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Echinacea and the common cold–Myth vs. Science

It’s getting close to winter once again, so people always recommend their various lotions and potions to either prevent the common cold or, at least, to reduce the course of the disease. Alternative medicine’s favorite disease to treat is the common cold, mainly because it’s an easy disease to handle without too many serious problems. Also, from the patient’s perspective, the length and seriousness of the cold is usually very subjective, since the patient has a difficult time making an accurate determination when the cold started or ended, and making a quantitative assessment of the seriousness of the disease. Moreover,  confirmation bias is usually the reason one hears that something worked for the cold–the person who reports some product works forgets all the times it doesn’t. Or completely misjudges the actual effects of any treatment.

The list of products that you might run across in your local pharmacy that claim to have an effect on the common cold are many. Zinc, oscillococcinum, garlic, and vitamin C. I wrote about these products last winter, and they mostly don’t work. The strangest cold remedy you might find is oscillococcinum, which is a homeopathic preparation derived from duck liver and heart, diluted to 200C, or 200 1:100 dilutions.  In other words, in a liter of water there are precisely no molecules of duck guts. And there isn’t any logical explanation of a possible mechanism that would allow one to conclude that duck offal has an effect on cold viruses. Though Oscillococcinum is supposed to be used for flus, many use it for colds, but it doesn’t matter, why would a diluted potion of duck guts cure any virus? Well, Cochrane Reviews concluded that ”current evidence does not support a preventative effect of Oscillococcinum-like homeopathic medicines in influenza and influenza-like syndromes.Read More »Echinacea and the common cold–Myth vs. Science

Mark Crislip’s Dumb Asses and Vaccines

It’s getting close to flu season, and it’s time to get your flu shot. Of course, there are myths for why people won’t get their flu shots. All of them are amusingly bad. 

Last fall, Dr. Mark Crislip published A Budget of Dumb Asses (requires a Medscape account) that takes on anti-science with a whole new level of snark. I have part of it here for you, thanks to Biodork’s (great name) Time for your flu shot! It’s all about getting (or not getting) the flu vaccination, but you can replace flu with any other vaccination. Apparently, he wrote it for health care workers, but hey, I think it works for patients too!

Mark Crislip starts out his snark with a quick statement about not getting a flu shot. You might be a dumb ass, if you’re unwilling to get the vaccine:

I wonder if you are one of those Dumb Asses who do not get the flu shot each year? Yes. Dumb Ass. Big D, big A. You may be allergic to the vaccine (most are not when tested), you may have had Guillain-Barre, in which case I will cut you some slack. But if you don’t have those conditions and you work in healthcare and you don’t get a vaccine for one of the following reasons, you are a Dumb Ass.

Read More »Mark Crislip’s Dumb Asses and Vaccines

Multiple immunizations weaken immune system–Myth vs. Science

If you peruse the back alleys of the antivaccination movement, you will find a wide variety of myths that try to convince people that vaccinating children is dangerous. Or if you don’t want to vaccinate your children, the information is easily available. It doesn’t take much effort on google to find websites that provide you with the . Those myths range from outrageous, such as it’s a conspiracy of the government to control population (which I find odd, since the government is barely competent enough to build a post office), to scientific sounding, but ultimately pseudoscientific claims. There are a lot of great websites that debunk many of the myths, and they’re easy to find. Read More »Multiple immunizations weaken immune system–Myth vs. Science

Vaccine to block gluten sensitivity in celiac disease

Celiac disease (also known as coeliac disease in British English speaking countries) is an autoimmune disorder that afflicts the small intestine of certain  individuals who are genetically predisposed to it. The disease afflicts between 1 in 1,750 and 1 in 105 people in the United States (or about 200,000 to 3,000,000 people) and usually, but not always, results in chronic diarrhea, low pediatric weight gain, and fatigue. This disease is caused by a reaction to a gluten protein found in wheat, and similar proteins found common grains such as barley and rye

Upon exposure to gluten, the immune system causes an inflammatory reaction of the lining the small intestine. This interferes with the absorption of nutrients. The only known effective treatment is a lifelong gluten-free diet. This disease should not be confused with wheat allergy, which is also caused by a reaction to wheat proteins.Read More »Vaccine to block gluten sensitivity in celiac disease

What is causing the fatal meningitis outbreak?

Over the past week or so, there have been numerous reports about a fungal meningitis outbreak that was traced to medicines associated with three lots of preservative-free methylprednisolone acetate produced by the New England Compounding Center.  The drug is an injectable steroid that is used for pain relief. The potentially contaminated injections were given starting May 21, 2012. Symptoms of the fungal meningitis include: fever, new or worsening headache, neck stiffness, sensitivity to light, new weakness or numbness, increasing pain, redness or swelling of the injection site. So far, 7 people in the US have died.

Because the drug is delivered via an epidural injection directly into the epidural space, any contamination can lead to a meningitis infection. In this case the steroid produced by the New England Compounding Center was contaminated with a fungus which caused the fungal meningitis. It’s important to note that unlike other types of meningitis, such as bacterial meningitis, it is not contagious. Fungal meningitis also does not have a vaccine, because it is quite rare. (Viral meningitis is less severe, and usually resolves itself without treatment.)

Data Table for Persons with Meningitis Linked to Epidural Steroid Injections, as of October 7, 2012

Read More »What is causing the fatal meningitis outbreak?

State legislatures making vaccine exemptions more difficult to obtain

Outstanding news. Tara Haelle reported in Nature News & Comment that US state legislatures are beginning to pass laws that make it more difficult for parents to obtain so-called personal exemptions to vaccinations before children attend public schools.

According to Haelle, “Each US state sets its own vaccination policies, and most will not generally allow children to attend public school unless they have been vaccinated against diphtheria, tetanus and pertussis (whooping cough); hepatitis B; the Haemophilus influenzae bacterium; measles, mumps and rubella; polio; and varicella (chicken pox).” In general, most states require that students meet the Centers for Disease Control and Prevention schedule (pdf) for children between 0 and 6 years old, which is set by the Advisory Committee on Immunization Practices.

All states allow legitimate medical exemptions from the immunization schedule, because of certain medical conditions that might make vaccinations problematic for young children. Some of these medical issues are: allergies to some of the components in the vaccines, immunocompromised conditions, family history of seizures, and other issues outlined in the General Recommendations on Immunization of the Advisory Committee on Immunization Practices.Read More »State legislatures making vaccine exemptions more difficult to obtain

The Placebo Effect–Myth vs. Science

Background

There has been a large uptick in interest about the so-called placebo effect, mostly from the complementary and alternative junk medicine (CAM) crowd. Evidently, they feel that being equivalent to doing nothing is good enough to be real. A recent article in the Wall Street JournalWhy Placebos Work Wonders, is indicative of this recent pro-placebo point-of-view.  

What exactly is the placebo effect? The definition is often misused, implying some beneficial effect from a sugar pill or sham treatment. But in medicine, a placebo is actually a failure. If a new pharmaceutical, procedure or medical device shows no difference in efficacy compared to a placebo, then it is rejected.  But the CAM-pushing herd thinks that proves its a success when one of its potions and lotions is equivalent to a placebo. What? A failure of a modality in evidence-based medicine is somehow converted into a successful product in the CAM world?

Read More »The Placebo Effect–Myth vs. Science

Protecting infants from whooping cough by cocooning

Infant being treated for pertussis infection. ©CDC, 2012.

This year, 2012, was one of the worst whooping cough (Bordetella pertussis) outbreaks in the USA for the past 70 years, which included an outright epidemic in Washington state. Some of the reasons for the spread of the disease were a reduced whooping cough (Dtap) vaccination rate and reduced effectiveness of the Dtap (or TDaP) vaccine. Whooping cough is a serious disease, especially to children under the age of one year old, who have not been fully vaccinated. According to the Centers for Disease Control and Prevention, of those infants who are hospitalized with pertussis about:

  • 1 in 4 (23%) get pneumonia (lung infection)
  • 1 or 2 in 100 (1.6%) will have convulsions (violent, uncontrolled shaking)
  • Two thirds (67%) will have apnea (slowed or stopped breathing)
  • 1 in 300 (0.4%) will have encephalopathy (disease of the brain)
  • 1 or 2 in 100 (1.6%) will dieRead More »Protecting infants from whooping cough by cocooning

Disappointing 2011 flu vaccination rates

The Centers for Disease Control and Prevention recently published a comprehensive analysis of influenza vaccination rates of the US population during the 2011-2012 season. Mostly, the numbers continue to be disappointing, even in groups that should have higher rates of flu shots, such as pregnant women and healthcare workers. These numbers continue to demonstrate the difficulty in increasing the vaccine uptake rate in the US.

Public health officials has been pushing to increase the flu vaccination rates of healthcare workers. The numbers are somewhat disappointing, but as more states mandate flu vaccinations for healthcare workers, the rate may improve. The CDC found that about 63.4% of healthcare workers had been vaccinated for the flu as of November 2011, an 8 point improvement over 2010. 

But, according to a report in NBC News, “the group that should have 100 percent vaccination is health care workers. The CDC data show that more than 86 percent of physicians are vaccinated, followed by more than three-quarters of nurses. But the numbers plummet to just half of workers in long-term care facilities, where patients are especially vulnerable to flu.”Read More »Disappointing 2011 flu vaccination rates