so, you're not vaccinating, now what? part 2: diphtheria, rubella, tetanus, influenza

So You’re Not Vaccinating. Now What? Session Two

John “Doc” Edwards, DC, CACCP

Mama’s Chiropractic Clinic

Pathways Connect SWFL

[email protected]

(239) 549-MAMA

Today…

• Diphtheria

• Tetanus

• Rubella

• Influenza

• What it looks like

• Signs & Symptom Timeline

• How long to stay home

• Death/Injury Risk of Illness

• Treatment

HealthStory Productions, LLC

Diphtheria (Toxin)

Thick dirty white/grey/green/black coating “Bull Neck”

Sore throat, low grade fever, croupy cough, runny nose, drooling, breathing problems, throat coating

Diphtheria (Toxin) S/S


Introduction(Droplet: respiratory, shared objects or skin in tropics)

2-5 days 30 days

Heart/Kidney toxins

30 days untreated

“Contagious,” stay at home

Natural Course

28-42 days

humanIllnesses.com

48 hours treated

Mild case: No S/S

Diphtheria (Toxin) Risk

• 4 US diphtheria cases since 2000 (WHO).

• 1 in 15,925 risk of death in low vacpopulation, 0-5 cases/100,000, 10% death rate in high vac (vaxtruth)

• Thickened mucosa leading to respiratory distress, toxin impacts heart, kidneys (NVIC).

• Antitoxin effective, Antibiotics not (WHO)

• Africa, Asia, South America, US Reservations; usually winter months (humanillnesses)

• Clean water, Sanitation, Poverty, Crowded Living Conditions, (Bathing < 1 wk) (NVIC)


Image: The Economist (2013)

Diphtheria (Toxin) Treatment

• Are you allergic to horse serum?

• Anti-toxin inactivates Toxin, antibiotic helps others not get infected but doesn’t treat symptoms.

• Schick Test: Studies with Swedish alcoholics, Danish and English mixed predictability for antibody immunity (Settergren).


Image: Koplick, H. (1918)

Vitamin C Dosage

“Dr. Frederick R. Klenner of Reidsville, North Carolina, who has had more actual clinical experience in megascorbic prophylaxis and megascorbic therapy in the past thirty years than anyone else in the world, routinely prescribes ten grams of ascorbic acid daily to his adult patients for the maintenance of good health. His daily dosage schedule for children is one gram of ascorbic acid per year of age up to ten years and ten grams daily thereafter (e.g. a four-year-old child would receive four grams daily). Dr. Pauling concluded that the optimum daily intake of ascorbic acid, for most human adults, is in the range of 2.3 grams to 9 grams,” (Stone).


Tetanus (Toxin)


Tetanus (Toxin) S/S


Introduction:Puncture Trauma, cultivated soil or fecal matter, deep enough for no flow, oxygen

Spasms of the jaw or facial muscles, hands, flexed arms, straight legs, and head/back extension triggered by touch/sound

3-21 days (average: 8)

Not “Contagious”

Natural Course

Harvard Medical School

Muscular stiffness of the jaw and neck, headache, irritability, fever, and chills

30-60 days

WebMD

Tetanus (Toxin) Risk

• 5 cases in 100 Million under 20 year-olds (smartvax)

• 4 cases neonatal tetanus since 1989

• 5 Yr Cumulative Death Risk High Vac/Low Vac: 1 in 759,000 (smartvax)

• 1972-2001 half of cases, 75% of deaths age 65+

• Diabetes, IV drug users (NVIC)



Tetanus (Toxin) Treatment

• Am I walking around in an area where people and animals poop?• Am I punctured, can I clean it, is there good blood flow?• Antibiotic, Anti-toxin, Sedatives. No exposure-based immunity, no

long-term neurological damage (medicine.net) • Stone: Animals given tetanus toxin and Vitamin C at various stages,

1 g/kg. 100% kill= No C, 48 hours. Ranged from no symptoms with prophylactic treatment to stoppage of symptoms & complete recovery when given up to 47 hours after injection.

• Cochrane Review 2008: In the children aged 1 to 12 years (n = 62), vitamin C treatment of 1 g/day IV was associated with a 100% reduction in tetanus mortality; 13-35 same dose, 45% mortality. (Hemilä 2008)

• Cochrane Review 2013: This was still the only study done.


Rubella (German Measles)

• Mild fever, sore back of neck/ear lymph nodes

• Faint Pink/Red Spots merge to itchy patches on face, more noticeable after warm shower.

• Patches leave face, may peel, will fade as it spreads head to toe.

• Older children: Pink eyes, headache, loss of appetite, joint pain.

• CRS: Fetus of unexposed 1st trimester moms: deafness, cataracts, heart defects, mental retardation

(kidshealth.org)


Compare to Varicella (Chicken Pox)

Fluid-filled, small spots Will scab, but individual points


Compare to Measles

Mottled rash Black dot Koplic Spot

Rubella S/S


Introduction(Droplet)

“Contagious,” stay at home (and away from 1st trimester pregnant women)

Natural Course

Centers for Disease Control & Prevention

Rash appears on face

7 days 30 days7-16 days

Mild fever (99-100) Swollen tender lymph nodes back of neck & ears

1-2 days “3 days”

7 days

Rash leaves face, spreads head to toe

Rubella Risk

• 50% of cases are asymptomatic/subclinical (CDC); CRS shed 1 year.

• 2006-2009: 11 cases of rubella annually, none naturally transmitted since (NVIC, WHO)

• Peak infection was 5-9 yo, now 65% are 20+ (smartvax).

• Risk of death to non-vaccchild: 1 in 1,048,329. (smartvax)



Rubella Treatment

• “No specific treatment exists,” –World Health Organization (2012).

• “We did not identify any studies assessing the effectiveness of MMR in preventing rubella.” Cochrane Review covering 14.7 M children (Demicheli 2012).

• How do you treat a mild fever?

• How do you treat itching?


Influenza (The Flu*) S/S


Introduction(Droplet)

1-3 days

Reduced to Cough, Feel crummy

“Contagious,” stay at home

Natural Course

14 days3-5 days

Centers for Disease Control and Prevention

1 day

5-10 days

Headache, fever, muscle aches, sore throat, cough, runny nose. Kids: vomiting, ear aches

*80% of “flu-like illness” not Influenza Type A or B.

Live virus nasal vaccine (NVIC)

7 days

Influenza Risk

• 0-2 yrs flu shot = placebo (Jefferson).

• 5 yr Non-Vac Death Risk 1 in 600,000

• 5 yr Non-Vac Death Risk from primary influenza = 0.

• Under 5 less likely to have fever & cough (CDC)

• Bacterial pneumonia is major secondary factor (smartvax)



Influenza Treatment

Vitamin D • 10,000 IU/week (15 min full body exposure) … 23 vs 26% URTI in young adults, (Goodall et al 2014),

400-2000 IU/day in children good for prevention of URTI (Charan et al 2012).

Vitamin C • Stone reported Klenner (1949) utilized Vitamin C effectively to treat many cases of influenza.• Specifically, one report from another doctor in 1963 treated 130 cases of influenza for one to three

days using up to 45 grams of ascorbic acid. The patients were both male and female, aged ten to forty years; 114 recovered and 16 did not respond.

• Cochrane Review: Vitamin C has a role in shortening pneumonia (Hemilia 2013)• Humphries: The starting dose in children for sodium ascorbate is 200-375 mg per kg over 24 hours.

H1N1• Cheng et al (2012) found that the appropriate dose of IV Vitamin C (20 mmol/L) “eliminated viral

infectivity with treatment times as short as 4 hours at early stage of infection.”• Uchide & Toyoda (2011) found Vitamin C works to improve the action of the antiviral drugs used to

treat influenza. • Because existing drugs may not be useful for future outbreaks, Banerjee & Kaul (2010) developed a

hypothesis of using Vitamin C to prevent future pandemics• Fever socks• Hydration


A note on influenza studies

“An earlier systematic review of 274 influenza vaccine studies published up to 2007 found industry-funded studies were published in more prestigious journals and cited more than other studies independently from methodological quality and size. Studies funded from public sources were significantly less likely to report conclusions favourable to the vaccines. The review showed that reliable evidence on influenza vaccines is thin but there is evidence of widespread manipulation of conclusions and spurious notoriety of the studies.” Cochrane Review (Jefferson et al 2012)


Questions:

• Traveling with unvaxxedkids? What are the actual risks and is it something to seriously consider?

• If we decide not to vax, and our child gets the disease and dies what could happen to us?

• NVIC.org- state news, religious exemptions


Commonalities

• Diphtheria & Tetanus: Be aware of your environment (Third World Countries, Africa, SE Asia, serving the homeless or reservations).

• The diseases are not found in US children 0-5.


Connection


Mama’s Chiropractic(239) 549-MAMA (6262)


Saturday August 2nd 11:00 amThe Skinny Pantry, Fort Myers

The Infant Series (In conjunction with The Great Latch-On)

• Hepatitis B

• PCV (or the “ear infection” vaccine)

• Haemophilus Influenzae B (Hib)

• Rotovirus


References

Banerjee D, Kaul D. (2010). “Combined inhalational and oral supplementation of ascorbic acid may prevent influenza pandemic emergency: a hypothesis.” Nutrition. 2010 Jan;26(1):128-32. doi: 10.1016/j.nut.2009.09.015. Pubmed. http://www.ncbi.nlm.nih.gov/pubmed/20005468Centers for Disease Control and Prevention (2014). “Tetanus Photos.” Immunization Action Coalition http://www.immunize.org/photos/tetanus-photos.aspCenters for Disease Control and Prevention (2014). “Characteristic maculopapular rash indicative of rubella.” Image. http://www.vaccineinformation.org/rubella/photos.aspCenters for Disease Control and Prevention (2014) “Rubella.” Epidemiology and Prevention of Vaccine-Preventable Diseases, 12th Edition, April 2011.Ch. 19 (275-290). http://www.cdc.gov/vaccines/pubs/pinkbook/downloads/rubella.pdfDemicheli V, Rivetti A, Debalini MG, Di Pietrantonj C. (2012). “Vaccines for measles, mumps and rubella in children.” Cochrane Database Syst Rev. 2012 Feb 15;2:CD004407. doi: 10.1002/14651858.CD004407.pub3. PubMed: http://www.ncbi.nlm.nih.gov/pubmed/22336803Charan J, et al ( 2012). “Vitamin D for prevention of respiratory tract infections: A systematic review and meta-analysis.” J Pharmacol Pharmacother. 2012 Oct-Dec; 3(4): 300–303. doi: 10.4103/0976-500X.103685. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3543548/Cheng et al (2012). “ [An in vitro study on the pharmacological ascorbate treatment of influenza virus]. “ Article in Chinese. Zhonghua Jie He He Hu Xi Za Zhi.2012 Jul;35(7):520-3. Pubmed: http://www.ncbi.nlm.nih.gov/pubmed/22931805Economist.com (2013). “Daily Chart: Danger of Death!” http://www.economist.com/blogs/graphicdetail/2013/02/daily-chart-7Goodall EC, et al (2014). “Vitamin D3 and gargling for the prevention of upper respiratory tract infections: a randomized controlled trial.“BMC Infect Dis.2014 May 19;14:273. doi: 10.1186/1471-2334-14-273. http://www.ncbi.nlm.nih.gov/pubmed/24885201Hemila et al (2013). “Vitamin C for preventing and treating pneumonia. “Cochrane Database Syst Rev. 2013 Aug 8;8:CD005532. http://www.ncbi.nlm.nih.gov/pubmed/23925826The Historical Medical Library of The College of Physicians of Philadelphia.(1918). Koplik, H. “The Schick Diphtheria Toxin Skin Reaction at the Fifth to Sixth Day.” The Diseases of Infancy and Childhood, 4th ed. Philadelphia: Lea & Febiger, Image. http://www.historyofvaccines.org/content/schick-test-iiHemilä H, Koivula TT (2008). “Vitamin C for preventing and treating tetanus.” Cochrane Database Syst Rev. 2008 Apr 16;(2):CD006665. doi: 10.1002/14651858.CD006665.pub2. Pubmed: http://www.ncbi.nlm.nih.gov/pubmed/18425960Hemilä H, Koivula TT (2013). “Vitamin C for preventing and treating tetanus.” Cochrane Database Syst Rev. 2013 Nov 13;11:CD006665. doi: 10.1002/14651858.CD006665.pub3. http://www.ncbi.nlm.nih.gov/pubmed/24226506Humphries S (2012). “The Vitamin C treatment for Whooping Cough.” http://www.vaccinationcouncil.org/2012/09/07/vitamin-c-for-whooping-cough-updated-edition-suzanne-humphries-md/Jefferson T et al (2012). “Vaccines for preventing influenza in healthy children.” Cochrane Database Syst Rev. 2012 Aug 15;8:CD004879. doi: 10.1002/14651858.CD004879.pub4. Pubmed: http://www.ncbi.nlm.nih.gov/pubmed/22895945Humanillnesses.com (2014). “Diphtheria.” http://www.humanillnesses.com/Infectious-Diseases-Co-Ha/Diphtheria.html


http://www.ncbi.nlm.nih.gov/pubmed/20005468


http://www.immunize.org/photos/tetanus-photos.asp

http://www.vaccineinformation.org/rubella/photos.asp

http://www.cdc.gov/vaccines/pubs/pinkbook/downloads/rubella.pdf



http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3543548/



http://www.economist.com/blogs/graphicdetail/2013/02/daily-chart-7









http://www.vaccinationcouncil.org/2012/09/07/vitamin-c-for-whooping-cough-updated-edition-suzanne-humphries-md/


http://www.humanillnesses.com/Infectious-Diseases-Co-Ha/Diphtheria.html

References

Kidshealth.org (2014). “Infections: Rubella. http://kidshealth.org/parent/infections/skin/german_measles.html#Medicine.net (2014). “Tetanus.” http://www.medicinenet.com/tetanus/page2.htm#what_is_the_course_of_the_tetanus_disease_what_are_the_symptoms_and_signs_of_tetanusNational Vaccine Information Center (2014). “Diphtheria.” http://www.nvic.org/vaccines-and-diseases/Diphtheria.aspxNational Vaccine Information Center (2014). “Influenza.” http://www.nvic.org/Vaccines-and-Diseases/Influenza.aspxNational Vaccine Information Center (2014). “Tetanus.” http://www.nvic.org/Vaccines-and-Diseases/Tetanus.aspxSettegren BO et al (1986) “Schick test as a predictor of immunity to diphtheria and of side effects after revaccination with diphtheria vaccine.” Br Med J (Clin Res Ed) 292(6519): 524–525. www.ncbi.nlm.nih.gov/pmc/articles/PMC1339509/?page=1smartvax.com (2014). “Disease Risk Analysis.” http://www.smartvax.com/index.php?option=com_content&view=article&id=75Smith, L. (2014). “Clinical Guide to the Use of Vitamin C: The Clinical Experiences of Frederick R. Klenner, M.D., abbreviated, sumarized and annotated by Lendon H. Smith, M.D.” http://www.seanet.com/~alexs/ascorbate/198x/smith-lh-clinical_guide_1988.htmStone, I (1972). “The Healing Factor: Vitamin C Against Disease.” online: http://vitamincfoundation.org/stone/World Health Organization (2014). “Media Centre Fact Sheet: Rubella” http://www.who.int/mediacentre/factsheets/fs367/en/Uchide N Toyoda H (2011). “Antioxidant therapy as a potential approach to severe influenza-associated complications.” Molecules. 2011 Feb28;16(3):2032-52. doi: 10.3390/molecules16032032. Pubmed. http://www.ncbi.nlm.nih.gov/pubmed/21358592WebMD (2014). “Understanding Tetanus- The basics.” http://www.webmd.com/children/vaccines/understanding-tetanus-basicsWikipedia (2014) “Diphtheria.”Image.

http://upload.wikimedia.org/wikipedia/commons/thumb/0/01/Dirty_white_pseudomembrane_classically_seen_in_diptheria_2013-07-06_11-07.jpg/220px-Dirty_white_pseudomembrane_classically_seen_in_diptheria_2013-07-06_11-07.jpg


http://kidshealth.org/parent/infections/skin/german_measles.html

http://www.medicinenet.com/tetanus/page2.htm#what_is_the_course_of_the_tetanus_disease_what_are_the_symptoms_and_signs_of_tetanus

http://www.nvic.org/vaccines-and-diseases/Diphtheria.aspx

http://www.nvic.org/Vaccines-and-Diseases/Influenza.aspx

http://www.nvic.org/Vaccines-and-Diseases/Tetanus.aspx

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1339509/?page=1

http://www.smartvax.com/index.php?option=com_content&view=article&id=75

http://www.seanet.com/~alexs/ascorbate/198x/smith-lh-clinical_guide_1988.htm

http://vitamincfoundation.org/stone/

http://www.who.int/mediacentre/factsheets/fs367/en/



http://upload.wikimedia.org/wikipedia/commons/thumb/0/01/Dirty_white_pseudomembrane_classically_seen_in_diptheria_2013-07-06_11-07.jpg/220px-Dirty_white_pseudomembrane_classically_seen_in_diptheria_2013-07-06_11-07.jpg

so, you're not vaccinating, now what? part 2: diphtheria, rubella, tetanus, influenza

Health & Medicine