Recently in Medicine and Health Category

Faster please - vaccine

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From The Wall Street Journal:

Experimental Drug Promises to Kill the Flu Virus in a Day
As Americans suffer through the worst influenza outbreak in almost a decade, a Japanese drugmaker says it has developed a pill that can kill the virus within a day. But even if the experimental drug lives up to the claim, it likely won’t be available in the U.S. until next year at the earliest.

A late-stage trial on Japanese and American flu patients found that for the people who took the Shionogi & Co. compound, the median time taken to wipe out the virus was 24 hours. That is much quicker than any other flu drug on the market, including Roche AG’s Tamiflu, which the trial showed took three times longer to achieve the same result. Quickly killing the virus could reduce its contagious effects, Shionogi said.

Also, Shionogi’s experimental drug requires only a single dose, while patients need to take two doses of Tamiflu a day, for five days.

Both Shionogi’s compound and Tamiflu take roughly the same amount of time to entirely contain flu symptoms, but Shionogi says its compound provides immediate relief faster.

Scientists at the Japanese company leveraged their work on a blockbuster anti-HIV drug to create the compound, which works differently from existing flu medicines. It blocks the flu virus from hijacking human cellular machinery, Chief Executive Isao Teshirogi said. Switzerland’s Roche has acquired the international license to distribute Shionogi’s experimental drug.

Not available in the USA as yet but great news nonetheless.

Not a good thing to do for many reasons - from The Atlantic:

The Startling Link Between Sugar and Alzheimer's
In recent years, Alzheimer’s disease has occasionally been referred to as “type 3” diabetes, though that moniker doesn’t make much sense. After all, though they share a problem with insulin, type 1 diabetes is an autoimmune disease, and type 2 diabetes is a chronic disease caused by diet. Instead of another type of diabetes, it’s increasingly looking like Alzheimer’s is another potential side effect of a sugary, Western-style diet.

And the upshot:

A longitudinal study, published Thursday in the journal Diabetologia, followed 5,189 people over 10 years and found that people with high blood sugar had a faster rate of cognitive decline than those with normal blood sugar—whether or not their blood-sugar level technically made them diabetic. In other words, the higher the blood sugar, the faster the cognitive decline.

Much more at the site. Trish and I are both eating reduced carb diets and are feeling a lot better for it. Trying to stay under 30 grams/day seems to be the real sweet-spot.

The Flu - three articles

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Just wonderful - flu season

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From Time magazine:

The Flu May Be Spread Just By Breathing, Study Says
For years, you’ve been told to cover your mouth when you cough or sneeze, especially when you’re sick. But a new study finds that it may be possible to spread the flu just by breathing—no coughing or sneezing required.

“People shed a lot of virus all the time, even when they don’t cough,” says Donald Milton, author of the study published in PNAS and a professor of environmental health at the University of Maryland School of Public Health. “As a result, it’s important to realize you can be infectious at any time.”

During the 2012-2013 flu season, Milton and his colleagues studied 142 University of Maryland students with active influenza, attempting to track how and when they expelled virus particles. During a total of 218 30-minute observation sessions, the students sat in a machine that could measure the droplets they shed while breathing, talking, coughing or sneezing. While coughing did expel some flu particles, the researchers discovered that almost half of the aerosol particles collected in the absence of coughing also contained flu matter, suggesting that simply inhaling germ-ridden air could get you sick.

Joyful news - especially since I am summoned for jury duty this coming week. I'll see how I feel and then give them a call on Monday morning to see if I can get out of it.

Scientific American has more:

Warning: A Flu Pandemic Today Could Kill As Many As 80 Million People
If the 1918 flu pandemic broke out today, it would likely kill at least 62 million people, or slightly more than the number that die in a single year from all other causes combined. The estimate stems from a new tally of flu deaths from 1918 to 1920 in different countries, which varied widely. Based on their findings, authors of the study say that 96 percent of the victims of a present-day pandemic would be in the developing world.

The report comes on the heels of fears that the H5N1 flu virus currently circulating among birds in Southeast Asia and Africa may be the precursor to a deadly global outbreak or pandemic. To gauge the potential threat, researchers reviewed the toll of the most severe previous case, which occurred in 1918 when a flu swept the world, claiming at least 20 million lives. "It's the benchmark against which we worry about future flu pandemics," says population health researcher Christopher Murray of the Harvard Initiative for Global Health.

Just great - we have another - and worse strain - waiting to cross over to humans.

News you can use - sneezing

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Makes perfect sense - I always use the inside of my elbow to stifle mine. From the UK Guardian:

Achoo! Why letting out an explosive sneeze is safer than stifling it
In a season where colds are rife, holding your nose and closing your mouth might seem like a considerate alternative to an explosive “Achoo!”. But doctors have warned of the dangers of such a move after a man was found to have ruptured the back of his throat when attempting to stifle a sneeze.

Medics say the incident, which they detail in the British Medical Journal Case Reports, came to light when a 34-year old man arrived in A&E with a change to his voice, a swollen neck, pain when swallowing and a popping sensation in his neck after he pinched his nose to contain an expulsion.

The team took scans of the man’s neck to investigate and discovered bubbles of air in the tissues at the back of the throat, and in the neck from the base of the skull to halfway down the man’s back. 

That, they say, suggested a tear had occurred at the back of the throat as a result of increased pressure from the stifled sneeze, leading to air collecting in his soft tissues. 

“For reasons of propriety and etiquette, one sometimes stops a sneeze. However on unfortunate rare occasions it might lead to potentially serious complications,” said Dr Sudip Das, co-author of the report from the University Hospitals of Leicester NHS Trust.

Propriety and etiquette be damned - use your elbow or a hankerchief. Do not spread it around but also, First Do No Harm.

The 2018 flu season

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It is getting worse - from the medical blog STAT:

Flu season is shaping up as one of the worst in years, officials say
The entire continental United States is experiencing widespread flu right now, the first time in the 13 years of the current tracking system that that has happened, according to the Centers for Disease Control and Prevention.

Officials said that this flu season is shaping up to be one of the worst in recent years.

The rate of flu hospitalizations — the number of people hospitalized with flu per 100,000 — nearly doubled last week compared with the previous week. Last week it was 22.7 per 100,000 people; the week before that rate was 13.7.

I lost a dear friend who was only 52 and in great health. His memorial service was less than a week ago.

The Flu - some advice

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Some great advice from Aesop - an Emergency Room Doctor and blogger: RACONTEUR REPORT

PSA: Flu 2018 - Updated
Thirty-six states report influenza activity as "widespread". That would be all the brown ones in the CDC map, above.
Nota bene the number of states with no influenza activity this year is "zero".
The CDC has identified 648 different active influenza virus sub-types this year, to date.

Anecdotally, where I am, approximately 4 out of every 6 persons swabbed for flu for URIs in the ER are coming back with positive results. (My patient pop. average age is markedly older than most of the county.) Just the other night, I admitted three different people over the age of 60 to the hospital, for flu which had debilitated the patients, who subsequently acquired pneumonia as well, the latter affliction being well capable of killing you deader than canned tuna untreated. Breathing underwater has that effect on people.

Flu symptoms are fever, sore throat, cough, body aches, fatigue, muscle aches, and possibly nausea/vomiting.

If you have a fever, you are infectious to others.
If you're treating a fever with Tylenol/ibuprofen/etc., you are infectious to others.
If either of those apply, keep your dumb ass at home, until you're over it. Period.
Anything else deserves a crotch kick.
(A co-worker was patient Zero at my ER, and another colleague gifted me with the crud for two weeks, followed by another four weeks of dreadfully lingering cough. This year's cold has a horrendous URI "tail" of hacking cough that just hangs on.)

Treatment
1) Stay the f*** home. Until it's ALL gone.
2) Get plenty of sleep and rest, but get up and move around, if only to use the bathroom, make a sandwich, pee, poop, or puke. Lying immobile increases your odds for bigger problems.
3) acetaminophen/ibuprofen for fever control and aches.
4) Water, water, water. Anything less than an hourly pee trip, and your pee isn't clear and mostly colorless, you're probably not drinking nearly enough water.
5) Soups, Gatorade, Jell-O, popsicles, etc. are also water.
6) And more water.
7) Caffeine and alcohol are diuretics, and dehydrate you more, and faster. Avoid both.
8) Take any number of "snivel" meds to mitigate symptoms, loosen congestion and mucus, suppress cough, etc.
9) If you find homeopathic voodoo meds that help, use them. They likely can't hurt.
10) Stay the f*** home. Until it's ALL gone.

This year's flu outbreak is in addition to normal viral illnesses (a "cold"), which are similarly rampant, especially from Thanksgiving to Easter, when intergenerational family members gather to share diseases and finger-bang everything they touch and cough on, for everyone from snot-monkey age to grandma and grandpa.

Prevention
1) Keep yourself and your little bastards home when they're sick.
2) Wash your hands.
3) Wash your hands before you eat, drink, or touch your face.
4) Wash your hands.
5) Wash your hands after you poop, pee, cough, or touch anything else in the entire world.
6) Wash your hands.
7) Cover your mouth when you cough.
8) Keep at home all your kids too young and stupid to learn to cover their mouths when they cough.
9) Carry personal disinfectant/sanitizer, and use it vigorously and frequently.
10) Understand that if I catch you or your kids out and about in public, coughing, sneezing, and dribbling your snot-mitts on everything, I may replace or augment my personal disinfectant with OC spray, and I will use it on you. If you can still identify me afterwards, and I'm still in the same area 30 minutes later when your vision clears up, I may express feigned/mock regret over my "mistake" in grabbing the wrong spritzer and using it on you.
11) Or, not.

NB: OC Spray is Oleoresin capsicum - pepper spray. - good words of wisdom...

Three headlines - romaine lettuce

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From Canada's Public Health AgencyOutbreak of E. coli infections linked to romaine lettuce

From the USA's Centers for Disease ControlCDC Investigating Multistate Outbreak of E. coli O157:H7 Infections

From Consumer Reports magazine: Avoid Romaine Lettuce for Now, Consumer Reports Says

Things are pointing to a Canadian source - 59 people ill and two fatalities - washing the lettuce does nothing. Time to switch to iceberg or butter...

The Flu in England

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From the UK Telegraph:

NHS hospitals ordered to cancel all routine operations in January as flu spike and bed shortages lead to A&E crisis
Every hospital in the country has been ordered to cancel all non-urgent surgery until at least February in an unprecedented step by NHS officials.

The instructions on Tuesday night - which will see result in around 50,000 operations being axed - followed claims by senior doctors that patients were being treated in “third world” conditions, as hospital chief executives warned of the worst winter crisis for three decades.

Hospitals are reporting growing chaos, with a spike in winter flu leaving frail patients facing 12-hour waits, and some units running out of corridor space.

The joys of socialized medicine - the system creaks along until something like this epidemic happens and then it collapses. There is no resiliency built into the system. That costs money and they do not have any.

Bad all over - flu

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Kurt died from the flu and he was in really good health. It is bad all around the USA - from the Los Angeles Times:

Severe flu brings medicine shortages, packed ERs and a rising death toll in California
So many people have fallen sick with influenza in California that pharmacies have run out of flu medicines, emergency rooms are packed, and the death toll is rising higher than in previous years.

Health officials said Friday that 27 people younger than 65 have died of the flu in California since October, compared with three at the same time last year. Nationwide and in California, flu activity spiked sharply in late December and continues to grow.

The emergency room at UCLA Medical Center in Santa Monica typically treats about 140 patients a day, but at least one day this week had more than 200 patients — mostly because of the flu, said the ER’s medical director, Dr. Wally Ghurabi.

Wash your hands frequently and stay away from crowds. This season is a bad one. There is a bit of good news from the Centers for Disease Control:

Flu vaccines have been updated to better match circulating viruses

Good news - the initial vaccines didn't cover this year's prevailing strain.

Influenza in the news

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My manager's husband died from the flu a few days ago - it has been a very bad season for this disease. Here are a few links:

The Centers for Disease Control show that the prevailing strain is not what people were being vaccinated for.

The California fires

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It will be interesting to see if the State of California will take funds away from social programs nad spend them on repairing their crumbling infrastructure. The winds caused power lines to arc and this is what caused the majority of the fires. Here is one other cause - from the Los Angeles Times:

Fire at a homeless encampment sparked Bel-Air blaze that destroyed homes, officials say
The blaze that swept through the hills of Bel-Air last week, destroying six homes and damaging a dozen others, was sparked by a cooking fire at a homeless encampment in a nearby ravine, Los Angeles officials said Tuesday.

The encampment was nestled in a canyon several hundred feet from Sepulveda Boulevard and the 405 Freeway, hidden from passing cars. For several years, it had been home to an unknown number of people, officials said.

Investigators said the fire had not been set deliberately and they have not found any of the people who lived there. The camp — one of scores of makeshift communities that have grown along freeways, rivers and open space across Los Angeles — was largely destroyed in the fire, leaving authorities with little evidence.

And of course, it is not the homeless who are at fault:

News that one of Los Angeles’ most affluent neighborhoods was damaged in a fire sparked by some of the city’s poorest residents added a sober note to the incident, with some officials saying it underscores the need to do more to house the homeless.

The majority of the homeless are mentally ill - they used to be institutionalized and although these institutions were mundane and many times underfunded, at least they were fed and kept clean and given things to do according to their mental abilities. Enter President John F. Kennedy and his Community Mental Health Act - passed in 1963, it caused widespread deinstitutionalization. Every single act by progressives have only exacerbated the homeless problem. We need to return to a program of institutionalization. People will cry that this would violate the "rights" of the mentally ill but the mentally ill - by the very definition - are not capable of acting on their own best interests.

From Dr. Helen Smith writing at PJ Media:

I Believe It: Vegetarian Men More Depressed
A recent study finds men who don't eat meat are more depressed:

From the same dataset that brought you the information that vegetarian mothers create drug-addled children, we learn that vegetarian men are more depressed than their meat-eating brothers. The study, Vegetarian diets and depressive symptoms among men, is in the Journal of Affective Disorders.

That dataset, Avon Longitudinal Study of Parents and Children (ALSPAC), has over 9,000 men self-reporting on their eating habits. This study looked at the 350 self-identified vegetarians in their midst. These men completed a survey including a set of measures on depression at roughly the 18th week of their spouses’ pregnancy. Vegans were lumped in with vegetarians because of their small numbers. The researchers found that vegetarian men were more likely, with an odds ratio of 1.71 (that is a 70% increased risk) to be depressed. The authors say they accounted for a range of sociodemographic factors including family history, prior childhood psychiatric contact, educational level, number of children at home, marital and employment status, alcohol and tobacco use and educational level. The longer time an individual had been a vegetarian did not correlate, at least at a statistical significance, with depression.

Dr. Smith closes with this excellent observation:

I have to say that the stricter people are with their diet, the more out of  control they seem to feel about their lives, and I think too many vegetables and not enough protein is a recipe for disaster, especially for men.

My chicken breasts should be thawed out by now - time to make a quick marinade and get them ready for dinner tonight.

News you can use

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Trish and I have been looking at getting some more exercise. We are both pretty fit but I want to take it up a notch or three - this news makes perfect sense. From Australia's University of Sydney:

Strength exercise as vital as aerobic
Push ups and sit ups could add years to your life according to a new study of over 80,000 adults led by the University of Sydney.

The largest study to compare the mortality outcomes of different types of exercise found people who did strength-based exercise had a 23 percent reduction in risk of premature death by any means, and a 31 percent reduction in cancer-related death.

Lead author Associate Professor Emmanuel Stamatakis from the School of Public Health and the Charles Perkins Centre said while strength training has been given some attention for functional benefits as we age, little research has looked at its impact on mortality.

“The study shows exercise that promotes muscular strength may be just as important for health as aerobic activities like jogging or cycling,” said Associate Professor Stamatakis.

Interesting and it looks like a well-run survey. 80,000 is a great sample size - good p-Value. The disgraced study that caused all the controversy about vaccines and autism had a sample size of 12.

America's Opioid crisis

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Americans are dying from opioid overdose and the numbers are rising sharply. It seems that people are looking into this - especially one of the families responsible. From the U.S. Attorney’s Office - District of Massachusetts:

Founder and Owner of Pharmaceutical Company Insys Arrested and Charged with Racketeering
The founder and majority owner of Insys Therapeutics Inc., was arrested today and charged with leading a nationwide conspiracy to profit by using bribes and fraud to cause the illegal distribution of a Fentanyl spray intended for cancer patients experiencing breakthrough pain.

John N. Kapoor, 74, of Phoenix, Ariz., a current member of the Board of Directors of Insys, was arrested this morning in Arizona and charged with RICO conspiracy, as well as other felonies, including conspiracy to commit mail and wire fraud and conspiracy to violate the Anti-Kickback Law. Kapoor, the former Executive Chairman of the Board and CEO of Insys, will appear in federal court in Phoenix today. He will appear in U.S. District Court in Boston at a later date.

And the charges:

(long list of people including Kapoor) conspired to bribe practitioners in various states, many of whom operated pain clinics, in order to get them to prescribe a fentanyl-based pain medication.  The medication, called “Subsys,” is a powerful narcotic intended to treat cancer patients suffering intense breakthrough pain.  In exchange for bribes and kickbacks, the practitioners wrote large numbers of prescriptions for the patients, most of whom were not diagnosed with cancer.

Emphasis mine. Lots more at the site. This is only one instance but it is a great place to start.

I have always wondered why we do not outright buy the entire Afghani opium crop each year and just destroy it after refining what the world medical industry needs. One sure way to get it off the streets.

A new Shingles vaccine

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Time to get the jab again - from UPI:

CDC recommends new shingles vaccine for people over 50
On the heels of approval of a better vaccine for the painful condition shingles, adults over 50 should plan to roll up their sleeves -- again.

The new vaccine, Shingrix, will likely be recommended even for those already inoculated with an older vaccine.

An advisory panel of the U.S. Centers for Disease Control and Prevention recommended Wednesday that all adults 50 and older receive the new two-shot vaccine, just days after the U.S. Food and Drug Administration announced its approval of Shingrix.

Planning to get this myself. I have known a couple people who had Shingles and would not wish this on anyone...

Great little eye-opener from Conservative Tribune:

Socialism at Work: British Feds Ban Surgery for Smokers and the Obese
Socialized medicine is a wonderful, compassionate system that brings important care to everyone… at least, that’s what leftists in the United States and Europe keep insisting.

As the United Kingdom is finding out, however, everyone is not actually equal under health care socialism. As soon as the system starts running out of other people’s money, people are quickly pushed out… and you’d better hope that you’re not one of the unlucky ones who gets thrown aside!

That’s exactly what happened this week in Britain, as the socialized National Health System announced that patients are being banned from important surgeries if they happen to be a bit overweight or smoke tobacco.

More at the site - tip of the hat to Wirecutter at Knuckledraggin My Life Away for the link.

The link between childhood vaccinations and autism is simply not there. It first reared its pointy little head in a 1998 paper in the British journal Lancet based on research by Dr. Andrew Wakefield. Slight problem - Wakefield's research was funded by an insurance company which hoped to profit off future lawsuits against vaccine makers. The paper was retracted and Dr. Wakefield now goes by Andy - his license to practice medicine was stripped from him.

Still, like a chicken, the head was chopped off but the body still twitches. From Canada's CBC News:

UBC researchers pull paper linking vaccine component to autism after data alleged to be manipulated
Researchers from the University of British Columbia are retracting their scientific paper linking aluminum in vaccines to autism in mice, because one of the co-authors claims figures published in the study were deliberately altered before publication — an issue he says he realized after allegations of data manipulation surfaced online.

The professor also told CBC News there's no way to know "why" or "how" the figures were allegedly contorted, as he claims original data cited in the study is inaccessible, which would be a contravention of the university's policy around scientific research.

The paper looked at the effects of aluminum components in vaccines on immune response in a mouse's brain. It was published in the Journal of Inorganic Biochemistry on Sept. 5.

Talk about a two-fer - not only the vaccine/autism fraud but they were looking at aluminum which has been featured highly in the do not use aluminum cookware as it can give you Alzheimers bullshit. A bit more:

However, subsequent scrutiny has raised questions about the validity of the data, with one doctor calling the paper "anti-vaccine pseudoscience."

The allegations were published last week on Retraction Watch, a site that reports on withdrawn papers as "a window into the scientific process."

By the middle of September, commenters on PubPeer — a database where users can examine and comment on published scientific papers — pointed out that figures in the study appeared to have been altered, and in one case lifted directly from a 2014 study also authored by Shaw and Tomljenovic.

Soo busted. A lot more at the site. One of the researchers had a previous paper retracted for dodgy data in 2016. Who is funding these idiots and why do they still have tenure at UBC?

Healthcare in Canada

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In the USA, our health-care system is a muddled mess. It started off fine but grew larger and larger as more and more activists lobbied for their niche causes. Add congressional lobbying by pharmaceutical companies and you have a big steaming expensive mess. As we look for alternatives, Canada keeps coming to mind. Turns out the numbers simply do not add up. From Canada's Financial Post:

Why Canada’s ‘best’ health-care system just got ranked last — again
Because liberal Americans see us, in this age of Trump, as an oasis of sanity in a worldwide desert of populism, The New York Times is doing more reporting on Canada, presumably so its U.S. readers don’t lose all hope that saner choices could be available in an alternative world.

It also offers a weekly “Canada letter” on worthwhile and actually sometimes interesting Canadian initiatives. Recently the letter reported on a health-care tournament the Times organized in which five experts decided which of eight rich countries had the best health-care system.

We didn’t win. In fact, we went out in the first round, losing to Britain, which then lost to Switzerland, which ultimately beat France, though only by three votes to two in the final. Other first-round losers were Singapore, Australia and Germany. The U.S. made it to the semis where it was beaten by France, three votes to two.

Wait times were the big issue. This is a perfect example of rationing which is what Obamacare and Single Payer will be implementing. "Free" medical is only good if you can get it in a timely manner.

Obamacare meltdown

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Looks like President Trump is taking Obamacare to the mat - three headlines:

Stick a fork in it - it is done and over with. Private insurance, free market competition. Those will drive down the costs - a centralized administration will drive up the costs.

Two different stories, two different cities:

Not like this is a new event either. From 2015. From 2016. From 2017.

Good news - baby Charlie Gard

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Baby Charlie was born with a genetic disorder and will not live unless he receives an experimental treatment in the United States. His parents raised over $1.5 million but England's National Health Service (their version of government single-payer health care) is insisting that Charlie die with dignity at home. This case is really demonstrating the failure of the single-payer system plus the fact that when a single-payer system is installed, the available funding to do basic research dries up - there are no experimental treatments in England, only in America.

But, some good news from CNS News:

Judge Rules Against London Hospital--In Favor of Charlie Gard's Parents
A judge at London's High Court ruled against the hospital and in favor of the parents of baby Charlie Gard--who is suffering from a rare genetic disorder--that they may present new scientific evidence concerning their son's treatment, which will be reviewed this Thursday and could possibly lead to Charlie receiving treatment in the United States. But the outcome is still uncertain and Charlie's fate is precarious.

Charlie Gard is 10 months old. He lives on life support in the Great Ormond Street Hospital in London. His genetic disorder is destructive to muscles and organs, and most people who have the problem die in infancy. The baby's parents, Chris Gard and Connie Yates, want their son to undergo an experimental treatment, which has been helpful in some cases. An online campaign has raised more than $1.5 million for the baby's treatment.

Under the health care laws in Britain, however, the parents are not allowed to pursue this option. The hospital contends Charlie is brain-damaged and beyond medical hope, and the hospital wants to shut off his life support. This denial of the parent's desire to seek treatment for their son elsewhere led to several court rulings -- in favor of the hospital. On Monday, July 10, the judge who previously ruled against the Gards agreed to review whatever new evidence they can present to him for a reevaluation.

Single-payer health care - Canada

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Single payer does not work. There is no competition so costs escalate. When the costs get too high, rationing happens. When rationing happens, delays occur. From Canada's Frasier Institute:

Waiting Your Turn: Wait Times for Health Care in Canada, 2016 Report
Waiting for treatment has become a defining characteristic of Canadian health care. In order to document the lengthy queues for visits to specialists and for diagnostic and surgical procedures in the country, the Fraser Institute has—for over two decades—surveyed specialist physicians across 12 specialties and 10 provinces.

This edition of Waiting Your Turn indicates that, overall, waiting times for medically necessary treatment have increased since last year. Specialist physicians surveyed report a median waiting time of 20.0 weeks between referral from a general practitioner and receipt of treatment—longer than the wait of 18.3 weeks reported in 2015. This year’s wait time—the longest ever recorded in this survey’s history—is 115% longer than in 1993, when it was just 9.3 weeks.

There is a great deal of variation in the total waiting time faced by patients across the provinces. Ontario reports the shortest total wait (15.6 weeks), while New Brunswick reports the longest (38.8 weeks). There is also a great deal of variation among specialties. Patients wait longest between a GP referral and Neurosurgery (46.9 weeks), while those waiting for Medical oncology begin treatment in 3.7 weeks.

The full report can be found here (PDF). No wonder so many Canadians come down here for healthcare.

A couple of days ago, I posted about baby Charlie in England where their single-payer healthcare system's Doctors sugested that he should be able to ‘die with dignity’ even though his parents had raised £1.4million so he could come to America and try some experimental treatments.

Today, our President weighed in - from The Hill:

Trump offers help for critically ill British child
President Trump on Monday offered to help a critically ill British child who has become a flashpoint in the U.K. debate over whether the government should have a say in individual matters pertaining to life and death.

Trump tweeted his support for Charlie Gard, a 10-month-old infant on life support due to complications from a mitochondrial disease. The controversy around Gard has engulfed the Vatican, which infuriated some on the right by not immediately siding entirely with the parents, who want to seek experimental medication in the U.S. or bring their child home to die.

“If we can help little #CharlieGard, as per our friends in the U.K. and the Pope, we would be delighted to do so,” Trump tweeted.

This is leadership - plain and simple. A refreshing change.

Here is what England's National Health Services is doing - from Louder with Crowder:

PURE EVIL: Baby Sentenced to Death by Government Healthcare
There are some things in life that should remain private. Like your IBS, your foot fetish, or the lack of underwear under those jeans. When it comes to more important decisions and information, like healthcare, privacy is essential (see California Senate Flips Bird to Taxpayers. Passes Single-Payer Healthcare Bill… and Women’s ‘Healthcare’? Planned Parenthood ONLY Performs Ultrasounds to Kill the Baby). So too is privately funding your own healthcare. When one’s government funds it, that government also makes some horrendous calls.

Trigger warning for snowflakes: this story doesn’t have a fairytale ending. Move to the UK.

The parents of terminally-ill baby Charlie Gard are ‘utterly distraught’ and facing fresh heartbreak after losing their final appeal in the European Court of Human Rights.

Chris Gard, 32, and Connie Yates, 31, wanted to take their 10-month-old son – who suffers from a rare genetic condition and has brain damage – to the US to undergo a therapy trial.

Doctors at Great Ormond Street Hospital for Children in London, where Charlie is being cared for, said they wanted him to be able to ‘die with dignity’.

But the couple, from Bedfont, west London, raised almost £1.4million so they could take their son to America but a series of courts ruled in favour of the British doctors.

Let me pause here. The couple has raised their own money to take their own son to the United States for possibly life-saving medical care. The UK government told them no. The UK government has sentenced a child to death.

Much more at the site - as said, the couple raised the so they could take their son to America but the National Health Service said no - the doctors want the baby to be able to ‘die with dignity’. Heaven help that someone should be able to actually cure the baby - that would show the NHS doctors to be the incompetent fools that they are.

Notice also that under a Single Payer Healthcare system, there is no research. There are no experimental treatments. There is no money for these because all of the money is sucked into the daily operation of the bureaucracy. If more money should become available, the bureaucracy will incrementally grow in size until it absorbs that extra money for its daily operation.

The idea that such a system could take root in America makes me sick to my stomach.

From The Seattle Times:

Elizabeth Warren: ‘The next step is single-payer’ health care
Sen. Elizabeth Warren said Tuesday that opposing the Republican health-care bill wasn’t enough and the Democratic Party should start running on a new national single-payer plan.

“President Obama tried to move us forward with health-care coverage by using a conservative model that came from one of the conservative think tanks that had been advanced by a Republican governor in Massachusetts,” she told The Wall Street Journal. ”Now it’s time for the next step. And the next step is single payer.”

Massachusetts tried single-payer and it failed spectacularly with overall costs skyrocketing. There is no incentive for a hospital to keep costs low - there is no competition. England has its National Health Service and it too is failing with staffing shortages, exorbitant waiting times (hip and knee replacements have average wait times of over 100 days), a large number of unnecessary deaths - 1 in 28 - four times that of US Hospitals.

Single payer is the worst form of health care - if we think that the Veterans Hospitals are bad, wait until every hospital is just as bad. Open up the health care markets - bring in competition and we will see better care and lower costs.

Dilbert on Health Care

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Dilbert creator Scott Adams writes:

The Only Way to Fix Healthcare Insurance in the U.S.
Our system of government has been amazingly robust for hundreds of years, but it fails when you have these two conditions:

    1. An issue is too complicated for the public to understand.
    2. Big companies are willing to distort the system for profits.

That situation describes the healthcare debate going on in the United States right now. Our undersized brains can’t grasp all the nuances and implications of any particular healthcare plan. And when our brains are confused, we default to our biases (usually party loyalty) or to whatever metric is simple enough to understand. With healthcare, the one metric that matters is how many people will be covered compared to Obamacare. If the Republican plan covers more people, it will pass. If not, it will fail.

A lot more at the site - this is a very well thought out post.

Interesting bit on Opioids

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There is a lot in the news about opioid addiction rising in the general population. Turns out this is Fake News - it is not the general population at all. From Kaiser Health News:

Patients With Mental Disorders Get Half Of All Opioid Prescriptions
Adults with a mental illness receive more than 50 percent of the 115 million opioid prescriptions in the United States annually, according to a study released Monday. The results prompted researchers to suggest that improving pain management for people with mental health problems “is critical to reduce national dependency on opioids.”

People with mental health disorders represent 16 percent of the U.S. population.

The findings are worrisome, the researchers reported. They had expected that physicians were more conservative in prescribing these painkillers to people with mental illness.

“We are prescribing way too much opioids,” said Dr. Brian Sites, an anesthesiologist at Dartmouth-Hitchcock Medical Center in New Hampshire and one of the study’s researchers. “And that prescription behavior is resulting in significant morbidity in the country.”

Morbidity is the medical term for kicking the bucket - in this case via overdose. Why prescribe?

“The opioids are prescribed primarily for pain,” but patients with mental illness find that the drugs alleviate their mental issues too, said Dr. Edwin Salsitz, an attending physician in the Division of Chemical Dependency of Mount Sinai Beth Israel Medical Center in New York who was not involved in the study. And this, he said, is what can lead to long-term use.

And there you go - America's heroin problem wrapped up in a neat package with a little bow on the top. Prescribing opioids is the easy way to alleviate the symptoms of mental illness. I am surprised that these people only constitute 16 percent of the total population - there are a lot more registered Democrats out there... (rimshot)

The beginning of the end - Mylan

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Mylan Pharmaceuticals is having some problems - could not happen to a nicer company. From Derek Lowe:

Mylan Begins Harvesting the Crop It’s Sown
There’s an interesting fight going on inside Mylan Pharmaceuticals. They, of course, are the longtime generic drug maker whose EpiPen prices have (understandably) made them a lightning rod for complaints about drug pricing in general. This New York Times article will give you the flavor of the company, and most unappetizing it is:

To understand Mylan’s culture, consider a series of conversations that began inside the company in 2014. A group of midlevel executives was concerned about the soaring price of EpiPens, which had more than doubled in the previous four years; there were rumors that even more aggressive hikes were planned. (Former executives who related this and other anecdotes requested anonymity because they had nondisclosure agreements or feared retaliation. Aspects of their accounts were disputed by Mylan.)

In (2014) meetings, the executives began warning Mylan’s top leaders that the price increases seemed like unethical profiteering at the expense of sick children and adults, according to people who participated in the conversations. Over the next 16 months, those internal warnings were repeatedly aired. At one gathering, executives shared their concerns with Mylan’s chairman, Robert Coury.

Mr. Coury replied that he was untroubled. He raised both his middle fingers and explained, using colorful language, that anyone criticizing Mylan, including its employees, ought to go copulate with themselves. Critics in Congress and on Wall Street, he said, should do the same. And regulators at the Food and Drug Administration? They, too, deserved a round of anatomically challenging self-fulfillment.

The CEO of Mylan is the daughter of U.S. Sen. Joe Manchin (D-WV). Her mother is head of the National Association of State Boards of Education and she spearheaded a 2012 push to require schools to maintain a stock of EpiPens. A Google search for Mylan Scandal returns with 319,000 hits.

Raw Milk

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There are some people out here who have very strange eating habbits including raw milk. Some numbers from Food Safety News:

What are the odds? 840 times more likely for raw milk drinkers
Based on statistics from the five-year period 2009-2014, people who drink unpasteurized, raw milk are 840 times more likely to contract a foodborne illness than those who drink pasteurized milk.

The statistics, included in a research report scheduled for publication in the upcoming June issue of “Emerging Infectious Diseases” also show raw milk drinkers are 45 times more likely to be hospitalized if they get sick than people who become ill from drinking pasteurized milk.

“Unpasteurized milk, consumed by only 3.2 percent of the (U.S.) population, and cheese, consumed by only 1.6 percent of the population, caused 96 percent of illnesses caused by contaminated dairy products,” according to the report scheduled for June publication by the Centers for Disease Control and Prevention.

Hard to argue with those numbers...

Health care - a plan

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This is going to be a long slog for people to read but this is one of the best and most intelligent health care plans that I have run across. Saves a lot of money and gives great (and affordable) care to everyone.

Some people are going to have their rice bowls taken away - lobbyists, hospital administrators (we have way to many high-paid administrators and too few actual Doctors), the drug sales representatives and those individuals who will not institute lifestyle changes (cutting carbohydrates for diabetics) and depend on everyone else to compensate for their inaction..

From Karl Denninger at The Market Ticker - Part One:

The Bill To Permanently Fix Health Care For All
Let's lay out the parameters for a bill, a fairly-modest update to my two previous missives on this point here and here (note the dates) and which can be easily turned into formal legislative language:

    • All providers must post, in their offices and on a public web site without any requirement to sign in or otherwise identify oneself to access it, a full and complete price list which shall apply to every person.  This instantly allows customers to compare pricing between providers for services and products in the medical realm.
    • All customers must be billed for actual charges at the same price on a direct basis at the time the service or product is rendered to them. This immediately and permanently decouples "insurance" from the provision of care.  The current system of an "explanation of benefits" that often features a "negotiated discount" of some 90% is nothing other than an extortion racket and is arguably felonious -- threatening to bankrupt someone if they don't buy your "insurance" through a threat to charge them ten times as much certainly appears to be a criminal enterprise and, given that more than one entity is involved, looks like it meets the definition of Racketeering.  Insurance coverage may well cover some, part or none of a given bill, and nothing prevents an insurer from telling you in advance of your visit how much they will pay (if anything) for a given procedure or drug.  Indeed you should demand that information from them and use it as part of choosing where to obtain treatment but the bill still has to be rendered to you, you have to be the one to file the claim and everyone must pay the same price to the same provider for the same kind and quantity of product or service.
    • For a bill to be valid and collectible it must be affirmatively consented to in writing, with a disclosure of the actual price to be charged from the above schedule for each item to be provided whether good or service, prior to the service being performed or the good furnished, subject only to the emergency exception below.  A bill that is increased, has items added to it after consent is obtained, which contains any open-ended promise to pay without an actual price listed for each service or good prior to customer consent or is issued with no consent at all (including having a customer sign a consent form while under the influence of drugs the facility gave them as occurs in virtually every instance today while you're being wheeled into the OR) is deemed fraudulent and void. This instantly stops "drive-by" doctor charges in hospitals as just one example.  It also prevents charging $20 for an aspirin; nobody would tolerate being billed by the square for toilet paper in a hotel!  Hospitals will of course squawk that they cannot operate like this as they "can't" figure out what is required until after-the-fact but that's false; nothing prevents them from advertising "Appendectomy: $2,000" and that being the soup-to-nuts price.  In fact that's exactly what the Surgery Center of Oklahoma does today so quite-clearly it both can and does work.  In addition this change will permanently and immediately put a stop to the ridiculous practice of defensive medicine (read below for the explanation.)  You would never accept a gas station that only displays the cost of your gasoline after you pumped it and varied that price based on who your car insurance was bought from or a grocery store that had no prices posted at all and only gave you a total after your groceries were taken out of the store and the transaction could not be refused.
    • No event caused by or a consequence of treatment can be billed to the customer.  This instantly aligns the interest of the customer in not having such an adverse complication (e.g. MRSA, etc) with the medical provider.  As it stands right now hospitals actually have an incentive for you to have a complication since they make more money if you do.  If you call me to fix your roof and I drop my ladder causing it to crash through your picture window I get to pay for the glass I broke through my ineptness.  The same must apply to medical providers. For those who claim hospitals and similar can't adopt such a model I point to the OKC surgery center, which does exactly this -- and has a lower complication rate (gee, I wonder why when they have to eat it if they cause it....)

Much more at the site - plan on spending 30 minutes reading through this and following the links.

And Part Two:

Implementation Of Permanent Health Reform

Again, these are two long and dense articles but they are incredibly well thought out and would be a shining beacon to other nations seeking to implement a national form of healthcare.

Measles outbreak - vaccination

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When people do not vaccinate their children, these things happen - from the Duluth, Minnesota News Tribune:

Measles outbreak at 32, with Somali-Minnesota children hit hard
A Ramsey County child is among 32 confirmed cases of the measles this month as unfounded fears of a link to autism have contributed to stubbornly low vaccination rates among Somali-Americans.

The Minnesota Department of Health says at least 28 of the outbreak's victims are Somali-American. Just one is known to have received the MMR vaccine, which protects against measles, mumps and rubella.

And the reason?

Somali-Americans in Minnesota once had higher vaccination rates than the general population. But that changed following news reports in 2008 about high rates of autism among Somali-American students in Minneapolis Public Schools.

Kris Ehresmann, infectious disease division director at the Health Department, said anti-vaccine activists seized on the 2008 news "almost immediately," spreading fears about a debunked link between the MMR vaccine and autism.

I really hope that Andy Wakefield comes to grips with the damage he has done. Revoking his Medical License should have beeen just the first step - charges should be filed.

From Ars Technica:

South Indian frog oozes molecule that inexplicably decimates flu viruses
From the slimy backs of a South Indian frog comes a new way to blast influenza viruses.

A compound in the frog’s mucus—long known to have germ-killing properties—can latch onto flu virus particles and cause them to burst apart, researchers report in Immunity. The peptide is a potent and precise killer, able to demolish a whole class of flu viruses while leaving other viruses and cells unharmed. But scientists don’t know exactly how it pulls off the viral eviscerations. No other antiviral peptide of its ilk seems to work the same way.

The study authors, led by researchers at Emory University, note that the peptide appears uniquely nontoxic—something that can’t be said of many other frog-based compounds. Thus, the peptide on its own holds promise of being a potential therapy someday. But simply figuring out how it works could move researchers closer to a vaccine or therapy that could take out all flus, ditching the need for yearly vaccinations for each season’s flavor of flu.

Since it seems to target a specific kind of virus, it might be amenable to molecular tweaking to target different viruses - AIDS comes to mind. Viruses can not be killed with antibiotics like bacteria can. The current therapies seek to inhibit its spread and reproduction. This would be amazing if it works out.

Glad I do not live on Maui

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From ABC News:

Hawaiian officials fear infections of rare parasitic worm will increase
A spike in infections from a rare parasitic worm in the Hawaiian island of Maui has local health officials concerned about the parasite's potential to spread.

A worm called Angiostrongylus cantonensis causes the infection; there is no treatment, and in rare cases, it can be fatal. People who catch the infection by eating raw or undercooked snails, or contaminated fruits and vegetables, can develop meningitis.

Earlier this week, health officials in Maui reported that six cases of the parasitic infection have been reported in the last three months compared to the previous decade when only two cases were found, according to the Associated Press and ABC News affiliate KITV.

This is quite the up-tick in infections. Wonder if it was food borne and from where.

Price gouging - medicine

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The price of EpiPens was in the news recently because their price went from $100 to $600 in a few years. Say hello to mebendazole sold under the trade name of Emverm and used to treat pinworms.

From Jacksonville, Florida station WJXT:

Pinworm prescription jumps from $3 to up to $600 a pill
It's something a lot of kids get, but it's also easily cured. One single prescription pill can stop a contagious case of common pinworm, ringworm or even roundworm. It used to cost only a few dollars per pill, but that price has skyrocketed.

Dr. Saman Soleymani treats a lot of kids at Avecina Medical, and therefore, he sees a decent amount with worms -- mostly pinworm, which is the most common type of intestinal worm infection. He says the treatment is easy.

You take one little pill of a prescription drug called mebendazole, which is sold under the name brand Emverm, and the worms are usually gone. So when Soleymani prescribed it recently, he was shocked.

"The pharmacy called me about an hour later saying the treatment is about $1,800 and it's not covered by pretty much any insurance company," said Soleymani.

Soleymani realized that prescription, which used to cost patients about $3 a pill, now costs anywhere from $500 to $600 for that same pill.

A tip of the hat to Joe Mama writing at Eaton Rapids Joe for the link. He also mentions that there is a veterinary version of this medicine which sells for $6.99 for 24 grams - about 65 human-equivalent doses. Not something to do if the 'real stuff' is available but simple and cheap enough to keep on hand for SHTF scenarios.

Vitamin D supplements - now even better for you

I take 5,000U every morning - big difference. From New Scientist:

Vitamin D supplements may prevent millions of winter infections
If everyone took vitamin D supplements, more than 3 million fewer people in the UK would have respiratory infections like colds or flu every year. That’s according to a new analysis of data from nearly 11,000 people.

Vitamin D is known to be important for bone and muscle health. Last year, Public Health England stated that people are not generally getting the recommended 10 micrograms of vitamin D a day from sunlight in winter. But whether vitamin D supplements can help has been a hot topic, with some arguing that benefits of taking these are uncertain.

The latest study pulled together data from 25 clinical trials, conducted in 14 countries. It concluded that supplements can help prevent acute respiratory tract infections, particularly among those who are deficient in vitamin D.

The most common respiratory tract infection is the common cold, but others include bronchitis, pneumonia, and infections of the sinuses or ears. At least 70 per cent of the population gets one or more respiratory infection in any given year.

But the study found that vitamin D supplements can cut the proportion of people getting such infections by 12 per cent. “Daily or weekly vitamin D supplements will mean 3.25 million fewer people would get at least one acute respiratory infection a year,” says Adrian Martineau, at Queen Mary, University of London, who led the study.

Interesting - I regularly take D, some baby aspirin and some multivitamins.

A potential for caution - Flu

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Maybe nothing but... From the AAAS magazine Science:

Bird flu strain taking a toll on humans
An avian influenza virus that emerged in 2013 is suddenly spreading widely in China, causing a sharp spike in human infections and deaths. Last month alone it sickened 192 people, killing 79, according to an announcement this week by China's National Health and Family Planning Commission in Beijing.

The surge in human cases is cause for alarm, says Guan Yi, an expert in emerging viral diseases at the University of Hong Kong in China. "We are facing the largest pandemic threat in the last 100 years," he says.

As of 16 January, the cumulative toll from H7N9 was 918 laboratory-confirmed human infections and 359 deaths, according to the World Health Organization (WHO). Despite its high mortality rate, H7N9 had gotten less attention of late than two other new strains—H5N8 and H5N6—that have spread swiftly, killing or forcing authorities to cull millions of poultry. But so far, H5N8 has apparently not infected people; H5N6 has caused 14 human infections and six deaths.

We had a pandemic in 1918 that killed about 5% of the population. Something like this is not out of the ordinary and can happen again. Medical technology has gotten better but viruses are notoriously tricky to deal with.

From United Press International:

New gut microbe study may lead to potential autism treatment
Researchers at Arizona State University have found improved autism symptoms in participants who were given medications to treat gut microbes.

The research team of scientists from Arizona State, Northern Arizona University, Ohio State University and the University of Minnesota, studied 18 people ages 7 to 16 with autism spectrum disorders for 10 weeks.

Study participants were given a treatment of antibiotics, a bowel cleanse, and daily fecal microbial transplants over an eight-week period.

The study showed an average of 80 percent improvement in gastrointestinal symptoms common in people with autism and a 20 to 25 percent improvement in certain autism behaviors including social skills and sleep habits.

That is interesting and entirely believable. I have known a couple families with autistic children and they all seemed to have strange diets - mostly vegetarian. That would make a lot of sense regarding internal flora. BTW, I am not saying a vegetarian diet is a bad one, these people had strange ideas about what was good and what was not good to eat.

The Flu season - pretty serious

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Looks like it's not just me and Lulu - from The Bellingham Herald:

Flu death toll in Washington state at 46, none in Whatcom County
The number of deaths caused by the flu in Washington state has climbed to 46 as the flu continued its grip on the state, according to information released Friday.

None of the deaths were in Whatcom County, which also has seen a spike in the number of people sickened by the flu during a season that hit hard and about a month early.

The deaths were for the flu season as of Jan. 7.

Illness kept students out of school and outbreaks occurred at long-term care facilities in Whatcom County.

Flu remained at epidemic levels in the state and was straining hospitals in Western Washington.

“We are seeing a lot of influenza and other respiratory infections in our medical offices, ED (emergency department/room) and hospital, and it is too early to tell if influenza has reached its peak,” said Greg Stern, Whatcom County health officer.

A lot of people out here have come down with it - nasty. Anecdotally, there seems to be zero difference between those vaccinated and not. They have to forecast the particular strain of flu over six months in advance and sometimes they get it right and sometimes they get it wrong and the vaccine is minimally effective.

Not good - Mumps on the upswing

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From The Medical Press:

Mumps spreads on college campuses
Caroline Brown, a sophomore at the University of Missouri, got a fever over Thanksgiving break. Soon it became painful to bite down, and her cheek began to swell. A trip to her physician confirmed it: she had the mumps.

"Mumps kind of sounds like this archaic thing," Brown said. "We get vaccinated for it; it just sounds like something that nobody gets. So I just didn't think that it was possible that I would get it."

But  is back, and is having its worst year in a decade, fueled in part by its spread on college campuses. Since classes began at the University of Missouri in August, school officials have identified 193 mumps cases on campus. Nationwide, more than 4,000 cases have been reported to the Centers for Disease Control and Prevention - nearly triple the number in 2015 and the largest increase in 10 years.

Some public health officials are asking questions about the  protocol.

Dr. Susan Even, executive director of the University of Missouri's Student Health Center, said she hasn't seen anything like the current  in her 31 years at the school. She said all of the students her team treated for mumps had two MMR (Measles, Mumps and Rubella) vaccine doses - a school requirement - but they got sick anyway.

"The fact that we have mumps showing up in highly immunized populations likely reflects something about the effectiveness of the vaccine," Even said.

This is not good - if a guy catches it after they hit puberty, there is a good chance that they can be rendered sterile. There is a major outbreak in Arkansas:

The largest current outbreak is in Arkansas, which reports over 2,000 cases among school-age children and adults throughout the state since August this year.

Time to re-examine the vaccines in use and maybe up the dosage. The anti-vaxxers should get sent in for re-education. They are compromising the populations Herd Immunity.

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