 | | | | |  | An antidote to panics based on dodgy statistics and dubious arguments.
Edited by Rob Lyons. |  | | |  |  |
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| | | 10 August 2004 | An injection of perspective
Panic: 'Chaos over 5-in-1 jab' declared the UK Daily Mail, reporting that the government plans to replace an existing four-in-one jab, protecting against diptheria, whooping cough, Hib and tetanus, with a new one that adds protection against polio. The new vaccine will also not contain the preservative thiomersal, a mercury compound, which has been linked to autism by studies in the United States - leading to suggestions that the current vaccine is not safe. Campaigners also raised fears of immune system overload in infants coping with five different vaccines at once. Jackie Fletcher, founder of the support group Justice, Awareness and Basic Support (JABS), told the Guardian: 'Increasing the combinations increases the potential for an adverse reaction and restricts choice for parents.'
Don't panic: These are two panics here. The first is that mercury in the old vaccine, in the form of thiomersal, is harmful. The evidence against thiomersal is based on reports condemned by the American Academy of Paediatrics as containing 'numerous conceptual and scientific flaws, omissions of fact, inaccuracies and misstatements'.
The amount of mercury involved is so tiny that it simply could not be toxic, even to an infant. There is no evidence that it is harmful. It is not used in the new vaccine simply because it is incompatible with the polio element that has been added. However, by even implying that vaccines containing mercury should be withdrawn on a precautionary basis, the government has lent credence to the notion that thiomersal could be harmful.
The second panic is that the immune system of infants could be overloaded by a new multiple vaccine. This is similarly without substance. Newborn babies face a large number of potential infections, even in the process of being born. To counter this they already have the capability to deal with many different threats, a capability which develops further within a few days of birth. On the other hand, immune responses to some infections, like Hib, are much weaker in babies than they are in adults. For that reason, the vaccines used are specially designed to encourage immunity by stimulating well-developed parts of the immune system instead. This is also the reason why early vaccination is very important.
A review published in the journal Pediatrics concludes: 'Current studies do not support the hypothesis that multiple vaccines overwhelm, weaken, or "use up" the immune system. On the contrary, young infants have an enormous capacity to respond to multiple vaccines, as well as to the many other challenges present in the environment.'
While it is assumed that multiple vaccines must be more harmful, developments in protein chemistry mean that all the usual vaccines taken today, 11 in all, use fewer immunity-triggering proteins than just one vaccine (smallpox) did in the past. It seems that problems are found even where there has been progress.
Any conceivable harm caused by these vaccines is far outweighed by the harm done by the diseases they prevent. As Jennie Bristow notes elsewhere on spiked, we can fret about the slim possibility of vaccine damage precisely because of the remarkable success of the vaccination campaign. What this debate requires is an injection of perspective.
Read: |  | Doctors try to head off new vaccine row, | | Guardian, 10 August 2004 | | Addressing parents' concerns: do multiple vaccines overwhelm or weaken the infant's immune system?, | | Pediatrics, 1 January 2002 (pdf format) | | Three cheers for the five-in-one jab, | | by Jennie Bristow |
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| | | 6 August 2004 | Return of the mad cow panic
Panic: 'Experts warn of wider CJD threat', reports BBC News. The CJD Surveillance Unit has looked into the case of a man infected with the prion protein suspected of causing the disease. The man, who had no symptoms of vCJD when he died, had received a blood transfusion from someone who had died of vCJD. The new report says that his genetic make-up was not the same as those who have developed symptoms, suggesting that more people may be carrying the disease. Professor James Ironside told BBC News, 'It's absolutely possible that there may be a new epidemic, because the cases we've seen so far may only be those who are unusually susceptible or have the shortest incubation periods'.
Don't panic: The number of deaths from vCJD has been in decline over the past four years - not that there were very many to start with. The first cases, three in total, were identified in 1995. The number of deaths rose to a peak of 28 in 2000, but has fallen since. There have been three deaths this year, and 142 in total over the course of a decade.
Far from suggesting a new epidemic, the latest report seems to indicate that even if the prion protein thought responsible for the disease is present in an individual, some other factor must also be present for the disease to develop. In March, researchers presented the results of tests done on 12,000 tissue samples at Derriford Hospital in Plymouth. Just three showed signs of prion infection. If only a small proportion of the small number infected actually develop the disease, that would be one explanation for the tiny number of cases to date - and why we need not worry about a wider outbreak.
Despite protestations from CJD researchers to the contrary, the spin put on this latest report seems like scaremongering at a time when it is becoming apparent that vCJD is not the mass killer suggested in the past. At one time, epidemiologists suggested that millions would die from vCJD - but a more recent estimate is that 540 people would die in total. At the current rate of cases, even that revised figure seems a long way off.
While there is much fretting about potential epidemics, the measures taken to prevent an epidemic have been disproportionate and occasionally have caused more harm than good. For example, the use of disposable surgical implements may have led to one death while the risk of transmission by this route was described as 'theoretical'. Rules on who can give and receive blood have been tightened up, and some blood products are now imported specifically because of the vCJD threat. Schemes to eradicate BSE from cattle, while not solely concerned with human health, have cost billions of pounds.
It is suggested that 'mad' cows have spread vCJD - but it is the panic attached to this rare disease that is truly bonkers.
Read: | | Experts warn of wider vCJD threat, | | BBC News, 6 August 2004 |
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| | | 28 July 2004 | Rampant scaremongering
Panic: 'Britain is facing an epidemic of sexually transmitted diseases as the safe-sex message fades and treatment clinics are forced to turn more people away', reports The Times (London). Figures from the UK Health Protection Agency suggest that the number of cases of sexually transmitted infections (STIs) rose by four per cent in 2003. Compared to 1995, cases of syphilis are up over 1,000 per cent, gonorrhea is up 150 per cent, chlamydia by 190 per cent, genital herpes by 15 per cent, and genital warts by 27 per cent. The rises are blamed on declining awareness of safe sex and long waiting times at sexual health clinics. There are also concerns that these figures may hide many more cases - particularly of chlamydia, which is often symptomless.
Don't panic: The most serious of these diseases is syphilis but the absolute numbers are still small - there were about 1,500 cases last year. The rises in other diseases are substantial, but not nearly as spectacular in relative terms. Rates of genital herpes, once regarded as the Next Big Thing after AIDS, are essentially static.
The recorded increase in sex disease seems to be largely a result of increased awareness, rather than an increase in rates of infection. This makes particular sense in the case of chlamydia, a disease you would probably never know you had unless you were specifically tested for it. For example, there was a sharp and sudden increase in chlamydia diagnosis at the end of the 1990s - rising by 20 per cent in men between 1999 and 2000 (totalling 27,702 cases), and by 26 per cent in women (totalling 36,928 cases). This was precisely the time that the Department of Health started its posters-in-pub-toilets campaign encouraging women to have the chlamydia test, and when the Public Health Laboratory Service (PHLS) organised a pilot involving 18,000 sexually active women between the ages of 16 and 25 to examine the prevalence of chlamydia in the UK.
'There was a lot of publicity about the availability of screening, so people were presenting themselves', Dr Pimenta of the PHLS told BBC News in 2001. The 'crisis' in sex clinics is partly down to more STI-free people going for testing. These are the 'worried well', people who needlessly seek tests for STIs because scare propaganda constantly tells them they're at risk from STIs. Between 1991 and 2001 the clinic workload increased by 155 per cent, but diagnoses increased by less than half this amount, at 61 per cent.
This seems to be a bad case of sexual morality disguising itself as a health panic. When AIDS and genital herpes don't work as a scare anymore, bring on chlamydia.
Read: | | HIV and sexually-transmitted infections, | | Health Protection Agency, 21 July 2004 | | Sex disease hits one in ten, | | BBC News, 17 September 2001 |
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| | | 20 July 2004 | Binge boozing
Panic: Binge drinking is creating a culture of 'thuggery and intimidation' according to UK home secretary David Blunkett, interviewed in the Observer. Blunkett says there has been a rise in 'lager loutettes', as more and more women drink unsafe amounts of alcohol. The number of women found to drink more than 21 units of alcohol per week has apparently risen from 14 per cent to 33 per cent. Blunkett added that the stereotype of women as a calming influence on violent male drunks was fading fast, leading to more crime.
Don't panic: A Cabinet Office report produced in 2003 notes that, while drinking levels have been rising since 1945, they are still substantially below consumption levels in 1900. Per capita consumption in the UK is still lower than that in Ireland, France and Germany. In fact, most of the population drinks less than the abstemious levels recommended by the Department of Health, and 4.7million Brits are teetotal.
Binge drinking is defined as drinking twice the recommended daily allowance in one sitting. For men, this means roughly four pints of ordinary-strength beer or one bottle of wine. For women, it means three pints or two-thirds of a bottle of wine. While drinking to excess frequently is certainly a bad idea, these definitions of binge drinking lump together ordinary social drinking with alcoholism.
What the government has been keen to promote is a late-night culture as a way of reviving city centres after years of decline. Unfortunately for them, this hasn't led to a sophisticated café culture but to super-pubs shifting large quantities of lager and alcopops to crowds of young people looking to let their hair down. With so many inebriated people in a relatively small area, it is not hard to find someone embarrassing themselves or getting into a fight.
But whether this is a major social problem, or even particularly different from the past, is to be doubted. While levels of violent crime haven't changed much, what has changed is the fear of violent crime - something which Blunkett seems only too happy to stoke.
| | Bingeing women fuel crime, | | Observer, 18 July 2004 | | Alcohol Misuse: Interim Analytical Report, | | Prime Minister's Strategy Unit, September 2003 |
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| | | 14 July 2004 | Bread and obesity
Panic: 'White bread could spoil your diet', says a story from BBC News. Researchers from Tufts University in Boston looked at five different diets where one food-type was prominent - 'healthy food' (ie, whole grains, fruits and vegetables), white bread, alcohol, sweets or meat and potatoes - in 459 healthy men and women. Those who ate a diet with a relatively large amount of white bread saw the biggest increases in their waist measurement. In a year, their girth increased by an average of about one centimetre, three times more than people who ate a diet high in fibre and whole-grain foods such as brown bread. Professor Katherine Tucker said: 'Waist circumference was very much associated with this high-refined grains pattern.' White bread is the mostly commonly consumed food in Britain, with an average daily consumption of three slices.
Don't panic: This is a small study with a variety of flaws, which make it difficult to draw definitive conclusions.
To determine whether white bread causes weight gain, you would need to have a controlled study in which the only difference between two groups was the consumption of white bread. Unfortunately, that was far from the case here. As a spokeswoman for the British Nutrition Foundation told BBC News: 'Looking at the data, those that ate white bread consumed more calories, more fat and less fibre, than those that ate wholemeal bread, so it is hard to say that white bread is the reason for this weight gain.' Nor do we know if there were differences between the exercise levels of the various groups.
However, this study fits with the widespread prejudice that refined food is bad, and 'wholefood' is good. In reality, there is no such thing as bad food. A diet where a variety of different foods are eaten is probably better, if only from the point of view of avoiding boredom, but human beings have demonstrated a remarkable capacity to live perfectly healthily on diets made up of entirely the 'wrong' things.
Snootiness about bread quickly disappears when that bread is from France or Italy - despite these countries' preference for the white stuff. Both countries have lower levels of obesity than Britain or the USA, too - which suggests that this study bears little relationship with reality. Still, researchers have got to earn a crust....
Read: | | White bread could spoil your diet | | BBC News, 13 July 2004 |
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