NBC News’s World Blog carried a series on malaria and fighting it around the world. Here’s part I:
PAILIN, Cambodia – The border crossing between Thailand and Cambodia at Pailin has a rather bleak feel about it at the best of times. In the heavy monsoon rain, the dingy checkpoints are reduced to gray smudges.
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Africa, Asia, Health care, History, Malaria, medicine, Public health | Tagged: Africa, Asia, Cambodia, Health care, Malaria, medicine, Pharmaceuticals, Public health | 
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Posted by Ed Darrell
Eugene Robinson stuck to the facts, and noted that by a careful count, 62 percent of Americans oppose the Republican vote to repeal the new health care law:
What actually happened, though, is that the Republican majority managed to win the votes of just three Democrats – all of them Blue Dogs who have been consistent opponents of the reform package anyway. In terms of actual defectors, meaning Democrats who changed sides on the issue, there were none. This is momentum?
The unimpressive vote came at a moment when “the will of the people” on health care is coming into sharper focus. Most polls that offer a simple binary choice – do you like the “Obamacare” law or not – show that the reforms remain narrowly unpopular. Yet a significant fraction of those who are unhappy complain not that the reform law went too far but that it didn’t go far enough. I think of these people as the “public option” crowd.
- Washington Post header for Eugene Robinson’s columns .
The numbers:
A recent Associated Press poll found that 41 percent of those surveyed opposed the reform law and 40 percent supported it. But when asked what Congress should do, 43 percent said the law should be modified so that it does more to change the health-care system. Another 19 percent said it should be left as it is.
More troubling for the GOP, the AP poll found that just 26 percent of respondents wanted Congress to repeal the reform law completely. A recent Washington Post poll found support for outright repeal at 18 percent; a Marist poll pegged it at 30 percent.
In other words, what House Republicans just voted to do may be the will of the Tea Party, but it’s not “the will of the people.”
[My math: 43% +19%=62%.]
The facts:
The CBO, which “scores” the impact of proposed legislation, calculated that the health-reform law will reduce federal deficits by at least $143 billion through 2019. Confronted with the fact that repeal would deepen the nation’s fiscal woes, Republicans simply claimed the CBO estimate to be rubbish. Who cares what the CBO says, anyway?
Er, um, Republicans care, at least when it’s convenient. Delving into the CBO’s analysis, they unearthed a finding that they proclaimed as definitive: The reform law would eliminate 650,000 jobs. Hence “Job-Killing” in the repeal bill’s title.
One problem, though: The CBO analysis contains no such figure. It’s an extrapolation of a rough estimate of an anticipated effect that no reasonable person would describe as “job-killing.” What the budget office actually said is that there are people who would like to withdraw from the workforce – sometimes because of a chronic medical condition – but who feel compelled to continue working so they can keep their health insurance. Once the reforms take effect, these individuals will have new options. That’s where the “lost” jobs supposedly come from.
So, in other words, Republicans voted to keep people slaves to jobs that provide health care benefits. The party of Abraham Lincoln has fallen so far not even Abraham Lincoln at his most charitable moment would recognize it any longer.
6 Comments | Health care, Legislation, Politics, Polling and Public Opinion, President Obama, U.S. House of Representatives | Tagged: Eugene Robinson, Health care, Legislation, ObamaCare, Politics, Polls, U.S. House of Representatives | Permalink
Posted by Ed Darrell
Getting everybody insured is the first step toward controlling health care costs — and the bill we have makes significant savings even without being so strong as it should be. Watch and listen to White House adviser Stephanie Cutler’s explanation.
Tip of the old scrub brush to Mary Almanza.
1 Comment | Health care, Politics, Taxes | Tagged: Affordable Care Act, Balanced Budget, Health care, ObamaCare, Politics | Permalink
Posted by Ed Darrell
Don’t ask me what work she’s done, because I couldn’t tell you. I can tell — based on the headlines of the clipping services — that Mandy Moore is popular.
Ironically, in her brief tour of Africa and — shall we label it? — probably-shallow understanding of the issues, Ms. Moore has a deeper understanding of malaria and how to fight it than the most erudite of the DDT denialists, like Michael Crichton, or Rutledge Taylor. Innocence wins.
For ABC News, the actress talked about charity work in Africa:
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It’s a case of a celebrity doing “Do a Good Deed” duty, most likely. In the video, Mandy Moore puts DDT denialists to shame. In writing? Moore doesn’t come off as well. (Did she write that piece herself? Maybe she should write what she talks.)
3 Comments | Africa, DDT, Disease, Health care, Malaria, medicine, Movies, Public health, Television | Tagged: Africa, DDT, Disease, Health care, Malaria, Mandy Moore, medicine, Nothing But Nets, Public health, Rutledge Taylor | Permalink
Posted by Ed Darrell
Lancet is one of the premiere research journals in the world for all of science, but especially for issues of health and medicine.
Image from Lancet –
Mother and child under a mosquito bite-preventing bednet.
On October 29, 2010, Lancet published a special report, “Malaria Elimination.” Much science. Much history. No call for more DDT.
A plan for research is laid out. Plans to eradicate malaria from more than 90 nations are laid out, explained and debated. Calls for more research are made. Calls for disciplined action from nations and health care organizations, and donor organizations.
But no call for more DDT.
Go take a look at the issue. Several of the articles are available for no charge, out from behind the usual Lancet paywall.
Get the real science, real history, real policy. Environmentalists are not evil villains there. malaria is the villain in that story, and serious health care researchers and deliverers discuss serious methods to beat the disease. Consequently, DDT has only a bit part.
Resources:
8 Comments | Africa, Asia, DDT, Malaria, medicine, Research, Science | Tagged: Africa, Asia, DDT, Health care, History, Malaria, Medical Care, Research, Science | Permalink
Posted by Ed Darrell
People so wedded to a hoax, or just wrong, view of events cannot be swayed away from their convictions easily.
Elizabeth Whelan’s hoax science policy group, the American Council on Science and Health (ACSH), put out a press release taking note of the study published in Lancet that calls into question the count of malaria deaths in India promulgated by the World Health Organization (WHO). You remember, the study suggests the malaria death toll among adults in India may be as high as 200,000 annually, compared to the 15,000 estimated by WHO.
ACSH can’t resist the spin. Implicit the debunking may be, but the study thoroughly debunks ACSH’s claim that more DDT will help defeat malaria. India is the world’s greatest user of DDT, using more than all the rest of the world together. Clearly a surplus usage of DDT has not created the miracle end to malaria that ACSH and other hoaxsters claim it would.
Still, ACSH sticks to their views, even when those views are grossly wrong. ACSH said, “ACSH has called for resumed use of indoor residual spraying of small amounts of DDT to prevent mosquito bites, repel mosquitoes, and reduce malaria deaths.”
No word from India on whether it will dramatically reduce DDT use to meet ACSH’s call for “small amounts.”
ACSH’s press release calls attention to a Wall Street Journal Blog article describing WHO’s response to the Lancet-published study of India malaria deaths — WHO questions the “verbal autopsy” methodology, and says it stands by its estimates of malaria deaths in the nation:
“The new study uses verbal autopsy method which is suitable only for diseases with distinctive symptoms and not for malaria,” WHO’s India representative Nata Menabde said in an email statement Thursday.
The WHO says it takes into account only confirmed cases of malaria and surveys those using healthcare facilities.
Malaria symptoms include fever, flu-like illness and muscle aches. Malaria is endemic to parts of India, where many people live in mosquito-infested areas. Confirming the presence of malaria requires tests like the “Peripheral Smear for Malarial Parasite” and “Rapid Malaria Antigen”.
Lancet said the determinations made by its field researchers were reviewed by two of 130 trained doctors for all the 6,671 districts who determined whether or not the person had died from malaria.
The data concluded that 205,000 deaths before the age of 70, mainly in rural areas, were caused by malaria each year – 55,000 in early childhood, 30,000 among children ages five to 14 and 120,000 people 15 and older.
The WHO called for further review of the study.
“Malaria has symptoms common with many other diseases and cannot be correctly identified by the local population,” Dr. Menabde said, adding: “The findings of the study cannot be accepted without further validation.”
4 Comments | DDT, denialism, Health care, India, medicine, Research, Science, WHO - World Health Organization | Tagged: DDT, denialism, Health care, India, Malaria, medicine, Research, Science, World Health Organization | Permalink
Posted by Ed Darrell
This is a story about the persistence of bad information, and about the flow of news and other new information.
At about the same time I was writing about the Lancet study on potential undercounting of malaria deaths in India, Debora McKenzie at New Scientist pored over the same article (maybe the same Bloomberg News piece), and reported it in greater detail than I did here. McKenzie’s piece is worthy of a read.
Glenn Reynolds, Instapundit
Glenn Reynolds at Instapundit picked up on McKenzie’s piece — but reflecting his pro-poison and anti-humanitarianism bias, he tacked on a gratuitous slap at health workers, scientists and governments who tried to eradicate malaria in the 20th century:
MALARIA KILLING MORE PEOPLE THAN WE THOUGHT?
Malaria has always been one of humanity’s biggest killers, but it may be far bigger than we realised. An unprecedented survey of the disease suggests that it kills between 125,000 and 277,000 people per year in India alone. In contrast, the World Health Organization puts India’s toll at just 16,000.
Other countries using similar accounting methods, such as Indonesia, may also be underestimating deaths from malaria. That means it could be killing many more than the WHO’s official estimate of nearly 1 million people a year worldwide, suggesting more money should be spent to fight it.
It’s too bad the malaria eradication efforts were allowed to fail.
“Allowed” to fail? Reynolds assumes someone wanted the program to fail? Reynolds assumes someone could have stopped the failure, other than the pro-DDT forces who overused the stuff and drove mosquitoes to evolve resistance, or other than the governments of Subsaharan Africa who could not mount massive health care campaigns due to the instability of their governments? It’s too bad the program failed — it was mighty ambitious. “Allowed to fail” is an undeserved slap at malaria fighters like Fred Soper.
This slip to finger-pointing is what I warned about in my post: Though India is the world’s greatest manufacturer of DDT, and though more DDT is used in India today than the rest of the world combined, someone will look at the undercount story, blame the imaginary ban on DDT, blame Rachel Carson (who never advocated a ban on DDT), and make some smug political snark.
Reynolds was pulled away from the snark, fortunately. Reader Kevin O’Brien wrote to Reynolds about the difficulties of beating any disease, using smallpox as his launching point. Beating smallpox was a massive effort, made easier by the fact that the pox resided only in humans, as opposed to the malaria parasite’s two-species life cycle. O’Brien’s missive to Reynolds, a few errors included, is the best commentary Reynolds has had on DDT and disease in some time.
One frequently-obnoxious blogger pulled back from the brink is not enough, though.
Andrew Bolt
Andrew Bolt jumped the shark at his blog for the Melbourne (Australia) Daily Sun. The headline for his post is inflammatory and wrong, and warns us that most of what Bolt writes will be wrong:
How many children did Carson’s green lies kill?
Foolish hope that DDT could be a magic bullet against malaria, like Bolt’s, helps frustrate workable plans to fight the disease. Policy makers being convinced that some political conspiracy keeps DDT from working to beat malaria, in effect kills children. Fighting malaria requires long, hard work, to bolster health care systems in entire nations, to accurately and quickly diagnose malaria, and to provide complete treatment to cure human victims. That work is hampered by policy makers and popular opinion who hold that DDT would be cheaper and quicker, and effective. Bolt takes any source, no matter how scurrilous, in his unholy condemnation of conservationists and scientists, especially Rachel Carson. His sole source to condemn Carson is a publication from the far, far-fringe.
How many children will Bolt’s brown lies kill? one could ask.
Watch. Advocates of poisoning Africa and Asia will claim scientists and environmental activists are somehow to blame for any underreporting, and they will call for more DDT use, claiming a ban has made India a refuge for malaria. Those reports will fail to mention India’s heavy DDT use already, nor will they suggest an ineffectiveness of the nearly-sacred powder.
Andrew Bolt, you’ve made me a prophet — a saddened and disappointed prophet. It’s good to see Glenn Reynolds step back from the brink of hysteria. It’s too bad Bolt took the plunge. Others will probably follow Bolt.
How far will the bad claims spread?
Leave a Comment » | Accuracy, DDT, Health care, India, Journalism, Junk science, Malaria, Science, Voodoo history, Voodoo science | Tagged: Accuracy, Andrew Bolt, DDT, Glenn Reynolds, Health care, India, Instapundit, Journalism, Malaria, Rachel Carson, Science | Permalink
Posted by Ed Darrell
Malaria hotspots in India. Image from Nature magazine, 2010. News report on Lancet study that suggests mortality from malaria in India may be significantly higher than WHO reports indicate.
Good news from the war on malaria has been that annual deaths are calculated to be fewer than 1 million annually, as low as 880,000 a year — the lowest human death toll from malaria in human history.
Researchers in India suggest that deaths there are grossly underreported, however — not the 15,000 estimated by the World Health Organization, but closer to 200,000 deaths a year, nearly 15 times as great.
Reading that news, DDT partisans might get a little race of the pulse thinking that this might improve the urgency for the case for using more DDT, as advocated in several hoax health campaigns and media, such as the recent film “3 Billion and Counting.”
The problem, though, is that India is one of the few places where DDT manufacturing continues today, and India is one of the nations where DDT use is relatively unregulated and heavy. In short, if DDT were the miracle powder it’s claimed to be, any finding that malaria deaths are 15 times greater than reported by WHO is nails in the coffin of DDT advocacy.
Researchers based their estimate on interviews with family members of more than 122,000 people who died between 2001 and 2003. The numbers “greatly exceed” the WHO estimates of 15,000 malaria deaths in India each year, the researchers wrote in the study, published today in the journal The Lancet.
“It shows that malaria kills far more people than previously supposed,” said one of the study authors, Prabhat Jha of the Center for Global Health Research in Toronto, in a statement. “This is the first nationwide study that has collected information on causes of death directly from communities.”
Remote regions may have an undocumented malaria burden, because conventional methods of tracking the disease are flawed, according to the authors. In India, the government malaria data, which is used by the Geneva-based WHO, only counts patients who had tested positive for the disease at a hospital or clinic. Others who died of symptoms closely resembling the malady but didn’t get a blood test aren’t included, co-author Vinod Sharma of the Indian Institute of Technology in New Delhi said in an interview today.
The lack of accurate data may hinder efforts by governments and aid organizations to provide diagnosis and treatment to the population at risk, the authors said.
Watch. Advocates of poisoning Africa and Asia will claim scientists and environmental activists are somehow to blame for any underreporting, and they will call for more DDT use, claiming a ban has made India a refuge for malaria. Those reports will fail to mention India’s heavy DDT use already, nor will they suggest an ineffectiveness of the nearly-sacred powder.
The article in the Lancet became available on-line on October 21 — it’s a 4.5 megabyte .pdf document: “Adult and child malaria mortality in India: a nationally representative mortality survey.” A team of researchers is listed as authors of the study: Neeraj Dhingra, Prabhat Jha, Vinod P Sharma, Alan A Cohen, Raju M Jotkar, Peter S Rodriguez, Diego G Bassani, Wilson Suraweera,Ramanan Laxminarayan, Richard Peto, for the Million Death Study Collaborators.
Accurate counts of infections and deaths provide essential information for effective programming of the fight against the disease. Researchers point no particular fingers, but make the case in the article that better methods of counting and estimating malaria deaths must be found.
There are about 1·3 million deaths from infectious diseases before age 70 in rural areas in which fever is the main symptom. If there are large numbers of deaths from undiagnosed and untreated malaria in some parts of rural India then any method of estimating overall malaria deaths must rely, directly or indirectly, on evidence of uncertain reliability from non-medical informants and, although our method of estimating malaria mortality has weaknesses, indirect methods may be even less reliable. The major source of uncertainty in our estimates arises from the possible misclassifi cation of malaria deaths as deaths from other diseases, and vice versa. There is no wholly satisfactory method to quantify the inherent uncertainty in this, and indeed the use of statistical methods to quantify uncertainty can convey a false precision. However, even if we restrict our analyses to deaths immediately classifi ed by both physician coders as malaria, WHO estimates (15 000 deaths per year at all ages)1 are only one-eighth of our lower bound of malaria deaths in India (125 000 deaths below the age of 70 years; of which about 18 000 would have been in health-care facilities).
Our study suggests that the low WHO estimate of malaria deaths in India (and only 100 000 adult malaria deaths per year worldwide) should be reconsidered. If WHO estimates of malaria deaths in India or among adults worldwide are likely to be serious underestimates, this could substantially change disease control strategies, particularly in the rural parts of states with high malaria burden. Better estimates of malaria incidence and of malaria mortality in India, Africa, and elsewhere will provide a more rational foundation for the current debates about funding for preventive measures, about the need for more rapid access to malaria diagnosis, and about affordable access in the community to effective antimalarial drugs for children and adults.
More:
111 Comments | Africa, DDT, Health care, India, medicine, Research, Science, World Health Organization (WHO) | Tagged: Africa, DDT, Health care, India, Malaria, medicine, Research, Science, The Lancet, WHO, World Health Organization | Permalink
Posted by Ed Darrell
“3 Billion and Counting” premiered at a tiny New York venue a couple of weeks ago, the latest skirmish in the War on Science. Physician-to-the-stars Dr. Rutledge Taylor claims that malaria could be eradicated if only DDT had not been banned from Africa.
What? No, no, you’re right: DDT has never been banned from Africa, not even under the 2001 Persistent Organic Pollutants Treaty. The film comes out of Hollywood, starring a Hollywood physician. Perhaps that should clue us in that it is not a serious documentary, and not to be taken at face value.
Nor at any value.
Taylor engaged a publicist and conducted a national campaign to launch the movie. In that campaign he someone appeared on Howard Stern’s radio show. [There’s a guy in comments who claims it wasn’t Taylor, though Taylor wrote it in the first person. Odd as hell.]
How silly are the claims in the movie?
A post at the movie’s blog revealed that Ronnie, Stern’s limousine driver, had a fight with bedbugs, and that Stern thinks DDT should be brought back. That’s how bad this movie is: Howard Stern is the science advisor.
Yes, yes, you’re right: DDT stopped working against bedbugs in the 1950s (see Bug Girl’s recent post). That doesn’t stop the publicists from defending the movie at the movie’s blog. “Royce” [who claims not to be a publicist for the movie] said:
The problem with DDT is that it worked too well in stomping out malaria. The science proves that it minimally impacted the environment. But this information was suppressed. Wonder why and by whom? This movies addresses and uncovers the answers to these questions..Questions that many of us had about this issue.
I tried, without success I’m sure, to set him straight:
Royce,
First, DDT was not the weapon that eradicated malaria in the U.S. We worked for 30 years to improve medical care, beef up the Public Health Service and county public health officers, educate people on how to drain mosquito breeding areas near their homes, be certain people with malari were fully treated to a cure, and to raise incomes to improve housing so that people could live in a home where mosquitoes could not enter at night (the times malaria-carrying mosquitoes bite). By 1939, malaria was essentially eliminated from the U.S. DDT was not available for use for another seven years.
Earlier we had defeated malaria and yellow fever in Panama, during the construction of the Panama Canal — long before any insecticide existed. Beating malaria is possible with discipline, accurate information, and sustained effort. No pesticide is necessary.
Second, DDT has never been out of use in Africa since 1946, nor in Asia. DDT is in use right now by the World Health Organization (WHO) and at least five nations in Africa who have malaria problems. If someone told you DDT is not being used, they erred.
Unfortunately, overuse of DDT by agricultural interests, in the early 1960s, bred mosquitoes that are resitant and immune to DDT. DDT simply is not the effective pesticide it once was, and for the WHO project to eradicate malaria, this problem was the death knell. WHO had to fall back to a malaria control position, because pro-DDT groups sprayed far too much of the stuff, in far to many places, mostly outside.
Third, all serious studies indicate that DDT greatly affects environment, with doses of the stuff multiplying from application through the top of the trophic levels in the ecosystem. A minimal dose of DDT to kill mosquito larva in an estuary, for example, multiples many times as zooplankton and the mosquito larva soak it up. The next level of consumers get about a ten-times dose from what was sprayed, and that multiplies exponentially as other creatures consume the lower-level consumers. By the time an insect or crustacean-eating bird gets the critter, the dose is millions of times stronger, often to fatal levels for the bird.
If the dose is sub-lethal, it screws up the reproduction of the bird. DDT in the egg kills the chick before it can fledge from the nest, often before it can hatch. If by some miracle the chick does not die from acute DDT poisoning, the eggshells produced by a DDT-tainted female bird are often too thin to survive the growth of the embryo — either way the chicks die. (There are a couple of studies done on plant-eating birds which showed that the chicks did not die before hatching — they died shortly after hatching.)
DDT is astoundingly effective at screwing up the reproduction of birds.
Fourth, studies show that humans exposed to DDT rarely get an acutely toxic dose, but that their children get screwed up reproductive systems, and there is a definite link from DDT exposure to the children of the mother — the cancer goes to the next generation. DDT is not harmless to people at all — it is just not acutely toxic, generally.
Fifth, as I note above, DDT is no longer highly effective in controlling mosquitoes. Where once it killed them dead, they have developed immunity, and now digest the stuff as if it were food. There are studies that show DDT is also weakly repellent, but there are better, less-toxic repellents, and there is no reason to use something so deadly to all other creatures in the ecosystem to get a weak repellent effect.
Because of the biomagnification, DDT kills the predators of mosquitoes much more effectively, and for a much longer period, than it kills mosquitoes. This sets the stage for mosquitoes to come roaring back, with all the natural checks on mosquito population out of commission.
Why use a poison that is not very effective, but very deadly, when there are better alternatives available?
Malaria death rates are the lowest they have been in human history. There is no good case to be made that more DDT could provide any benefit.
DDT is still manufactured in astonishing quantity in North Korea, for one. DDT is used in Africa and Asia, but no one with any sense uses it to eradicate malaria — DDT screwed up that chance 50 years ago.
Rutledge’s movie appears to be sinking from release (it’s played two theaters that I can find, for less than a week at each). It may be far underwater already. It would be to DDT what “Expelled” was to creationism, but it lacks the cloying, gullible religious fanatics to push it.
Thank God.
Mystery photo: If spraying pesticides to fight malaria isn't allowed in Africa as Rutledge Taylor argues, why are these pesticide sprayers pictured in this photo? Publicity still from "3 Billion and Counting" via Rotten Tomatoes website
Also see, at Millard Fillmore’s Bathtub:
155 Comments | Accuracy, Africa, DDT, Health care, Junk science, Malaria, Rachel Carson, Science, Voodoo history, Voodoo science | Tagged: 3 Billion and Counting, Africa, DDT, Health care, Hoaxes, Junk science, Malaria, Rachel Carson, Rutledge Taylor, Voodoo science | Permalink
Posted by Ed Darrell
I like a hostel. More than once I’ve said I love a hostel. I’m downgrading my heartfelt affection a notch or two.
My stay here, which up to now comes to a little more than four months — twice as long as my second marriage — has been killing me from day one, or so I believe — little by little, slowly but surely, softly with its song.
“Sssssssssss!”
I don’t feel well — and haven’t for weeks. I can hardly lift a finger, take a single step. I walk around like — well, like the living dead.
For many months now — no doubt, way before I ever arrived — there has been a leak in a gas pipe just outside the kitchen door, which is left open during the daylight hours. It’s a miracle of sorts that nothing disastrous has happened despite the fact that guests have been cooking all the while on the gas stove, the leak just a short ways away.
From the online edition of The Hindu, India’s National Newspaper, 2008: “Two died as gas exploded in a hostel kitchen in Bangalore. The explosion damaged window panes of the hostel as well as those of neighboring houses.”
From BBC News: “Last September four Brits were among 13 guests at an alpine hostel in Tyrol, Austria, who were treated for carbon monoxide poisoning from a leak from a faulty heating system after some of the guests complained of dizziness, headaches, and blurred vision.”
Dizziness? I can relate to that of late.
A few weeks ago, I got up one morning, lit a cigarette on the back veranda, took a puff or two, stood up, and had to catch myself, gripping firmly onto the iron grate of a nearby Spanish gate, afraid I was going to faint.
Headaches? I can relate to that, too.
When I was younger, I suffered mightily from severe migraines. After getting the holy crap beat out of me in D.C. a few years ago, the migraines mysteriously went away. I was mugged and beaten so bad that the culprits, afraid they had killed me, ran off without taking my wallet and money. As a result of the beating, my daily migraines vanished. Poof! Some good came from bad. But, in the past few weeks, the headaches have returned.
Blurred vision? That, too I can relate to, but it’s not a recent development. In my youth, I worked for Sen. Orrin Hatch. That’s what brought me Washington, the nation’s murder capital at the time.
From “Messageboards – Bolivia: “Our first night we had carbon monoxide poisoning from the hostel we stayed in. People were passing out, being sick and we all had massive headaches.”
Being sick? That I have been. Very, very sick. Massive headaches? Not massive but, as I mentioned, headaches have become a part of my daily life once again.
I haven’t passed out, but I can barely stand at times. One morning Rodreigo, daytime receptionist/nighttime musician, happened to come out the back door to the veranda, where I was bracing myself again, one hand grasping a nearby rail. I had just had my first morning puff of a cigarette. I handed him my newly-bought pack. “Take ‘em!” I said. “They’re killing me!” I went for a long walk along the beach down the road.
From Wikipedia: “Oxygen works as an antidote as it increases the removal of carbon monoxide.”
Soon after talking in the fresh sea air I felt much better — for a short time.
From Wikipedia again: Symptoms of mild acute poisoning include headaches (check), vertigo (check), and flu-like effects.”
A few weeks back a visitor from Finland stayed here for a time. We became fast friends. He was moving to Canada for the warm weather. (That’s how cold Finland is!) He did not enjoy his time here. He was sick with the flu almost his entire stay, as I was long after he left. He thought he had caught it from two visiting Germans who had the flu. They, too, without knowing it, may well have been suffering from carbon monoxide poisoning.
From Wikipedia once again: “Chronic exposure to low levels of carbon monoxide can lead to depression.
I was sitting one day on the veranda. Two guests were sitting talking at the picnic bench — one from the mainland of Mexico, one from Switzerland. Both where jovial and happy — on vacation from worry and woe. The Mexican smiled and asked me, “Enjoying life?”
“Nope!” I replied and I was deadly serious.
Shortly after, the two rose from their seats and returned inside. I could read their thoughts: “What’s his problem? He’s no fun!”
I’m almost always “up”. I rarely, if ever, get depressed. And when I am, I try my best to hide the fact. But when you feel like you’re dying . . .
From the website “Silent shadow : silent killer”:
“Carbon monoxide, also known as CO, is a potentially deadly gas that can have devastating effects upon your life — assuming, of course, that it doesn’t kill you.”
I’ve been inhaling the fumes for months now. One day, some weeks back, I felt so sick that I strolled slowly up the street to the nearest hospital, which wasn’t that close, to the emergency entrance. Gathered outside were countless poor. Standing and sitting in the waiting room were countless more. The receptionist didn’t speak English. We tried to communicate with each other best we could. She asked one of those waiting to show me her card. It was in Spanish, but I got the gist. It was a Mexican social security card. The receptionist wanted to know if I had one. I shook my head no and went on my way.
From some internet source (I’ve misplaced my notes; I’m not thinking straight): “Exposure to carbon monoxide can lead to confusion.”
To say the least! A month or so ago, I lost my debit card. The cash machines here are in Spanish. Of course! I pressed the wrong button and it ate my card. I had to take the bus to the border an hour and half away, to the closest Chase Bank to get cash. Gabrielle/Gabby, the hostel manager, lent me money for the fare.
The bad news: Chase won’t mail me a new card until I have a U.S. address to mail it to.
The good news: When I withdrew much-needed cash, I found several hundred dollars that I didn’t know was there. My bestest best friend in the world had deposited it into my account. Who does that but a saint? She has little money to spare. She was up for tenure this year as full professor at the University of Houston-Clear Lake but was let go — only to be rehired directly afterward as an adjunct professor, teaching the same classes she’s been teaching the past five years at the same university at half or so the salary. And she’s not the only one! Class-action law-suit stuff!
In the movies. Not in real life.
Once again, from “Silent shadow : silent killer”: “The effects of carbon monoxide poisoning can and does kill thousands of people each year. Some people simply slip away into unconsciousness or a deep sleep from which they will never reawaken.”
Thank heaven for the frequent all-night drinking parties on the back veranda. Few guests if any — carbon monoxide or no — are likely to slip away into a deep sleep here.
From some source on the internet (I forget which one): “Carbon monoxide poisoning can cause memory loss.”
Memory loss. Memory loss. Hmmm. What’s that? Oh, yes, memory loss! (Check.)
Just kidding. I can well remember the night a gas leak was first suspected. Three or so weeks back, I was out on the back veranda again, chatting with a young London couple and a young backpacker from Australia.
One of them asked, “Can you smell that?”
I said, “No, what?” My nose has been broken so man times I can’t smell a thing.
“Smells like rotten eggs.”
“It’s gas,” said another. “Leaking gas.”
“Holy shit!” said a third.
From “Silent shadow : silent killer”: “Carbon monoxide has no taste, color or odor, and can be breathed in over a short or long time without you ever knowing that it is present.”
Suppliers add a rotten egg scent to signal that harmful gas vapors are loose in the air. Until that night, no one had complained about it. Except for the Danes, and they had pointed their fingers at me! Those damn Danes!
I immediately informed Gabby, who wrinkled her brow and said she had been having headaches for months.
A few days later, the owner — of the business, not the building — who lives in Switzerland, paid a short visit with his wife, whom he had met here at the hostel. He’s Mexican-born and very dashing. She’s Parisian and very lovely. They both look like movie stars. I like movie stars. But, at that present time, for this particular precarious predicament, what the place needed was a GLS — a Gas-Leak Specialist.
Hostels are wonderfully inexpensive because they’re run on the cheap. A buck saved here, a buck saved there. Some bad comes with good. Life is a two-sided coin.
Shortly after his arrival, the owner of the hostel business (not the building) smeared soap suds from a cloth on the gas pipes in and around the boiler, watching for bubbles to arise, exposing the leak. Unable to detect one, the dashing pair dashed on their way — they were on vacation — the scent of leaking gas still in the air.
The task and glory of finding the leak fell upon the shoulders of Rodreigo, the daytime receptionist/nighttime musician. Several days went by without success. Then one morning on bended knee, he leaned an ear down to listen.
“Sssssssssss!”
The sssss-hissing sound was coming from a puncture in a very thin pipe on the ground by the kitchen door. He smeared soap on it and the bubbling suds billowed up as if it were a boiling mud pot in Yellowstone National Park. You had to see it to believe it! Caught on film, it surely would have been a huge hit on YouTube. Rodreigo covered the leak with a wet towel. Ole!
A professional Gas-Leak Specialist was contracted to replace the punctured pipe. While doing so, he told Gabby a story about another leak he had recently fixed. After leaving the premises upon completion of his task, according to the specialist, the gentleman residing there had lit himself a cigar and — boom! — one of the walls exploded outward in flames, leaving a major peep-hole in his bedroom. Fumes from the gas leak had seeped into the paint on the wall.
But, anyway, back to the hostel here . . .
So all’s well, right? Perhaps, perhaps not. I can’t breathe. I can’t think. I can’t write. I can’t walk but for a few short steps at a time. When I’m not resting in my bunk, I’m resting on the one “comfortable” chair on the back veranda.
Gabby has told me more than once: Everyone else is okay! — though, she herself experienced headaches many days after the leak was fixed. (But, then again, perhaps the headaches were caused by me! That could very well be!)
I, in rebuttal, have replied: Most everyone else stays for a couple of days or so. I’ve been here for four straight months. Most everyone else takes in the sights, so they’re out and about. I’ve been staying inside, day in and day out, writing and typing away at the computer here. I rarely leave the place.
A couple of nights ago I came out from resting in my room for a bite to eat in the kitchen. “Are you okay?” she asked. She, too, now is concerned about my health.
I lied and said I was.
First thing the next morning, gazing at me with deep concern, she asked, “You want me to take you to the Red Cross?”
I told her there was a VA medical center in La Jolla and that I was going to take the bus there in the next couple of days.
“I have business to do in Tijuana,” she said. “I will drive you to the border.”
From Googling again: “In many cases, the symptoms may wear off within a short period.”
Good to hear, comforting to know!
“However, in some cases the effects are permanent, particularly in the case of brain damage.”
This, I must admit, is worrisome. When you’re down and out, you get through each day thinking to yourself that you’ll get out of the mess you’ve got yourself into — somehow, someway. There are still opportunities out there, you tell yourself, if you can just hang in there and brave it out.
But with brain damage, well, you have no options but one: being bused to Glenn Beck and Sarah Palin rallies.
4 Comments | air pollution, Dan Valentine, Health care, Mexico, Travel | Tagged: Clean Air, Dan Valentine, Ensenada, Health care, Mexico, Travel | Permalink
Posted by Ed Darrell
Should you allow your kids to be vaccinated, or are you worried about autism?
Penn and Teller lay out the facts. Warning: Profanity (well deserved, but profane, all the same):
Tip of the old scrub brush to DrJohnSea.
4 Comments | Accuracy, Communication, Health care, Science, Vaccinations, Voodoo science, War on Science | Tagged: Autism, Health care, Hoaxes, Public health, Vaccinations, Voodoo science, War on Science | Permalink
Posted by Ed Darrell
Once upon a time I easily found a chart from the World Health Organization (WHO) which provided a year-by-year tally of malaria deaths, worldwide, from the 1940s to the present.
Of course, now that I need that chart to note that malaria deaths are much lower today than they were when DDT was overused generally and sometimes misused in the fight against malaria, I can’t find it. So, we’ll take the figures where we can find them.
In 2008, worldwide there were over 880,000 deaths from malaria. This is significantly lower than the usual claim of “millions of deaths each year.” We can find this figure in a document from the Global Environmental Facility (GEF), the organization that organizes the work of 182 nations to work for solutions to environmental problems, including fighting malaria, in a report on the 2009 meeting of the Stockholm Convention focused on fighting malaria, “Countries move toward more sustainable ways to roll back malaria.”
However concern over DDT is matched by concern over the global malaria burden in which close to 250 million cases a year result in over 880 000 deaths. Thus any reduction in the use of DDT or other residual pesticides must ensure the level of transmission interruption is, at least, maintained.
Numbers here may be estimates not updated from current-year records. The figure “over 880,000 deaths” looks and sounds awfully close to numbers reported in 2006, as you can see in this report from the Kaiser Family Foundation on U.S. global health policies:
Number of Annual Malaria Cases Worldwide Decreases, Disease Still Remains a Challenge, WHO’s World Malaria Report 2008 Says
Thursday, September 18, 2008
There were about 247 million malaria cases worldwide in 2006, according to the World Malaria Report 2008, which was released by the World Health Organization on Thursday, Reuters reports (MacInnis, Reuters, 9/18). According to the report, 3.3 billion people worldwide were at risk for malaria in 2006, and the disease remains a major burden among children younger than age five and in many African countries (AFP/Google.com, 9/18).
The report included reduced estimates of the global malaria burden that were calculated with new surveillance measures for non-African countries. The estimate of 247 million malaria cases is lower than the estimated 350 million to 500 million annual malaria cases reported in WHO’s World Malaria Report 2005. The new report estimated there were 881,000 malaria deaths in 2006, down from the previous estimate of one million deaths. The reduced figures are the result of new calculation methods, and it is unknown whether malaria cases and deaths actually declined from 2004 to 2006, WHO said (Reuters, 9/18). Although malaria control efforts have helped reduce the global malaria burden, most malaria-endemic countries are not meeting WHO targets for malaria control, the report said, noting that there is “no evidence yet to show that malaria elimination can be achieved and maintained in areas that currently have high transmission” (Bennett/Doherty, Bloomberg, 9/18).
WHO attributed the revised malaria estimates to new assessment measures in Asia, where data used for the 2005 report had not been updated for 40 years. According to Mac Otten — coordinator of surveillance, monitoring and evaluation at WHO’s Global Malaria Program — factors such as deforestation, urbanization and malaria control efforts have affected malaria estimates in Asia (Blue, Time, 9/17). Cambodia, Laos, the Philippines, Thailand and Vietnam all reported a decline in malaria deaths in 2006 (Bloomberg, 9/18).
WHO’s surveillance methods in Africa, which estimate malaria prevalence by using climate data and sample surveys, have remained the same since the 2005 report, the report said (Reuters, 9/18). According to the report, 45 of the 109 malaria-endemic countries worldwide are in Africa, and more than half of the continent’s malaria cases in 2006 occurred in the Democratic Republic of Congo, Ethiopia, Kenya, Nigeria and Tanzania (AFP/Google.com, 9/18). The report noted that malaria interventions have helped reduce malaria cases and deaths by more than 50% in Eritrea, Rwanda, Sao Tome and Principe, and the Tanzanian island of Zanzibar (Time, 9/17).The report found that about 40% of people at risk for malaria in Africa had access to insecticide-treated nets last year, compared with 3% in 2001 (Bloomberg, 9/18). The report also found that the number of ITNs distributed to national malaria control programs was enough to cover 26% of people in 37 African countries but that most African countries did not meet WHO’s target of 80% coverage for the four main malaria treatments: ITNs, artemisinin-based combination therapies, indoor-insecticide spraying programs and treatment for pregnant women (AFP/Google.com, 9/18).
Note also that this total of 880,000 is more than the previously reported 863,000. Hmmm.
35 Comments | Africa, DDT, Environmental protection, Health care, Malaria, Science | Tagged: Africa, DDT, Global Environmental Facility (GEF), Health care, Malaria, POPs Treaty, Rollback Malaria, Science, Stockholm Convention | Permalink
Posted by Ed Darrell
French researchers looked at men who possess a gene that predisposes them to Parkinson’s Disease, and found that DDT exposure correlates with actual onset of the disease.
(Reuters) – Men with certain genetic variations who were exposed to some toxic pesticides which are now largely banned run an increased risk of developing Parkinson’s disease, French scientists said Monday.
Researchers found that among men exposed to pesticides such as DDT, carriers of the gene variants were three and a half times more likely to develop Parkinson’s than those with the normal version of the gene.
The scientists, whose work was published in the Archives of Neurology journal, think the brains of people with the gene variant fail to flush out toxins as efficiently as those with normal versions of the gene, suggesting environmental as well as genetic factors are important in the risk of Parkinson’s.
DDT, which belongs to a group of pesticides known as organochlorines, is one of the “Dirty Dozen” chemicals banned by a 2001 United Nations convention after it was found to be a toxin that can suppress the immune system.
It is infamous for threatening bird populations by thinning eggshells, and has also been linked to increase risks in humans of diseases such as cancer and Parkinson’s — an incurable and often deadly brain disease.
But exemptions to the DDT ban are allowed in many developing nations because it so effective in killing mosquitoes. DDT’s Swiss inventor Paul Hermann Muller won the 1948 Nobel Prize for Medicine — before its wider toxic effects were known.
Alexis Elbaz and Fabien Dutheil, of France’s National Institute for Health and Medical Research (INSERM) studied 101 men with Parkinson’s and 234 without the disease to look at links between organochlorine exposure and Parkinson’s disease.
The study included only men, and all of them had had high levels of exposure to pesticides through their work as farmers.
The scientists found the link was around 3.5 times stronger in men who carried two copies of a gene known as ABCB1, which plays a role in helping the brain flush out dangerous chemicals.
File that one away for the next time some yahoo claims there are no harmful effects to health from DDT. The study probably could not distinguish between heavy exposure to pesticides and the much lighter exposure assumed to result from Indoor Residual Spraying of DDT, such as is used in some places in Africa in the fight against malaria.
Anybody got a copy of the actual study, in English?
5 Comments | DDT, Disease, Green Politics, Health care, Malaria | Tagged: Africa, DDT, Disease, Health care, Malaria, Parkinson's Disease, Research | Permalink
Posted by Ed Darrell
Dr. Andrew Wakefield’s license to practice medicine in Britain was stripped away by British authorities earlier today, due to his “ethical lapses” in conducting research against measles vaccines.
Wakefield’s research claims, published in the distinguished medical journal Lancet in 1998, sparked a worldwide hysteria over the claimed link of Mumps-Measles-Rubella vaccine (MMR) to autism. The journal earlier withdrew the article when the research was exposed as faulty and reaching erroneous conclusions.
Lancet retracted the paper earlier this year.
Effects of Wakefield’s errors ripple across the globe, as children pay the price with measles rates up worldwide, especially in Africa, and in North America. Rob Breckenridge described the damage for the Calgary Herald:
However, Wakefield’s foul legacy is very much consequential. His latest comeuppance is hopefully a small step in undoing that legacy’s damage, but much damage has already been done.
Wakefield authored a now-discredited paper published in 1998 in The Lancet, which implied that the MMR (measles-mumps-rubella) vaccine was linked to autism.
Numerous studies have shown no such link exists, but Wakefield’s research had the predictable effect of scaring people away from the MMR vaccine. Vaccination rates plummeted in the U.K., and the number of measles cases soared.
In 2008 in the U.K., there were almost 1,400 cases of measles compared with 56 the year Wakefield’s paper was published. In 2006, a 13-year-old boy died from measles — the first time in 14 years such a death had been recorded.
On top of the multiple studies rejecting the MMRautism link, The Lancet issued a formal retraction of Wakefield’s paper in February, citing his unethical and irresponsible conduct.
Once a disease like measles becomes rare, we tend to drop our guard, either forgetting how serious it is or assuming it can never come back. As we’ve seen in the U.K. it can come back with a vengeance. Unfortunately, it’s not only the U.K. where we’re learning that lesson.
This month, Alberta Health Services confirmed five cases of measles in the Calgary area. Given our lack of recent experience with measles — there was only one case provincewide in 2009 — AHS offered a primer on the disease.
Measles is extremely contagious, meaning one need not have close contact with an infected person. There is no cure, but vaccination can prevent it. There are still pockets of the province where vaccination rates are low and measles cases there have been higher.
Southwestern Alberta is one of those regions. Not only has measles made a comeback there — a 2000 outbreak closed a Lethbridge-area private school — but cases of mumps and whooping cough have been documented over the past two years.
In B.C., 87 measles cases have been confirmed this year. It’s believed many stem from infected out-of-country visitors at the Vancouver Olympics.
All cases involve people who were either not vaccinated, or only partially vaccinated. Eight cases were associated with a single household, where no one had been vaccinated.
3 Comments | Disease, History, Hoaxes, medicine, Public health, Research, Science | Tagged: Autism, Disease, Health care, Hoaxes, Measles, medicine, MMR, Mumps, Public health, Research, Rubella, Science, Vaccines, Wakefield | Permalink
Posted by Ed Darrell
A paper in the May 20 edition of Nature reports that global warming probably won’t expand the range of malaria much. That’s good news.
Here’s the press release from the University of Florida, touting the paper written by two University of Florida researchers, among others:
Scientists: Malaria control to overcome disease’s spread as climate warms
GAINESVILLE, Fla. — Contrary to a widespread assumption, global warming is unlikely to expand the range of malaria because of malaria control, development and other factors that are at work to corral the disease.
So concludes a team of scientists including two University of Florida researchers in a paper set to appear May 20 in the journal Nature.
Scientists and public policy makers have been concerned that warming temperatures would create conditions that would either push malaria into new areas or make it worse in existing ones. But the team of six scientists, including David Smith and Andy Tatem, faculty members with UF’s biology and geography departments and both at UF’s Emerging Pathogens Institute, analyzed a historical contraction of the geographic range and general reduction in the intensity of malaria — a contraction that occurred over a century during which the globe warmed. They determined that if the future trends are like past ones, the contraction is likely to continue under the most likely warming scenarios.
“If we continue to fund malaria control, we can certainly be prepared to counteract the risk that warming could expand the global distribution of malaria,” Smith said.
The team, part of the Wellcome Trust’s multinational Malaria Atlas Project, noted that malaria control efforts over the past century have shrunk the prevalence of the disease from most of the world to a region including Sub-Saharan Africa, Southeast Asia and South America, with the bulk of fatalities confined to Africa. This has occurred despite a global temperature rise of about 1 degree Fahrenheit, on average, during the same period.
“The globe warmed over the past century, but the range of malaria contracted substantially,” Tatem said. “Warming isn’t the only factor that affects malaria.”
The reasons why malaria has shrunk are varied and in some countries mysterious, but they usually include mosquito control efforts, better access to health care, urbanization and economic development. The banned pesticide DDT was instrumental in ridding the disease from 24 countries in Southern Europe, the former Soviet Union and elsewhere in the world between 1955 and 1969, Smith said. Researchers debate how the U.S. defeated malaria, but the reduction of mosquito breeding grounds, improved housing and reduced emphasis on agriculture that comes with development — and the reduced risk of bites that accompanies urbanization – probably played a role, Smith said.
“There is no one tale that seems to determine the story globally,” Tatem said. “If we had to choose one thing, we would guess economic development, but that’s kind of a cop out” because the specific mechanisms may still remain unclear, and controlling malaria might also help to kick-start development.
In any case, current malaria control efforts such as insecticide-treated bed nets, modern low-cost diagnostic kits and new anti-malarial drugs, have proved remarkably effective, with more and more countries achieving control or outright elimination. Unless current control efforts were to suddenly stop, they are likely to counteract the spread of mosquitoes or other malaria-spreading effects from anticipated temperature increases, Smith said.
Simon Hay, an author of the Nature paper and one of the chief architects of the Malaria Atlas Project, noted that modern malaria control efforts “reduce transmission massively and counteract the much smaller effects of rising temperatures.”
“Malaria remains a huge public health problem, and the international community has an unprecedented opportunity to relieve this burden with existing interventions,” he said. “Any failure in meeting this challenge will be very difficult to attribute to climate change.”
Key to controlling malaria is the treatment of the disease in human victims. Malaria parasites must spend part of their life cycle in humans; if medical care can cure humans, mosquitoes have no well of the disease to draw from, to spread it.
This paper says that global warming won’t spread the disease, so long as medical care and local health officials can keep effective treatments — a complete cure for human victims — coming quickly.
Resources:
1 Comment | DDT, Disease, Health care, History, Malaria, medicine, Radio, Research, Science | Tagged: DDT, Disease, Global warming, Health care, Malaria, medicine, Research, Science, University of Florida | Permalink
Posted by Ed Darrell
Ed Darrell on Texas's Colorado River
Come on in, the water's fine. Come often: Cleanliness is next to godliness.
Millard Fillmore's Bathtub 