’t aerosolize?

              Yeah, I can’t do all the research for you, maybe you should start looking up these questions yourself instead of JAQing off. Again, your concerns about Ebola appear to be based on your lack of knowledge about the disease, not anything about the disease itself. But if I’m wrong and Ebola leads to a world-wide pandemic apocalypse, you can gloat as you bleed out of your eyeballs.

              On the other hand, I can think of reasons why Ebola would be harder to stop than norovirus, like its longer incubation period.

              Yeah, that’s great. But do actual experts on Ebola think this? Why not? Merely because you can ask a question doesn’t mean your concerns about your imputed answer are valid. Ebola may have a longer incubation period, but it doesn’t aerosolize the same way.

              Ok, but hospitals are full of sick people. You mean hospitals don’t test for MRSA or isolate MRSA carriers because most of them won’t die from it, even though they spread it to others who die from it.

              Gosh, it sounds like people with Ebola and MRSA shouldn’t walk around hospitals spitting in the mouths of the immune-compromised! And my statement is more a recognition that testing for MRSA is probably futile because it is ubiquitous. Oh, and merely because MRSA exists doesn’t mean Ebola is as dangerous, contagious, or transmitted the same way as MRSA.

              Jebus, maybe listen to the thousands of experts on the topic rather than assuming you know better than the people who spend their entire lives studying the damned thing.

              1. Max says:

                My concerns about Ebola are based on what I’ve read about the disease, including from experts whom I already quoted: the WHO and the Public Health Agency of Canada agreeing that Ebola is spread though indirect contact with surfaces where infectivity is stable at room temperature for several days, and the Public Health Agency of Canada stating that airborne spread among humans is strongly suspected.

                You on the other hand haven’t cited a single expert. Are you an expert? I don’t know who you are.

                The argument that this outbreak isn’t that bad doesn’t hold water when the WHO admits that the numbers of reported cases and deaths vastly underestimate the magnitude of the outbreak.

                So spare me the sarcasm, it doesn’t do anything for me. You want to make a difference, explain exactly what “direct contact with bodily fluids” means. People keep saying it without defining it. Explain how doctors wearing protective equipment and following all protocols contracted Ebola through direct contact with bodily fluids. Did they participate in burial rituals too?

              2. Sawyer says:

                My concerns about Ebola are based on what I’ve read about the disease, including from experts whom I already quoted:

                So how is it that every single news story I’ve heard (NPR, BBC, New York Times, Washington Post, my local newspaper, here, This Week in Virology) has cited experts that claim it’s highly unlikely ebola is spread via aerosol? Is there a conspiracy among every news agency on earth to ignore scientists investigating aerosol transmission?

                I wouldn’t completely rule out unknown vectors, but jesus, you are being incredibly dishonest about the overall stance of experts in this field. If you’re going to claim special knowledge about this topic, you need to show people your credentials. Your conclusions absolutely DO NOT line up with what I’ve heard anywhere else.

              3. KayMarie says:

                You also seem to be assuming the people in Africa all have modern protective gear in adequate quantities all the time, every time.

                From the report from Doctor’s without Borders there is fair amount of evidence from people on the field that the conditions in Atlanta are likely quite different from the conditions in the tent isolation wards in Liberia.

                There may be some spread from not having adequate decontamination facilities to get out of whatever protective gear you actually have.

                Generally caregivers have extended periods of time with a live body, possibly even more than you do washing and preparing a body for burial. After all you given how many days someone with Ebola is sick you likely have many more days of caring for the sick person than you do burying a body even with extensive rituals. Then add you have many more bodies to care for at a time given the isolation tents are full.

                Again if it were wildly infective and everyone that ever rode a bus got everyone else on the bus near them when they were sick you would see 2000 people falling ill a day or week not 2000 over 6 months. The cities in Africa are just as crowded as cities in the US if not more (after all the US has urban sprawl on a level you do not see in cities on any other continent) with worse public health conditions like hygiene. It should spread much much faster there, not really really slowly there but like wildfire once it gets to US shores.

                But you’ve made up your mind we are all going to die, so I don’t know why I bother.

              4. Max says:

                “So how is it that every single news story I’ve heard has cited experts that claim it’s highly unlikely ebola is spread via aerosol?”

                Good question. That’s what I’ve been asking. Why does the information on the PHAC’s website seemingly contradict what the media says? You have an answer?
                But not all news stories agree that “direct contact” is required. NPR interviewed an expert who said that Ebola can be caught through indirect contact with the protective suit.

                KayMarie,

                The WHO says the reported cases and deaths vastly underestimate the magnitude of the outbreak, so I have no idea how big the outbreak really is.

                “There may be some spread from not having adequate decontamination facilities to get out of whatever protective gear you actually have.”

                Right, and would that count as “direct contact with bodily fluids” or “indirect contact with bodily fluids”?

                Take me step by step how the virus gets from the Ebola patient into the health worker, and why that couldn’t happen in the U.S. or through touching a doorknob.
                I know it’s not because American doctors are so diligent about washing their hands, that’s for damn sure.

                One Ebola patient who traveled to Nigeria infected NINE people there, and 177 people were being monitored for symptoms, so the argument about full isolation tents doesn’t apply there.

              5. MadisonMD says:

                Why does the information on the PHAC’s website seemingly contradict what the media says? You have an answer?

                Yes, I do have an answer. Read the actual website.:

                The Ebola virus can spread through:
                -contact with infected animals
                -contact with blood, body fluids or tissues of infected persons
                -contact with medical equipment (such as needles) that are contaminated with infected body fluids
                As long as precautions are taken, there is low risk of contracting Ebola in a country where the disease is present.

                No contradiction at all. And hell yes, it can be indirect. Poke yourself with a dirty needle and you can get HepC, HIV, or Ebola. But somehow you conflate this with touching a doorknob? Where the hell did you get that from?

              6. JD says:

                @ Max

                Good question. That’s what I’ve been asking. Why does the information on the PHAC’s website seemingly contradict what the media says? You have an answer?

                Let’s look at the references provided here: http://www.phac-aspc.gc.ca/lab-bio/res/psds-ftss/ebola-eng.php

                It doesn’t seem that the PHAC guidelines are based on the most recent literature. More recent work demonstrates that **in lab non-human primates** there is not evidence for aerosol transmission: http://www.nature.com/srep/2014/140725/srep05824/full/srep05824.html

                Plus it appears that a lot of the argument for aerosol transmission hinged on a study that has been called out for potential cross-contamination: https://www.sciencenews.org/article/airborne-transmission-ebola-unlikely-monkey-study-shows

                It’s not ridiculous for the PHAC to practice the precautionary principle, as this evidence doesn’t rule this out in humans. But, as of now, we have no solid evidence (scientific or anecdotal) that would lead us to believe that aerosol transmission is a problem, and to state that there is a strong possibility of aerosol transmission is misleading.

                But not all news stories agree that “direct contact” is required. NPR interviewed an expert who said that Ebola can be caught through indirect contact with the protective suit.

                I would say that ebola is capable of being spread through direct contact **with viable bodily fluids**, explaining why contact with a soiled protective suit could be a problem. I would define direct contact in this context as handling or dealing with bodily fluids of ebola victims (namely blood or vomit) to an extent that fomites are a problem.

                I envision that being tasked with decontamination duties can put one at risk because you have to be in direct contact with the fluids. This would negate the false comparison you have offered regarding the burial rituals.

              7. KayMarie says:

                You keep assuming Africa is exactly like America.

                There is not nearly enough adequate isolation wards and protections there.

                They aren’t spreading it by touching door knobs.

                There is a big fear of the scary foreigners with full hazmat suits so assuming every Ebola patient is immediately put into full and proper quarantine to prevent spread is not likely.

                People catch it from caring from the sick people, not riding in the bus next to someone who hasn’t gotten ill yet.

                Sure we’d probably get a few here who run to the local stand in for a witch doctor when they got sick in the US but I think we’ve got a bit better public health infrastructure here to prevent spread in the event someone travels here outside of a jet ambulance. Lord knows the cops have enough military equipment to enforce a quarantine and what not.

                Again, if it was from touching a doorknobs when someone sneezed in their hand we’d still be seeing thousands a day and huge pits on the edges of every city to dump the dead into and it would be in many more countries, etc.. Like we did during the plague, cholera epidemics and all the other things that spread a lot faster and easier than Ebola.

                And yes I can believe the numbers are higher, but it isn’t in the hundreds of thousands or anything like that. We don’t know how many holed up somewhere to die.

                Again, it is dangerous, we do know how to protect against it, but when you don’t have adequate resources and education it isn’t going to be easy to control.

              8. Sawyer says:

                Thank you to Madison for following up. I suspected that the overall information from our Canuck friends wasn’t really contradicting other public health agencies, but I was in too much of a rush to check.

                Shame on me for trusting Max’s detective skills. :(

              9. MadisonMD says:

                On second review, Max’s claim of PHAC stating aerosol spread seems to date back to the Pathogen Data Safety Sheet cited by JD. The data sheet is dated 2010, which explains why it does not contain the critical new data cited by JD in 2014 and, moreover, aerosol spread is not mentioned in the PHAC data sheet dated 8/15/2014.

                The 2010 data sheet is indeed based on the precautionary principle without data. It says:

                Humans may be infected by handling sick or dead non-human primates and are also at risk when handling the bodies of deceased humans in preparation for funerals, suggesting possible transmission through aerosol droplets (2, 6, 28). In the laboratory, infection through small-particle aerosols has been demonstrated in primates, and airborne spread among humans is strongly suspected, although it has not yet been conclusively demonstrated (1, 6, 13). The importance of this route of transmission is not clear.

                There seems to have been mis-citation here.

                Citation 1 is a 2004 US Army Medical manual*
                Citation 2 is a 2003 textbook*
                Citation 6 is this 2001 article which makes the following statement without citation or supportive data:

                Infection, although occurring indirectly through body fluids, is strongly suspected to occur through airborne as well as skin contact transmission.

                Citation 13 is a 2004 textbook*
                Citation 28 is this 2003 article is a descriptive study about cultural beliefs concerning a 2000-2001 outbreak of Ebola in Uganda. It actually doesn’t say anything about airborne spread (but does list the cultural belief of a “bad spirit” that enters the body!)

                *Textbooks and army manuals do not contain primary data.

                So, Max seems to be putting all his faith in an outdated public health page at PHAC which was not actually based on evidence of aerosol transmission. At the same time, he seems to reject or be unaware of more recent evidence such as the Scientific Reports article linked by JD. This most recent evidence appears to be reflected in the 8/15/2014 PHAC Ebola information webpage I linked above.

                Oy vey! You can’t just ‘google the hell’ out of a topic and then know more than public health authorities.

              10. JD says:

                On second review, Max’s claim of PHAC stating aerosol spread seems to date back to the Pathogen Data Safety Sheet cited by JD.

                I had originally looked at the more recent one as well, had to track down the 2010 version. Thanks for making my point in a far more comprehensive manner than I had.

                I find it interesting that Kobinger of the PHAC was involved with both studies, the one that indicated pigs could transmit to NHP’s (which was criticized) and the follow-up that showed different results. I wonder if this could explain why the statement that aerosol transmission is a “strong possibility” was removed in the updated version.

              11. WilliamLawrenceUtridge says:

                the WHO and the Public Health Agency of Canada agreeing that Ebola is spread though indirect contact with surfaces where infectivity is stable at room temperature for several days, and the Public Health Agency of Canada stating that airborne spread among humans is strongly suspected.

                Yes, and humans can breath through their necks and you can survive being lit on fire. But that doesn’t mean that it is common or inevitable. The infectivity of Ebola sitting on a surface may be stable, but it’s still low. And note that if it’s strongly suspected, not only is aerosol transmission not confirmed, it’s obviously not likely.

                You on the other hand haven’t cited a single expert. Are you an expert? I don’t know who you are.

                I’m mostly summarizing what Dr. Crislip, an infectious disease doctor, and Dr. Gorski say. And what public health doctors have repeated ad nauseum on the radio. But here’s the CDC too.

                I’m not an expert, but I am willing to describe their views accurately. You are apparently not either.

                The argument that this outbreak isn’t that bad doesn’t hold water when the WHO admits that the numbers of reported cases and deaths vastly underestimate the magnitude of the outbreak.

                Sure, but the number of deaths is still orders of magnitude below a single day’s death from cholera or malaria. It’s still a tiny amount, and a tiny risk – particularly in the US.

                So spare me the sarcasm, it doesn’t do anything for me.

                Well I’ve tried facts, and now I’ve moved on to mockery, so tough chops there champ. Don’t like it, don’t read my replies.

                You want to make a difference, explain exactly what “direct contact with bodily fluids” means. People keep saying it without defining it. Explain how doctors wearing protective equipment and following all protocols contracted Ebola through direct contact with bodily fluids. Did they participate in burial rituals too?

                Why would I want to make a difference? You’re never going to catch Ebola, so anything I or any other official says won’t make a difference. If you really cared, you’d go read the conclusions of the convergence of experts on the subject.

                If you read the CDC link, you’ll see that health care workers are at the highest risk of getting sick. This has been recognized for decades. You being unable to reconcile this with your beliefs about Ebola isn’t my problem. Maybe read a book or something.

              12. WilliamLawrenceUtridge says:

                So, Max seems to be putting all his faith in an outdated public health page at PHAC which was not actually based on evidence of aerosol transmission.

                What Max is really doing is what all pseudoscientists do when they want to appear sophisticated and as if they cared about the scientific literature – ignore consensus, cherry pick the few sources that could be misinterpreted to support their position, and ignore any dissenting information.

            2. Max says:

              You got it on the second try, MadisonMD.
              The 2010 Pathogen Safety Data Sheet (PSDS) isn’t that old, and I don’t see an updated one. That webpage was last modified on 8/1/2014, probably to add the link to the general information webpage that you referenced, which is not a detailed PSDS.
              Whatever was in those textbooks and manuals from 2004, it convinced the PHAC in 2010 that airborne spread among humans is strongly suspected. Four years seems pretty quick to go from strongly suspected to not suspected, but I’m not up on the latest research.
              The current page for health professionals still says, “Any testing related to a suspected Ebola infection must be carried out in a containment level 4 (CL4) laboratory. CL4 ensures maximum containment through complete sealing of the laboratory, isolation of personnel from the viruses through the use of positive pressure suits, double HEPA (high-efficiency particulate absorption) filtration of exhausted air, HEPA filtration of supply air.”
              What’s with all the emphasis on filtering the air? Just don’t kiss the patients and stick yourself with needles, right?

              And I’m less concerned about airborne spread than fomite spread. Was the PSDS outdated about Ebola infectivity being stable at room temperature for several days? Read my first comment with all the quotes.

              1. JD says:

                Any testing related to a suspected Ebola infection must be carried out in a containment level 4 (CL4) laboratory.
                What’s with all the emphasis on filtering the air? Just don’t kiss the patients and stick yourself with needles, right?

                You are making erroneous assumptions about why certain things are classified as Category A bioterrorism threats and need to be studied in BSL-4 labs. Ebola fits this category because it is an “agent which cause severe to fatal disease in humans for which vaccines or other treatments are not available.” It has nothing to do with aerosol transmission.

                Hell, in our lectures, they talked about how viral hemorrhagic fever viruses with high mortality would be absolutely terrible bioterrorism agents because death happens so rapidly and this wouldn’t facilitate spread and wouldn’t achieve “social disruption” as intended.

                http://www.cdc.gov/biosafety/publications/bmbl5/BMBL.pdf (pg 24-26)

                http://www.bt.cdc.gov/agent/agentlist-category.asp

                And I’m less concerned about airborne spread than fomite spread. Was the PSDS outdated about Ebola infectivity being stable at room temperature for several days? Read my first comment with all the quotes.

                You seemed pretty concerned previously, requiring multiple responses. Like I said above, I will give you that fomites are a concern for those in endemic areas, those dealing with Ebola patients, or (maybe) those travelling with personal items capable of spreading the virus. On the last point, it seems that travel restrictions have gone into effect, so this shouldn’t be an issue.

                But, I am confused, how does this apply to anyone else? Will bodily fluids from Ebola patients somehow make it onto the MARTA bus with no one noticing? Not sure if this has been posted already above, but I think the opera singer scenario Colbert outlines is more probable: http://thecolbertreport.cc.com/videos/nm2atj/ebola-panic

              2. Max says:

                It has nothing to do with aerosol transmission, but they felt the need to list all the ways the labs protect against contaminated air: “positive pressure suits, double HEPA filtration of exhausted air, HEPA filtration of supply air.”

                “You seemed pretty concerned previously, requiring multiple responses.”

                LESS concerned than about fomite spread, get it? And it takes persistence to get a straight answer out of people in many subjects.

                Will bodily fluids from Ebola patients make it onto the bus or subway with no one noticing?
                Of course, even on the way to the doctor or pharmacy. They don’t know they have Ebola at first, they think they have a stomach flu.
                And so what if passengers notice? You never noticed sick people on a bus or subway?
                “Witnesses say Sawyer, a 40-year-old Liberian Finance Ministry employee en route to a conference in Nigeria, was vomiting and had diarrhea aboard at least one of his flights with some 50 other passengers aboard.”
                He infected NINE people in Nigeria even though he was quarantined when he got there.

              3. KayMarie says:

                AFAIK only his caregivers (and again most third world hospitals are not set up for the best infection contol)

                Or nine random people. Were any of them from the plane?

                Or were they caregivers who didn’t have enough protective gear and decontamination equipement.

                How many proven from door knobs, etc?

              4. MadisonMD says:

                Whatever was in those textbooks and manuals from 2004, it convinced the PHAC in 2010 that airborne spread among humans is strongly suspected.

                Yeah, people wrote articles saying it was strongly suspected. But there was no direct evidence. Of course a public health authority would be cautious without evidence to the contrary, which has since emerged.

                Four years seems pretty quick to go from strongly suspected to not suspected, but I’m not up on the latest research.

                Apparently you are not up to date, and that is fine. But the CDC and PHAC sure as hell better be because that is their purpose and I suspect that these experts can do it better than you or me. Four years is plenty of time to gather new information on an emerging international health problem of transmissible fatal disease without vaccination. You can bet that $ are being invested in gathering that critical knowledge and scientists who provide timely and accurate information that saves lives will be widely recognized for the importance of their work.

                And I’m less concerned about airborne spread than fomite spread. Was the PSDS outdated about Ebola infectivity being stable at room temperature for several days? Read my first comment with all the quotes.

                Max, if you really want to know the rationale for recommendations from public health authorities, then you will have to do due diligence and read the literature. JD has already demonstrated that current recommendations about airborne spread are based on recent evidence not contained in 2010 PHAC data sheet. I already showed you that the 6 cites on that data sheet do not provide evidence of aerosol transmission. Now you are asking the same about fomites and why do the public health authorities mainly concern themselves with medical equipment contaminated with bodily fluids. Go through the cites yourself, then find the most up to date literature on pubmed to identify more recent information. Then have the humility to imagine you still could have still missed something that is known to public health authorities when they make recommendations and public announcements on Ebola.

              5. JD says:

                It has nothing to do with aerosol transmission, but they felt the need to list all the ways the labs protect against contaminated air: “positive pressure suits, double HEPA filtration of exhausted air, HEPA filtration of supply air.”

                Good lord, my point was that this has to do with standards for **ALL** BSL-4 labs, not Ebola virus. These precautions are taken even if something has no chance of aerosol spread. So your point is not relevant.

                LESS concerned than about fomite spread, get it?

                I get that none of our responses have made any kind of difference and you continue to hold a position not in accordance with public health officials.

                Of course, even on the way to the doctor or pharmacy. They don’t know they have Ebola at first, they think they have a stomach flu. And so what if passengers notice? You never noticed sick people on a bus or subway?

                I’ve never been vomited or bled on. I feel like we are getting lost in absurd hypothetical situations. There is absolutely no reason to suspect that the outbreak would not be effectively managed if someone made it on an international flight to the US.

                So, to recap, we need someone to make it past travel restrictions, they need to make it to the US, they need to be symptomatic (with severe diarrhea, vomiting, and bleeding), they need to get on the MARTA bus, passengers on the bus need to be close enough to come in direct contact with bodily fluids, and passengers need to actually contract the infection. And we won’t know that this is going on, despite the ridiculous amount of attention now focused on Ebola due to widespread sensationalism.

                Witnesses say Sawyer, a 40-year-old Liberian Finance Ministry employee en route to a conference in Nigeria, was vomiting and had diarrhea aboard at least one of his flights with some 50 other passengers aboard.

                This is a sad story that has been ridiculously sensationalized. To me, it is pretty good news that the authorities were made aware and are actively tracing contacts. Not as likely to happen now that travel restrictions are in place (and likely revamped). Again, this does not mean that the virus cannot be contained if brought to the US.

                He infected NINE people in Nigeria even though he was quarantined when he got there.

                Please give me a credible reference of the number infected. Until then, there’s no way to separate the sensationalism from what actually happened.

              6. Sawyer says:

                @JD

                Wait that Finance Minister story was real? I thought Max was so vindictive that he was wishing Ebola on me.

                :)

              7. Max says:

                Two days ago, Reuters reported, “Nigeria has confirmed 10 cases of Ebola, the latest being a doctor who treated the Liberian man, and four have died.
                The doctor had been one of those involved in the initial treatment of Patrick Sawyer. The fourth death recorded today was a Nigerian nurse who participated in the initial management of the index case.
                A member of staff of West African regional economic body Ecowas this week became the third person in Nigeria to die of the disease. [NOT a healthcare worker]
                A nurse with Ebola caught from Sawyer skipped quarantine in Lagos and headed to her home in the southeastern city of Enugu…”

                That credible enough for you?

              8. Max says:

                “These [BSL-4] precautions are taken even if something has no chance of aerosol spread.”

                That’s fine. My point was that PHAC’s page on EBOLA listed all the air filtering standards that are supposedly completely irrelevant to Ebola, out of all the BSL-4 standards they could’ve listed.

                “I’ve never been vomited or bled on.”

                That’s why I’m concerned about fomites! You ever hold on to the handrails or straps on buses while standing? Ever smell urine on the seats?

              9. MadisonMD says:

                That credible enough for you?

                Sure. It shows the disease is transmissible, consistent with the CDC and PHAC websites which describe modes of transmission. Consistent with that, most of the infected were health care workers.

                If you want to stay off public transportation in West Africa, that’s your business. But you have provided no data or information from public health authorities suggesting this is necessary.

              10. JD says:

                That credible enough for you?

                Yes, thank you. But I really hope you noticed how ridiculous the coverage of this story is and how it is being used to feed disproportionate hysteria in the US and elsewhere.

                I think experts are appropriately worried about spread to an area as population-dense as Lagos. Currently, this is being viewed as a near miss though with only 10 infected. Most importantly, the US does not equal Lagos in terms of infection control, emergency preparedness, or living conditions.

                That’s fine. My point was that PHAC’s page on EBOLA listed all the air filtering standards that are supposedly completely irrelevant to Ebola, out of all the BSL-4 standards they could’ve listed.

                We are just running in circles. So, the fact that they listed the main requirements for a BSL-4 lab means that aerosol transmission is a problem for the general population? Please re-read what we have explained above. There is no evidence for aerosol transmission and these requirements are simply extreme safeguards when dealing with the pathogen in lab.

                That’s why I’m concerned about fomites! You ever hold on to the handrails or straps on buses while standing? Ever smell urine on the seats?

                I guess I should have been clear. All of this requires the virus to somehow get on the bus. And this is an absolutely absurd notion. One of the only tiny benefits to all of this hysteria, which you have obviously bought into, is that it would now be even more impossible for someone to make it to the US with the virus **and spread it to many others here**, as this would be reported and dealt with effectively.

                So, beyond the near impossible scenario of the virus coming to the US and not being contained, all we have left is even more ridiculous scenarios. Ben Carson’s urine terrorism comes to mind as one of the most absurd.

              11. WilliamLawrenceUtridge says:

                Whatever was in those textbooks and manuals from 2004, it convinced the PHAC in 2010 that airborne spread among humans is strongly suspected. Four years seems pretty quick to go from strongly suspected to not suspected, but I’m not up on the latest research.

                The thing is, even if you are quoting the PHAC health sheet, 1) You are misinterpreting it since it says “Ebola on surfaces is stable in infectivity”, which isn’t the same thing as “Ebola found on surfaces is highly infections” (it is stably uninfective in the absence of an open wound), a criticism that applies to most of your quotes of the PHAC page and 2) PHAC isn’t the only public health agency in the world; you’re ignoring the rest because you can’t quote-mine and misinterpret them in the same way.

                Strongly suspecting that airborne transmission is possible is not the same thing that it is likely, common, or a cause for widespread concern. It’s possible to give a fully-vaccinated, immune competent person mumps. You just have to breathe directly in their face for hours. That doesn’t mean vaccinated people need to worry about their commute home on the subway.

                The CL4 lab guidelines are for research on Ebola, and are generic to all CL4 labs. You don’t customize the lab depending on the pathogen.

                You’re citing basically any thin gruel you can find to support your contention, while continuing to avoid the conclusion of actual public health experts – Ebola isn’t particularly contagious through aerosol transmission. The fact that you have to quote mine, interpret and distort what thin evidence you can find is further evidence that actual experts don’t take this risk seriously.

                Was the PSDS outdated about Ebola infectivity being stable at room temperature for several days?

                Nope, it’s just that this route of transmission is possible but unlikely. I’ll point out that you can catch HIV the same way, or herpes, theoretically.

              12. MadisonMD says:

                Turns out that Max was just drinking the Mikey cool-aid. That’s where he got the doorknob bit and his sources about aersolization and surfaces. I suppose Max believes is a grand conspiracy of the government that was unraveled by the Y2K spammer.

                Max, your credibility is shot. Best of luck to you navigating a world where only spammers can be trusted.

              13. JD says:

                @Madison

                Oh man, that’s rich. I bet that particular flavor tastes like sh*t.

                I’m always amazed that these acolytes of Adams had the foresight to get the concrete bunker hooked up with a LAN line (can’t get a strong Wifi signal through all of the tin foil). I guess that’s the only way to get the up-to-date, lifesaving information offered by Natural News and Infowars though.

              14. WilliamLawrenceUtridge says:

                So, to recap, we need someone to make it past travel restrictions, they need to make it to the US, they need to be symptomatic (with severe diarrhea, vomiting, and bleeding), they need to get on the MARTA bus, passengers on the bus need to be close enough to come in direct contact with bodily fluids, and passengers need to actually contract the infection. And we won’t know that this is going on, despite the ridiculous amount of attention now focused on Ebola due to widespread sensationalism.

                Don’t forget having an open wound to rub against the blood and vomit.

                Max:

                That’s why I’m concerned about fomites! You ever hold on to the handrails or straps on buses while standing? Ever smell urine on the seats?

                May I suggest not rubbing any bloody, or vomit-covered handrails against any bleeding wounds on your body? Maybe don’t rub your eyes and nose against them? OK, good.

              15. Max says:

                I didn’t read Natural News. I saw a commenter on a news site quote the PHAC about infectivity outside the host, so I checked it out for myself on the PHAC’s PSDS and corroborated it with the WHO page on Ebola, and while doing this, I noticed the section in the PSDS about airborne spread among humans.
                Therefore, I believe in some vast government conspiracy I never heard off.
                So your credibility is shot for making an ASS out of U and ME, but mostly out of U. Hope your BS gets you sued for libel some day.

              16. Max says:

                “it’s just that this route of transmission is possible but unlikely.”

                WHY is it unlikely? Even if it’s empirically demonstrated to be 100% true, I’m still curious about the mechanism.
                It takes a single Ebola virus to infect a person, which is why Ebola is highly infective, and infectivity on surfaces is stable for several days. So WHY is it so much more difficult to infect yourself with Ebola picked up from a surface than with the cold, flu, or norovirus picked up from a surface?
                And if contaminated surfaces are so non-infective, then why are there guidelines for disinfecting airplanes that carried Ebola patients, and why do Doctors Without Borders incinerate the belongings of Ebola patients?

                This should be easy to answer, but it’s become clear that you just don’t know, and instead of saying so, you respond with insults and strawmen, and pull wrong answers out of your butt. Pathetic pseudo-skepticism, no better than the quacks.

              17. WilliamLawrenceUtridge says:

                I didn’t read Natural News. I saw a commenter on a news site quote the PHAC about infectivity outside the host, so I checked it out for myself on the PHAC’s PSDS and corroborated it with the WHO page on Ebola, and while doing this, I noticed the section in the PSDS about airborne spread among humans.

                Well then now you know that your comments are indistinguishable from something Mike Adams might say. That should be enough to make you stop.

                And again – restrictions regarding lab research are not the same thing as guidelines for taking care of patients. Also, theoretical concerns aren’t the same thing as empirical evidence.

                Therefore, I believe in some vast government conspiracy I never heard off.
                So your credibility is shot for making an ASS out of U and ME, but mostly out of U. Hope your BS gets you sued for libel some day.

                Well I hope you die of Ebola one day. Or AIDS. That you got from a toilet seat.

                You can hardly blame us, given how indistinguishable your blather was from Mike Adams’ nonsense.

                WHY is it unlikely? Even if it’s empirically demonstrated to be 100% true, I’m still curious about the mechanism.

                How the fuck should we know, nobody here does Ebola research. You want to know why, get a PhD in virology and work at a category 4 lab.

                It takes a single Ebola virus to infect a person, which is why Ebola is highly infective, and infectivity on surfaces is stable for several days.

                It takes a single particle but it is not highly infective. Not everyone will get infected, and some people exposed to a thousand times that much won’t be infected. Despite 6 months touring a crowded area of Africa, less than 3,000 infected and less than 1,500 dead. The theoretical risk of “single virus infectivity” has empirically not translated into a world-wide pandemic and massive die-off.

                So WHY is it so much more difficult to infect yourself with Ebola picked up from a surface than with the cold, flu, or norovirus picked up from a surface?

                Probably because Ebola is not optimized for human transmission (or viral survival). Viruses that kill most people quickly are often zoonotic, because if humans were the primary host the virus would be likely to go extinct. Cold, ‘flu and norovirus are either respiratory or gastrointestinal, and they are optimized to a) not kill most of those infected and b) to infect via these routes. Why? Who knows? Get a PhD and find out.

                And if contaminated surfaces are so non-infective, then why are there guidelines for disinfecting airplanes that carried Ebola patients, and why do Doctors Without Borders incinerate the belongings of Ebola patients?

                Fucking duh, because if you do get infected you have a 90% chance of dying from it. The consequence is significant even if the likelihood is low. Jesus, if they let everyone on a plan have a bomb, chances are most flights still wouldn’t be hijacked or blown up. But we still screen for bombs.

                This should be easy to answer, but it’s become clear that you just don’t know, and instead of saying so, you respond with insults and strawmen, and pull wrong answers out of your butt. Pathetic pseudo-skepticism, no better than the quacks.

                Of course we don’t fucking know, we aren’t virologists specializing in hemmoragic fevers. Don’t expect much from random internet commentors, do you? Are you seriously telling me that because strangers on the internet can’t answer extremely detailed questions about an obscure virus, that means the CDC doesn’t know what it is talking about? Why not send your questions to the CDC, if they don’t ignore you, I’m sure they can give you good reasons. Hell, send an e-mail to TWIV and ask, at least they are virologists.

                Only idiots in the grips of Dunning-Kruger think 20 minutes on the internet is enough be able to debate with actual experts. And you, my friend, are just such an idiot.

                Want the answer? Go find out yourself. Don’t imagine that it doesn’t exist merely because the first group of strangers you JAQ off on can’t answer highly detailed discussions on the topic.

              18. KayMarie says:

                WHY is it unlikely? Even if it’s empirically demonstrated to be 100% true, I’m still curious about the mechanism.

                Well the 1-10 from the safety data sheets seems to come from lab experiments where they mechanically aerosolize the virus (which you can do even if it never does that in nature) and shove it in the nose of a monkey and come from can we make it a bioweapon research from what I could tell.

                Why that way instead of let monkeys touch blood, or 10 day old semi-disinfected gloves, well you can control the number in and all that better.

                So what you can do in a lab may not always mirror what happens out in the world.

                Most of the rest of the evidence is going to have to come from observational/epidemiological studies as you can’t just go around infecting a bunch of humans with Ebola in a controlled experiment to see what it is going to take.

                So really. We have no hard data on how any human gets it. You want to volunteer to be infected so we can know exactly how long you can sit 25 feet away from someone and get it through the air, go right ahead.

                Heck for all we know maybe an image of the virus is the virus and we are all doomed. :-)

                So how can anyone be certain of anything about transmission?

                If you compare it to other illnesses, and talk to people that got it and find out what happened…it’s people touching the sick and the dead. Typically with inadequate personal protective equipment in homes. After all, if hospitals in Africa don’t have aspirin, they don’t have enough gloves, hazmat suits and disinfectant cleaners, etc to go around, either.

                If you compare it things that get transmitted because you pooped and didn’t wash your hands, or things where you sneezed in a room and someone later walked in, etc. etc. it doesn’t seem all that easy to catch. Stuff that is really really easy to catch you talk to the survivors and they don’t even know anyone who was sick. You talk to people who catch other things where you gotta have sex with them (as really the scary thing about Ebola for me is how long it survives in the semen after everything else seems cleared up) or touch their blood or stuff like that. They all know who the sick person was they got it from or you can easily trace who gave it to whom with some mild detective work.

                Finally, there are two main reasons you go all hazmat on something and isolate people who are sick. 1. It is really really easy to catch (and usually you get millions of people sick in a few months) or 2. It is really really easy to die if you get sick.

                Ebola isn’t a death sentence, but you better hope you got enough IV’s and other basic medical supplies at your nearest hospital.

                Compare to SARS where you got fairly quickly people in very different geographical areas sick and dying with it. How long has this been going on and how localized is it? Those sorts of “natural history” of the illness tell you loads about how easy it is to catch or how far you can get while able to infect others.

              19. JD says:

                I didn’t read Natural News. I saw a commenter on a news site quote the PHAC about infectivity outside the host, so I checked it out for myself on the PHAC’s PSDS and corroborated it with the WHO page on Ebola, and while doing this, I noticed the section in the PSDS about airborne spread among humans. Therefore, I believe in some vast government conspiracy I never heard off.

                Well, a word of general advice. If you ever find out that your viewpoint is consistent with anything appearing on that abysmal website, a critical re-appraisal is needed, in short order.

                WHY is it unlikely? Even if it’s empirically demonstrated to be 100% true, I’m still curious about the mechanism. It takes a single Ebola virus to infect a person, which is why Ebola is highly infective, and infectivity on surfaces is stable for several days. So WHY is it so much more difficult to infect yourself with Ebola picked up from a surface than with the cold, flu, or norovirus picked up from a surface?

                It is unlikely based on our understanding of this outbreak and previous outbreaks. We can all agree that the specific mechanisms of Ebola virus transmission have not been fully elucidated. More study is needed. But, if transmission was as easy as you are claiming, the number of cases would be substantially higher, and we would know about them, because the disease is so severe and the incubation period averages about 10 days (up to 21 is a possibility).

                Your comparisons to respiratory diseases and norovirus are false. I really, really hope you will read the following thoroughly (they are not the sacrosanct PHAC, so I’m not sure how far this will go).

                For diseases spread by respiratory droplets (eg rhinoviruses), Don Goldmann provides a good explanation here: http://sciencenetlinks.com/science-news/science-updates/germy-surfaces/

                Norovirus is a little trickier, as I would argue that it is not as well-studied as something like influenza. Here is Aron Hall from the CDC: http://jid.oxfordjournals.org/content/205/11/1622.full

                And then read this, on Ebola: http://jid.oxfordjournals.org/content/196/Supplement_2/S142.full

                Influenza is easily carried in droplets of moisture from a sneeze or cough, Ebola is not. Rhinoviruses are viable on surfaces contaminated by respiratory droplets, blood or vomit would have to contaminate the surface for Ebola (if it remains viable for a long while, which is up for debate). Norovirus is the “perfect pathogen” because 1) verified low infectious dose; 2) copious shedding; 3) environmentally stable; 4) resistant to disinfectants; 4) rapid evolution. I would argue, based on outbreak investigation, that all of these factors have been demonstrated for norovirus. Not the case for Ebola, despite your claims, the relevance of the infectious dose and persistence is unclear. Based on what happens to the Boy Scout Jamboree every year, I give the nod to norovirus in terms of communicability. http://blogs.scientificamerican.com/artful-amoeba/2012/01/17/misery-inducing-norovirus-can-survive-for-months-perhaps-years-in-drinking-water/

                The JID Ebola article is interesting, please read the discussion section. All of these hypothetical transmission scenarios we have gone through ad nauseam are possible but not probable. Importantly, there is no solid evidence to lead us to believe aerosol transmission is a threat.

                This is likely to play out is something like SARS coronavirus in 2004. We will look back at this outbreak and learn a lot about the virus from it. That will be when many of the complex questions you have asked will be answered more comprehensively.

              20. MadisonMD says:

                Max continues to “Just Ask Questions.” I have a few for him:
                (1) Why do the most recent CDC and PHAC main pages not list aerosol as a mechanism of Ebola dissemination?
                (2) Why does the outdated PHAC page Max keeps referring to fail to provide citations that demonstrate aerosol spread?
                (3) Is it possible that recommendations for lab-based handling of Ebola could differ from care of patients with the disease because certain laboratory procedures, such as high-speed centrifugation can create aerosolized particles whereas such aerosols are not created spontaneously by patients with the disease?
                (4) Could non-medically trained people such as Max, Mike Adams, and anonymous commenters on news sites be confused by the distinction between droplet and aerosol dissemination mechanisms for which distinct precautions are recommended for health care workers?
                (5) If Ebola is so damn contagious, why has there not been an outbreak in Atlanta in the 3-weeks since Ebola patients were flown in from Africa?
                (6) What motive would compel the CDC and PHAC to knowingly provide inaccurate or misleading information by failing to mention the aerosol spread in their main pages and explicitly denying it elsewhere?
                (7) If Ebola can spread through the air, why would the CDC say “You can’t get Ebola through the air.”
                (8) Why would anonymous commenters on news sites link to an outdated PHAC page that refers to laboratory methods of handling the Ebola virus but not link the main PHAC page (which the PHAC directs them to at the top) that clearly indicates mechanisms of contagion that do not include aerosol?
                (9) Did you check out this infographic?
                (10) Why does Max think an anonymous “commenter on a news site” is a more reliable source of information than Mike Adams? [This is actually defensible.]
                (11) Why does Max keep talking of door knobs just like Adams if he didn’t read Adams? (“Great” minds think alike?)
                (12) Why does the CDC recommend droplet but not aerosol precautions to U.S. Hospitals for patients with Ebola, when patients are not undergoing special procedures such as bronchoscopy?
                (13) Why does the CDC say “Ebola poses no significant risk in the United States” if this is not true?
                (14)If Ebola spreads via aerosol, why is there no documented case of human-to-human transmission by this mechanism?
                (15) If Patrick Sawyer had a highly contagious airborne disease during an airflight with 50 other people, why didn’t any of the people on the plane catch Ebola?

                Just askin’! :)

  13. tiny says:

    “Don’t be fat”

    Being fat is not causally linked with negative health effects.
    http://www.hindawi.com/journals/jobe/2014/983495/

    1. WilliamLawrenceUtridge says:

      That paper doesn’t seem to say what you think it says.

      Every time someone posts a paper published by Hindawi, it seems to lead somewhere quacky.

    2. Jopari says:

      I do hope you’re joking, and if not I hope it doesn’t spread. It’s bad enough debunking germ theory denialists, global warming denialists, homeopathy advocates, without adding ‘fat doesn’t cause negative health effects’ being touted.

      Seriously.

      1. WilliamLawrenceUtridge says:

        Fat denial is a pretty substantial subcurrent in pop culture, as is fat acceptance and fat is beautiful. And to a certain extent, there’s truth there – a single beauty ideal is stupid and “fat” or fat people can be beautiful (and healthy given appropriate diet and exercise). The problem arises when the fat is gained through a nutrient-poor, processed diet and sedentary lifestyle, which is unhealthy.

        1. Andrey Pavlov says:

          fat people can be beautiful (and healthy given appropriate diet and exercise).

          I’m going to disagree with you a bit. Being fat is bad for your health no matter what. Even if you exercise, eat a great diet, whatever, there is data that show being fat is an independent cause of mortality and morbidity even when other factors are controlled for.

          The only question is how to actually define “fat” in a manner meaningful to this question. Obviously a subjective cultural definition will fail and while the extremes are obvious the middle becomes gray (in no small part because of individual variability in the impact being fat will have on a person).

          That does not mean we need to denigrate people for being fat, but we also should not promulgate the idea that one can be fat and healthy in the same way a person at ideal body weight is healthy. One may be able to do things to help mitigate the negative health effects of being fat, but at the end of the day it simply cannot be said that being fat is anything but a net negative in terms of health.

          1. mouse says:

            But isn’t there research that shows a BMI defined as overweight is associated with lower all cause mortality than normal weight?

            http://jama.jamanetwork.com/article.aspx?articleid=1555137

            If that’s the case, wouldn’t that indicate that a person who is fat (or overweight BMI) can be healthy?

            But, clearly, using a vague term like fat is going to cause a roadblock in discussion. People have very different ideas of what fat is. My dad thought any man over 9% or woman over 15% body fat was “fat”. While I’ve met other people who clearly have a much broader definition of normal (or not fat).

            1. Andrey Pavlov says:

              Yes, but BMI is a flawed descriptor of what we are actually talking about here – adiposity.

              Body fat percentage is much more important than BMI and where the fat actually is is also important. Central and visceral obesity is worse than peripheral.

              You raise the good point that who is considered “fat” is largely subjective, which I touched upon as well. The key here is that at a certain point (which is not well defined, but undoubtedly exists) having increased adiposity is a net negative in regards to health, even though there are benefits to having increased adiposity (adipose tissues release estrogens, for example, which are protective of bone density… but also increase the risk of certain cancers).

              1. mouse says:

                Andrey Pavlov “The key here is that at a certain point (which is not well defined, but undoubtedly exists) having increased adiposity is a net negative in regards to health, ”

                Certainly, just as decreased adiposity, at a certain point, will have a negative health effect. Also I was happy that you covered the subjectivity of the criteria “fat”. I just thought I’d throw in an additional comment because I wondered what you would say in response to the JAMA article.

                Also, I would guess that a pretty large number of people think that someone with a BMI in the overweight range is considered “fat”. I was surprised by this JAMA results. So I wanted to throw it out there…just for the broader audience.

              2. Andrey Pavlov says:

                Certainly, just as decreased adiposity, at a certain point, will have a negative health effect.

                No doubt. However I think that the breakpoint is closer to the decreased adiposity. If you make an imaginary scale from 1 – 10 with 1 being maximally “skinny” and 10 being maximally “fat” the breakpoint would not be at 5, but perhaps something like a 3 or 4. Perhaps even a 2.

                Also I was happy that you covered the subjectivity of the criteria “fat”.

                As someone who used to be fat (enough so that the quotes really aren’t necessary) I can fully appreciate how the fact someone is overweight is often used to unfairly malign them or make character inferences that are not justified. At the same time it is important to separate out the cultural aspects of obesity from the medical ones and realize that it is just as wrong to argue one can be “fat and healthy” as it is to claim that “fat people are lazy and unintelligent.” Of course it is a complex issue that I am doing no justice in my current brevity, but I am sure you can grok my intent.

                Also, I would guess that a pretty large number of people think that someone with a BMI in the overweight range is considered “fat”.

                Well it certainly does correlate well, particularly in the populations of developed nations. If I gave you a random distribution of BMIs and told you they were from Americans you’d be stupid to not bet that those with BMI >30 aren’t “fat.” You’d get punked by a couple of people who are particularly muscular, but not that often. If I told you the population was professional MMA athletes, it would be a different story.

                The JAMA article can be a bit misleading based on the abstract. If you look at the results section you’ll notice that the overweight and Grade 1 obesity were statistically significant but still rather small effect sizes. Compare overweight (which they defined as BMI 25-30, which happens to be where I am… currently 26) with a hazard ratio of 0.94 (CI .90-.97) with grade 1 obesity of 0.97 (CI .90 – 1.04). You’ll notice that the actual HR difference between the two is rather small as is the actual HR effect size itself. The reason why G1 obesity is not associated with significantly increased mortality is because it crosses 1, which is only because the distribution of the CI is larger (by double, in fact). So this could easily be statistical artifact which is perfectly reasonable given how difficult it is to collect the data that they are meta-analyzing in the first place.

                Personally I would read this as saying that the negative health effects of being slightly overweight are not that profound and that the benefits of not being underweight plus the benefits of some adiposity plus the murkiness around that breakpoint mean it comes out to be a wash; some people suffer more negative health consequences than others. In any case it essentially supports my previous assertion that the breakpoint is fuzzy and difficult to define but that once you move away from the middle it becomes much more obviously clear.

          2. WilliamLawrenceUtridge says:

            The only question is how to actually define “fat” in a manner meaningful to this question.

            Ya, I think we actually agree in all cases, including this one. See the hyperlink in my last post. Someone like Renee Zellweger in Bridget Jones Diary is considered ‘fat” by Hollywood standards. By nearly any other standard, at nearly any other time in history, she would be either “normal” or “voluptuously desireable”. I’m reading a book on Costanza Piccolomini which was inspired by her bust, and I find myself reacting to the faint double-chin with a statement of “that was considered beautiful in 17th-century Italy?” Because I’m a 20th century male who has a historically absurd beauty standard.

            While I think nobody would argue that a BMI of 45 is in good health, someone with a BMI of 30 who exercises regularly certainly can be.

            Yes, being fat is unhealthy, but being “fat” is not.

            1. n brownlee says:

              Zaftig! And it’s NOT FAT.

              1. Windriven says:

                Rubenesque.

              2. KayMarie says:

                Not fat, fluffy!

              3. n brownlee says:

                “Zaftig” and “Rubenesque” are not equivalent. “Zaftig” is Zellweger in Bridget Jones, “Rubenesque” is Sophie Tucker in her later decades. Just to keep the Yiddish reference alive. Zaftig is lusciously curvy, not sloppy- Monroe; Ginger Rodgers, every single chorine in the Ziegfeld Follies, etc.

                A few weeks ago I watched a Sherlock I’d taped and missed. In it, he’s seduced by a whip-wielding stick insect, wearing black décolletage which invited the audience to count her ribs- all the way up to her clavicle. As she panted and licked her corded, withered chops in a simulation of irresistible passion, I marveled at the changes in popular taste in my lifetime…

              4. Windriven says:

                Kvetch, kvetch, kvetch. Zaftig. Rubenesque. To me, Rubenesque is softly rounded and very sexy. Zellweger isn’t my cuppa and I don’t know that film so … she might have been zaftig. But probably she was fat. :-)

              5. simba says:

                The Three Graces is a classic example of ‘if there’s urns, it’s art’. As Pratchett put it, three naked voluptuous women and one small piece of gauze could be pornographic, were it not for the helpful urn or small naked chubby child with angels and a trumpet (paraphrasing, I haven’t my copy of Thud on me).

                I typed that without looking at the picture. I was so delighted to find out it has both urn and cherub. And one small piece of gauze. Pratchett clearly knows his stuff. It’s nice to see fictional women who have bellies.

              6. WilliamLawrenceUtridge says:

                I’m desperately searching for the Oblongs episode where Helga says “I’m not fat, I’m Zaftig!”

                No luck, curse you YouTube.

              7. mouse says:

                Simba “The Three Graces is a classic example of ‘if there’s urns, it’s art’. As Pratchett put it, three naked voluptuous women and one small piece of gauze could be pornographic, were it not for the helpful urn or small naked chubby child with angels and a trumpet (paraphrasing, I haven’t my copy of Thud on me).”

                Ha! I just came across this scrolling down to the newer comments. A remark is probably a lost cause here, but…

                There’s a reason they call it Ecstatic Baroque.

            2. Windriven says:

              My BMI is probably 30 or closing on it and I would argue that I am phat rather than fat.

            3. KayMarie says:

              https://www.youtube.com/watch?v=pHENaXJOFt8

              about 6:10

              From Wikipedia

              Flush, Flush, Sweet Helga [1.7]

              Debbie: [gasps] Crashers! and that fat girl has my locket!
              Helga: Debbie! It’s Me, your best friend, Helga… and I’m not fat, I’m zaftig.

              1. KayMarie says:

                For WLU, should have been up thread, and it is wikiquote not wikipedia. :-)

              2. WilliamLawrenceUtridge says:

                Awesome :)

  14. Ken Pidcock says:

    That has changed and there is some suggestion that as the number of partners has declined along with an increase safer sex, HIV may have become more virulent. With less opportunity to be passed on, only the more infectious/virulent strains survive, although HIV maintains the same mode of transmission.

    I’m confused by this. Conventional evolutionary theory suggests that virulence should be selected for when opportunities for transmission are abundant and host health is unnecessary to the reproductive success of a parasite. I’m not questioning what Crum-Cianflone et al. have measured, just pointing out that it’s somewhat counter-intuitive.

    1. Andrey Pavlov says:

      I’m confused by this. Conventional evolutionary theory suggests that virulence should be selected for when opportunities for transmission are abundant and host health is unnecessary to the reproductive success of a parasite.

      No, you are thinking of conventional evolutionary theory wrong. If there are fewer chances for transmission then only themost virulent strains (which mutate by chance and genetic drift) will be likely to continue infection. The lower virulence strains will simply die out (with their hosts) and the remaining population (and new hosts) will necessarily harbor the more virulent strain.

      In times of abundant opportunities for transmission then the strain with less virulence will be selected for. Because statistically speaking those that let their hosts stick around more to keep giving opportunities for transmission will propagate and become a larger percentage of the total population of HIV out there.

      Now where you may be getting confused is that in times of abundant transmission the absolute number of both more and less virulent strains will be higher – but that is simply because more people will be infected. But the proportion of more to less virulent will be different. In “lean times” (if you will) the absolute numbers of both will be decreased, but of the ones remaining (and, more importantly, the ones doing the infecting and creating new HIV positive individuals) will be will be a much higher proportion of more virulent strains.

      So in the times of fewer partners and safer sex your overall risk of contracting HIV is lower but the risk of contracting a more virulent strain is higher.

  15. WilliamLawrenceUtridge says:

    Incorrect. Improve sanitation and nutrition, remove drugs and life spans would be longer and better.Yeah…most third-world countries, in particular most people in the countryside, aren’t getting better sanitation or nutrition, and they still face rock-bottom levels of infectious diseases that are vaccinated against. Your argument is shit. According to you, these people should be living longer than Americans and Europeans because they get no drugs at all – yet somehow they don’t. They die, much younger and much more often. Your explanation?

    Dr. Hall write “Babies in the US routinely get antibiotics on the first day of life to prevent devastating gonorrheal eye infections, but the risk is low today. In Sweden, they are not treated, and there is no effect on the rate of infection. Perhaps we should reconsider.” (This is the evidence based practice Dr. Novella likes to write about – what was the % ).

    What’s your point? An honest re-evaluation of the clinical literature is a healthy part of medical science. It can’t happen overnight and it must be based on an exhaustive review – which takes time. It’s always retrospective. You seem to be blaming medicine for not being able to see the future.

    You contradict yourself and all those who write on behalf of SBM. In the past people took drugs and died because of them, left alone they would have been ok. Recall the cholera and the flu epidemics of the 19th and 20th century.

    So…people didn’t die of cholera or the flu in the 19th and 20th century? Or they didn’t take drugs? Or they did? You’re unclear. And the 19th century is a bad time to look at medicine – science had disproven many of the historically-held beliefs about medcine and biology, but hadn’t come up with any new theories or treatments to fill the gap. In the 20th century, meanwhile, we’ve seen lifespans double and triple, and infant mortality plummet, because of medicine.

    Also, if people were fine with cholera and influenza in the past, we would never have to worry about them and there wouldn’t have been city-paralyzing epidemics. There were. Stop getting your history from the homeopaths.

    Most drugs compromise immunity. Read “ Antibiotics vs. the Microbiome” carefully, “and the possibility that antibiotics may have a causal role in several of the so-called diseases of civilization.” Which names of diseases would you like to take out and which names would you include in this list?

    Some drugs compromise immunity. Oral antibiotics are a special case because of the microbiome, but even there – you are essentially trading a reduced risk of immediate death for a possible increased future risk of later autoimmunity or perhaps gut disturbance. Something you only know about because of medical science, thanks. But while the microbiome might play a role in the diseases of civilization, so do many other things. Pretending it’s simple, and pretending homeopathy works, doesn’t make it true.

    1. Iqbal says:

      WilliamLawrenceUtridge

      …… According to you, these people should be living longer than Americans and Europeans because they get no drugs at all – yet somehow they don’t. They die, much younger and much more often. Your explanation?….

      Japanese live longer than Americans: they live in similar clean conditions, have access to proper food and take less drugs.

      “This is precisely the reason for death and disability rates to plummet in Israel recently when doctors struck work for three months. Similar experience was reported from Saskatchewan in Canada twenty years ago and from Los Angeles country ten years ago when doctors went on strike. There has been hardly any difference in the per capita deaths due to chronic myeloid leukemia at the Christy’s Hospital, Manchester, during the two time slots, 1900-1940 and 1950-1990, although there were sea changes in our approach during the latter period.” (http://www.bmhegde.com/bmh/usearticle1.php?id=11)

      ….What’s your point? An honest re-evaluation of the clinical literature is a healthy part of medical science. It can’t happen overnight and it must be based on an exhaustive review – which takes time…..

      Considering the process in the first place should have been evidence based (Steve Novella: are you listening) how come the review is 180 degrees opposite?

      ..And the 19th century is a bad time to look at medicine… In the 20th century, meanwhile, we’ve seen lifespans double and triple, and infant mortality plummet, because of medicine….

      Would you like to reconsider the 20th century as the time to look at medicine?

      Remember Dr. Lucien Leape of the Harvard Medical School in 1994 and Barbara Starfield in the year 2000 (JAMA 2000;284:483-485) were counting over hundred thousand dying of adverse drug effect and ” three million injuries due to medical interventions in a year with 44,000 to 98,000 deaths annually. Nosocomial infections alone caused 80,000 deaths in one year in hospitals. One hundred million people suffer from chronic debilitating illnesses partly due to medical interventions.” This was for USA only. (The world population is a 100 times USA or is it 500 times?)

      ……Also, if people were fine with cholera and influenza in the past, we would never have to worry about them and there wouldn’t have been city-paralyzing epidemics. There were. Stop getting your history from the homeopaths…

      I agree. If people followed homeopathy, trillion of dollars of trade would vanish.

      … But while the microbiome might play a role in the diseases of civilization, so do many other things. Pretending it’s simple, and pretending homeopathy works, doesn’t make it true…

      What does your science say? The science does not know human body but it surely can comment on homeopathy. Homeopathy looks at the overall effect in the patient.

      1. Chris says:

        Do keyboards in India lack a quotes key?

        Iqbal, please show that homeopathy is effective for curing bacterial infections, and is better for cholera.

        Also prove Andre Saine’s contention that homeopathy is better for rabies than the modern vaccine.

        Also provide evidence that homeopathy is effective for either preventing or curing malaria.

        Why are you ignoring my questions?

        1. Iqbal says:

          Chris

          Our family migrated to India in 1945 and started with agriculture as our livelihood. There were many villages near our farmland. In the family we had a homeopathic doctor.

          It was common for the womenfolk to deliver babies at home and end with septic fever for want of hygienic delivery. You have some idea of septic fever? Temperature is up to 104 deg F in short period and the patient ends up with delirium – and many women died for lack of proper medicine.

          The homeopathic medicine: Pyrogenum 200 – 2 doses. The woman would be working in the fields within a week of being sick after delivery.
          Delivery deaths stopped in the villages and to be fathers would keep the medicine with them in advance.

          1. Iqbal says:

            Please read medicine as “Pyrogenium 200″.

          2. Chris says:

            Argument from blatant assertion is useless, answer my questions with real evidence.

          3. WilliamLawrenceUtridge says:

            How many people took Pyrogenium 200 and died afterwards?

          4. Andrey Pavlov says:

            The homeopathic medicine: Pyrogenum 200 – 2 doses. The woman would be working in the fields within a week of being sick after delivery.
            Delivery deaths stopped in the villages and to be fathers would keep the medicine with them in advance.

            Let me posit a story.

            100 women who are sick in the fields go and see this homeopath and get Pyrogenum 200. 80 of them die, 15 of them mostly recover and 5 of them are perfectly fine later on.

            You heard the story from 1 of those 5.

            1. Harriet Hall says:

              Here’s another story: 100 women don’t get any treatment and 5 of them recover completely. You never hear about them.

              1. Iqbal says:

                Andrey Pavlov

                “100 women who are sick in the fields go and see this homeopath and get Pyrogenum 200. 80 of them die, 15 of them mostly recover and 5 of them are perfectly fine later on.

                You heard the story from 1 of those 5.”

                The death rate dropped to zero for the woman who got the medicine.

                It is easy to talk about science based medicine when poor people are dying long distance in Africa. If the virus reaches New York, Beijing, Bombay, London or any such location, then I would like to see the reaction towards any alternative medicine that can make a difference.

              2. Andrey Pavlov says:

                The death rate dropped to zero for the woman who got the medicine.

                That sentence is completely meaningless. You can’t have a rate with a single individual and a single instance.

                It is easy to talk about science based medicine when poor people are dying long distance in Africa. If the virus reaches New York, Beijing, Bombay, London or any such location, then I would like to see the reaction towards any alternative medicine that can make a difference.

                You can bet your bottom dollar I will not be exploring any alternative medicine in that (or any) instance.

              3. WilliamLawrenceUtridge says:

                The death rate dropped to zero for the woman who got the medicine.

                Two points:

                1) It was a lactose pill, not medicine
                2) What was the original N of the trial? How many women ended up taking the pill? And how old were you at the time – is it possible that you were a child and people simply didn’t tell you about all the dead women accumulating?

                It is easy to talk about science based medicine when poor people are dying long distance in Africa. If the virus reaches New York, Beijing, Bombay, London or any such location, then I would like to see the reaction towards any alternative medicine that can make a difference.

                I would like to see any alternative medicine make a difference, so real doctors could use it. But in my opinion, desperation doesn’t justify quackery.

      2. Sawyer says:

        Ah yes, the Death By Medicine gambit. Thank you so much Iqbal. None of us were aware of this. It’s literally never been covered by authors on this site or commenters, and is totally not taken out of context in a deliberate attempt to obscure the facts.

        I honestly wonder if you’re being taught how to use the internet by a 95 year old. Can you not use a search box to reveal that we’ve had these discussions hundreds of times, and that this talking point has never yielded the conclusions you claim it reveals?

        1. Chris says:

          It is the old boring: There are problems with real medicine, therefore homeopathy works. Which is incredibly silly.

          If you want to prove homeopathy works, he has to show it actually works for real diseases. You will note he has not bothered to provide any evidence of that.

          1. Iqbal says:

            Chris

            “It is the old boring: There are problems with real medicine, therefore homeopathy works. Which is incredibly silly. ”

            There are NO REAL MEDICINES. Only drugs.

            Once you understand this, you will start to understand medicine.

            1. Jopari says:

              Physiotherapy, surgical intervention, and other methods exist, I hope you don’t need citation to find that. Medicine is more than drugs.

              Next, what on earth does your statement have to do with anything?

              Oh, medicine isn’t useful at all, the prevention of deaths was caused by some arcane methods unknown and unacknowledged by science that have failed all scientific methods to test it. Our life expectancy didn’t double from medicine and treatment.

              I’m sorry to say, you don’t understand jack about what you’re saying.

            2. WilliamLawrenceUtridge says:

              There are NO REAL MEDICINES. Only drugs.

              Iqbal, you can keep saying this, but at best it means you are using a term in a way nobody else will understand. You’re not being convincing here, you are reinforcing the point that your definitions of terms are different from everyone else’s and a careful examination of them reveals that you are simply engaging in a “no true scotsman” argument. If you define “medicines” as “not drugs”, unsurprisingly you will not reveal any drugs that have medical benefits. But if I redefine “death” as “a state of living”, everyone doesn’t suddenly become immortal. It just means I am wrong.

              At worst, you look like a nutjob with mental issues.

              And in the middle, you look like a conspiracy nut.

      3. WilliamLawrenceUtridge says:

        Japanese live longer than Americans: they live in similar clean conditions, have access to proper food and take less drugs.

        The Japanese are ethnically and genetically homogeneous (one of the most homogeneous on the planet), and consume a wildly different diet than most Americans. In addition, there is a lot of shaming for “fat daughters”, a lot more walking, and are generally a leaner society. So yeah – they live longer, by employing principles that are recognized as vital to human health but ignored by most patients. If more Americans ate and exercised like the Japanese, they would live a lot longer and need fewer drugs.

        You’re confusing correlation and causation. They aren’t in better health because they take fewer drugs – because they are in better health, they take fewer drugs.

        Your link to Hegde’s page didn’t link to a specific statement, so I can’t consult his references to verify he isn’t simply lying. But a quick google shows that he cites no sources. So is he even accurate? Or simply lying?

        Remember Dr. Lucien Leape of the Harvard Medical School in 1994 and Barbara Starfield in the year 2000 (JAMA 2000;284:483-485) were counting over hundred thousand dying of adverse drug effect and ” three million injuries due to medical interventions in a year with 44,000 to 98,000 deaths annually. Nosocomial infections alone caused 80,000 deaths in one year in hospitals. One hundred million people suffer from chronic debilitating illnesses partly due to medical interventions.” This was for USA only. (The world population is a 100 times USA or is it 500 times?)

        Would all of those patients have survived with no treatment?

        Were there others getting the same treatment who survived?

        You are pointing out a need to reduce iatrogenic harms – but that’s not proving in any way that all medicine is a net cause of harm. That’s your assumption, and a common one for those who like placebo treatments.

        What does your science say? The science does not know human body but it surely can comment on homeopathy. Homeopathy looks at the overall effect in the patient.

        But the treatment is always the same thing – a series of small lactose pills sprinkled with water that is allowed to dry, that have no effects on the body.

        1. Iqbal says:

          WilliamLawrenceUtridge

          “The Japanese are ethnically and genetically homogeneous (one of the most homogeneous on the planet), and consume a wildly different diet than most Americans.”

          What is the explanation of higher life expectancy for people from Singapore (mix of Chinese/Indians/Asians), Italy(bad eating habits), Spain, France, Australia and another 33 countries? (http://en.wikipedia.org/wiki/List_of_countries_by_life_expectancy)

          ” If more Americans ate and exercised like the Japanese, they would live a lot longer and need fewer drugs.”

          Italians eat as badly as Americans, spend less on drugs and still live longer!

          “You’re confusing correlation and causation. They aren’t in better health because they take fewer drugs – because they are in better health, they take fewer drugs.”

          If lifestyle is more important than drugs, on what basis do you link life expectancy to drugs?

          “Improve sanitation and nutrition, remove drugs and life spans would be longer and better.” This is Japan’s philosophy.

          “But a quick google shows that he cites no sources. So is he even accurate? Or simply lying?”

          You cannot even google.

          “Would all of those patients have survived with no treatment?Were there others getting the same treatment who survived?”

          I have sent a message to Dr. Leape to come on this site and apologize to you for his errors. You should also visit the site and remind him for the apology due to you. http://www.hsph.harvard.edu/lucian-leape/

          ” In 2006, Modern Healthcare named him as one of the 30 people who have had the most impact on healthcare in the past 30 years. In 2007, the National Patient Safety Foundation established the Lucian Leape Institute to further strategic thinking in patient safety.”

          It seems you need to know more about modern health care.

          1. Chris says:

            Where is the evidence supporting Andre Sainte’s claim that homeopathy works better for rabies than modern vaccines?

            What real proof is there that homeopathy is effective for malaria?

          2. WilliamLawrenceUtridge says:

            What is the explanation of higher life expectancy for people from Singapore (mix of Chinese/Indians/Asians), Italy(bad eating habits), Spain, France, Australia and another 33 countries? (http://en.wikipedia.org/wiki/List_of_countries_by_life_expectancy)

            Again, there are considerable differences in diet and exercise (the traditional Italian diet is quite high in olive oil, fresh fruits and vegetables, and tomatoes, and the Italian lifestyle incorporates a lot of walking by the way). Not to mention, they all have public health care options and the United States doesn’t – so one might say “access to drugs is what explains their higher life expectancies”.

            Italians eat as badly as Americans, spend less on drugs and still live longer!

            According to whose definition? The Italian diet involves a lot of home cooking, even in restaurants, using fresh ingredients and a lot of fruits and vegetables. Their cities are also much more walkable – in fact they are often downright painful to drive in. Venice barely has roads! So the diet and exercise habits of the two countries are very, very uncomparable, to the point where it is recommended that Americans adopt a Mediterranean diet like the Italians eat, to improve their health.

            If lifestyle is more important than drugs, on what basis do you link life expectancy to drugs?

            I don’t, I think lifestyle is much more important to overall health than drugs – which is why doctors recommend eating well and exercising so strongly. Drugs, however, are good for helping people with terrible lifestyles live longer. You seem to think that I believe people should eat hotdogs and potato chips, as long as they take drugs at the same time. This is wrong. People should eat a diet rich in fresh fruits and vegetables and exercise regularly, which will reduce the number of drugs they need to take to maintain their health. Having access to drugs is correlated with having access to doctors, health care, clean water and food, good infrastructure and general wealth however.

            “But a quick google shows that he cites no sources. So is he even accurate? Or simply lying?”

            You cannot even google

            My expectation is that a scholarly source gives citations for a claim. If I have to google to confirm the things they are saying, then it’s not a scholarly source and isn’t worth spending time on. It’s not my fault that Hegde is an incompetent scholar, but it is your fault for citing him with a straight face.

            I have sent a message to Dr. Leape to come on this site and apologize to you for his errors. You should also visit the site and remind him for the apology due to you. http://www.hsph.harvard.edu/lucian-leape/

            I have no doubt that Dr. Leape is a brilliant and diligent scholar – certainly his work on iatrogenic harms is necessary and recognized by the medical community (which is why medical school and practices have systems in place to monitor and reduce iatrogenic harms). The problem isn’t with Dr. Leape’s work – the problem is with your interpretation of it. You seem to claim that Dr. Leape’s work justifies the belief that “iatrogenic problems are so damaging, medicine ultimately does more harm than good.” His work does not substantiate this belief. His work substantiates the belief that iatrogenic harms are a substantial problem that requires time and resources to reduce. It does not prove that medicine actually kills more than it saves.

            Can you find any quote by him where he explicitly says “the world would be better off without medicine”? Or is it more like “the world needs better medicine”? I’m thinking it is more the latter, perhaps he will appear in the comments to correct one of us.

          3. simba says:

            Coming from Ireland, we are a nation of pill poppers, I would say most people I know get antibiotics when sick, take painkillers whenever they have a headache, and many many people are on prescription drugs. Most elderly people are on one or more drugs.

            We do pay less, individually, because the government has a drugs payment scheme: “Under the Drugs Payment Scheme, an individual or family in Ireland only has to pay €144 each month for approved prescribed drugs, medicines and certain appliances for use by that person or his or her family in that month.”

            “If you are ordinarily resident, you are entitled to either free or subsidised approved prescribed drugs and medicines and certain medical and surgical aids and appliances.”

            http://www.citizensinformation.ie/en/health/entitlement_to_health_services/prescribed_drugs_and_medicines.html

            1. Andrey Pavlov says:

              @simba:

              A very random comment…

              It seems that in my head I tend to keep a rather neutral “voice” in reading comments from others, without much thinking about whether the commenter is a male or a female. Recently learning that both you and whoa are female was about 3 seconds of pause in that I had not considered what sex you were followed by a slight change in the “voice” in my head when I read your comments.

              Now that you say that you are Irish as well, that voice has gained an accent.

              I don’t know if you actually have one or not, but I’m just going to assume you do, since I find the Irish accent (particularly a woman with one) rather pleasant.

              Which also ended up reminding me of this this. LOL.

              1. Thor says:

                Funny what a ‘random’ comment can generate.
                I just can’t stop laughing and it’s really starting to hurt!

                Morrison’s “Soft Parade” on full display.

                Up till now haven’t had many visuals, mainly impressions of what kind of person you might be by the writings. It’s often fairly apparent.

                @ Simba: Truth be told – I AM (just) Thor.

                @ mouse: Your screen name seems perfectly apt – despite your obvious humility and modesty (not demureness), you can give any feline predator a run for its money. Still waiting for that photo.

                @ Andrey: How can anyone be so friggin’ handsome yet so friggin’ smart?! (Not to denigrate all the fabulous-looking Einsteins.)

                @ WLU: It’s next to impossible for me to connect a high-pitched, “feminine” voice to you, as your admirably testosterone-filled, incisive, and always enjoyable mini-dissertations boom otherwise. Sure wasn’t a surprise to hear of your Hendrixian-size organ (“like an anaconda head swinging in the wind” – Hicks).

                @ n Brownlee: Can’t shake the nature-girl image. Wholesome, kind of “earth-mamaish”, not much make-up, not too concerned with ostentatious manner of dress, lack of pretension.

                @ Windriven: Your wit and verbal acuity totally surpasses image, although Alan Alda could work, or a more robust (BMI 30) John Oliver.

                @ KayMarie: Thank Darwin for well-informed people willing to share the facts!

                Regardless, wish I could hug you all (although I’d only reach your waists ;-) )

            2. simba says:

              Andrey Pavlov- I can nearly guarantee you’re not reading it in my accent, I have a particularly boring Irish accent.

              I find I attribute particular voices to commenters over time, but they don’t actually have anything to do with, well, anything. I just noticed this since you commented on it. WLU is very deep-voiced, for some reason.

              Oh, and the relevance of my comment about Ireland- I forgot to draw the explicit link. Maybe our longer life expectancy compared to the U.S. is related to our provisions for medication for the sick? And the idea, although it isn’t consistently carried out, that the government has an obligation at least try to provide some sort of safety net for some of its citizens.

              1. Andrey Pavlov says:

                @simba:

                I have no doubt I am not reading in in yours. But there is one now nonetheless. Though I don’t know what a “boring” Irish accent would be.

                But it is interesting how we attribute a voice to the written word of others. In thinking more on it I think the voice I have for most commenters here is simply the standard one I use for my internal monologue (in other words, I read other comments in the same voice I hear as I write my own, which seems entirely neutral to me for some reason).

                As for your link… seems reasonable and plausible. Most countries that have a public health system seem to do better than we do, after all.

              2. WilliamLawrenceUtridge says:

                Three points:

                Andrey, stop hitting on simba unless you’ve a pre-existing allowance for polyamory with your fiancee. It’s tacky otherwise.

                Simba – don’t lie. There is no such thing as an unsexy Irish accent. It’s tacky.

                I just noticed this since you commented on it. WLU is very deep-voiced, for some reason.

                Ironically, it’s quite the opposite. I get called “ma’am” on the phone on a regular basis. Happened yesterday in fact. It’s one of the reasons why I don’t argue in person (the other reason is it’s easier to give a thought-out point-by-point in rebuttal). But I’ll take the implied compliment that my remarks contain gravitas.

                I do have enormous genitals though, if anyone was wondering.

                One final point – I was watching Jesus of Montreal one time, French with subtitles. At near the end of the movie, they switched to English, and I had an incredibly jarring experience of hearing all those pure, unaccented English people I’d read suddenly having thick French accents. It was a bizarre and startling experience.

                But let’s not distract ourselves from my enormous genitals. My scrotum alone can hold a basketball. Sometimes I use it as a blanket for my cat.

              3. Andrey Pavlov says:

                Andrey, stop hitting on simba unless you’ve a pre-existing allowance for polyamory with your fiancee. It’s tacky otherwise.

                LOL. An Irish accent (and Irish women) are indeed sexy. And I need to agreement of polyamory to make such a simple statement of fact.

                But I do apologize if it seemed like I was trying to hit on you Simba. It was not my intent*.

                But let’s not distract ourselves from my enormous genitals. My scrotum alone can hold a basketball. Sometimes I use it as a blanket for my cat.

                Three points:

                1. Not everyone likes huge genitals

                2. I’m not a urologist but if you were my patient I’d refer you to one.

                3. That is playing with fire. Cats have sharp claws and teeth.

                *Though I think it is probably just WLU taking the piss.

              4. WilliamLawrenceUtridge says:

                Sometimes when I try to take a piss on my cat, because of my firehose-like penis the cat ends up waking up from her nap by the time I take the piss.

              5. simba says:

                There was a nice civilized conversation going on and then YOU showed up…

                WLU- you have clearly never ever been to Ireland. There are many unsexy Irish accents.

                I am duly impressed by your firehose-like penis. And somewhat sorry for your cat.

              6. KayMarie says:

                Simba, it may be a matter of proximity and familiarity as to whether one finds some characteristic exotic and sexy or mundane and unattractive.

              7. WilliamLawrenceUtridge says:

                It dismays me that you haven’t acknowledged the simple truth that all Irish accents are sexy. There’s no wiggle room here people, stop trying to make it wiggle.

                And yes, I am very good at uncivilizing civilized conversations. My apologies.

              8. Thor says:

                As is par for the course for me, I just posted under Andrey’s first ‘random’ comment instead of under simba’s.
                Tell you what – this is one hell of a confusing site for commenting, as it’s sometimes all just a jumble of numbers.

                Anyway, I wanted to add that I didn’t want to leave the readers in general with the impression that this site is about a closed group – a clique, if you will – of insider’s cozying up with each other and stroking egos. I sincerely appreciate ALL the comments, even many with contra-viewpoints. It’s just that the subjects discussed and analyzed on SBM are weighty and intensely serious. A lot of mental effort is given, not only to read the posts, but to comment (read Andrey’s and WLU’s , or Peter Moran’s, for just three examples). This thread was just a bit of personal, light-hearted relief. With frequent interaction a fondness naturally gets generated. It simply broke into this display of affection.

            3. mouse says:

              Why was I reading about Chinese plagues, when clearly the good reading is in ebola. Jeez!

              I can’t help but add to the random comment, I hear only one standard interior voice when reading comments. (I can’t even hear a Irish accent…well maybe a rather vague Fiona Ritchie, If I want Scottish I have to go to David Tennant’s – Doctor Who)

              I do get a picture of the commentor though, and you are all gorgeous*. Unfortunately the picture is almost always male, until I find out otherwise, then it usually shifts for me. Sometimes it’s, I think, arbitrarily female (but maybe I’ve just picked up a clue without realizing it.) Any other visual information, gets worked into the picture in unpredictable ways. Regardless, the picture is NEVER accurate and it’s very jarring when I meet someone or see a picture of someone who’ve I’ve spoken with online. I suspect this very common, but possibly not, maybe I’m just weird.

              WLU is often “deliberately” screwing with my picture. first he resembles a sandy haired version of an old friend of mine** who was a construction worker and looked like a body builder, then he resembles a skinny naked guy with a big adams apple and scrotum draping down to his knees (small penis, though. I guess my subconscious is isn’t taking his word for that).

              It’s kinda strange, delightful and distressing how the mind works.

              *Either hollywood has impacted my imagination or my subconscious is very shallow and just likes to live with the beautiful people.

              **This was actually the boyfriend of a good friend of mine. We were all in our 20s. A group of us would all go out to the bar, then go to their place and sit around and get stoned and watch Warner Bros cartoons. We used to joke that this friend looked like Foghorn Leghorn. He died in a hunting accident. Fell out of the tree he was using as a deer blind. Strange, because their personalities are, on the surface, nothing alike, but I’ve tried to replace other visuals and it doesn’t take. I think there is a sort of gleefulness that they have/had in common that sorta sticks.

              1. n brownlee says:

                I think you look like Carol Kane, about 1975-1980. I think Windriven looks like Steve Buscemi.

              2. Windriven says:

                More like Marty Feldman, actually.

              3. mouse says:

                I always wanted to look like Carol Kane, or any of the other pixie type actresses. Unfortunately, I have the soul of a pixie in a proletariat body.

                eg http://fineartamerica.com/featured/russia-soviet-poster-1920-granger.html

                I’m the one with the hammer.

              4. n brownlee says:

                @Mouse
                I have quite similar shoes.

              5. mouse says:

                Windriven always comes up kinda like a cross between Alan Alda and my father in law only younger.

                n brownlee – Sorta like Susan Sarandon only with short wispy hair cut, with side part bang swept across forehead.

              6. n brownlee says:

                @Mouse
                I’ll take it- with grateful thanks!

              7. simba says:

                For some reason N Brownlee comes up as very strongly blonde for me.

                Mouse is a librarian with glasses and a pixie cut. Based loosely on a teacher of mine who used to be cuttingly sarcastic over her glasses.

              8. WilliamLawrenceUtridge says:

                WLU is often “deliberately” screwing with my picture.

                Yes, very much so. There was a comment a while back where I actually described myself as Steve Buscemi with 36-inch biceps and a pronounced limp. That was a lie. Picture me more as Brad Pitt with Alec Baldwin’s hair, Ben Kingsley’s nose, David Borneaz’ abs, and Liz Lemon’s hands.

                Also, I dress like a French waiter/prostitute.

              9. Windriven says:

                Perhaps one day SfSBM will have an annual and we’ll all get to burst our fantasies :-)

              10. mouse says:

                @Simba

                You WERE a professional version of a previous male coworker who had sandy hair a wry grin and was known for his calm in a crisis*. He was inclined to t-shirts and flannel shirts**, but for you – I saw more casual office, khaki’s and a blue button shirt.

                Now you are more like this http://www.flickr.com/photos/40051317@N05/6441633987/
                But still sandish hair. Sorry, I’m guessing the proportions are wrong, but – shrug.

                I do wear reading glasses alot these days and the sarcasm is undeniable. So you are definitely on the right track.

                *Well as much as graphic designers can have crisis.
                **Our dress code was “You must wear shoes.”

                @WLU – That’s much better, now you are Adrian Brody in a black suit and one of those extra long waiter’s aprons that you see in really sheshe restaurants. Actually that doesn’t work. I don’t think it will stick. Seth Rogen? You look like Seth Rogen, don’t you?

              11. mouse says:

                @windriven – To be honest, If there was ever a SfSBM event close enough for me to get to I would creep in the back door, stand as out of the way as possible trying to figure out if I knew anyone, then sneak out again for fear that I’d have to talk to someone and would inevitably say something stupid. That’s how I roll.

              12. WilliamLawrenceUtridge says:

                Very close, imagine Seth Rogen, with a beard, but as a woman. And don’t forget the 36-inch biceps, basketball-containing scrotum, and firehose penis.

                Also, you’ve just given us all the information we need to identify you at the SfSBM conference…unless it’s a trick? IT’S A TRICK, ISN’T IT!?!?!?!?!

              13. n brownlee says:

                @WLU You have described Wonder Warthog. Not that there’s anything wrong with that.

              14. mouse says:

                I could be right. WLU. Maybe It’s a trick. Now I’ve updated the link to include a real picture of myself.

                I’m not really worried about being recognized. I’ve got profound wallflower skillz.

                And by the way, I think you just described Seth Rogen, only with more detail.

                I’m feeling bad now because I never realized how white my subconscious was, ick. I need to stimulate some racial diversity back there.

              15. WilliamLawrenceUtridge says:

                That constructive spirit link doesn’t let me look at anything by the way, the images aren’t public.

                And it’s always a trick.

              16. mouse says:

                @WLU “But it’s so simple. All I have to do is divine from what I know of you: are you the sort of man who would put the poison into his own goblet or his enemy’s? Now, a clever man would put the poison into his own goblet, because he would know that only a great fool would reach for what he was given. I am not a great fool, so I can clearly not choose the wine in front of you. But you must have known I was not a great fool, you would have counted on it, so I can clearly not choose the wine in front of me. ”

                Hm, and I was so proud of myself for embedding a link. I guess the technology gods decided I should be more discreet.

              17. n brownlee says:

                @Mouse
                If one of those pictures is you, I think you’re mean not to say which one. You’re all cute, anyway.

              18. Thor says:

                This may be the best thread ever on SBM!! The creative, personal comic relief is endearing and wonderful. I’ve developed much affection and fondness for all of you. Gush.
                Regarding Windriven’s annual, someone wise once said to never meet your heroes in person, otherwise the disappointment will be overwhelming.

                And I can’t even come up with anything. Other than to say that “Thor” is just overcompensation for my meager physical presence. I’m practically a midget at 4’8, but strangely with a deep baritone, and balding with a hefty bread-belly, and eyes that meet too close to the center of my face. Evolution gone awry (but it’s the heart that counts).
                Oh (to follow WLU’s brave revelation), and my penis is a measly 3”. Erect. Okay, I lied – 2 3/4”. But, I’ve been told on not too rare occasion that I make up for all of this – even the teensy member – with movements that even make grandmothers scream in ecstasy. See! You can’t judge a book by its cover.

              19. Andrey Pavlov says:

                @Mouse:

                You are clearly that cute puppy with the glasses. From henceforth that will be the mental image I get whenever I read your comments. If the comment is particularly good a mouse in a top hat with a cane dancing off stage will appear.

                Funny thing. If you google image search my name you will see many very unique, interesting, and cool pictures involving ants. If you add my title (as either a prefix or suffix) there are actually pictures of me. One from 2008, one from 2012, and one from 2013. Interestingly you will also find a picture of my best friend who also happens to have co-authored two posts with me here on SBM.

                Oh. And if you look up my posts here you will see a picture of me as well. So much for being mysterious and clever.

              20. simba says:

                Mouse- aww, that is so flattering! Both versions, actually.

                I am a short 30DD pale-skinned Irish redhead.

                The funny thing is I actually am, but I do not look like the above description sounds. Think more something out of ‘gremlin’. Actually, don’t, keep your original picture, it sounds much nicer.

                And I always picture you with mouse-coloured hair, for obvious reasons. It’s okay, I am the same at social gatherings, we can hide at the back together. Maybe a SFSBM convention could have screens where we could all sit and type to each other- ease ourselves into actual human contact, as it were?

                I am interested as to what a French waiter/prostitute dresses like. And is this a common job combination?

                Now WLU looks like a mishmash of body parts sewn together, with a deep voice.

                Andrey Pavlov is a mysterious Russian blonde with longish hair, glasses, and delicate features. Apologies, you are probably not Russian in any way.

                Windriven has a very very cheeky grin, combined with a generally sophisticated appearance (usually a well-tailored suit). Kind of James Bond mixed with Stephen Fry.

              21. Andrey Pavlov says:

                Andrey Pavlov is a mysterious Russian blonde with longish hair, glasses, and delicate features. Apologies, you are probably not Russian in any way.

                Well, I was born a Soviet citizen, I do have longish hair (it has changed a number of times in the last few years though: short and spiky before med school, shaved my head bald in the 1st year of med school, then didn’t cut it again till 3rd year so I had shoulder length hair, then back to short and spiky, and now longish), I used to wear glasses until I got pew-pew lasered in the eyeballs some 12 years ago. But I am certainly not blond and I am not sure what “delicate features” are but I am pretty sure I don’t have those either. LOL.

                My father was blonde haired and blue eyed (and Russian) but I have all the dominant Mediterranean genes from my mother (who is Bulgarian). So I tan well and rarely burn, even without sunscreen (which my fiance is very jealous of) and have dark hair and brown eyes.

                As I said though you can actually find out what I look like if you are interested – look up my guest post here or google image search me. However, only one picture you can find has my current hair style except for one and that is in the google search.

              22. simba says:

                Andrey- I think I was reading Saki one day before SBM and that influenced it. He specializes in descriptions like that.

                I find it interesting how people’s ideas about other commenter’s looks are formed. In a way it’s interesting that we form ideas about commenter’s looks or voices at all. Like Mouse having mouse-coloured hair is obvious. But where did all the other things come from?

                Thor- I didn’t mention this, but you are just Thor. Not the movie version, the picture I had in my head when I first read Norse legends.

              23. WilliamLawrenceUtridge says:

                For everyone attributing me a deep voice – the one thing I wasn’t kidding about was my voice. I really do get called “ma’am” on the phone on a regular basis. My voice is both shrill and nasal, it’s startlingly unpleasant to listen to.

                Also, my default pitch and measure is best described as “condescending”, which I’m sure nobody here will have any trouble believing.

              24. mouse says:

                @Simba – I’ve read your comment and you now look like Merida in Brave. I actually lobbied for a resemblance to another former coworker who is British with fair skin and red hair (with a great sense of humor, great designer, successful business leader) but my brain decided to go with Merida.

                Thor – Strange – I didn’t really have a good image on your face. Kinda a profile with blondish hair, receding hairline, kinda Peter Fondaish, and a close up on rather fine wrists with strong forearms. Then some fashion thrown in jeans, t-shirt, leather necklace with a shark tooth*, sandals. Your description didn’t cover these traits (shrug). The only thing that was a contradiction is that I did picture a big guy who sort of slouches to make himself not intimidating. I guess that’s a blend of your screen name and your persona.

                Guys – No offense, but the size of your penis is not integral to my mental image of you. Your fashion sense is much more important. I was actual far more concerned with mentally constructing pants in which WLU would be comfortable (luckily it seems a new version of MC hammer pants is coming into style). Not that I’m offended, but just FYI.

                *Look, I’m sorry – I’ve lived in the midwest all my life, there is a psychological toll. I hear red hair Irish woman I get Brave. I hear California, apparently that mean leather necklace with sharks tooth. This is why artist know NOT to go with their first impression when creating art.

              25. Andrey Pavlov says:

                I hear California, apparently that mean leather necklace with sharks tooth.

                Well…. a hemp necklace with a hand carved hook made of Koa with a small snail’s operculum found on Hook Island in the Whitsundays.

                But close enough I suppose ;-)

              26. WilliamLawrenceUtridge says:

                No offense, but the size of your penis is not integral to my mental image of you.

                A point needs to be made here – whenever a man talks about their penis, it’s always about buttressing self-esteem, less about trying to influence others’ perceptions of one’s self.

                Your fashion sense is much more important. I was actual far more concerned with mentally constructing pants in which WLU would be comfortable (luckily it seems a new version of MC hammer pants is coming into style). Not that I’m offended, but just FYI.

                I wear a lot of kilts. Since I’m also really hairy I just flip it over the top pretend it’s a sporran. You go through a lot of conditioner, but I’ve got a Costco membership.

              27. mouse says:

                Andrey – I actually knew what you looked like, from a picture you posted years ago. If my subconscious had thought of your hemp necklace it certainly would have used it, it’s much more authentic and sounds handsome.

              28. Andrey Pavlov says:

                Andrey – I actually knew what you looked like, from a picture you posted years ago. If my subconscious had thought of your hemp necklace it certainly would have used it, it’s much more authentic and sounds handsome.

                Ah yes, I recall that.

                And thanks for the compliment. The necklace does actually have some special meaning that I imbued it with given the coincidental timing of its receipt as my 25th birthday gift. I can count on 1 hand how many times I have taken it off since then (and I am getting long in the tooth these days at 31 ;-) ).

  16. mouse says:

    WLU “whenever a man talks about their penis, it’s always about buttressing self-esteem, less about trying to influence others’ perceptions of one’s self.”

    That’s good to know it may come in handy with mr. mouse and mouse-son.

    Also – kilts are great. I used to date a couple guy (at different times) that went in for skirts. They are the ultimate in comfort.

    1. mouse says:

      Shoot, I screwed up the threading.

      1. WilliamLawrenceUtridge says:

        You didn’t screw up the threading, you reset the conversation to a much more readable and functional arrangement – doubtless informed by your fine artistic instincts.

      2. mouse says:

        Thor “Anyway, I wanted to add that I didn’t want to leave the readers in general with the impression that this site is about a closed group – a clique, if you will – of insider’s cozying up with each other and stroking egos. I sincerely appreciate ALL the comments, even many with contra-viewpoints. ”

        I’m just putting this here, cause I’ve lost track of what goes where now.

        I enjoy the talk of medicine, scientific method and logic, but I have a general rule that when I have the opportunity to just chat about whatever topic with an interesting, intelligent person (or people), I just take it. It just gives life more flavor, I guess.

      3. Jopari says:

        Mouse, while I may agree with your sentiment on chit chat, I generally do not think it’s appropriate here, I mean, if someone actually has a legitimate concern, there is a lot I have to skip, since on mobile I can’t select individual comments and just skip to it. Not to mention that I may skip this thread normally, just my opinion of course.

        But heck, if you guys are keen on continuing, don’t let me stop you.

  17. mouse says:

    @Jopari – (shrug) Nope, I was done anyway. The thread is all yours.

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