The person who follows the crowd will usually go no further than the crowd.
The person who walks alone is likely to find himself in places
no one has ever seen before.
Just what is behind the panic over the Zika virus?
19th February 2016
Do you not think that there might just be something a bit fishy about the current panic over the mosquito-born Zika virus that has invaded Brazil? I know that we get these wretched new diseases appearing occasionally, as people spread ever more rapidly around the globe, but this is not a new pathogen.
It's been known for around 60 years, and has never, ever been associated with the alarming condition of small-headed children (microcephaly) that has suddenly developed in North West Brazil.
After the recent Ebola scare, obviously there's cause to take any possible new development seriously but just how appropriately are the health authorities responding to this new epidemic? Well in my books, the frantic alarmist advice to young women not to get pregnant for a while (in a Catholic country? Oh come on!) merely reinforces a pretty weak presumption that a Zika infection actually causes this condition al all
Some real numbers, for the record.
How do we know if a mother has been infected by the Zika virus? Well, for up to 5 months afterwards she'll have detectable antigns in her blood serum for up to 5 months. If she gets infected later on during pregnancy, then she may have these present when the baby's born, and so also may the baby have them, obtained from its Mum.
The North Eastern State of Pernambuco in Brazil is where the microcephaly problem is most common. So how many microcephalic babies and/or their mothers there had such antigens at delivery?
There haven't been that many tests done yet, but amongst the mothers of 270 infants with microcephaly who've been checked out so far, only 6 (yes, six) have tested positive for Zika antigens. So only 2.2% of the mothers have had Zika recently enough to detect the antigens at delivery. A bit low, that, don't you think?
And as of 2nd February, only 17 of the 404 microcephalic infants tested in the whole of Brazil (that's 4.2% of the kids) had any evidence of a previous or on-going Zika infection.
So whilst the absence of detectable antigens at birth doesn't ensure that they weren't infected earlier and the evidence could have disappeared by now, you'd expect at least a fair proportion of both to have some indication of Zika infection, even if were to have been only acquired later during pregnancy - and there are hardly any.
How early does a fetus need to be exposed to something that could cause this skeletal deformity?
This is quite a killer question. The baby's skeleton,including the skull, starts to form during the first two to three months after fertilisation. Nothing that happens later will cause the amount of distortion of the skull that these unfortunate Brazilian infants experience.
So if a mother contracts, or is exposed to, some pathogenic agent that can affect the fetus later during pregnancy, then the infant may have severe mental capacity issues at birth, but won't have microcephaly. So we can rule out infection later during pregnancy as the cause.
It's rather odd, then, that if the Zika virus might be causing this problem, the US Centers for Diseases Control (CDC) should recently recommend that all infants born with microcephaly, and their mothers, should be tested for Zika antigens at the time of birth, months after any initial infection that is unlikely to reveall them at the time of birth.
Since fetal skeletal mis-development occurs many months earlier, this advice is not consistent with the measured very low prevalence of Zika antigens in microcephalic infants at full term. It's also inconsistent with the CDC's own advice that pregnancy or sexual contact should be avoided for 12 weeks after potential exposure to Zika.
So what other explanations might there be?
So what else is new then? This is where things start to get interesting. Those pharmaceutical people have rolled into town, that's what.
There's been a bit of a problem in Brazilian recent years with a couple of troublesome diseases, Measles and German Measles have become a bit too common for comfort, so in 1999 the government introduced a progressive universal vaccination programme, using the MMR vaccine to control them.
Oh no not the dreaded MMR Vaccine!
Now I know that the more excitable amongst you will become quite noisy at this point. Ah, there you go then that MMR muck again! So hang on for a moment and listen to the full story first.
The MMR vaccine is given to infants after birth, and to mothers of childbearing age. So vaccination at that time can't possibly cause microcephaly. And as far as the Brazilian health people were aware this vaccine has never been given at least, not knowingly - to pregnant women.
But young people being occasionally extremely enthusiastic about having more kids, there was always a chance that a recently-delivered mother could have already become pregnant again when her first infant (and she too) got vaccinated the first time around. So the programme did its best, but could never be 100% reliable.
And indeed, that's what turned out to be the case. A study in 2011 found that during this campaign a small proportion of women who were unknowingly in early pregnancy were indeed accidentally vaccinated.
Now the MMR vaccine contains live attenuated rubella virus, and a rubella infection of the mother during early pregnancy can indeed cause microcephaly (it's part of the 'Congenital Rubella Syndrome CRS).
But the crunch is that none of none of the infants born to these accidentally vaccinated mothers had CRS. So the MMR vaccine cannot be blamed for the new outbreak.
But it's not that simple.
In fact, there has been one recent change, and it's potentially a big one. But for some reason, no-one seems to want to talk about it. So is it possible to tie things down really tightly, and narrow that 'window of vulnerability' for the onset of microcephaly just a little bit tighter? Yes, it is.
Remember that the first reports of the outbreak of microcephaly began trickling in in October 2015. They must have been initiated by something that happened around the start of last year, or perhaps a little sooner, say in late 2014.
In the run-up to the end of 2014 the Brazilian health people were getting worried about another killer disease of infants that was getting a bit too common for comfort - Whooping Cough, also known as Pertussis.
So in December 2014 the Brazilian government started a new universal and compulsory vaccination programme against pertussis, aiming to vaccinate alll women of child-bearing age. Any woman at all, between the ages of 12 and 39 years, was required to be vaccinated with the Tdap vaccine,marketed by GlaxoSmithKline as 'Boostrix'.,
Now once again, this has been around for some time at least ten years in Brazil itself. This Tdap (Tetanus, Diphtheria and Pertussis) vaccine contains pertussis toxiod, not a live virus, so it can't cause either the mother or the infant to develop pertussis during or after pregnancy.
But crucially perhaps, it has never been given to pregnant women. Indeed, like Thalidomide, it's not even been tested on them (well,obviously, really, you might well say!) But it most certainly is not recommended to be given to them..
And yet, as we have already seen, preventing that happening to women who might be unaware that they were already in early pregnancy when their turn came round for the vaccination shot,wasi and remains just plain impossible.
As the Brazilian government already knew, these national programmes do have an unavoidable low rate of accidental vaccinations of women in early pregnancy,
So it is a reasonable assumption that some women in early pregnancy were indeed vaccinated by the Boostrix vaccine, as from the end of 2014, and into the early part of 2015. And this is precisely when that dangerous developmental 'window of vulnerability' was wide open.
Is it really a coincidence that the first of those microcephalic babies were born nine months later?
So what's the point of this message?
The claim that Zika is causing this outbreak is completely unsupported by hard evidence. There is NO science that establishes causation.
This does NOT mean that the new vaccination programme is inevitably the cause of the problem. We don't know that either.
But the Zika virus in its claimed mutated form if that's what you want to argue - is already spreading further across South America, into countries where there's no compulsory vaccination of women with the Tdap vaccine.
So it shouldn't be hard to discover if there are or are not more microcephalic babies elsewhere. Has anyone got around to doing that yet, I wonder?
Of course there may be some other altogether different explanation to all this, one for which apparently no-one is actually looking at the moment. There could indeed be some obscure and unfathomed complex interactions of a range of social and medical processes that may be at work here.
But we don't know, and nor do my professional correspondents either.
Even now, some academics are muddying the water even more by claiming that there is not actually any outbreak of microcephaly in Brazil at all, that it's all down to past under-reporting (unlikely ask the first GPs who called the new cases in).
Or they argue that the way that it's identified is unreliable (when confronted with inconvenient evidence, try changing the way you measure things!)
What we need is hard evidence and a bit more thinking 'out of the box', just in case we're missing something really important here. Or, of course, you might think that someone might be anxious that we do precisely that, for their own secret reasons!
You may say that, I couldn't possibly comment.
The killing fields - opening for business again.
But despite all this fudge and fumble, and the total absence of reliable material to go on, the spread of the hysterical reaction to this recent outbreak in Brazil is beginning to affect the whole world. As the media hype it up, it is rapidly becoming an even worse travesty of medical science than the response to the recent Ebola outbreak.
Very soon, it will start killing people.
Is this me scaremongering too? Not at all - just sit back and think about this for a minute. Women who have visited Zika-infested areas are now being warned that they should either avoid going outside or else 'cover up', to avoid getting bitten (Ha! Have you ever been out in a steaming hot, soggy Brazilian rain forest?)
And they are also sternly warned not to get pregnant for some weeks after they return home. To cap it all, there are even delicious reports that men may be bringing it home from overseas trips. What a God-send to the sensation-hungry media!
The very thought that Zika can be the next wildly proliferating sexually transmitted disease has got them really steamy under the collar!
Well, you can be quite certain that some women have discovered that their recent holiday in Brazil (and of course, elsewhere) was triumphed by more than just getting a very nice tan. You can bet on it that some will already have found that they did indeed get themselves cooperatively pregnantt, either shortly before or during their holiday break.
So now, without any reasonable cause whatever, they are going to be terrified.
And what do you imagine that some at least will do about that? They're going to panic, and decide they daren't risk carrying a potentially devastatingly handicapped infant. So they'll go off and have it aborted, a response that, on all present evidence, is totally unwarranted.
So I am concerned that unless this Zika Freakout is brought under control, and quickly, infants are going to be killed because some fools jump to instant and almost certainly unjustified conclusions. Without some programme to straighten out this mess, someone is going to have to answer some extremely probing questions.
Killing kids through sheer negligence is utterly repugnant.
Those GM mosquitoes it's all down to them, right?
Nope not on your life! So let's look a little more closely at what's going on here. Zika virus originated in Africa and only recently spread through Polynesia and to South America.
It's been known in South Asia for years too, and is now appearing in many more parts of the tropical world, allegedly (note that 'allegedly' bit) because the climate is getting warmer and the Aedes egypti mozzies are putting themselves about a bit more widely than usual.
To try to control these disease-bearing wild mo
zzies, artificially-reared genetically modified male mozzies are being released in their millions in Brazil to try to bring the natural breeding cycle under control. And it's working brilliantly, at least, where they're doing these trials. And the crazies are now trying to blame these mozzies for the microcephaly outbreak!
Just a little problem here, Guys.
The catch two catches, actually? Male mozzies don't bite people, they feed on flowers, so they absolutely can't transfer Zika virus to people. And the places where the trials are being done are hundreds of km away from where the microcephaly outbreak started. Whoops!
The GM mozzie control programme has been in operation since 2012 - but NOT where the microcephaly outbreak first appeared. So this new outbreak was not caused by Zika or Zika control measures. If it were then this problem would have emerged elsewhere and earlier.
And yet just watch the TV News or read the Daily Scaremonger tabloid press and you'll hear or see veiled, or even quite blatantly open, references to the Zika virus being the cause of the microcephaly. Where is the damned proof, then?
There is absolutely no evidence it's yet another of those correlation thingies again, that so beset and confuse the lower grades of scientists (and of course, all grades of media people).
Just give me the facts, Man
So, has something else changed recently, something that might offer just a little more light into what's going on?
Well, as it happens, yes, there has been one thing that could and I emphasise here could have a bearing on the problem. So let's look at a few more facts first.
How many kids in Brazil are being born with microcephaly? The prevalence of microcephalic births in the affected area of NE Brazil is around 1%,