Aftermath News

Associated Press | May 11, 2008

By KEVIN FREKING

WASHINGTON - Families claiming that a mercury-based preservative in vaccines triggers autism will challenge mainstream medicine Monday as they take their case to a federal court.

They seek vindication and financial redress from a government fund that helps people injured by shots.

Two 10-year-old boys from Portland, Ore., will serve as the test cases that determine whether the children and their families should be compensated. Attorneys for the boys will attempt to show the boys were happy, healthy and developing normally. But, after being exposed to vaccines with thimerosal, they began to regress and show symptoms of autism.

Thimerosal has been removed in recent years from standard childhood vaccines, except the flu shot. In 2004, a committee with the Institute of Medicine concluded there was no credible evidence that vaccines containing thimerosal caused autism.

Overall, nearly 4,900 families have filed claims with the U.S. Court of Claims alleging that vaccines caused autism and other neurological problems in their children. Lawyers for the families will present three different theories of how vaccines caused autism.

The case beginning Monday focuses on the second of those theories: that thimerosal-containing vaccines alone cause autism. Lawyers for the petitioning families said they will present evidence that injections with thimerosal deposit a form of mercury in the brain. That mercury excites certain brain cells that stay chronically activated trying to get rid of the intrusion.

“In some kids, there’s enough of it that it sets off this chronic neuroinflammatory pattern that can lead to regressive autism,” said attorney Mike Williams.

In the end, the families’ attorneys hope to convince a special master of the U.S. Court of Claims that thimerosal belongs on the list of causes for the inflammation that leads to regressive autism.

To win, the attorneys for the two boys, William Mead and Jordan King, will have to show that it”s more likely than not that the vaccine actually caused the injury.

Many members of the medical community are skeptical of the families’ claims. They worry that the claims about the dangers of vaccines could cause some people to forgo vaccines that prevent illness.

“I think that what’s so endearing to me about the anti-vaccine people is they’re perfectly willing to go from one hypothesis to the next without a backward glance,” said Dr. Paul Offit, director of the Vaccine Education Center at the Children’s Hospital of Philadelphia.

Autism is a developmental disability that typically appears during the first three years of life and affects a person’s ability to communicate and interact with others. Dr. Andrew Gerber, a psychiatrists, said that medical experts don’t have a comprehensive understanding of what causes autism, but they do know there is a strong hereditary component.

Toxins from the environment could play a role, but currently, data does not support that they do, Gerber said.

Arguments are scheduled to go on throughout the month. A final decision could take several more months to occur. Claims that are successful would result in compensation taking into account lost earnings after age 18 and up to $250,000 for pain and suffering.

The families or the federal government can also appeal the decision of the special master to the Court of Federal Claims or to a federal appeals court.

While there have been about 5,000 claims relating to autism, there have been fewer than 3,000 claims for all other vaccines.

Doctors to decide who lives and who dies in coming pandemic

Who should MDs let die in a pandemic? Report offers answers

AP | May 5, 2008

By LINDSEY TANNER

CHICAGO (AP) — Doctors know some patients needing lifesaving care won’t get it in a flu pandemic or other disaster. The gut-wrenching dilemma will be deciding who to let die.

Now, an influential group of physicians has drafted a grimly specific list of recommendations for which patients wouldn’t be treated. They include the very elderly, seriously hurt trauma victims, severely burned patients and those with severe dementia.

The suggested list was compiled by a task force whose members come from prestigious universities, medical groups, the military and government agencies. They include the Department of Homeland Security, the Centers for Disease Control and Prevention and the Department of Health and Human Services.

The proposed guidelines are designed to be a blueprint for hospitals “so that everybody will be thinking in the same way” when pandemic flu or another widespread health care disaster hits, said Dr. Asha Devereaux. She is a critical care specialist in San Diego and lead writer of the task force report.

The idea is to try to make sure that scarce resources — including ventilators, medicine and doctors and nurses — are used in a uniform, objective way, task force members said.

Their recommendations appear in a report appearing Monday in the May edition of Chest, the medical journal of the American College of Chest Physicians.

“If a mass casualty critical care event were to occur tomorrow, many people with clinical conditions that are survivable under usual health care system conditions may have to forgo life-sustaining interventions owing to deficiencies in supply or staffing,” the report states.

To prepare, hospitals should designate a triage team with the Godlike task of deciding who will and who won’t get lifesaving care, the task force wrote. Those out of luck are the people at high risk of death and a slim chance of long-term survival. But the recommendations get much more specific, and include:

_People older than 85.

_Those with severe trauma, which could include critical injuries from car crashes and shootings.

_Severely burned patients older than 60.

_Those with severe mental impairment, which could include advanced Alzheimer’s disease.

_Those with a severe chronic disease, such as advanced heart failure, lung disease or poorly controlled diabetes.

Dr. Kevin Yeskey, director of the preparedness and emergency operations office at the Department of Health and Human Services, was on the task force. He said the report would be among many the agency reviews as part of preparedness efforts.

Public health law expert Lawrence Gostin of Georgetown University called the report an important initiative but also “a political minefield and a legal minefield.”

The recommendations would probably violate federal laws against age discrimination and disability discrimination, said Gostin, who was not on the task force.

If followed to a tee, such rules could exclude care for the poorest, most disadvantaged citizens who suffer disproportionately from chronic disease and disability, he said. While health care rationing will be necessary in a mass disaster, “there are some real ethical concerns here.”

James Bentley, a senior vice president at American Hospital Association, said the report will give guidance to hospitals in shaping their own preparedness plans even if they don’t follow all the suggestions.

He said the proposals resemble a battlefield approach in which limited health care resources are reserved for those most likely to survive.
Bentley said it’s not the first time this type of approach has been recommended for a catastrophic pandemic, but that “this is the most detailed one I have seen from a professional group.”

While the notion of rationing health care is unpleasant, the report could help the public understand that it will be necessary, Bentley said.
Devereaux said compiling the list “was emotionally difficult for everyone.”
That’s partly because members believe it’s just a matter of time before such a health care disaster hits, she said.

“You never know,” Devereaux said. “SARS took a lot of folks by surprise. We didn’t even know it existed.”

The Criminalization of Raw Milk

Counterpunch | Apr 27, 2008

A Mennonite Farmer is Hauled Away

By LINN COHEN-COLE

On April 25, 2008, in Cumberland County, Pennsylvania, Mark Nolt, a Wenger Mennonite (Horse and Buggy Mennonite) dairyman, threatened for months with arrest for selling raw milk without a permit was removed from his property by state troopers.

Jonas Stoltzfus, a friend, fellow farmer, and Church of the Brethen, was asked by Mr. Nolt to speak for him, and said of the raid yesterday - “Six state troopers and a man with the Pennsylvania Department of Agriculture trespassed onto his property, and stole $20-25,000 of his product and equipment.”

Mr. Stoltzfus explained that Mr. Nolt did not have a permit because “he chose to turn his permit back in because it did not cover all the products he was selling. He felt he was being dishonest selling stuff that was not covered by the permit. He is a man of great integrity.”

“According to reports from neighbors and the Farm-to-Consumer Legal Defense Fund, several officials of the Pennsylvania Department of Agriculture participated in the raid, and while Mark was being transported by police car to the courthouse, PDA officials confiscated $20,000 to $25,000 worth of dairy products and production equipment. Neighbors reported the farm had been closed and that a large group of officials had gathered, with videos prohibited.”

“Mr. Nolt was told that people had gotten sick from eating his food, but no one ever came forward and no proof was ever offered.”

“This is a Gestapo raid,” Jonas Stotlzfus said, “complete with state troopers, raiding a hard-working farmer selling milk to friends and customers. And his customers ARE his friends.” Mr. Nolt

Mr. Stoltzfus said of Mr. Nolt, “he is not going to stop [selling raw milk] til he is ready to stop. He is the equivalent of that little black lady in Alabama who wouldn’t go to the back of the bus. He is doing the same thing, he won’t go to the back of bus.” Mr. Stoltzfus said “she got arrested for that and so did Mr. Nolt. He ignored [the threat] and kept on selling. He is a courageous man.” Mr. Stoltzfuz said “Mark believes it is his right to sell, according to the constitution, just like it was Rosa Park’s right to sit wherever she wanted on the bus. Same deal. There is nothing in the constitution to prevent Mr. Nolt from buying and selling, especially to his friends,” Mr. Stoltzfus said.

Stoltzfus commented that Mr Sheridan of the Pennsylvania Department of Agriculture (Stoltzfus does not have the spelling and believes he is with the licensing division) used to work for Dean Foods and Hershey Foods, big corporate operations, and that Sheridan was “jealous that farmers make a better product” and called the raid by Mr. Sheridan “a vendetta.”

This case is similar to that involving Meadowsweet Dairy LLC in New York, in that both Pennsylvania and New York allow raw milk sales, but adamantly oppose the sale of other raw dairy products.

Mr. Nolt was doing things the way his community has for generations, selling milk straight from his cows to those he knows.

Mr. Nolt contends that the regulations have not been approved by the legislature and shouldn’t apply to him because he is selling directly to consumers, via private contracts that are outside the purview of the state, making a privilege out of a right he believes he has - the right to private contracts.”

The permitting issue, ostensibly for food safety, is contradicted by a look both at raw milk itself and at its competition, corporate milk - pasteurized and often from cows injected with rBGH.

The medications have side effects which accelerate mental decline, triple the risk of stroke, and double the chances of premature death.

Telegraph | Apr 28, 2008

Ministers should step in to stop inappropriate prescriptions of powerful antipsychotic drugs for Alzheimer’s patients, an influential group of MPs said today.

Up to 105,000 people with dementia in Britain are wrongly being treated with the drugs, which are used to control behavioural symptoms such as aggression, they claim. Research has shown that the medications have side effects which can accelerate mental decline, triple the risk of stroke, and double the chances of premature death.

They are intended for psychotic patients suffering from delusions, paranoia and hallucinations. Yet the drugs continue to be used as a first resort to address the challenging behaviour of people suffering from Alzheimer’s disease and other types of dementia, according to the MPs. A report from the all-party parliamentary group (APPG) on dementia demanded Government action on the problem and urged the National Institute for Health and Clinical Excellence (Nice), the health watchdog, to carry out a review.

The report, A Last Resort, points out that no audit or regulation of such prescriptions exists. Jeremy Wright, the group’s chairman, said: “Antipsychotics can double risk of death and triple the risk of stroke in people with dementia, (can) heavily sedate them, and (can) accelerate cognitive decline.

“The Government must end this needless abuse. Safeguards must be put in place to ensure antipsychotics are always a last resort. We need to include families in decisions, give people with dementia regular reviews, and equip care staff with specialist training.”

The inquiry was told that 150,000 people with dementia were prescribed antipsychotic drugs in British care facilities. Psychiatric experts said 70 per cent of these prescriptions were inappropriate.

Neil Hunt, the chief executive of the Alzheimer’s Society, said more than 70 per cent of dementia patients exhibited challenging behaviour.

“More often than not this is an expression of unmet need, not a symptom of dementia, and there is no excuse for reaching for the medicine cabinet,” he said.

Official map shows areas around the San Francisco Bay to use aerial spraying

Bay City News Service | Apr 14, 2008

SAN FRANCISCO - Dozens of Bay Area residents of all ages gathered at the steps of San Francisco City Hall this afternoon to demonstrate their support for a resolution that opposes a state plan to conduct aerial chemical spraying to eradicate the invasive light brown apple moth.

The resolution, introduced by Supervisor Ross Mirkarimi, opposes the spraying by the California Department of Food and Agriculture and will go before the Board of Supervisors on Tuesday.

Amidst concerns of both short-term and long-term health affects that may be caused by the spraying, Mirkarimi said at today’s gathering that ‘the state needs to go back to the drawing board.”

“We do not want to see another DDT,” he said, referring to Dichloro-Diphenyl-Trichloroethane, a synthetic pesticide. ‘We do not want to see another Agent Orange.”

Bonnie Kirkland, of the California Alliance to Stop the Spray, San Francisco Chapter, said that other counties have suffered the consequences of the spraying and that San Francisco needs to take a strong stance to protect the health of its citizens.

After aerial spraying last year in Monterey and Santa Cruz counties, hundreds of residents reported respiratory and other problems ranging from mild to severe.

Paulina Borsook, a Santa Cruz resident, said that she was affected by the spraying and that many of her neighbors and other area residents ‘have not felt right since the spraying.”

“I know no one in Santa Cruz who wants to go through this again,” Borsook said.

Opponents of the program claim that spraying may cause respiratory problems, skin rashes, headaches and other health issues, and that pregnant women, children and elderly are thought to be those most susceptible. Several attendees at today’s rally held children in their laps while some held signs reading “Keep Your Spray Off My Baby.”

However, State Agriculture Secretary A.G. Kawamura issued a statement in response to today’s event, contending that the ‘program’s success is critical to our economy, our environment and public health.”

Kawamura has said that the pheromone products have been “fully reviewed and approved by state and federal environmental officials, who have not found any reason for concern in more than a decade of use.” He denied they contributed to any of the health problems.

The light brown apple moth, native to Australia, has been found recently in parts of the Central Coast and the Bay Area, including San Francisco, and is considered a serious threat to plants and agricultural crops.

Federal and state agriculture officials claim that if the moth is allowed to spread throughout the state, it could cause between $160 million and $640 million in crop damage each year.

Though the plan also includes placing “twist ties” containing the pheromone on trees, shrubs and fence posts in infested areas, and the release of millions of tiny, stinger-less wasps that target the moth’s eggs, the department considers aerial spraying its main option.

The Department of Food and Agriculture plans to continue aerial spraying to eradicate the pests beginning June 1 in Monterey and Santa Cruz counties, and Aug. 1 in San Francisco and parts of Marin, Alameda, Contra Costa and San Mateo counties.

Those opposed to the spraying claim that the eradication program has not been proven to be safe, effective or necessary.

James Carey, an entomologist from the University of California, Davis, has contended that the moth is already too widespread and that it would be ‘virtually impossible” to eradicate, and that the method has never been effective.

Frances Hsieh, a representative for state Sen. Carole Migden, said today that Migden supports the San Francisco resolution and that the city will be joining other cities throughout the Bay Area to take a stance in telling the state that Bay Area residents do not want to be ‘guinea pigs.”

A resolution proposed by Mayor Gavin Newsom and supervisors Bevin Dufty and Tom Ammiano supports state Sen. Carole Migden’s pending legislation to bring a moratorium on light brown apple moth aerial spraying and will also go before the Board of Supervisors Tuesday.

Mirkarimi’s resolution calls for the state to conduct a long-term study of health and environmental impacts of the aerial spraying that has already taken place in Monterey and Santa Cruz counties, and for state legislation requiring the consent of residents before any aerial spraying.

“I remain committed to continuing an open, transparent process and will continue to encourage public dialogue and dissemination of factual information about this important eradication program,” said Kawamura in the statement issued today.

A poison sign is posted at Soquel Nursery Growers outside of a building that keeps pesticides that kill moth infestation at this nursery in Soquel, Calif., Friday, April 4, 2008. If the larvae keep hatching, state officials warn the invasive moth could chomp through up to $640 million worth of crops this year alone that is plaguing California’s central coast.

State warns more lethal pesticide may be needed to fight moth

Mercury News | Apr 15, 2008

Genevieve Bookwalter - Sentinel staff writer

SANTA CRUZ — State agriculture leaders issued a warning to the city and county Monday that if plans are delayed to spray pheromone over the county by plane to fight the light brown apple moth, another, more potent insecticide could be dropped instead.

“The risk of greater conventional pesticide is out there,” said Steve Lyle, spokesman for the California Department of Food and Agriculture, elaborating on a position outlined in a legal brief released Monday.

The document was filed in response to a city and county lawsuit that demands an environmental review before more of the synthetic pheromone CheckMate LBAM-F is sprayed over the county. Some residents were furious last fall when airplanes hired by the state flew over the city and parts of the county dropping the pheromone, which confuses male moths and stops them from mating.
The state initiated the spraying last November after Santa Cruz County reported the state’s highest infestation of light brown apple moth, an invasive pest from Australia. If left unchecked, state officials argue, the moth could wreak havoc on California agriculture. Others argue the threat is overblown.

The state argued in its brief that a delay in spraying the pheromone to fight the moth would allow more of the winged creatures to reproduce. To kill them all, a stronger insecticide would be required. In addition, state attorneys wrote, residents would likely pick up pesticides themselves to fight the pest in their gardens.

The pesticide at issue is bacillus thuringiensus, or Bt, which the brief describes as “an insecticide that is a lethal agent and is not species specific.”
While Bt is approved for use by organic farmers, it is deadly to most moth and butterfly caterpillars that ingest it, said Arthur Shapiro, professor of evolution and ecology at UC Davis.

The San Francisco Bay Area has one of the largest populations of endangered and threatened moths and butterflies in the country, if not the world, Shapiro said. As a result, state leaders would have to be very careful about where they dropped the pesticide.

Santa Cruz Councilman Tony Madrigal accused state leaders of employing scare tactics to push their spraying agenda.

“They’re proposing a choice to the people between bad and worse,” Madrigal said.

To stop the moth in time, state leaders said, an environmental review of the decision to spray would not be possible.

City and county leaders disagreed and sued the state. The case is scheduled to be heard April 24 in Santa Cruz Superior Court.

Contact Genevieve Bookwalter at gbookwalter@santacruzsentinel.com.

‘What’s happening with subsidies in some countries is just criminal’

The poor should protect themselves with subsistence agriculture

The Times of S Africa | Apr 13, 2008

By Brendan Boyle, Adele Shevel, Don Robertson and Marcia Klein

Higher and higher food prices are on the menu

“Don’t panic,” Finance Minister Trevor Manuel urged yesterday as food riots spread around the world.

Worldwide Food Riots

While global financial leaders have declared an international food emergency, South African labour federation, Cosatu, planned country-wide protests against price collusion and rampant inflation in the country’s food industry. The ruling ANC has also called on the Competition Commission to investigate the causes of high food prices. The price of a loaf of bread in September this year is likely to be at least 25% higher than it was a year ago.

Speaking to Business Times from the annual spring meeting of the International Monetary Fund and the World Bank in Washington, Manuel branded the behaviour of some richer countries who subsidise farmers to produce cereals for biofuel rather than for food as “criminal”.

He urged Opec, the oil producers’ cartel, to slash the incentive to divert food to fuel by pumping more oil.

He said the current economic squeeze, which has forced the Treasury to lower the growth forecast to 4% of GDP this year, would not interfere with the social safety net on which at least one in five South Africans rely to stay alive.

But he said poor South Africans should be encouraged to protect themselves by resuming the subsistence agriculture that was a part of the country’s heritage.

“The food crisis was triggered by the shift of food into biofuels, especially in the US, where about a third of the maize is being converted into bio-ethanol,” he said.

First World farm subsidies, based on the current record cost of oil, price staple grains out of the reach of the world’s poorest people. Rich motorists outbid the world’s poor so that maize goes to fill empty fuel tanks rather than empty tummies.

“What’s happening with subsidies in some countries is just criminal,” Manuel said, without naming the US, where subsidies are highest. The IMF released a map showing the countries that benefit from the food price escalation. SA is amongst those moderately affected, but most of Africa is in the most affected category.

Western nations benefit from the higher prices as trade balances swing in their favour.

Cosatu general secretary Zwelinzima Vavi said the labour federation would begin a series of protests outside Eskom and Pick n Pay premises on April 17 to press for negotiations on food prices. “We’re moving towards a food crisis in this country because people cannot afford it.

“We want to force negotiations between the farmers, the food processors, the retailers and the government on this issue. They say the prices are because of the rising price of oil, but we want to see the figures,” Vavi said.

He said Cosatu supported the expansion of Competition Commission investigations beyond the milk and bread industries, where collusion has already been proven to other food sectors and would press for jail sentences for company directors responsible for price-fixing.

Manuel declined to say whether he would back prison terms for price fixers, but said he was strongly in favour of tougher competition regulation.

He said he supported the right of workers to engage in legal protest, but cautioned that campaigns such as Cosatu’s needed to be focused on credible goals and should not undermine the economy on which everyone depends.

“We’re in this together and I think the premature identification of enemies would be costly to the economy,” he said. “There are huge panic reactions in respect of countries who are now deciding to ban imports and exports of various crops. There is a lot of panic reaction and panic tends to drive prices up further,” he said.

Manuel insisted there was no immediate alternative to the globalised market economy that sets the prices of fuels and foods and cautioned that attempts to isolate small countries behind tariff and other barriers would backfire.

“To merely suggest right now that whatever is happening is because of some evil plot by these terrible capitalists is not the most useful of issues,” he said.

IMF and World Bank leaders have made the food price crisis the main feature of their Washington meeting this week, saying the price spiral has set the fight against poverty back at least seven years. Official figures showed that the price of wheat had more than doubled in the past year and the African and Asian staples — maize and rice — are up nearly 80% in the same period.

While there is no crisis facing people in the rich G-8 nations, including Britain, Japan and the US, millions in the developing world are having to spend up to four-fifths of their total family income on food. The World Bank estimates that 33 countries around the world face social unrest because of food and fuel price rises. Deadly food riots have already broken out in Egypt, Indonesia, Cameroon, Peru and Haiti.

Manuel said he hoped SA would not go down that road, but stressed that firm and swift international action was needed to break the price spiral.

ANC spokesman Jessie Duarte said while the party understood that food prices were influenced by exogenous factors, it did not understand how some prices went up exponentially in a country where those items were grown and manufactured locally.

Cooking oil has increased almost fourfold in 18 months, for example. “Our concern is how this impacts on the urban poor, in particular those who cannot do subsistence farming,” she said.

Standard Bank group economist Goolam Ballim said SA had the money to help should things deteriorate further, but he added that the country had never been as globalised as it is now, and it was as vulnerable to global successes as it was to global threats. The food price issue was an example.

Nico Hawkins, economist at Grain SA, said some prices, including those of wheat, had doubled in a year.

Hawkins added that the higher price of wheat was based on import parity pricing. SA produces a crop of about 1.6 million tons but requires about 2.8 million tons. Grains grown locally are priced the same as the imported ones.

The Gazette | Mar 18, 2008

By Cindy Hadish

In about the time it takes to toast your bread, someone in America develops Alzheimer’s disease. By mid-century that time will be cut by more than half.

A report released Tuesday shows an estimated 10 million baby boomers — one out of eight — will develop the progressive brain disorder.

Up to 5.2 million Americans have the disease.

“It’s not an aging issue,” said Kelly Hauer, executive director of the Alzheimer’s Association East Central Iowa Chapter. “It’s a public health issue.”

In just two years, Iowa’s population of Alzheimer’s patients is predicted to grow from 65,000 to 69,000, according to the report, issued by the Alzheimer’s Association.

With 70 percent of Alzheimer’s patients living at home, the disease touches not only those afflicted, but their families and caregivers.

Last year, 95,733 Iowa caregivers provided more than 82 million hours of unpaid care for someone with Alzheimer’s or other dementia, valued at $874 million.

“It’s a tough job,” said Kathy Good, 61, of Cedar Rapids, whose husband, David Good, also 61, developed early onset Alzheimer’s at age 56.

A district court judge, David Good lost even simple abilities, such as finding the right word for “toothbrush.”

Kathy Good considers the couple lucky. Friends take her husband out to lunch or the YMCA. She has some flexibility in her job as a social worker. They have financial stability.

That’s not the same for everyone.

A bill in the Iowa Legislature would address the needs of Iowans living with Alzheimer’s and their caregivers.

Senate File 2341 calls for a county-by-county review to determine services and future needs of people with Alzheimer’s and other forms of dementia, and address availability of caregiver services.

Another component of the bill addresses training for people who work in care facilities and those who care for an Alzheimer’s patient at home.

Tuesday’s report showed:

l Alzheimer’s is the seventh leading cause of death nationwide and the fifth-leading cause of death for those over age 65.

l Every 71 seconds, someone in America develops Alzheimer’s disease; by midcentury someone will develop Alzheimer’s every 33 seconds.

l By 2010, almost one-half million new cases of Alzheimer’s will occur annually; by 2050, there will be almost 1 million new cases each year.

l Women are nearly twice as likely as men to develop Alzheimer’s disease (17 percent vs. 9 percent) basically because women live longer.

l One in six women and one in 10 men age 55 and older can expect to develop Alzheimer’s disease in their lifetime.

Hauer said death rates from diseases such as stroke and breast cancer are declining as research money goes toward finding treatments and cures, but Alzheimer’s deaths continue an upward trend.

“We’ve got a disease that doesn’t have a cure,” she said. “With our graying state … now is the time to develop an effective blueprint to deal with this disease.”

Related

Alzheimer’s cases may quadruple by 2050

AP | Mar 12, 2008

By MARIA CHENG

LONDON - As doctors struggle to eradicate polio worldwide, one of their biggest problems is persuading parents to vaccinate their children. In Belgium, authorities are resorting to an extreme measure: prison sentences.

Two sets of parents in Belgium were recently handed five month prison terms for failing to vaccinate their children against polio. Each parent was also fined 4,100 euros ($8,000).

“It’s a pretty extraordinary case,” said Dr. Ross Upshur, director of the Joint Centre for Bioethics at the University of Toronto.

“The Belgians have a right to take some action against the parents, given the seriousness of polio, but the question is, is a prison sentence disproportionate?”

The parents can still avoid prison — their sentences were delayed to give them a chance to vaccinate their children. But if that deadline also passes without their children receiving the injections, the parents could be put behind bars.

Because of privacy laws, Belgian officials would not talk specifically about the case, such as why the parents refused the vaccine or how much longer they have to vaccinate their children.

The polio vaccine is the only one required by Belgian law. Exceptions are granted only if parents can prove their children might have a bad physical reaction to the vaccine.

“Polio is a very serious disease and has caused great suffering in the past,” said Dr. Victor Lusayu, head of Belgium’s international vaccine centre. “The discovery of the vaccine has eliminated polio from Europe and it is simply the law in Belgium that you have to be vaccinated. … At the end of the day, the law must be respected.”

Some ethicists back the hardline Belgian stance.

“Nobody has the right to unfettered liberty, and people do not have a right to endanger their kids,” said John Harris, a professor of bioethics at the University of Manchester.

“The parents in this case do not have any rights they can appeal to. They have obligations they are not fulfilling.”

Aside from Belgium, only France makes polio vaccinations mandatory by law. In the United States, children must be vaccinated against many diseases including polio, but most states allow children to opt out if their parents have religious or “philosophical” objections.

In the U.S. state of Maryland, prosecutors and school officials in one county threatened truancy charges against parents who failed to vaccinate their children. The measure sharply reduced the number of unvaccinated children although nobody has been charged.

The only other case of mandatory polio vaccines is during the Muslim yearly Hajj pilgrimage in Saudi Arabia. Pilgrims from polio-endemic countries — Afghanistan, India, Nigeria and Pakistan — must prove they have been vaccinated. Saudi officials even give them an extra dose upon arrival at the airport.

Since the polio virus can live in the human body for weeks, it jumps borders easily. That makes health officials even in developed countries nervous, since the threat of an outbreak remains as long as the virus is circulating anywhere.

Polio is a highly infectious disease spread through water that mainly strikes children under five. Initial symptoms include fever, headaches, vomiting, stiffness in the neck and fatigue. The polio virus invades the body’s nervous system and can lead to irreversible paralysis within hours. In extreme cases, children can die when their breathing muscles are immobilized.

Incidence has dropped by 99 percent since the World Health Organization and partners began their eradication effort in 1988. But the virus is still entrenched in Afghanistan, India, Nigeria and Pakistan, and occasionally pops up elsewhere.

For developed countries, imported polio cases could cause chaos in the health system, warned Dr. Steve Cochi, an immunization expert at the United States’ Centers for Disease Control and Prevention.

He said that unlike other medical problems, in which rejecting treatment only affects the individual, refusing a vaccine for a transmissible disease like polio puts others at risk as well.

“Most of the time, polio outbreaks do spill into the general population,” Cochi said.

Ethicists argue that people who refuse vaccinations are taking advantage of everyone else who has been vaccinated. Once the majority of a population is vaccinated, there are few susceptible people the disease can infect, thus lowering the odds of an outbreak.

People who refuse to be vaccinated are “free riders,” Harris said. “They can only afford to refuse the vaccine because they are surrounded by people who have fulfilled their obligations to the community.”

Health officials doubt that Belgium’s strategy will be useful to countries still battling polio.

“It is up to individual countries to decide their own policies, but we do not feel that imprisonment would help,” said Dr. David Heymann, WHO’s top polio official.

AP | Mar 16, 2008

By MARTHA MENDOZA

Test it, study it, figure out how to clean it — but still drink it. That’s the range of reactions raining down from community leaders, utilities, environmental groups and policy makers in reaction to an Associated Press investigation that documented the presence of pharmaceuticals in major portions of the nation’s drinking water supplies.

“There is no wisdom in avoidance. There is wisdom in addressing this problem. I’m not suggesting that people be hysterical and overreact. There’s a responsible way to deal with this — and collectively we can do it,” said Washington-based environmental lawyer George Mannina.

A five-month-long inquiry by the AP National Investigative Team found that many communities do not test for the presence of drugs in drinking water, and those that do often fail to tell customers that they have found trace amounts of medications, including antibiotics, anti-convulsants, mood stabilizers and sex hormones. The stories also detailed the growing concerns among scientists that such pollution is adversely affecting wildlife and may be threatening human health.

As a result, Senate hearings have been scheduled, and there have been calls for federal solutions. But officials in many cities say they aren’t going to wait for guidance from Washington to begin testing.

Pharmaceutical industry officials said they would launch a new initiative Monday with the U.S. Fish and Wildlife Service focused on telling Americans how to safely dispose of unused medicines.

The subject of pharmaceuticals in drinking water also will be discussed this week when 7,000 scientists and regulators from 45 countries gather in Seattle for the annual meeting of the Society of Toxicology. “The public has a right to know the answers to these questions,” said Dr. George Corcoran, the organization’s president.

“The AP story has really put the spotlight on it, and it is going to lead to a pickup in the pace,” he said. “People are going to start putting money into studying this now, instead of a few years from now, and we’ll get the answers sooner than we would have otherwise.”

Environmental leaders said some answers are easy.

“It’s basic. We need to test, tell and protect health,” said Richard Wiles, executive director of the Washington-based Environmental Working Group.

Wiles said the Environmental Protection Agency needs to widely expand the list of contaminants that utilities are required to test for. That list currently contains no pharmaceuticals. He also said government agencies and water providers that don’t disclose test results “are taking away people’s right to know, hiding the fact that there are contaminants in the water. We don’t think they have that right. It’s hubris, it’s arrogance and it’s self-serving,” said Wiles.

As part of its effort, the AP surveyed 62 metropolitan areas and 52 smaller cities, reporting on positive test results in 24 major cities, serving 41 million Americans. Since release of the AP investigation, other communities and researchers have been disclosing previously unreleased local results, positive or negative.

In Yuma, Ariz., for example, city spokesman Dave Nash said four pharmaceuticals — an antibiotic, an anti-convulsant, an anti-bacterial and caffeine — have been detected in that city’s drinking water. In Denver, where the AP had reported undisclosed antibiotics had been detected, a Colorado State University professor involved in water screening there e-mailed the names of 12 specific drugs that had been detected.

Officials at many utilities said that without federal regulations, they didn’t see a need to screen their water for trace amounts of pharmaceuticals. But others have now decided to test, including Scottsdale and Phoenix in Arizona, Palm Beach County in Florida, Chicago and Springfield, Ill., Bozeman, Mont., Fargo, N.D.; Danville, Va.; and a group of four sewer partners in the Olympia, Wash., region.

“We read the AP story and made a determination that we should test our water and be transparent, just let the people know what we find. I’m confident we have safe and clean drinking water,” said Phoenix Mayor Phil Gordon.

Officials in Freeport, Ill., one of the smaller cities surveyed, said they plan to work with the state EPA to test the area’s drinking water for pharmaceuticals. Mayor George Gaulrapp said he is looking to the state agency for standards, regulations and testing procedures for that city’s water, which comes from a deep well.

In some places, residents learned that the rivers and lakes that feed their drinking water treatment plants have already been tested, or that tests are under way.

In Marin County, California, officials said repeated tests in their watershed for pharmaceuticals have come back clean. In Massachusetts, the state Department of Environmental Protection announced a program to screen rivers, streams and reservoirs for pharmaceuticals.

Dozens of newspaper editorials called for testing in communities where water is not being screened and the release of any test results.

“The first, and least expensive, step is to let the sunshine in: Water utilities that currently test for pharmaceuticals should make that information freely available to their customers, along with more information on the potential impacts of drugs in the water supply,” read an editorial in the Daytona Beach News-Journal.

The Fort Worth Star-Telegram has filed an open records request for a copy of a study conducted on the city’s water after the mayor refused to give the AP and the newspaper the name of a pharmaceutical detected in the drinking water. City officials say publishing that information could jeopardize public safety, citing post-Sept. 11 security concerns. A Texas attorney general’s opinion is being sought on possible release of the information.

The Milwaukee Journal Sentinel urged readers to take responsibility as well.

“It’s a problem in which the average person has both a stake and a role in the solution,” read a Journal Sentinel editorial. “He or she can do something as simple as not flushing unused medications down the toilet or into the drain.”

And the Pittsburgh Post-Gazette observed that “given the national scope of the problem, a strong leadership role for the federal government suggests itself in areas such as testing and upgrading water treatment plants. So it is discouraging to note that the Bush administration in its 2009 budget proposal cut $10 million from the water monitoring and research program.”

While the local responses are encouraging, Lisa Rainwater, policy director of Riverkeeper, a New York-based environmental group, said the EPA should step aside and let the National Academy of Sciences or the General Accounting Office study the impacts on humans and wildlife.

“Frankly, the EPA has failed the American public for doing far too little for far too long,” she said.

At least one local water official is putting part of his faith in another quarter. Wayne Livingston of the Oxford Water Works in Alabama said he has confidence in the existing treatment system. But he said his agency probably will test for pharmaceuticals now, although he doubts anything will turn up because the water is pumped from underground.

“The good Lord filters it,” he said. “But this is something we should keep an eye on.”