School-age vaccine waivers drop 39 percent in Michigan

Recent preliminary data suggests that there has been a 39 percent decline in school-age vaccine waivers in the state, which experts attribute to a non-medical vaccination waiver rule change from January 2015.

Two years ago, Michigan had the sixth-highest vaccination waiver rate within the U.S. Over 5 percent of kindergarten students did not receive vaccinations and still had their waivers.

To change this, state officials mandated parents use a non-medical waiver if their child did not have vaccinations. The parents also needed to speak with local health department staff before they could have the waiver – earlier, the waiver could be found at the school.

“By ensuring that parents have the opportunity to address and discuss concerns with their local health department, we’re providing parents with knowledge they can use when making a decision about vaccinating their child,” Nick Lyon, director of the Michigan Department of Health and Human Services (MDHHS), said. “Michigan’s local health departments have been instrumental in working with and educating parents who have had concerns about vaccines and I applaud them for their understanding, assistance and dedication.”

As of today, there are approximately 8,000 fewer vaccination waivers for Michigan’s children.

“This improvement in our vaccination coverage rates means that more kids are protected from outbreaks and serious vaccine-preventable diseases,” Dr. Eden Wells, chief medical executive for the MDHHS, said. “Unfortunately we have not eradicated some very serious diseases that affect children and adults alike. We continue to see outbreaks of pertussis, (whooping cough) and chickenpox in areas of Michigan as well as nationwide.”

Zika virus detected in the brain of a terminated foetus with severe brain injury…

In a new paper in the New England Journal of Medicine, Mlakar and colleagues present some compelling evidence for the presence of Zika virus (ZIKV) in brain tissue of a foetus, probably infected by the mother (vertical transmission), that was medically terminated because of severe brain disease, microcephaly and a poor prognosis.[1] 

This study has a very strong title: Zika Virus Associated with Microcephaly

…and it can make that claim because of several robust findings.

  1. Presence of flavivirus-like particles in foetal brain as imaged using electron microscopy, which the authors suggest may reflect persistence in an immune-privileged site. They don’t have data to support that though but presumably infection would need to persist for long enough to cause the structural damage seen in these diagnoses – whether that must begin within the first trimester has not been shown, just hypothesized. We do know that virus in the blood usually clears in a week, with virus detectable in the urine for a little longer
  2. Detection of viral RNA in the brain tissue at levels, or ‘viral load’, higher than usually reported in adult ZIKV patients
  3. Detection of antibodies in the mother’s serum indicating past ZIKV, and also Dengue virus, infections
  4. Determination of a complete, full-length genome of the Asian clade of ZIKV, from the foetal brain tissue (KU527068) using an Ion Torrent deep sequencing approach
  5. Absence of ZIKV RNA in many other tissues
  6. Absence of finding other viral genetic material which were sought and included dengue viruses, chikungunya virus, cytomegalovirus, herpesviruses, enteroviruses, rubella virus and others
This very tightly focussed located finding of ZIKV in brain tissues but not any other tissues, (including the spinal cord?), suggests a strong liking for brain tissue.  

An accompanying Editorial [2] notes that this is not proof of cause, but it definitely adds more and better information building a a stronger case for ZIKV doing something in the brain that we had seen just once before, in the French Polynesia outbreak of 2014.[3]

Virus was not cultured – but the finding of a complete viral genomes is good evidence of intact virus present. There have not yet been any studies to identify whether there are babies with ZIKV in their brain tissues but no brain injury disease (babies who died of other, unrelated causes perhaps?) nor is there any gauge of whether every case of comparatively similar brain injury in the region has ZIKV in their brains. We also don’t know if ZIKV may simply be a passenger in the brain, or if whether brain tissue is a last, transient site of an infection that is being dispelled by the body after being acquired my the mum and passed to the foetus during an epidemic of that virus. 

Much work lies ahead, but this is stronger evidence towards an association than we have seen so far.

References…
© 2013-2015 Ian M. Mackay. PhD.
This content was originally published at http://bitly.com/1Kas2vY
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Not testing for the virus you are trying to associate with a disease is really dumb…

Ventura%2Bet%2Bal_Ophthalmological.jpgI quickly skimmed over two new papers last Friday (AEST) and was appalled.[1,2] 

In their current format, these papers really just should not have been published at all. 

Any respectable peer review would have sent them back for additional results, to be completely re-written as a letter or more simply – and what I would have recommended to the Editor – that they be rejected outright. 

I was asked if this was just a lost-in-translation error, but complete absence of laboratory data is not that. And that’s what these lack – any testing for the virus they name – Zika virus. 

How can you publish something even hinting that a disease is caused by a virus infection, when you present no data to show that person was ever infected by that virus? How can you seriously have that conversation at all?

And using “presumable”and “clinically diagnosed” doesn’t get you out of jail either. 

You need some evidence that the virus is or was in the tissue(s) in question (viral genetic material or infectious virus isolated in culture), or was present at some point in the past (antibodies or cells tat respond to the virus when challenged by it in the laboratory) in the person. Neither of the papers here do that. Which astounds me.

Sadly today, there seems to be a journal willing to take any manuscript so that even had the authors been rejected, they most likely would have had their paper appeared elsewhere. 

Or perhaps they had been rejected – and this is that “elsewhere”.

I think this sort of publishing sets a hugely dangerous precedent. If the “scientific and medical” literature cannot be relied upon to present its results accurately and with necessary context, how do we expect the community to be able to accurately judge risk and respond reasonably, or our public health experts to find the extra time to sort the signal from the background noise, or the media to get the story straight? 

The Zika virus epidemic of 2015/16 has made much more background noise than signal to date. I hope that changes soon because its hugely disappointing to see so many responding to noise as if it were fact, and fact as if it was hiding conspiracy.

References…

  1. Ophthalmological findings in infants with microcephaly and presumable intra-uterus Zika virus infection.
    Arquivos Brasileiros de Oftalmologia
    http://bitly.com/1V7ubAf
  2. Zika virus-related hypertensive iridocyclitis
    Arquivos Brasileiros de Oftalmologia
    http://bitly.com/1RuBvab
© 2013-2015 Ian M. Mackay. PhD.
This content was originally published at http://bitly.com/1Kas2vY
9920132014201599

(2/2)“When I heard I was HIV-positive I didn’t cry….

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(2/2)“When I heard I was HIV-positive I didn’t cry. Neither did my world collapse. The first thing that went through my mind was, now I have this label attached to me and I’m never getting rid of it. I will always be the one who is HIV-positive. The second thing that went through my mind was the concern that I might infected someone else. The first person I called after I found out was a friend who is also a colleague of mine. Her first reaction was: ’‘I will be here for you! No matter what, I still love you.” Those words hit me hard and I started to cry for the first time. Three months have passed I feel really good. Of course I’m devastated that I have this virus but at the same time I’m not an unhappy person. Finding happiness is something I have fought for my entire life. When I found out I was HIV-positive it hit me hard. The first weeks I cried a lot but now I’m getting my life back on the road. I have a wonderful job, great friends and supportive parents. I’m open about it because I find it important to be honest and I hate lying. I have decided to take matters into my own hands and I won’t let the HIV define me or determine my happiness.“