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In this week’s bmj there is an article by Thomas Jefferson of the Cochrane Vaccine Institute (“Relation of study quality, concordance, take home message, funding, and impact in studies of influenza vaccines: systematic review“) whom I have often quoted before (“Flu Shots are for Idiots“) regarding the dubious evidence behind policy recommendations regarding flu shots. Now he presents data that studies of flu shots funded by pharmaceutical companies are more likely to be published in prestigious journals than those funded by other sources, in spite of the fact that they have the sample sample size and comparable methodology. He goes on to write:
The study shows that one of the levers for accessing prestige journals is the financial size of your sponsor. Pharmaceutical sponsors order many reprints of studies supporting their products, often with in-house translations into many languages. They will also purchase publicity space on the journal. Many publishers openly advertise these services on their website. It is time journals made a full disclosure of their sources of funding.
A position supported by the staff at Drug Safety and Health News. He goes on to discuss the “impact factor”, a metric related to how many times other authors of journal articles cite you in their articles, which is supposed to be a measure of how good or important your study is. However there is a tendency to cite articles in the big journals like JAMA or New England Journal of Medicine just because we all think that if they got in there they must be really good. What this does is give an advantage to those physicians and researchers who are doing the clinical trials funded by pharma, makes them more cited, enhancing their prestige, and hence even more valuable to their pharma friends. Soon everyone is wining and dining, have a good time, and making more money all around.
Yeah! Let's Have Some Drugs with our Wine!
But you can see how this has a corrupting influence on the practise of medicine. As pointed out in a letter to the editor of Houmatoday.com in Terrabonne Parish, Louisiana, by Dr. Randolph M. Howes (“Death by Peanut Butter or Drugs?”) 50% more people die of prescription drugs every hour than have collectively died from peanut butter.
Hat tip to Dan Abshear.
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A Very Concerning Sub-Microscopic Infectious Agent
Influenza is the virus responsible for the disease that has its name. This virus created the last pandemic in the United States less than 100 years ago. When this occurred, the whole world experienced about 100 million deaths due to malicious virus.
The Influenza pandemic that occurred before the 1918 Spanish Flu happened about thirty years before this one. Influenza epidemics normally occur about every 9 months or so, it has been reported
The disease of Influenza is caused by this virus penetrating a host, which could be a human or an animal. Once infected, the virus replicates within the cell of the host in the cell’s cytoplasm. To survive, the influenza virus targets an enzyme called polymerase that directs the content of this cell to produce proteins the virus needs to survive.
With the 1918 pandemic, it is believed that it was called the Spanish Flu because the first human case was identified in Spain. The pandemic ended up killing more than those that died during WWI.
Understandably there was panic among people worldwide, as the influenza virus itself was not discovered until 1933, so the mystery was rather frightening of what was happening at that time.
Those who survived have allowed others to obtain antibodies from them to develop other antibodies for future viral outbreaks that may occur with this type of virus.
This last influenza pandemic also allowed others to obtain this virus from those who died as a result to create effective treatments and vaccines for viral outbreaks that may happen in the future as well. Over a half a million people in the U.S. died as the result of the Spanish Flu- and those that did die was due often to a bacterial pneumonia that followed the viral invasion and the damage this virus caused. Specifically, the bacteria that killed those due to this flu were called strept pneumo. On average, it took about 9 days for one to die after being infected. The Spanish Flu caused an unusually severe immune response in the human host which made it very deadly due to overkill of the cells of this host. The influenza virus has this ability on occasion, which makes it very deadly to its host.
The influenza viruses are categorized into A, B, and C. The Influenza A virus is the one that historically has caused pandemics that have developed-, such as the Spanish Flu Pandemic.
The other influenza pandemics primarily have occurred in countries in Asia.
With influenza, it is understood that the disease influenza is a disease caused by a RNA virus that can now infect and kill both mammals and birds. In fact, at least one particular virus can mutate to where it can be shared between the two life forms and multiply within each one of them with ease.
Unlike coryza, influenza expresses symptoms more severely, and usually lasts two weeks until one recovers who has the flu. Influenza, however, poses a danger to some with compromised immune systems, such as the chronically ill, so the risk is greater in such populations, along with women who may be pregnant during the flu season, residents of nursing homes or chronic care facilities. If untreated with such patient populations, influenza can create complications such as bacterial pneumonia or encephalitis.
Health care personnel are encouraged to get a flu vaccine. However this vaccine, as will be described in a moment, offers no guarantee that the one immunized by this vaccine will not acquire the flu.
Such populations of those recommended to receive the flu vaccination are those believed to need the protection the vaccine may offer the most. This is of concern, as Influenza can progress rapidly into the more serious illness of pneumonia.
Symptoms of influenza usually start to express themselves symptomatically about two days or so after being infected with the virus. Over 10 percent of the population is infected with this virus every year- resulting in about 200,000 hospitalizations and nearly 40,000 deaths.
This season’s first influenza case was identified in Delaware in November of 2008, and it was a type B influenza strain.
The flu vaccination is trivalent- meaning it contains three viral strains of suspected viruses for flu outbreaks during a particular winter season, as determined by the World Health Organization, as well as the Centers for Disease Control, and other organizations.
Yet one should keep in mind that these three strains of influenza may not even exist in a particular flu season. The vaccination is a guess, at best, yet is certainly better than the absence of a flu vaccination.
Unfortunately, the influenza vaccine administered last flu season was largely ineffective due to unsuspected strains of the virus infecting others, although about 140 million injections of this vaccine were administered, and this proved to be pointless for preventative medicine.
After giving the vaccination dose to one, it takes about 10 days for that person to build up the immunity for the disease of influenza. The months of October to December are recommended to receive this vaccine. And the vaccine is about 50 percent effective in offering protection from influenza, according to others, if one calculates the previous flu seasons with flu vaccinations.
Vaccines are a catalyst for antibody production in humans, which protect them against the virus, if it happens to present itself within them.
Influenza vaccines can be given by injection or nasally.
Anti-virals, on the other hand, decrease greatly the ability for viruses to reproduce once established in a human. That seems like it should be a focus during viral seasons instead of any vaccination that exist today regarding the disease of influenza.
The flu season that is now occurring was supplied with 150 million vaccines in the United States. However, some studies have shown that this vaccine is rather ineffective based on incidences of the acquisition of the influenza virus by others anyway.
The influenza season peaks between the months of January and March. The vaccine for this influenza season is manufactured by 6 different companies.
Yet the strains chosen contain what are speculated influenza viruses, so this does not eliminate the chance of a new and dominant influenza viral strain that possibly could cause a pandemic regardless if one is vaccinated for influenza. Also, it takes manufacturers about 6 months to make and formulate the influenza vaccination.
There is a vaccine for this illness that is produced every year according to which type of virus types that may be prevalent during a particular flu season. If influenza occurs in a human host, the results may be the patient acquiring pneumonia or meningitis is possible, as well as their ability to transmit such a virus to another.
The presence of influenza can be widespread in certain states, yet not others. The vaccination is recommended to be administered to those who are at high risk, such as the chronically ill.
Also, it is recommended that those under 18 years of age get the vaccine, as well as those people over the age of 50. Furthermore, those people who regularly take aspirin should receive the vaccine, as the influenza disease can become a catalyst for what is called Reye’s Syndrome.
Pregnant women should receive the vaccine as well- as there are many vaccines available to hopefully prevent this potentially dangerous viral disease in this form.
However, the Avian influenza presented itself in China in 1997. Called the H5N1 virus subtype, it has the potential to be the next flu pandemic. The virus responsible for the 1918 pandemic was an avian influenza, which was called the H1N1.
This virus, unlike the human influenza virus, has a longer incubation period- about 5 days. Also, H5N1 has the ability to mutate more rapidly, as well as replicate at a similar speed. Avian influenza viruses are highly pathogenic.
This is because this particularly malicious virus is the result of two separate influenza viruses acquiring the same host at the same time. As a result of mutual sharing of genetic material between the two viruses, novel attributes are allowed to develop and create a H5N1 that obviously prove to be rather deadly.
For an influenza pandemic to occur, which means a global disease existence and presence, the virus must emerge from another species to humans without a strong immune system- as well as the ability to make more humans ill than normal due to the constant mutation of the influenza virus.
Also, the virus must be highly contagious for a pandemic to occur. This particular virus that has been identified is just that.
The H5N1 Avian influenza virus seems to have become progressively more pathogenic in the past decade, according to others. The letters H and N, by the way, stand for the antigens HA and NA,and are the letters of proteins that protrude from the viral shell.
It is these proteins that mutate so often with the influenza virus, and which is why we continue to be infected with this virus.
With the Avian Influenza existing with the H5N1 strain, millions of birds have been slaughtered due to the danger and unpredictability of this strain.
The first recorded incidence of human-to-human transmission of the H5N1 virus was believed to be in Thailand in 2004.
There have been outbreaks of Avian flu in about 15 countries in the world so far- with Indonesia being the worst. Migratory birds spread this influenza virus between continents.
The pathogenic strength of the H5N1 strain varies due to constant re-assortment or switching of genetic material between the viruses- essentially creating hybrid modifications of what it was before this occurs due to this re-assortment that makes this virus much more virulent.
So far, about 400 people worldwide have been infected with this strain- and about half have died from the infection. This is believed to be greater than 50 percent of all those infected with the H5N1 virus. Vaccinations are being developed and reformulated constantly at this time due to the pandemic threat of the H5N1 Influenza virus. —- Dan Abshear
• http://www.hhs.gov/pandemicflu/plan/appendixh.html
• http://www.cdc.org/flu/weekly
Thanks, Dr. B. Very parsimonious parsing.
Gina
The link to “Flu Shots are for Idiots” was appreciated. I felt only minutely bad for not getting a flu shot this year, but that even minimal “bad” feeling is now reduced to nothing.
The ways of big pharma are disconcerting on a massive scale. I remember it being a big thing about prescription drugs coming in from Canada– do you have any posts about that?