Archive #1 - Earlier Flu in the News1:
Older adults may be vulnerable to new swine flu virus
TORONTO — There may be a lot more vulnerability in the population to a new swine influenza virus than was first thought, new Canadian research suggests.
It has been believed that while children and teens are probably vulnerable to the new H3N2 variant, people over the age of 20 or so would have antibodies that would either block infection or protect against severe disease caused by the viruses.
But the new study suggests that while young adults do have antibodies that recognize the viruses, antibody levels start to drop sharply in middle-aged adults. When plotted on a graph, the decline is striking and suggests that the elderly may also be unprotected against this new flu virus.
Whether that's true or not remains to be shown. The study, published Thursday in the journal Eurosurveillance, only looked at blood samples from children 17 months to 10 years and adults aged 20 to 59.
But lead author Dr. Danuta Skowronski said the results suggest that if this new virus gets a foothold in humankind, it could sicken a lot more people than H1N1 viruses -- which also came from swine -- did during the 2009 pandemic.
Skowronski, an influenza expert with the British Columbia Centre for Disease Control in Vancouver, admitted the findings were a surprise.
"We had predicted that most adults would have some cross-reactive antibodies to the virus. But what we found was that young adults -- those in the range 20 to 30 -- did have antibodies to this swine H3N2. ... But we saw a decrease with increasing age in adults -- which for me is a concern," she said in an interview.
The swine H3N2 viruses were once human viruses that entered pig populations sometime in the early to mid-1990s. Studies suggest the contemporary pig viruses are most similar to a human H3N2 that circulated around 1995.
So the thought has been that people born before then probably would have had exposure to ancestors of the swine H3N2 and would have some protection from it.
Skowronski said it would be important to do similar work looking for antibodies in seniors to verify whether, as she fears, they are also susceptible to the new virus. Her group is doing a study, but she hopes others will as well. Patterns of protection against this virus may vary by geographic areas, she suggested.
Her concern relates to two factors, one specific to H3N2 viruses and the other which is a feature of flu in general.
After decades of experience with H3N2 viruses -- the human versions have been circulating since 1968 -- public health officials know this flu subtype takes a harsh toll on seniors. "The elderly ... don't handle H3N2 viruses well at all," Skowronski said.
And the notion of vulnerability in both children and seniors is a particular concern. It's recognized that children ramp up flu activity in a community, and that activity generally makes its way to the elderly.
"If we have a mix of broad susceptibility to an emerging swine H3N2 virus in children -- which our results suggest -- and we have a susceptibility because of lack of pre-existing antibody in the elderly, who don't handle H3N2 viruses well, that's not a good mix," Skowronski said.
"Children can propagate it and the elderly suffer the most severe consequences of H3N2 viruses."
Dr. Michael Osterholm, director of the Center for Infectious Diseases Research and Policy at the University of Minnesota, said it is important to pursue this line of study to assess the risk these new H3N2 viruses might pose.
"This really deserves further study," he said.
To date there have only been 12 reported human infections with the viruses, all in the United States. All but one of the cases have been children under the age of 10. About half had some exposure to pigs, but for the remainder the evidence suggests they probably caught the virus from another person.
Several of the people who have been infected have been hospitalized, but all have recovered. So far it appears the virus causes a regular and relatively mild flu in people, though experts suggest it is unwise to draw too many conclusions from so few cases.
Scientists have no way of predicting whether the virus will seed itself in the human population, like the 2009 H1N1 virus did, continue to cause sporadic cases or hit a dead end.
This study was done using stored blood samples taken before and after people were vaccinated with the seasonal flu shot in 2010.
The researchers also looked to see whether levels of cross-reactive antibodies rose in the samples taken between 21 to 28 days after the participants received their flu shot.
The aim of that was to see whether the H3N2 component in the shot, which is meant to protect against contemporary human strains of the virus, would trigger a rise in antibodies to the swine H3N2. It did not.
Natural cures for the common cold
Cold season is here. Between the sniffles, the coughs, and the runny noses, everyone is catching something; however, many have mixed feelings over the side effects from over-the-counter cold medicines, and some would rather take the natural route.
Dr. Roberta Lee, Medical Director of the Continuum Center for Health and Healing, talked with Dr. Manny Alvarez, senior managing health editor of FoxNews.com, about an assortment of natural remedies.
One new herb that is turning heads is called the Elderberry (Sambucus).
“It comes in liquid and tablet form, and it’s one of the few that has scientific studies showing it’s very effective against Influenza A,” Lee said of the herb.
As soon as people have even a hint of getting sick, Lee advised that’s the best time to reach for the Elderberry.
Another known healer are medicinal mushrooms, which come in pill form. While eating mushrooms with your meal is also beneficial for your health, Lee said to stick to the pills first.
“You can do that,” Lee said of eating typical shiitake mushrooms. “It’s helpful, but not as useful for viruses and colds as taking a capsule.”
Two die of H1N1 in Mexico: Official
MEXICO CITY (AFP) - An outbreak of A(H1N1) claimed the lives of two people - 19 and 21 years old - in Mexico's capital in the first weeks of the year, health authorities said on Saturday.
The health secretary of Mexico's Federal District, Armando Ahued, said there were 138 confirmed cases of the flu, including 110 cases of A(H1N1), a novel strain of the disease that was first detected in 2009.
Nationwide, 333 cases of the virus have been confirmed, the federal government's health secretary said earlier in the week, without saying how many deaths had been attributed to it.
The latest victims were a 19-year-old and a 21-year-old who died in separate hospitals. 'The tendency toward an increase in flu cases is normal because January is the month with the lowest temperatures,' said Ahued adding that the incidence of flu should begin to subside in February.
Three countries report H5N1 cases, deaths
Jan 19, 2012 (CIDRAP News) – The World Health Organization (WHO) today confirmed three new H5N1 avian influenza cases from Indonesia and Egypt, one of them fatal, a day after Vietnam's health ministry announced a death from the disease, its first in nearly 2 years.
Indonesia's newest case-patient is a 5-year-old girl from Jakarta province who died from her infection and is a family contact of a man who died from H5N1 on Jan 7, the WHO reported. The girl's illness was detected on Jan 7 during surveillance as part of the investigation into the man's infection.
She was referred to a hospital and began having breathing difficulties on Jan 13. The girl's condition worsened, and she died on Jan 16. The WHO said the girl had been exposed to the same pigeons implicated in the man's death and shared the same household environment. Surveillance of the patients' contacts hasn't found any more H5N1 infections.
The girl's illness and death raise Indonesia's H5N1 total to 184 cases, including 152 fatalities. The country leads the world in both categories.
One of Egypt's cases is in a 2-year-old girl from Cairo governorate who was treated for flulike symptoms as an outpatient at a hospital on Oct 30, according to a WHO statement. Her H5N1 infection was detected by Egypt's Central Public Health Laboratory during periodic screening of respiratory samples collected from outpatient surveillance sites.
An investigation into the source of her infection found she had been exposed to backyard poultry. The WHO said samples have been sent to the US Naval Medical Research Unit 3 (NAMRU 3) for further sequencing.
Egypt's other case is a 31-year-old man from Fayoum governorates who got sick on Jan 1, was treated with oseltamivir (Tamiflu) on Jan 14 and is still hospitalized in critical condition, the WHO said. He also had been exposed to backyard poultry.
The two new infections push Egypt's H5N1 total to 159 cases, which include 55 deaths. Egypt has the world's second-highest H5N1 case count and third-highest fatality total, behind Vietnam.
Meanwhile, a provincial health official in Vietnam said an 18-year-old man from Kien Giang province has died of an H5N1 infection, the Associated Press (AP) reported today. The official told the AP that the man, a worker on a duck farm, died on Jan 16, a day after he was hospitalized for fever and breathing difficulties.
Kein Giang province is in southern Vietnam's Mekong Delta region.
Neither of the two farms where the man worked had recently reported sick or dead poultry, according to the AP. Authorities are monitoring the man's contacts and collecting poultry samples. Vietnam's last H5N1 death was reported in April 2010, according to previous WHO reports.
If the WHO confirms this case, the global H5N1 tally would rise to 582 cases and 343 deaths.
Bird flu-infected Cambodian boy died
PHNOM PENH (Xinhua) -- A 2-year-and-7 month-old boy from northwestern province of Banteay Meanchey had died early Wednesday from avian influenza A (H5N1) virus after being admitted to hospital for about a week, said a senior health official.
"The boy passed away at 2:00 a.m. early Wednesday due to critical condition," Sok Touch, director of the Health Ministry' s anti-communicable disease department, told Xinhua over telephone on Wednesday.
He said the boy was the nineteenth person in Cambodia to become infected with H5N1 virus, and the first person died this year. "To date, 17 persons had died from H5N1 in Cambodia," he said.
According to a joint statement of Cambodia's Ministry of Health and the World Health Organization last Friday, the boy became sick on Jan. 3, 2012 suffering with fever, cough, runny nose, and vomiting.
He was initially treated by local private practitioners, but his conditions worsened and he was admitted to Angkor Hospital for Children on Jan. 9, where he died.
"The diagnosis of the clinical samples on Jan. 12 found that the boy had contact with sick or dead poultry prior to becoming sick," it said.
Banteay Meanchey is situated in northwest of Cambodia about 400 kilometers from capital Phnom Penh.
It's only natural that mother knows best
If I ever needed evidence to support the claim that "mother knows best", I certainly got it this week. Having suffered from a lingering sore throat and unsuccessfully self-medicated a cold for the past 10 days - it was somewhat fortuitous that I should be commissioned to write a piece about alternative flu remedies.
Interviewee after interviewee extolled the virtues of herbal medicine, an organic diet and plenty of exercise for a long and healthy life. They also claimed an abstinence from antibiotics ensured their swift recovery from illness and maintained a robust immune system.
I remained a sceptic, struggling to rationalise how a gnarled root of ginger and diced onion were able to trump the mighty force of Amoxycillin. Nevertheless, in the name of research, I gave it a go and duly stocked up on honey, herbal teas, probiotics, local veggies and an entire alphabet of supplements.
With my regime underway and my morning kick-started with a mug of hot water and lemon, the dots started to connect. Long have female members of my family been drinking this breakfast brew and raising eyebrows in restaurants by ordering fresh mint tea rather than coffee after a meal. Could there really be something in it?
More pennies dropped throughout the week as updating my food diary became something of a 20km run down memory lane. And tucking into a packets of nuts and dried fruit (instead of my habitual afternoon chocolate bar) suddenly took me back to prep-school.
Lunch time was never something I looked forward to as a child, for I knew only too well what my bright yellow tuck box contained. Precisely no tuck at all.
Lentils, rice and brown bread sandwiches made up the weekly menu and, "as a treat", sachets of sunflower seed and raisins would often be hiding inside a piece of kitchen roll. Far from taste being the problem, it was the giggles from my fellow diners who chomped merrily on Cheesy Wotsits and ruler-long Curly Wurly bars that made my cheeks flush.
How I longed for an additive-packed box of Um Bungo juice or a humble Proustian madeleine. But alas, it was not to be. Now, of course, I think my mother was light years ahead of her time and I can't thank her enough for force feeding me all the goodness the health-food chain Holland & Barrett had to offer. She's rarely ill so I guess there's a lot to be said for feeding your body the right fuel. Shame it took me 30 years to come around to her way of thinking. So look out for me in the organic section of your local supermarket. I'll be the flu-free evangelist eager to compare notes on the perfect sprouted adzuki-bean and kale salad. Sounds delicious, doesn't it?
rduane@thenational.ae
New Analysis Challenges Tamiflu Efficacy
A new review of the influenza drug oseltamivir (Tamiflu) has raised questions about both the efficacy of the medication and the commitment of its maker to supply enough data for claims about the drug to be evaluated by independent experts.
It also raises questions about the entire process of systematic review.
Researchers led by Tom Jefferson, MD, of the Cochrane Collaboration, pored over 15 published studies and nearly 30,000 pages of "clinical study reports."
But, they reported, the clinical study information – data previously shared only with regulators – was only a part of what internal evidence suggested was available.
And many published studies had to be excluded because of missing or contradictory data, Jefferson and colleagues reported. Action Points
Explain that a new review of an important flu drug has raised questions about the medication and the entire process of systematic review.
Point out that the review of oseltamivir showed that there was no evidence of effect on hospital admissions.
The drug's maker, Switzerland-based Roche, had promised after a previous Cochrane review to make all of its data available for "legitimate analyses." After a request for the data, Jefferson and colleagues reported, the company sent them 3,195 pages covering 10 treatment trials of the drug.
But, three of the reviewers noted in a parallel report in BMJ, the tables of contents suggested that the data were incomplete.
"What we're seeing is largely Chapter One and Chapter Two of reports that usually have four or five chapters," according to the BMJ article's lead author, Peter Doshi, PhD, of Johns Hopkins University.
Roche did not immediately respond to a telephoned request for comment.
Requests for More Data
The researchers then asked the European Medicines Agency (EMA) for the data, under a Freedom of Information request, and obtained a further 25,453 pages, covering 19 trials.
But that data, too, was incomplete, they said, although the agency said it was all that was available.
The FDA is thought to have the complete reports, but has not yet responded to requests for them, the researchers reported.
Regulatory agencies such as the EMA and FDA routinely see the large clinical study reports, Jefferson and colleagues said in BMJ, but systematic reviewers and the general medical public do not.
"While regulators and systematic reviewers may assess the same clinical trials, the data they look at differs substantially," they said.
The Cochrane group has been trying for several years to put together a clear-cut systematic review of the evidence on antivirals aimed at flu.
In 2006, the group concluded that the evidence showed that oseltamivir reduced the complications of the flu. But that conclusion was challenged on the basis that a key piece of data was flawed.
An updated review in 2009 – throwing out the flawed study -- concluded there wasn't enough evidence to show that the drug had any effect on complications.
For this analysis, the Cochrane reviewers had originally intended to perform a systematic review on both of the approved neuraminidase inhibitors – oseltamivir and zanamivir (Relenza), using the clinical study reports to supplement published trials.
In the end, they decided that for oseltamivir, they needed more detail in order to perform the review in its entirety. But, they reported, some conclusions could be drawn from published data on the 15 trials and from 16,000 pages of clinical study reports that were available before their deadline.
They also decided to postpone analysis of zanamivir (for which they had 10 trials) because the drug's maker, GlaxoSmithKline, offered individual patient data which they wanted time to analyze.
The oseltamivir analysis showed:
The time to first alleviation of symptoms in people with influenza-like illness was a median of 160 hours in the placebo groups and about 21 hours shorter in those treated with oseltamivir. The difference, evaluated in five studies, was significant at P<0.001.
There was no evidence of effect on hospital admissions: In seven studies, the odds ratio was 0.95, with a 95% confidence interval from 0.57 to 1.61, which was nonsignificant at P=0.86.
A post-protocol analysis of eight studies showed that oseltamivir patients were less likely to be diagnosed with influenza.
The data "lacked sufficient detail to credibly assess" any effect on influenza complications and viral transmission.
Data Discrepancies Found
But discrepancies between the published trial data and the clinical study reports "led us to lose confidence in the journal reports," Doshi and colleagues wrote in BMJ.
For example, they noted that one journal report clearly said there were no drug-related serious adverse events, but the clinical study report listed three that were possibly related to oseltamivir.
As well, the sheer scope of the clinical study reports meant that much was left out of journal reports. One 2010 study, on safety and pharmacokinetics of oseltamivir at standard and high dosages, took up seven journal pages and 8,545 pages of the clinical study report.
But the researchers were also shaken, they said, by the "fragility" of some of their assumptions.
For instance, they found that the clinical study reports showed that in many trials, the placebo contained two chemicals not found in the oseltamivir capsules.
"We could find no explanation for why these ingredients were only in the placebo," they wrote in BMJ, "and Roche did not answer our request for more information on the placebo content."
Jefferson and colleagues also reported they found disparities in the numbers of influenza-infected people reported to be present in the treatment versus control groups of oseltamivir trials.
One possible explanation, they noted, is that oseltamivir affects antibody production – even though the manufacturer says it does not.
Gaps in Knowledge Remain
That question is profoundly important, Doshi told MedPage Today, because it may offer clues to how the drug works – one of the gaps in knowledge about oseltamivir.
"You can't make good therapeutic decisions if you don't know how the drugs works," he said – information that he and his colleagues suspect may be buried in the mass of missing data.
It's also important, he said, because public health agencies have been making decisions to stockpile oseltamivir without a clear understanding of the facts.
Essentially, he said, those decisions have been based on the flawed study – a Roche-supported meta-analysis – that was thrown out of the 2009 Cochrane review.
"They're taking the drug manufacturer's word at face value," he said.
The results seem unlikely to resolve conflicts over the medical value of the drug, which is a major cash cow for Roche, adding some $3.4 billion to the company's bottom line in 2009 alone, according to Deborah Cohen, investigations editor of BMJ.
In an accompanying article, Cohen said that "clinicians can be forgiven for being confused about what the evidence on oseltamivir says."
She noted that the European Centre for Disease Prevention and Control, the CDC, and the World Health Organization "differ in their conclusions about what the drug does."
As well, those conclusions are often contradicted by claims on the drug labels – themselves allowed by regulators, Cohen argued.
The Cochrane reviewers reported grant support from the U.K. National Institute for Health Research and Jefferson and Doshi reported they had no recent financial links with industry.
Cohen is employed by BMJ.
Primary source: Cochrane Database of Systematic Reviews
Source reference: Jefferson T, et al "Neuraminidase inhibitors for preventing and treating influenza in healthy adults and children" Cochrane Database of Systematic Reviews 2011; 12. Art. No.: CD008965.
By Michael Smith, North American Correspondent, MedPage Today - Published: January 17, 2012 - Reviewed by Robert Jasmer, MD; Associate Clinical Professor of Medicine, University of California, San Francisco.
Man dies of swine flu in city
HYDERABAD: Swine flu claimed its first victim this year in city on Friday evening. A 60-year-old resident of Secunderabad succumbed to the virus at a private hospital in the city.
Sources said the victim had travelled to Bangalore a few days back and had returned with high fever. He was admitted to Apollo Hospital on Wednesday and the tests confirmed that he was suffering from H1N1 Influenza (swine flu).
His condition turned critical and was moved to intensive care unit and put on ventilator. He died of respiratory distress on Friday evening.
The district medical and health officer Dr Uma Maheshwari pleaded ignorance of the swine flu death case and refused to provide any information.
Little Egret tests positive for H5 virus
Hong Kong (HKSAR) - Preliminary testing of a dead Little Egret found in Yuen Long has tested positive for the H5 avian influenza virus, a spokesman for the Agriculture, Fisheries and Conservation Department (AFCD) said today (January 14), adding that further confirmatory tests are being conducted.
The bird carcass was found and collected beside a tree outside Yuen Long Office, Wetland and Fauna Conservation (Enforcement) Section of AFCD, Lot 1520RP, DD123, Nam Sang Wai, Yuen Long on January 12.The Little Egret is a common resident bird in Hong Kong.
The AFCD has stepped up cleansing and disinfection of the office.
The spokesman said that two chicken farms are within 3 kilometres of where the dead bird was found. AFCD staff inspected the farms and found no abnormal mortality or symptoms of avian influenza among the chicken flocks. These farms will be put under enhanced surveillance.
In view of the case, the AFCD has phoned poultry farmers to remind them to strengthen precautionary and biosecurity measures against avian influenza. Letters have been issued to farmers, pet bird shop owners and licence holders of pet poultry and racing pigeons reminding them that proper precautions must be taken.
The spokesman said the department would conduct frequent inspections of poultry farms and the wholesale market to ensure that proper precautions against avian influenza have been implemented.
The department will continue its wild bird monitoring and surveillance.
"People should avoid personal contact with wild birds and live poultry and their droppings. They should clean their hands thoroughly after coming into contact with them. The public can call 1823 for follow-up if they come across suspicious sick or dead birds, including the carcasses of wild birds and poultry," the spokesman said.
The Food and Environmental Hygiene Department (FEHD) will continue to be vigilant over imported live poultry as well as live poultry stalls. It will also remind stall operators to maintain good hygiene.
The Department of Health will keep up with its health education to remind the public to maintain strict personal and environmental hygiene to prevent avian influenza.
The AFCD, the FEHD, the Customs and Excise Department and the Police will strive to deter the illegal import of poultry and birds into Hong Kong to minimise the risk of avian influenza outbreaks caused by imported poultry and birds that have not gone through inspection and quarantine.
All relevant government departments will continue to remain highly vigilant and strictly enforce preventive measures against avian influenza.
Why I'm Anti-Antibacterial Soaps, Even in Flu Season
It started right after Thanksgiving -- a stomach flu that first hit Alden, my two-year-old. Then it got me, and then Graham (the baby), and finally my husband Chris. After the stomach flu completed its cycle, next up was this awful cold with a barking cough, which made the full round of our family twice and cut short our recent Christmas vacation.
The second time it hit Graham was the worst. My normally social and smiley baby didn't smile for almost a week. He could barely keep any food down and was hacking like a pack-a-day smoker with a 20-year habit.
With all this suffering, I'm sure you can understand why I've become obsessed with washing hands. My kids' hands, my hands, and your hands, too. Anyone who sets foot in my apartment will be politely requested to wash their hands thoroughly before touching anything, especially the baby.
But hand-washing obsessive though I might be, I won't use antibacterial soaps or antibacterial hand sanitizers as an extra precaution. They're not any better than washing with regular soap and water, and they contain something normal soap doesn't -- hormone-disrupting chemicals called triclosan and triclocarban.
Having had trouble becoming pregnant, I am only too aware of the studies demonstrating that triclosan interferes with thyroid hormone, and triclocarban can enhance the activity of male and female sex hormones. This is especially consequential for the growing bodies of children -- amplified hormonal effects at the wrong time may increase the risk of breast and prostate cancers as well as infertility. Scientists are also concerned that the overuse of antimicrobial chemicals like these could promote antibiotic resistance, leading to the creation of superbugs that are difficult to vanquish with today's antibiotics.
Am I putting my family at risk by not using a more "powerful" soap? Not at all. Scientific studies have shown, and the FDA agrees, that antibacterial soaps are no more effective than washing with regular soap and water. All that stuff you read on the label is marketing hype.
Why are these unnecessary chemicals in our soap in the first place? Because for more than 33 years, the FDA has been looking into antimicrobials like triclosan without coming to any conclusions, despite growing scientific evidence that there is cause for concern. NRDC filed a lawsuit in 2010 to pressure the FDA to complete its review. The agency was supposed to finally announce its findings on the safety of triclosan and triclocarban in the spring of 2011, but has since delayed the release of the findings to later this year.
NRDC is continuing to push the case in court, and meanwhile, in the absence of action by the FDA, consumer groups and some members of Congress have taken up the call. At their urging, some companies, such as Colgate-Palmolive and Reckitt-Benckiser, have voluntarily removed triclosan from some of their products, including dish soap, hand soap, and some face washes.
While the FDA continues to delay, these chemicals are finding their way into more and more products, like yoga mats, towels, footwear, and cutting boards. I steer clear of any product labeled "antibacterial" or "antimicrobial," or that has triclosan listed as an ingredient (because it is classed as a pesticide, triclosan must be listed on labels; triclocarban, however, does not have to be listed). For my family, good old soap and water and a thorough scrubbing do the trick.
Thorough scrubbing is key. A proper hand-washing should take a full 20 seconds and include the webbing of your fingers, the base of your wrists, and around your fingernails. Dr. Gina Solomon has recommended teaching your children to sing "Row Your Boat" while handwashing to ensure they do so long enough. If you're on the go and just can't get to a sink, use alcohol-based hand sanitizers or hand wipes. I carry Giovanni Organic Recharge or Herban Essentials brand wipes, which use plant-based essential oils for germ-killing power. (They smell good, too.)
Flu Shot or Not? Reaction to Young Girl's Death
Nicole and Justin Matten of Barton have lived every parent’s worst nightmare. On December 2 their 7-year-old daughter, Kaylynne, visited her physician for an annual checkup. She got a flu shot. The next day, she developed a bad headache and fever. On December 6, the normally happy and healthy girl, who had no previous history of chronic health problems or adverse reactions to vaccines, turned blue, stopped breathing and died in her mother’s arms.
“They worked on her for about three hours and did everything they could, but they just couldn’t get her back,” Nicole Matten says of her second child, who was a first-grader at Barton Graded School.
The state medical examiner has yet to determine the girl’s exact cause of death; the autopsy report is due within a few weeks. State health officials are also investigating the tragedy. Any child’s death “puts a hole in everyone’s gut, and when one dies, we all have to ask a lot of questions,” says Vermont Health Commissioner Dr. Harry Chen.
“We’re just waiting for an answer,” says Kaylynne’s mom, “but we believe in our hearts that it was the flu shot.”
Chen is not convinced. He points out that serious adverse reactions to vaccines, including deaths, are “extremely rare” — so rare, in fact, that none associated with the flu shot has ever been reported in Vermont. Since last fall, more than 130 million people nationwide have received the annual flu vaccine.
Chen and other state health officials are more worried about the effects of news reports prematurely linking the Barton girl’s death to the flu shot: specifically, that more parents will opt out of immunizing their children, or themselves, against seasonal influenza.
“Of course, it’s important for parents to understand the risks and benefits, and I have absolute respect for their right to make their own decisions,” Chen says. “But I don’t think that being alarmist contributes to overall public health. Vaccines have saved countless lives.”
Each year, seasonal influenza causes more than 200,000 hospitalizations nationwide, as well as 3000 to 49,000 deaths, according to data from the Centers for Disease Control and Prevention. The majority of those severe illnesses and deaths occur among infants, young children, pregnant women, seniors and people with chronic medical conditions.
Part of Chen’s concern stems from what he calls Vermont’s “mediocre” vaccination rate. Once among the highest in the nation, Vermont’s childhood vaccination rate has plummeted in the last decade to one of the lowest levels in the nation. The reasons are numerous and complex, health officials say, as more parents are questioning the safety and efficacy of vaccines and expressing concern that adverse reactions to vaccines are worse than the diseases they prevent.
Even the CDC acknowledges that there’s some educated guesswork involved in creating the flu shot each year. Vaccine strains are chosen based on international surveillance and scientists’ estimations about which types and strains of the virus will circulate that year. One result is that the influenza vaccine is only about 65 to 75 percent effective, compared to other vaccines, which are more than 90 percent effective.
In Vermont, the shot is not a prerequisite for admission to school or daycare.
The flu vaccine became a hotly contentious issue two months ago, when the American Academy of Pediatrics asked Delta Airlines to pull an in-flight video endorsing more parental choice and independent testing of vaccines. Made by the Virginia-based National Vaccine Information Center, the film gave tips on staying well during flu season without getting vaccinated.
AAP president Robert Block accused Delta of “putting children’s lives at risk” with a video containing “harmful messages.” The video was subsequently removed.
Chen won’t reveal any details about the specific vaccine administered to Kaylynne Matten — except to say that the health department has determined the manufacturer and lot number of the vaccine and reported it to the CDC, which has received no other reports of adverse reactions to that particular batch.
For her part, Nicole Matten admits she’s conflicted about the flu vaccine. Her three other children, who range in age from 1 to 12, all received them this year without incident. Matten is also pregnant and expecting her fifth child in May, which puts her at higher risk for contracting the virus.
When asked what advice she’d offer other parents, Matten says, “If you do get the flu shot, keep a close eye on your child afterward. If you even suspect something’s going wrong, get your child checked right away.”
“When in doubt, tell the truth.”
- Mark Twain
“Falsehood is easy, truth so difficult.”
- George Eliot
“Who is more foolish, the child afraid of the dark or the adult afraid of the light?”
- Maurice Freehill
“I know God will not give me anything I can't handle. I just wish He didn't trust me so much.”
- Mother Teresa
“A popular government without popular information, or the means of acquiring it, is but a prologue to a farce or a tragedy, or perhaps both.”
- James Madison
“The United States is unusual among the industrial democracies in the rigidity of the system of ideological control — 'indoctrination,' we might say — 'exercised through the mass media.'”
- Noam Chomsky
“Truth, like gold, is to be obtained not by its growth, but by washing away from it all that is not gold. ”
- Leo Tolstoy
“A newspaper, as I'm sure you know, is a collection of supposedly true stories written down by writers who either saw them happen or talked to people who did. These writers are called journalists, and like telephone operators, butchers, ballerinas, and people who clean up after horses, journalists can sometimes make mistakes.”
- Lemony Snicket
“Knowledge is the antidote to fear.”
- Ralph Waldo Emerson
“What the caterpillar calls the end of the world, the master calls a butterfly.”
- Richard Bach
“Fear is not in the habit of speaking truth; when perfect sincerity is expected, perfect freedom must be allowed; nor has anyone who is apt to be angry when he hears the truth any cause to wonder that he does not hear it.”
- Publius Cornelius Tacitus
“The man who fears no truth has nothing to fear from lies.”
- Thomas Jefferson
“Truthfulness has never been counted among the political virtues, and lies have always been regarded as justifiable tools in political dealings.”
- Hannah Arendt
“If Thomas Edison invented electric light today, Dan Rather would report it on CBS News as: 'Candle making industry threatened.'”
- Newt Gingrich
“Truth has no fear; Untruth shivers at every shadow.”
- Sri Sathya Sai Baba
“In spite of your fear, do what you have to do.”
- Chin-Ning Chu
“Fear grows in darkness; if you think there's a bogeyman around, turn on the light.”
- Dorothy Thompson
“Whenever the people are well-informed, they can be trusted with their own government.”
- Thomas Jefferson
“The man who fears no truths has nothing to fear from lies.”
- Francis Bacon
“A man goes to knowledge as he goes to war, wide awake, with fear, with respect, and with absolute assurance. Going to knowledge or going to war in any other manner is a mistake, and whoever makes it will live to regret his steps.”
- Carlos Castaneda
“Get your facts first, and then you can distort 'em as much as you please.”
- Mark Twain
“Don't waste life in doubts and fears; spend yourself on the work before you, well assured that the right performance of this hour's duties will be the best preparation for the hours and ages that will follow it.”
- Ralph Waldo Emerson
“The world is for thousands a freak show; the images flicker past and vanish; the impressions remain flat and unconnected in the soul. Thus they are easily led by the opinions of others, are content to let their impressions be shuffled and rearranged and evaluated differently.”
- Johann Wolfgang Von Goethe
“I learned that courage was not the absence of fear, but the triumph over it. The brave man is not he who does not feel afraid, but he who conquers that fear.”
- Nelson Mandela
“We are taught to understand, correctly, that courage is not the absence of fear, but the capacity for action despite our fears.”
- John McCain
“You can conquer almost any fear if you will only make up your mind to do so. For remember, fear doesn't exist anywhere except in the mind.”
- Dale Carnegie
“Courage is a special kind of knowledge: the knowledge of how to fear what ought to be feared and how not to fear what ought no to be feared.”
- David Ben-Gurion
“Fear is the path to the dark side. Fear leads to anger. Anger leads to hate. Hate leads to suffering.”
- Yoda
“The only sure bulwark of continuing liberty is a government strong enough to protect the interests of the people, and a people strong enough and well enough informed to maintain its sovereign control over the government.”
- Franklin D. Roosevelt
“How very little can be done under the spirit of fear. ”
- Florence Nightingale
“Listen to what you know instead of what you fear. ”
- Richard Bach
“To fear to face an issue is to believe the worst is true.”
- Ayn Rand
“A nation that is afraid to let its people judge the truth and falsehood in an open market is a nation that is afraid of its people.”
- John F. Kennedy
“It may well be that our means are fairly limited and our possibilities restricted when it comes to applying pressure on our government. But is this a reason to do nothing? Despair is nor an answer. Neither is resignation. Resignation only leads to indifference, which is not merely a sin but a punishment.”
- Elie Wiesel
“It would be difficult to dispel ignorance unless there is freedom to pursue the truth unfettered by fear. With so close a relationship between fear and corruption it is little wonder that in any society where fear is rife corruption in all forms becomes deeply entrenched.”
- Aung San Suu Kyi
“Fear is the main source of superstition, and one of the main sources of cruelty. To conquer fear is the beginning of wisdom, in the pursuit of truth as in the endeavour after a worthy manner of life.”
- Bertrand Russell
“If it's called the USA Today, why is all the news from yesterday? BAM. Busted!”
- Stephen Colbert
“Nothing in life is to be feared. It is only to be understood.”
- Marie Curie
“When even one American - who has done nothing wrong -- is forced by fear to shut his mind and close his mouth, then all of Americans are in peril.”
- Harry S. Truman
“A lie gets halfway around the world before the truth has a chance to get its pants on.”
- Winston Churchill
“When the people fear their government, there is tyranny; when the government fears the people, there is liberty.”
- Thomas Jefferson
“I do not mean to be the slightest bit critical of TV newspeople, who do a superb job, considering that they operate under severe time constraints and have the intellectual depth of hamsters. But TV news can only present the 'bare bones' of a story; it takes a newspaper, with its capability to present vast amounts of information, to render the story truly boring.”
- Dave Barry
“The truth is more important than the facts.”
- Frank Lloyd Wright
“Truth is tough. It will not break, like a bubble, at a touch, nay, you may kick it all about all day like a football, and it will be round and full at evening.”
- Oliver Wendell Holmes
“For my part, whatever anguish of spirit it may cost, I am willing to know the whole truth; to know the worst and provide for it.”
- Patrick Henry
“It is a puzzling thing. The truth knocks on the door and you say, 'Go away, I'm looking for the truth,' and so it goes away. Puzzling.”
- Robert M. Pirsig
“It is error alone which needs the support of government. Truth can stand by itself.”
- Thomas Jefferson
“When I tell any truth, it is not for the sake of convincing those who do not know it, but for the sake of defending those that do.”
- William Blake
“If I had my choice I would kill every reporter in the world, but I am sure we would be getting reports from Hell before breakfast.”
- William Tecumseh Sherman
“A nation of sheep will beget a government of wolves.”
- Edward R. Murrow
“If you tell a lie big enough and keep repeating it, people will eventually come to believe it. The lie can be maintained only for such time as the State can shield the people from the political, economic and/or military consequences of the lie. It thus becomes vitally important for the State to use all of its powers to repress dissent, for the truth is the mortal enemy of the lie, and thus by extension, the truth is the greatest enemy of the State.”
- Joseph Goebbels
“Newspapers are unable, seemingly, to discriminate between a bicycle accident and the collapse of civilisation.”
- George Bernard Shaw
“The truth is found when men are free to pursue it.”
- Franklin D. Roosevelt
“Hastiness and superficiality are the psychic diseases of the twentieth century, and more than anywhere else this disease is reflected in the press.”
- Alexander Solzhenitsyn
“I am a firm believer in the people. If given the truth, they can be depended upon to meet any national crisis. The great point is to bring them the real facts.”
- Abraham Lincoln
“A wave of panic passed over the vessel, and these rough and hardy men, who feared no mortal foe, shook with terror at the shadows of their own minds.”
- Arthur Conan Doyle
“Fear cannot be banished, but it can be calm and without panic; it can be mitigated by reason and evaluation.”
- Vannevar Bush
“Cowardice, as distinguished from panic, is almost always simply a lack of ability to suspend the functioning of the imagination.”
- Ernest Hemingway
“Courage is not the absence of fear but the ability to carry on with dignity in spite of it.”
- Scott Turow
“The media's the most powerful entity on earth. They have the power to make the innocent guilty and to make the guilty innocent, and that's power. Because they control the minds of the masses.”
- Malcom X
“If you once forfeit the confidence of your fellow citizens, you can never regain their respect and esteem. It is true that you may fool all of the people some of the time; you can even fool some of the people all of the time; but you can't fool all of the people all of the time.”
- Abraham Lincoln
“We hang the petty thieves and appoint the great ones to public office.”
- Aesop
“Media is just a word that has come to mean bad journalism.”
- Graham Greene
“By definition, a government has no conscience. Sometimes it has a policy, but nothing more.”
- Albert Camus
“Those who seek absolute power, even though they seek it to do what they regard as good, are simply demanding the right to enforce their own version of heaven on earth. And let me remind you, they are the very ones who always create the most hellish tyrannies. Absolute power does corrupt, and those who seek it must be suspect and must be opposed.”
- Barry Goldwater
“We are not afraid to entrust the American people with unpleasant facts, foreign ideas, alien philosophies, and competitive values. For a nation that is afraid to let its people judge the truth and falsehood in an open market is a nation that is afraid of its people.”
- John F. Kennedy
“I know of no safe repository of the ultimate power of society but people. And if we think them not enlightened enough, the remedy is not to take the power from them, but to inform them by education.”
- Thomas Jefferson
“Where large sums of money are concerned, it is advisable to trust nobody.”
- Agatha Christie
“Love all, trust a few.”
- William Shakespeare
“One of the saddest lessons of history is this: If we've been bamboozled long enough, we tend to reject any evidence of the bamboozle. The bamboozle has captured us. Once you give a charlatan power over you, you almost never get it back.”
- Carl Sagan
“All of us who professionally use the mass media are the shapers of society. We can vulgerize that society. We can brutalize it. Or we can help lift it onto a higher level.”
- William Bernbach
“I'm not upset that you lied to me, I'm upset that from now on I can't believe you.”
- Friedrich Nietzsche
“If one morning I walked on top of the water across the Potomac River, the headline that afternoon would read: 'President Can't Swim.'”
- Lyndon B. Johnson
“Lies are often much more plausible, more appealing to reason, than reality, since the liar has the great advantage of knowing beforehand what the audience wishes or expects to hear.”
- Hannah Arendt
“The public have an insatiable curiosity to know everything. Except what is worth knowing. Journalism, conscious of this, and having tradesman-like habits, supplies their demands.”
- Oscar Wilde
“When in doubt, tell the truth.”
- Mark Twain
“When distant and unfamiliar and complex things are communicated to great masses of people, the truth suffers a considerable and often a radical distortion. The complex is made over into the simple, the hypothetical into the dogmatic, and the relative into an absolute.”
- Walter Lippmann
“If such a plague came today, killing a similar fraction of the U.S. population, 1.5 million Americans would die, which is more than the number felled in a single year by heart disease, cancers, strokes, chronic pulmonary disease, AIDS, and Alzheimer’s disease combined.”
- Gina Kolata
