Category Archives: Rant
I spotted this article in the Health Section of the New York Times; an extensive retrospective study published in the journal Clinical Infectious Diseases has found no correlation between receiving the seasonal influenza vaccine and developing the serious neurological condition Guillain-Barré Syndrome (GBS). This finding gave me great joy, and also gives me an opportunity to link back to one of my favorite Rage Stroke®-inducing BIO230 postings. The possibility for correlation arose from the 1976 Swine flu vaccine, in which the Centers for Disease Control and Prevention reported a slightly increased risk for developing GBS following receiving that vaccine, with the risk being approximately 1 case of GBS per 100,000 vaccine doses. This measurable increase led to a moratorium and reformulation of the vaccine.
An extensive investigation by the Institutes of Medicine (IOM) confirmed the increased risk of developing GBS with the 1976 influenza vaccine, and although several theories were put forth to explain the potential correlation, the cause remains unclear. One possibility hypothesized in the IOM study linked above suggests that the clear association between developing GBS and infection with the bacterium Campylobacter jejuni might be to blame. Campylobacter is an ubiquitously distributed organism, however it does infect chickens, and eggs are used to produce the influenza virus used to produce the vaccine. The increased incidence of GBS with that year’s vaccine therefore might have been due to contaminating Campylobacter antigens present in the killed vaccine preparation.
The study described in the New York Times article recounts an extensive retrospective analysis of patients from a California health care system, and data examined covered more than 30 million person-years worth of medical records. In that data set, 415 cases of Guillain-Barré were observed for a total annual incidence of approximately 1 in 90,000 people in the population, a number that is very much in line with what is reported by the CDC. Out of those 415 confirmed cases, 25 of them had a reported influenza vaccine in the 6 weeks prior to developing GBS symptoms. Most of the cohort had received a flu vaccine at some point in their medical history, but had additionally had a large variety of other vaccines. The researchers recognize that the very limited number of GBS cases in relation to the large number of records examined limits the statistical power of their analysis, however no apparent correlation between first receiving a seasonal influenza vaccine and then developing GBS could be demonstrated. The researchers further affirm that during the 1976 outbreak there was a causal link between the swine flu vaccine and developing GBS, but as vaccine formulations have been modified, no further link exists. The much more likely culprit causing Guillain-Barré Syndrome is an underlying infection, most likely due to Campylobacter, which can be easily prevented by properly cooking food and washing your hands.
By now, all current students in BIO230 are likely aware of my stance towards vaccination. During the class discussion on safety issues with vaccines in general, I alluded to the story of Dr. Andrew Wakefield and his flawed report on a link between the Measles/Mumps/Rubella vaccine series and potential link to autism and inflammatory bowel disease. I first came across this link from artist Darryl Cunningham via my favorite Facebook group, I F***ing Love Science (and who doesn’t?). Mr. Cunningham has summarized the story of Andrew Wakefield in a lengthy comic strip, which he has published on his Live Journal page and I urge everyone to click through and read–it isn’t long, and it really nicely illustrates the incredible damage that is currently being done to public health measures due to individual greed.
I’ve come across two essays out on the Internet over the past few days that have caused me to think a bit about the public perception of science in the United States. I don’t speak of politics particularly much in BIO230, although I did put up a rant during the Republican primary season last year, and if asked I’ll be happy to talk about public policy with anyone. The first essay was from The Atlantic titled “The Danger of Making Science Political.” In this essay, it is noted that public polls leading up to the Presidential election suggest that only 6% of professional scientists identify themselves as Republicans. This disconnect was certainly made more public during the election season by several high profile candidates in state and national elections, with their comments on female reproductive biology, as well as my example above of a Presidential candidate’s opposition to the Human Papillomavirus vaccine.
The second was from Scientific American entitled “The Liberal’s War on Science” and makes to some extent a counterpoint arguing that the political left can be just a guilty of “bad science” political discourse, and cites groups opposed to GMO foods, vaccination, and nuclear power as examples. While the example of vaccination is valid (and one of my personal ragestroke triggers), it is important to note that opposition to vaccination is not particularly restricted to one political leaning or the other. With the other two examples (opposition to GMO foods and nuclear power), the opposition does not stem so much from a denial of the existence of nuclear reactions, but rather an opposition to the potential economic benefits to the technology.
I think that both of these essay omit one important point. Although science is properly conducted without preconception or bias, the science that does get conducted in the United States does not happen in a vacuum. Although scientists would strongly advocate that scientific inquiry ought to best be accomplished in a sort of search for pure truth, in fact since the public in the end pays for academic research, the public gets a voice in what research gets accomplished. The funding of science does then become politicized.
I think that what continues to be necessary is for scientists to continue to be advocates for their work, and it is further the responsibility of all Americans to work to be scientifically literate, so that we all can participate in the conversation.
As I cannot stay away from the Micro lab, even on the weekend, I made my Saturday morning pilgrimage to make sure nothing was amiss. I did find two things of note: first, even though there was a practical question dealing with the proper discarding of cultures that essentially everyone got correct, in practice people seem to miss what the proper procedure is. All to-be-discarded culture tube need to go in the appropriate rack, with all tape removed prior to discard. Second, I found about a dozen cultures in the incubator. Those of you who left cultures in the incubator for the weekend will need to run them again. I do feel somewhat like a broken record in this regard, as I did specifically state it to everyone repeatedly on Wednesday and Thursday, and wrote about it here previously, but perhaps it is time to reemphasize things that are important for success in a lab.
All of our cultures need to be run, incubated, and interpreted according to specific guidelines, or else the interpretation of the culture is completely invalid. The Clinical and Laboratory Standards Institute is a national organization that establishes guidelines for the proper way to set up and read clinical assays in laboratories. If a test is run for too short of an interval, there is a significant possibility of obtaining a false negative result, and if a test is run for too long of an interval, there is a possibility of obtaining a false positive result. Either case represents the possibility of a poor patient outcome: for the false negative, they might not receive notice that they have a given infection, and for the false positive, they might be started on an inappropriate treatment regimen.
At the tail end of the Fall 2011 semester, a fascinating report popped up in the medical literature that was picked up and widely reported in the popular press. Researchers at the Erasmus Medical Center in Rotterdam, and at the University of Wisconsin-Madison, reported their findings about the relative virulence of avian influenza (H5N1). The research, funded by the US National Institutes of Health, was to be published in the journals Science and Nature, however a national advisory panel (the National Science Advisory Board for Biosecurity) has asked the journals to withhold key details of the reports.
What the researchers did was not particularly novel. They utilized a virulent isolate of influenza virus which is poorly transmittable to humans. However, when humans acquire the virus from birds, the disease has an approximately 50% mortality rate which is several orders of magnitude higher than that observed for the 1918 worldwide pandemic influenza outbreak. So far, approximately 600 people have contracted this isolate of influenza since it was first identified in 1997. That low incidence figure drives home the point that this is not currently a significant pathogen of humans, however the great fear is that it could develop through random mutation the ability to more easily infect and be transmitted between humans. The high mortality rate then would be a calamity. Read the rest of this entry