Edition: International |
Published On: Fri, May 10th, 2013
The Vaccine Hoax is Over. Documents from UK reveal 30 Years of Coverup
1. Known the vaccines don’t work
2. Known they cause the diseases they are supposed to prevent
3. Known they are a hazard to children
4. Colluded to lie to the public
5. Worked to prevent safety studies
Those are the same vaccines that are mandated to children in the US.
Educated parents can either get their children out of harm’s way or continue living inside one of the largest most evil lies in history, that vaccines – full of heavy metals, viral diseases, mycoplasma, fecal material, DNA fragments from other species, formaldehyde, polysorbate 80 (a sterilizing agent) – are a miracle of modern medicine.Freedom of Information Act filed in the US with the CDC by a doctor with an autistic son, seeking information on what the CDC knows about the dangers of vaccines, had by law to be responded to in 20 days. Nearly 7 years later, the doctor went to court and the CDC argued it does not have to turn over documents. A judge ordered the CDC to turn over the documents on September 30th, 2011.
On October 26, 2011, a Denver Post editorial expressed shock that the Obama administration, after promising to be especially transparent, was proposing changes to the Freedom of Information Act that would allow it to go beyond declaring some documents secret and to actually allow government agencies (such as the CDC) to declare some document “non-existent.”
Simultaneous to this on-going massive CDC cover up involving its primary “health” not recommendation but MANDATE for American children, the CDC is in deep trouble over its decades of covering up the damaging effects of fluoride and affecting the lives of all Americans, especially children and the immune compromised. Lawsuits are being prepared. Children are ingesting 3-4 times more fluoride by body weight as adults and “[t]he sheer number of potentially harmed citizens — persons with dental fluorosis, kidney patients tipped into needing dialysis, diabetics, thyroid patients, etc — numbers in the millions.”
The CDC is obviously acting against the health of the American people. But the threat to the lives of the American people posed by the CDC’s behavior does not stop there. It participated in designed pandemic laws that are on the books in every state in the US, which arrange for the government to use military to force unknown, untested vaccines, drugs, chemicals, and “medical” treatments on the entire country if it declares a pandemic emergency.
The CDC’s credibility in declaring such a pandemic emergency is non-existent, again based on Freedom of Information Act. For in 2009, after the CDC had declared the H1N1 “pandemic,” the CDC refused to respond to Freedom of Information Act filed by CBS News and the CDC also attempted to block their investigation. What the CDC was hiding was its part in one of the largest medical scandals in history, putting out wildly exaggerated data on what it claimed were H1N1 cases, and by doing so, created the false impression of a “pandemic” in the US.
The CDC was also covering up e financial scandal to rival the bailout since the vaccines for the false pandemic cost the US billions. And worse, the CDC put pregnant women first in line for an untested vaccine with a sterilizing agent, polysorbate 80, in it. Thanks to the CDC, “the number of vaccine-related “fetal demise” reports increased by 2,440 percent in 2009 compared to previous years, which is even more shocking than the miscarriage statistic [700% increase].
The exposure of the vaccine hoax is running neck and neck with the much older hoax of a deadly 1918-19 flu. It was aspirin that killed people in 1918-19, not a pandemic flu. It was the greatest industrial catastrophe in human history with 20-50 million people dying but it was blamed on a flu. The beginning of the drug industry began with that success (and Monsanto was part of it). The flu myth was used by George Bush to threaten the world with “another pandemic flu that could kill millions” – a terror tactic to get pandemic laws on the books in every state and worldwide. Then the CDC used hoax of the pandemic hoax to create terror over H1N1 and to push deadly vaccines on the public, killing thousands of unborn children and others. (CDC will not release the data and continues to push the same vaccine.)
The hoax of the vaccine schedule is over, exposed by FOIAs in the UK.
The hoax of the CDC’s interest in children’s lives has been exposed by its refusal to respond to a doctor’s FOIAs around its knowledge of vaccine dangers.
The 1918-19 pandemic hoax has been exposed by Dr. Karen Starko’s work on aspirin’s role in killing people.
And despite refusing to respond to FOIAS, the CDC’s scandalous hoax of a 2009 flu pandemic and its part in creating it, was exposed by CBS NEWS.
And the Obama administration, in attempting to salvage the last vestige of secrecy around what is really happening with vaccines, by declaring agency documents non-existent, has made its claim of transparency, non-existent.
But pandemic laws arranging for unknown vaccines to be forced on the entire country are still in place with HHS creating a vaccine mixture that should never be used on anyone and all liability for vaccines having been removed. Meanwhile, a Canadian study has just proven that the flu vaccine containing the H1N1 vaccine which kills babies in utero, actually increases the risk of serious pandemic flu.
Americans who have been duped into submitting their children to the CDC’s deadly vaccines, have a means to respond now. People from every walk of life and every organization, must
1. take the information from the UK FOIAs exposing 30 years of vaccine lies, the refusal of the CDC to provide any information on what it knows about those lies, and the Obama Administration’s efforts to hide the CDC’s awareness of those lies, and go to their state legislatures, demand the immediate nullification of the CDC vaccine schedule and the pandemic laws.
2. inform every vet. active duty military person, law enforcement people, DHS agents and medical personnel they know, of the vaccine hoax, for their families are deeply threatened, too, but they may not be aware of it or that they have been folded into agency structures by the pharmaceutical industry (indistinguishable from the bankers and oil companies) that would make them agents of death for their country with the declaration of a “pandemic” emergency or “bio-terrorist” attack. It is completely clear now that the terrorism/bioterrorism structures are scams so that any actions taken to “protect” this country using those laws would in fact be what threatens the existence of Americans.
It was aspirin that killed millions in 1918-19. Now it is mandated and unknown, untested vaccines with banned adjuvants in them that threaten the country with millions of deaths. At the same time, the CDC is holding 500,000 mega-coffins, built to be incinerated, on its property outside Atlanta. Not to put to fine a point on this, but it’s clear now that the CDC should not be involved in any way with public health.
Thanks to the Freedom of Information Act (FOIA), we know that vaccines are not a miracle of modern medicine. Any medical or government authority which insists vaccines prevent diseases is either ignorant of government documents (and endless studies) revealing the exact opposite or of the CDC’s attempts to hide the truth about vaccines from the public, or means harm to the public.
Thanks to the Freedom of Information Act (FOIA), we know the vaccine schedule is a hoax.
The health danger to American children and adults are vaccines.
Andrew Baker, Food Freedom News
Documentation
The vaccination policy and the Code of Practice of the Joint Committee on Vaccination and Immunisation ( JCVI): are they at odds?
Related articles:
Harvard Scientists warn about Epidemic of Side Effects due to Corruption
‘All Trials’: because no test should go unheralded
Did you know that you can read nsnbc international on your iPhone, Cell Phone and other mobile devices, and that you can subscribe to nsnbc international to get free news, opinion and analysis every day ? To subscribe, go to the bottom of this page.
About the Author
Wednesday 18 March, 2015
Tension
Increases
- Federal Judge
Orders CDC to Produce Secret Documents...
The CDC Has Known All Along How Dangerous Vaccines Are - And Has Covered It Up... (Part Six)
The CDC Has Known All Along How Dangerous Vaccines Are - And Has Covered It Up... (Part Six)
Opinion by Consumer Advocate
Tim
Bolen
Friday, July 6th, 2012
This article is the sixth in a series
about THE MOST IMPORTANT CASE ABOUT
AUTISM currently being litigated - the
Hooker v. United States Department of
health and Humans Services, et al case.
Why is this the most important case?
Because of what happened in what was
called the "Omnibus
Autism Proceedings" (OAP) in 2010.
The special Vaccine Court created by
the
National Childhood Vaccine Injury Act
(NCVIA), in 1987, had become overloaded
with claims about 2007, and the Special
Masters running the court simply did not
want to have to trudge through the
backlog of the 5,400 cases facing it
over vaccine injuries.
There in 2010, a special Vaccine
Court sub-set, called the OAP, decided
six test cases - three from the MMR
Vaccine causes Autism argument, and
three from the Thimerosal (mercury)
in vaccines causes Autism argument.
Those cases were themselves,
representing a backlog of the 5,400
cases, which, in turn, represented the
interests of over 2,000,000 vaccine
damaged children in the US. More,
those cases, if won by the Plaintiffs,
would have set the stage for relief for
the families of the one in six children
vaccine damaged showing neurological
damage.
The OAP judges relied COMPLETELY, for
all six cases, on the truth and validity
of the five so-called studies ordered
and run by the Center for Disease
Control and Prevention (CDC).
Now you see the importance...
After reviewing Hooker's research it is
easy to come to a conclusion -
EVERY one of the CDC studies showing the
so-called safety of mercury in vaccines
has been intentionally faked, so as
to lead the American Public, and every
entity worldwide that relies on the CDC
for information, to believe that mercury
in vaccines is safe - it is not.
The case was a
setup...
Brian Hooker sued the CDC to get copies
of their internal memorandums, emails,
letters, etc.
"In late 2004 Biochemist Scientist Brian Hooker PhD
had had enough. He'd been looking, carefully,
through the US Center for Disease Control and
Prevention (CDC)'s so-called "Evidence" that
Thimerosal was "Safe and Effective" as a
preservative in vaccines. Having read all of the
then available CDC studies making that claim, he, as
a PhD Scientist, couldn't help but shake his head
"NO." To him, none of the purported proof was
anywhere near being scientifically adequate. Far
from it.
So, like any math teacher would do to a student he
began to communicate to the CDC his questions. In
essence he was saying "Show me your work. Show me
how you came up with these answers" - a reasonable
question series among scientists, teachers and
students, and frankly, the population of Planet
Earth.
What was CDC's response? STONEWALL - a six year
knock-down, drag-out brawl to get that information.
Brian Hooker would not let up. Neither would the
CDC
But Hooker and his team were playing a
trick. They knew that the same
people who would create fake studies
would try to cover up their tracks any
way they could. So, they set up a
trap - and the CDC walked right into it.
What was the trap? Hooker had a
good many of the documents, already, he
was being denied. More, he knew
where more of them were stored, and he
had been promised access. So, they
demanded documents, let the CDC reply
that (1) there weren't any, (2)
the documents didn't say anything
pertinent, (3) blah, blah, blah.
And then they spring the trap with the
Judge. As in "Gee Judge, these
bastards are lying."
Why do this? To set them up for
CRIMINAL Indictment. Period.
So, What's
Happening?
I love the US court system sometimes.
Not all the time, of course, but,
frankly, quite often.
Smile now.
Things are heating up in the Hooker v.
United States Department of Health AND
Human Services, et al federal court
case. The federal judge in the
case, has issued the following Order:
"Defendants are directed to deliver
the documents withheld under 5 U.S.C.
§ 552(b)(5) to chambers for an in
camera inspection to assist the
Court in making a responsible de
novo determination. In-Camera
Submission is due by Friday,
7/13/2012. (jth)"
What the
Judge's Order actually means...
FOIA Section
5 U.S.C. § 552(b)(5)
authorizes agencies to withhold
information related solely to the
internal personnel rules and practices
of an agency. The Judge is saying
"show me where this rule applies in
these communications."
In Camera inspection happens when a
judge reviews evidence (depositions,
documents, photos and the like) to
determine whether it should be provided
to other parties. This usually occurs
when both sides in a case disagree about
whether a certain, usually crucial piece
of evidence should come in.
The Court will review non-jury cases
de novo to determine if the agency
came to a reasonable conclusion.
So, in short, the Judge isn't buying the
CDC's arguments about why it is
withholding information. The trap
Hooker set paid off. It looks to
me that the federal judge is beginning
to smell the rat in the CDC's position.
Where is this
going?
The search for documents, in this court
case, is uncovering a pattern of
criminal activity. Whoever is
running, making the decisions to
withhold documents at CDC, knows where
all this is going. I am certain
that within the walls of the CDC, right
this minute, certain CDC employees -
past and present, contractors, and
consultants, etc. are quietly being told
to personally "lawyer-up," and
familiarize themselves on how to make
claim to the Fifth Amendment provisions
of the US Constitution (taking the
Fifth).
Is there really
criminal activity here?
You bet there is. Major criminal
activity. The people involved in
this denial of the effects of Thimerosal
in vaccines, and the cover up of the
real situation, are some of, perhaps,
the worst criminals in the history of
mankind. Just look at the numbers
of children damaged, and the cost to
society - worldwide. This is far
worse than anything the NAZIs, or
Stalin, did. This overshadows any
genocide effort in the history of
mankind.
This isn't about simple fraud, the
marketing of vaccines, or some
comparison of preservatives in vaccines.
This is about major damage to children.
And it is all coming out.
And that's the bottom line.
Stay tuned...
Tim Bolen - Consumer
Advocate
- See more at: http://www.bolenreport.com/Mark%20Geier/foiasuit6.htm#sthash.yTiNZKX9.dpuf
Tension
Increases
- Federal Judge
Orders CDC to Produce Secret Documents...
The CDC Has Known All Along How Dangerous Vaccines Are - And Has Covered It Up... (Part Six)
The CDC Has Known All Along How Dangerous Vaccines Are - And Has Covered It Up... (Part Six)
Opinion by Consumer Advocate
Tim
Bolen
Friday, July 6th, 2012
- See more at: http://www.bolenreport.com/Mark%20Geier/foiasuit6.htm#sthash.yTiNZKX9.dpuf
This article is the sixth in a series
about THE MOST IMPORTANT CASE ABOUT
AUTISM currently being litigated - the
Hooker v. United States Department of
health and Humans Services, et al case.
Why is this the most important case?
Because of what happened in what was
called the "Omnibus
Autism Proceedings" (OAP) in 2010.
The special Vaccine Court created by
the
National Childhood Vaccine Injury Act
(NCVIA), in 1987, had become overloaded
with claims about 2007, and the Special
Masters running the court simply did not
want to have to trudge through the
backlog of the 5,400 cases facing it
over vaccine injuries.
There in 2010, a special Vaccine
Court sub-set, called the OAP, decided
six test cases - three from the MMR
Vaccine causes Autism argument, and
three from the Thimerosal (mercury)
in vaccines causes Autism argument.
Those cases were themselves,
representing a backlog of the 5,400
cases, which, in turn, represented the
interests of over 2,000,000 vaccine
damaged children in the US. More,
those cases, if won by the Plaintiffs,
would have set the stage for relief for
the families of the one in six children
vaccine damaged showing neurological
damage.
The OAP judges relied COMPLETELY, for
all six cases, on the truth and validity
of the five so-called studies ordered
and run by the Center for Disease
Control and Prevention (CDC).
Now you see the importance...
After reviewing Hooker's research it is
easy to come to a conclusion -
EVERY one of the CDC studies showing the
so-called safety of mercury in vaccines
has been intentionally faked, so as
to lead the American Public, and every
entity worldwide that relies on the CDC
for information, to believe that mercury
in vaccines is safe - it is not.
The case was a
setup...
Brian Hooker sued the CDC to get copies
of their internal memorandums, emails,
letters, etc.
"In late 2004 Biochemist Scientist Brian Hooker PhD
had had enough. He'd been looking, carefully,
through the US Center for Disease Control and
Prevention (CDC)'s so-called "Evidence" that
Thimerosal was "Safe and Effective" as a
preservative in vaccines. Having read all of the
then available CDC studies making that claim, he, as
a PhD Scientist, couldn't help but shake his head
"NO." To him, none of the purported proof was
anywhere near being scientifically adequate. Far
from it.
So, like any math teacher would do to a student he
began to communicate to the CDC his questions. In
essence he was saying "Show me your work. Show me
how you came up with these answers" - a reasonable
question series among scientists, teachers and
students, and frankly, the population of Planet
Earth.
What was CDC's response? STONEWALL - a six year
knock-down, drag-out brawl to get that information.
Brian Hooker would not let up. Neither would the
CDC
But Hooker and his team were playing a
trick. They knew that the same
people who would create fake studies
would try to cover up their tracks any
way they could. So, they set up a
trap - and the CDC walked right into it.
What was the trap? Hooker had a
good many of the documents, already, he
was being denied. More, he knew
where more of them were stored, and he
had been promised access. So, they
demanded documents, let the CDC reply
that (1) there weren't any, (2)
the documents didn't say anything
pertinent, (3) blah, blah, blah.
And then they spring the trap with the
Judge. As in "Gee Judge, these
bastards are lying."
Why do this? To set them up for
CRIMINAL Indictment. Period.
So, What's
Happening?
I love the US court system sometimes.
Not all the time, of course, but,
frankly, quite often.
Smile now.
Things are heating up in the Hooker v.
United States Department of Health AND
Human Services, et al federal court
case. The federal judge in the
case, has issued the following Order:
"Defendants are directed to deliver
the documents withheld under 5 U.S.C.
§ 552(b)(5) to chambers for an in
camera inspection to assist the
Court in making a responsible de
novo determination. In-Camera
Submission is due by Friday,
7/13/2012. (jth)"
What the
Judge's Order actually means...
FOIA Section
5 U.S.C. § 552(b)(5)
authorizes agencies to withhold
information related solely to the
internal personnel rules and practices
of an agency. The Judge is saying
"show me where this rule applies in
these communications."
In Camera inspection happens when a
judge reviews evidence (depositions,
documents, photos and the like) to
determine whether it should be provided
to other parties. This usually occurs
when both sides in a case disagree about
whether a certain, usually crucial piece
of evidence should come in.
The Court will review non-jury cases
de novo to determine if the agency
came to a reasonable conclusion.
So, in short, the Judge isn't buying the
CDC's arguments about why it is
withholding information. The trap
Hooker set paid off. It looks to
me that the federal judge is beginning
to smell the rat in the CDC's position.
Where is this
going?
The search for documents, in this court
case, is uncovering a pattern of
criminal activity. Whoever is
running, making the decisions to
withhold documents at CDC, knows where
all this is going. I am certain
that within the walls of the CDC, right
this minute, certain CDC employees -
past and present, contractors, and
consultants, etc. are quietly being told
to personally "lawyer-up," and
familiarize themselves on how to make
claim to the Fifth Amendment provisions
of the US Constitution (taking the
Fifth).
Is there really
criminal activity here?
You bet there is. Major criminal
activity. The people involved in
this denial of the effects of Thimerosal
in vaccines, and the cover up of the
real situation, are some of, perhaps,
the worst criminals in the history of
mankind. Just look at the numbers
of children damaged, and the cost to
society - worldwide. This is far
worse than anything the NAZIs, or
Stalin, did. This overshadows any
genocide effort in the history of
mankind.
This isn't about simple fraud, the
marketing of vaccines, or some
comparison of preservatives in vaccines.
This is about major damage to children.
And it is all coming out.
And that's the bottom line.
Stay tuned...
Tim Bolen - Consumer
Advocate
- See more at: http://www.bolenreport.com/Mark%20Geier/foiasuit6.htm#sthash.yTiNZKX9.dpuf
H1N1 vaccine linked to 700 percent increase in miscarriages
Wednesday, December 08, 2010 by: Ethan A. Huff, staff writerTags: vaccines, miscarriages, health news
(NaturalNews) Recent data presented to the U.S. Centers for Disease
Control and Prevention's (CDC) Advisory Committee on Children's Vaccines
has revealed some shocking information about the effects of the H1N1 /
swine flu vaccine on pregnant women. According to the report, the rate
of miscarriage among pregnant women during the 2009 H1N1 / swine flu
pandemic soared by over 700 percent compared to previous years, pointing
directly to the vaccine as the culprit -- but the CDC denies the truth
and continues to insist nobody has been harmed.
According to the CDC, nearly 50 percent of all pregnant women were vaccinated with the H1N1 vaccine during the 2009 / 2010 influenza season. Those whose physicians instructed them to get a seasonal flu shot were three times more likely to get it, while those instructed specifically to get the H1N1 shot were ten times more likely to get it. And the numbers clearly show that along with the rise in vaccinations due to the H1N1 scare came the sharp increase in miscarriages, including a slew of actual reported adverse events.
But the CDC does not seem to care about the facts, as numerous reports indicate the agency has failed to report any of this vital information to vaccine suppliers. In fact, when presented with the data for the third time, Dr. Marie McCormick, chair of the U.S. Department of Health and Human Services (HHS) Vaccine Risk and Assessment Working Group, actually had the audacity to claim that there were no vaccine-related adverse events in pregnant women caused by the vaccine.
"This baseless and fallacious assessment by the CDC assessment group has given the green light to the CDC's Advisory Committee on Immunization Practices (ACIP) to continue their recommendation to give the 2010/11 flu shot to all people, including pregnant women," explained Eileen Dannemann, director of the National Coalition of Organized Women, presenter of the information.
"This upcoming 2010/11 flu vaccine contains the same elements that are implicated in the killing of these fetuses, the H1N1 viral component and the neurotoxin mercury (Thimerosal). Additionally, it contains two other viral strains -- a three-in-one shot for all people."
Overall, the number of vaccine-related "fetal demise" reports increased by 2,440 percent in 2009 compared to previous years, which is even more shocking than the miscarriage statistic. Meanwhile, the CDC continues to lie to the public about the vaccine, urging everyone, including pregnant women, to get it.
To read the report for yourself, visit: http://www.progressiveconvergence.com/H1N1-R...
Sources for this story include:
http://www.guerillahealthreport.com/post.php...
http://thepopulist.net/?p=6630
According to the CDC, nearly 50 percent of all pregnant women were vaccinated with the H1N1 vaccine during the 2009 / 2010 influenza season. Those whose physicians instructed them to get a seasonal flu shot were three times more likely to get it, while those instructed specifically to get the H1N1 shot were ten times more likely to get it. And the numbers clearly show that along with the rise in vaccinations due to the H1N1 scare came the sharp increase in miscarriages, including a slew of actual reported adverse events.
But the CDC does not seem to care about the facts, as numerous reports indicate the agency has failed to report any of this vital information to vaccine suppliers. In fact, when presented with the data for the third time, Dr. Marie McCormick, chair of the U.S. Department of Health and Human Services (HHS) Vaccine Risk and Assessment Working Group, actually had the audacity to claim that there were no vaccine-related adverse events in pregnant women caused by the vaccine.
"This baseless and fallacious assessment by the CDC assessment group has given the green light to the CDC's Advisory Committee on Immunization Practices (ACIP) to continue their recommendation to give the 2010/11 flu shot to all people, including pregnant women," explained Eileen Dannemann, director of the National Coalition of Organized Women, presenter of the information.
"This upcoming 2010/11 flu vaccine contains the same elements that are implicated in the killing of these fetuses, the H1N1 viral component and the neurotoxin mercury (Thimerosal). Additionally, it contains two other viral strains -- a three-in-one shot for all people."
Overall, the number of vaccine-related "fetal demise" reports increased by 2,440 percent in 2009 compared to previous years, which is even more shocking than the miscarriage statistic. Meanwhile, the CDC continues to lie to the public about the vaccine, urging everyone, including pregnant women, to get it.
To read the report for yourself, visit: http://www.progressiveconvergence.com/H1N1-R...
Sources for this story include:
http://www.guerillahealthreport.com/post.php...
http://thepopulist.net/?p=6630
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Salicylates and Pandemic Influenza Mortality, 1918–1919 Pharmacology, Pathology, and Historic Evidence
- Reprints or correspondence: Dr Karen M. Starko, 1515 Floribunda Ave, Burlingame, CA 94010 (karenstarko{at}gmail.com).
Abstract
The high case-fatality rate—especially
among young adults—during the 1918–1919 influenza pandemic is
incompletely understood.
Although late deaths showed bacterial pneumonia,
early deaths exhibited extremely “wet,” sometimes hemorrhagic lungs. The
hypothesis presented herein is that aspirin
contributed to the incidence and severity of viral pathology, bacterial
infection,
and death, because physicians of the day were
unaware that the regimens (8.0–31.2 g per day) produce levels associated
with
hyperventilation and pulmonary edema in 33% and 3%
of recipients, respectively. Recently, pulmonary edema was found at
autopsy
in 46% of 26 salicylate-intoxicated adults.
Experimentally, salicylates increase lung fluid and protein levels and
impair
mucociliary clearance. In 1918, the US Surgeon
General, the US Navy, and the Journal of the American Medical Association recommended use of aspirin just before
the October death spike. If these recommendations were followed, and if
pulmonary edema occurred in 3% of persons, a significant
proportion of the deaths may be attributable to
aspirin.
In February 1919…Edward's fever kept getting higher and higher…aspirin…was given to him by the 1/2-handful over and over…Edward
sweated through his mattress…Dr.…could not save his patient.
—Clella B. Gregory, Pandemic Influenza Storybook, US Department of Health and Human Services [1]
The unprecedented overall mortality and the
mortality rate among young adults during the 1918–1919 influenza
pandemic are
incompletely understood. Deaths in the United States
peaked with a sudden spike in October 1918. Later, Wade Hampton Frost
[2]
studied surveys of 8 US cities and found that, for every 1000 persons
aged 25–29 years, ∼30% were infected with influenza
virus, and 1% died of pneumonia or influenza. This 3%
case-fatality rate has been called, “perhaps the most important unsolved
mystery of the pandemic” [3, p 1022].
Mortality was driven by 2 overlapping clinical-pathologic syndromes: an early, severe acute respiratory distress (ARDS)-like
condition, which was estimated to have caused 10%-15% of deaths (sequential autopsy series are lacking) [3)]; and a subsequent, aggressive bacterial pneumonia “superinfection,” which was pres-ent in the majority of deaths [4, 5].
Factors that contributed to the severity of
illness and death (eg, viral pathogenicity, bacterial colonization,
immune response,
smoking, preexisting conditions, and treatment) remain
to be elucidated. Of most interest are those amenable to intervention,
because fear of another 1918-like influenza pandemic
drives pandemic planning today.
Recent studies suggest enhanced pathogenicity
of certain influenza viruses as well as abnormal immune host responses.
The
1918 influenza H1N1 virus, in contrast to a
conventional human H1N1 influenza virus (A/Kawasaki/173/01), infected
the lower
respiratory tract, produced acute respiratory
distress, and was associated with a dysregulated antiviral response in a
cynomologous
macaque model [6]. Also, the 1918 viral polymerase complex (PA, PB1, and PB2) promoted growth of the 1918 virus in the lower respiratory tract
of ferrets [7]. Similarly, 2003 human H5N1 isolates, like 1997 human H5N1 isolates, induced overproduction of proinflammatory cytokines
in human macrophages in vitro [8].
However, it is unlikely that the virus and immune responses alone were responsible for the 1918 deaths. As recently reviewed
by Brundage and Shanks [4],
most persons had self-limited disease with case-fatality rates of
<2%, and mortality and case-fatality rates differed widely
among populations. During the fall of 1918, death and
influenza case-fatality rates ranged from 0.58% to 3.3% and 2.1% to
10%, respectively, in the 12 US Army camps with
>10,000 cases of influenza or pneumonia each [9, 10]. Frost [2]
noted that the wide variation in mortality rates between cities, some
of which were close together, was not explained by
climate, population density, preventive measures, or
other environmental characteristics. These observations suggest the
importance
of factors related to location rather than the virus
itself. Likewise, the unusual mortality rate among young adults remains
unexplained. Salicylate has been suggested [3, 11, 12], and increased mortality rates have been found in ferrets exposed to influenza, aspirin, and an arginine-deficient diet,
compared with each alone or in 2 combinations [13], yet mechanistic and epidemiologic evidence has not been fully explored.
The hypothesis presented herein is that
salicylate therapy for influenza during the 1918–1919 pandemic resulted
in toxicity
and pulmonary edema, which contributed to the
incidence and severity of early ARDS-like lungs, subsequent bacterial
infection,
and overall mortality. Pharmacokinetic data, which
were unavailable in 1918, indicate that the aspirin regimens recommended
for the “Spanish influenza” predispose to severe
pulmonary toxicity.
A confluence of events created a “perfect
storm” for widespread salicylate toxicity. The loss of Bayer's patent on
aspirin
in February 1917 allowed many manufacturers into the
lucrative aspirin market. Official recommendations for aspirin therapy
at toxic doses were preceded by ignorance of the
unusual nonlinear kinetics of salicylate (unknown until the 1960s),
which
predispose to accumulation and toxicity; tins and
bottles that contained no warnings and few instructions; and fear of
“Spanish”
influenza, an illness that had been spreading like
wildfire.
More recently, influenza deaths have been
attributed to salicylate. From the 1950s to the 1980s, thousands of
deaths among
children following influenza and other infections (eg,
Reye syndrome) were unexplained until studies identified aspirin as
the major contributor [14-16], and aspirin label warnings were followed by a disappearance of the condition [17]. Reye syndrome toxicity (vomiting, hyperventilation, delirium, and coma, with brain swelling and fat in the liver and proximal
renal tubules) develops after ∼4 days of salicylate therapy [14] with reported mean daily doses of 25 mg/kg [18]. (Adults with salicylate toxicity present mainly with abnormal consciousness and respiratory distress [19].) Also, a recent avian influenza A-associated fatality involved Reye syndrome and aspirin use [20], and several autopsies of persons who had avian influenza revealed hemorrhagic lungs, fatty liver changes, and swollen kidneys
[21] consistent with salicylate intoxication.
Four lines of evidence support the role of
salicylate intoxication in 1918 influenza mortality: pharmacokinetics,
mechanism
of action, pathology, and the spate of official
recommendations for toxic regimens of aspirin immediately before the
October
1918 death spike. (Grains of aspirin used in older
texts are converted to milligrams as follows: 1 grain equals 65 mg).
Aspirin Regimens (Dose and Schedule) Recommended in 1918 Are Now Known to Regularly Produce Toxicity
In 1977, a US Food and Drug Administration panel [22]
recommended that the maximum safe daily dose of aspirin for the general
population was 4000 mg, with a mean hourly rate
of 167 mg/h, and that “dosing regimens exceeding
either this total daily dosage or mean hourly rate provide a
significantly
greater risk without a compensating therapeutic
benefit” (p 35360). As an example of the unusual nonlinear kinetics of
salicylate,
the panel noted that simulations show that, after
increasing the dose from 2 to 4 g daily (given every 6 h), “the total
amount
of drug in the body at steady state will increase
from 1.3 grams to 5.3 grams, a 400% increase.” In 2007, an
evidence-based
consensus guideline [23]
recommended that anyone with an acute ingestion of 150 mg/kg or 6.5 g
of aspirin equivalent, whichever is lower, warrants
referral to an emergency department and recognized
that, after multiple doses, it is difficult to generalize any dose
associated
with toxicity, because lower daily doses (2–3 g for
several days) may lead to toxicity in some patients.
In the early 1900s, physicians treating
serious conditions (eg, rheumatic fever) generally “pushed” salicylate
until the appearance
of toxicity and then backed off [24].
In 1918, dosing recommendations for pandemic influenza were similar to
these high-dose, hospital-based regimens, except
that the recommendations for influenza generally
offered no instruction for dose adjustment if toxicity occurred.
French's historic 1920 report for the British Ministry of Health [25] on the pandemic states that the aspirin dose was “15 to 20 grains” (975–1300 mg). No frequency was given. One London doctor
“drenched” his patient with salicin: 20 grains (1300 mg) hourly for 12 hours nonstop [26]. Others suggested sodium salicylate, 6 grains (390 mg) over 3 hours for several days [27]. Aspirin was recommended for pulmonary edema [28]. On 26 September 1918, the US Navy recommended a cathartic and 5 grains (325 mg) of aspirin, warning against large doses
[29]. However, the Navy's Materia Medica stated that the maximum dose was 1300 mg [30]. On 5 October 1918, The Journal of the American Medical Association [31]
recommended aspirin: “The acetylsalicylic acid may be given in a dosage
of 1 gm. (15 grains) every three hours…or a smaller
dose combined with 0.1 gm. (2 grains)
acetophenetidin, until symptomatic relief is secured” (p 1137). These
recommended doses
(1000–1300 mg), with frequencies ranging from
hourly to every 3 hours, resulting in daily doses of 8–31.2 grams, are
above
the maximum safe dose defined above and would lead
to accumulation, as noted below.
Hints of unusual pharmacokinetics and
individual variation were noted before the pandemic but largely ignored.
In 1906, Langmeade
[32]
observed “great variation in the amount required” (p 1824) for toxicity
and reported a hospitalized child (receiving 325
mg every 6 hours) who, on day 4, developed
vomiting, fever, dyspnea, cyanosis, and coma and died. He recommended
caution early
in treatment so “the personal factor may be
estimated.” In 1913, Hanzlik [24]
studied records of 400 hospitalized persons treated with a common
regimen, 10–20 grains of a salicylate hourly with sodium
bicarbonate until toxicity occurred (headache,
nausea, tinnitus or deafness, delirium, or hallucinations). He found
that the
mean toxic dose of aspirin for male persons was 165
grains (10,725 mg), a probable overestimation, because sodium
bicarbonate
greatly enhances salicylate excretion. The toxic
dose of synthetic salicylate in males ranged from 1300 to 31,200 mg.
The development of tests to measure salicylate in the blood in the 1940s allowed Alvin F. Coburn [33] of the US Navy, while studying rheumatic fever, to find that a dose of 10 g daily led to levels that averaged 36 mg/dL on
day 3 in 9 adults. In 1948, Graham and Parker [34]
were among the first to correlate the blood salicylate level with
symptoms of toxicity. First, after studying 58 individuals,
they found considerable variation in the level at
which symptoms developed, such as vomiting (16.3–38.6 mg/dL),
hyperventilation
(21–44.2 mg/dL), pulmonary edema (49.4 mg/dL), and
severe dyspnea (46–53.6 mg/dL). They also studied 33 patients who
attained
levels of 35 mg/dL during the first 7 days of
therapy and found the following severe toxicities: hyperventilation (in
33%),
vomiting (in 30%), marked sweating (in 12%),
headache (in 12%) severe drowsiness (in 12%), confusion (in 6%), severe
dyspnea
(in 6%), excitement (in 6%), epistaxis (in 6%),
vertigo (in 3%), pulmonary edema (in 3%), and hemorrhage (in 3%). The
incidence
of these toxicities may be higher, because
administration was halted when hyperventilation occurred. A
retrospective study
[35]
of 56 salicylate-intoxicated adults, with intoxication defined as a
peak salicylate level ⩾30 mg/dL, found 6 patients (11%)
with noncardiogenic pulmonary edema. For adults
aged >30 years, the incidence of noncardiogenic pulmonary edema was
35%. Interestingly,
none of 55 consecutive intoxicated pediatric
patients had pulmonary edema.
In the 1960s, scientists learned why
toxicity occurs with intense aspirin therapy: salicylates have unusual
and complex pharmacokinetic
characteristics that predispose to accumulation,
rendering both dose and schedule critically important. In 1965, Levy [36] showed that, when the amount of drug in the body reaches ∼360 mg, the half-life increases as elimination changes from first
order to zero order. Later, Bardare et al [37],
who studied children, observed half-lives of ∼5 h at a dosage of ∼50
mg/kg per day (3500 mg in a 70-kg person), of ∼15
h at dosages of 75–95 mg/kg per day, and of ∼40 h
at dosages >100 mg/kg per day. Dosing at intervals of the half-life
or less
will lead to accumulation.
In addition to the saturable metabolism described by Levy and colleagues [36, 38, 39], accumulation of salicylate can occur for other reasons, including individual variation in elimination rate [38], reduced renal excretion [40], and low urine pH [41]. Higher doses, as mentioned above, slow elimination [42] and enhance the volume of distribution [43]. Acidosis [44] and hypoproteinemia [45] increase brain uptake and toxicity. The salicylate level [42] and the level at which toxicity occurs [24, 34] vary among individuals. Therefore, it is likely that severe salicylate intoxication, including pulmonary edema, developed
in some persons who followed the recommended 1918 dosing regimens.
Salicylates Cause Immediate Lung Toxicity and May Predispose to Bacterial Infection by Increasing Lung Fluid and Protein Levels and Impairing Mucociliary Clearance
The occurrence of pulmonary edema in humans with salicylate intoxication is well documented [19, 35]. Increased pulmonary vascular bed permeability to fluid and protein, decreases in arterial pO2, and increases in postmortem
extravascular lung water followed salicylate administration in sheep [46]. Salicylate also depresses the lung's mucociliary transport system [47].
The Pathology of the Early Deaths Is Consistent with Aspirin Toxicity and Virus-Induced Pathology
Autopsy reports by pathologists of the
day describe extremely wet, sometimes hemorrhagic lungs in early deaths.
On 23 September
1918 at Camp Devens in Massachusetts, 12,604
soldiers had influenza, and 727 had pneumonia; after examining the lungs
of a
dead soldier, Colonel Welch concluded, “This must
be some new kind of infection or plague” [48, p 190]. What struck E. R. Le Count [49],
consulting pathologist to the US Public Health Service, as most unusual
was the amount of lung tissue actually “pneumonic”
seemed “too little in many cases to explain death
by pneumonia.” He saw a thin, watery, bloody liquid in the lung tissue,
“like the lungs of the drowned,” as well as pleural
exudates with small hemorrhages unlike those seen in “any other form of
acute pneumonia of which I am familiar.”
Importantly, he also noted the brain was “quite regularly swollen,” the
kidneys were
“regularly the seat of cloudy swelling,” and the
liver had “superficial fatty change,” (changes noted in children with
salicylate
intoxication; see below). He concluded, “It is
difficult to believe that a disease with so many distinctive features
and…novelty…can
fail to possess a correspondingly definite
etiology.” Brain weight was increased by 100–200 g in ∼50% of persons,
most likely
indicating cerebral edema; cerebral bleeding was
common [9, 10]. Wolbach [50],
chief pathologist at the Peter Bent Brigham Hospital in Boston,
Massachusetts, found bacterial infection in late deaths,
yet a person dying on day 2 exhibited edema and
congestion of the lung, a purpuric rash, and no bacterial growth. He
surmised
a natural progression from the early lesion to the
bacterial lesions: “Two types of lungs stand out.” In early deaths, the
lungs were “dark red and wet…dripping wet.” French [25]
described the lesion as “albuminuous, non-cellular, coagulable.…One
realized that this albuminous exudate…was the probable
cause of the cyanosis.” The exudates were “so
entirely unlike what is met with in any ordinary forms of pneumonia that
they
seemed to be essential importance, the other
changes—haemorrhages, broncho-pneumonia and so on—being super
additions.…”
Although these pathology findings have been induced with the 1918 influenza virus in models [6],
they are also consistent with aspirin toxicity. A study of 177 adults
with aspirin toxicity (and a 15% mortality rate)
found the most common presentations were depressed
consciousness (61%) and respiratory failure (47%), even “at therapeutic
levels” [19].
Autopsy findings for patients with the 26 fatal cases were pulmonary
edema (46%), ulcers (46%), cerebral hemorrhage (23%),
and cerebral edema (31%). Coagulation disturbance
or thrombocytopenia was found in 38%. A detailed autopsy of an adult
with
aspirin poisoning revealed cyanosis, pulmonary
congestion, alveolar hemorrhage, subpleural and subepicardial
hemorrhages,
petechiae, cloudy swelling of the kidneys, and
fatty degeneration of the liver [51, 52]. ARDS-like disease has also been reported [53]. Children with aspirin toxicity (or Reye syndrome) are less likely than adults to present with pulmonary edema [35], although in addition to brain swelling, fatty liver, and cloudy swelling of the kidneys [54, 55], some have pulmonary edema [55, 56], “frothy, blood-tinged fluid” [57], and lung hemorrhages [54].
A report from Camp Dix noted, “The
disease was a veritable plague. The extraordinary toxicity, the marked
prostration, the
extreme cyanosis and the rapidity of development
stamp this disease as a distinct clinical entity heretofore not fully
described.…Pneumonia
is an important but somewhat secondary factor” [58, p 1817]. Salicylate toxicity is often overlooked [59]
because another condition is present, the dose is thought to be
trivial, and the symptoms (hyperventilation, vomiting, sweating,
headache, drowsiness, confusion, dyspnea,
excitement [salicylate jag], epistaxis, vertigo, pulmonary edema, and
hemorrhage)
are nonspecific [34].
In 1918, differentiating progressive salicylate intoxication from
infection pathologically or clinically, “the dyspnea
lasts from a few hours to a day…followed by
respiratory failure, circulatory collapse, convulsions, and death” [40], was almost impossible.
Aspirin Advertisements in August 1918 and a Series of Official Recommendations for Aspirin in September and Early October Preceded the Death Spike of October 1918
In May 1918, usual but highly contagious influenza was publicized in Spain (hence, “Spanish influenza”) [48]. In June, after 6 weeks of usual influenza in Europe, serious pulmonary lesions and deaths increased in those “admitted
to the special inf luenza centres,” especially those with an “old-standing renal lesion” [60]. In July, increased mortality of young Londoners was documented [61].
Farbenfabriken Bayer's worldwide efforts
had left few places lacking aspirin. In the United States, Bayer's giant
factory
produced aspirin under “American” management. After
Bayer executives were charged with violating the Trading with the
Enemies
Act in August 1918, advertisements encouraged
confidence in aspirin [62].
The “Spanish lady” came to the United States and struck 2000 Navy men
in Boston in late August. The majority recovered,
but oddly, 5%-10% developed a “very severe and
massive bronchopneumonia,” which, in many, lacked an accompanying
leukocytosis
[63]. Influenza spread.
Official recommendations for aspirin were issued on 13 September 1918 by the US Surgeon General [64], who stated aspirin had been used in foreign countries “apparently with much success in the relief of symptoms” (p 13),
on 26 September 1918 by the US Navy [29], and on 5 October 1918 by The Journal of the American Medical Association [31]. Recommendations often suggested dose regimens that predispose to toxicity as noted above. At the US Army camp with the
highest mortality rate, doctors followed Osler's treatment recommendations, which included aspirin [48], ordering 100,000 tablets [65]. Aspirin sales more than doubled between 1918 and 1920 [66].
The number of deaths in the United States increased steeply, peaking first in the Navy in late September, then in the Army
in early October, and finally in the general population in late October [67]. Homeopaths, who thought aspirin was a poison, claimed few deaths [11, 48]. Others may have suspected that aspirin was responsible. On 23 November, 1918, Horder [68] wrote in The Lancet that, for “intensely toxic cases…aspirin and all so-called febrifuge drugs must be rigidly excluded from the treatment” (p
695)
In summary, just before the 1918 death
spike, aspirin was recommended in regimens now known to be potentially
toxic and to
cause pulmonary edema and may therefore have
contributed to overall pandemic mortality and several of its mysteries.
Young
adult mortality may be explained by willingness to
use the new, recommended therapy and the presence of youth in regimented
treatment settings (military). The lower mortality
of children may be a result of less aspirin use. The major pediatric
text
[69] of 1918 recommended hydrotherapy for fever, not salicylate; its 1920 edition [70]
condemned the practice of giving “coal tar products” in full doses for
reduction of fever. The occurrence of Reye syndrome-like
illness before the 1950s is debated and consistent
with the fact that children's aspirin was not marketed until the late
1940s.
Varying aspirin use may also contribute to the
differences in mortality between cities and between military camps.
To determine the proportion of
virus-induced pathology, subsequent bacterial infection, and overall
1918 pandemic mortality
attributable to salicylate, experimental models and
analysis of primary consecutive individual treatment and pathology
records
are needed. Prospectively, aspirin should be
investigated in countries where aspirin is used for influenza.
- Received March 29, 2009.
- Accepted June 25, 2009.
- © 2009 by the Infectious Diseases Society of America
References
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Vaccinations: Read this mum's message to parents after her baby son is put at risk of measles
Mum's emotional message shared more than 180,000 times on Facebook
Getty
An angry mum has taken to Facebook to accuse parents who don't get their children vaccinated for measles of putting her 15-day-old baby at risk of 'death'.
Jennifer Hibben-White said she was 'angry as hell' at mums and dads who she said put her son Griffin in danger of exposure to the potentially fatal virus and added: "If you have chosen to not vaccinate yourself or your child, I blame you."
The mum's tirade – which has been shared more than 180,000 times on Facebook – was sparked after a routine visit to their local doctor to get her son Griffin weighed on January 27.
Two weeks later, she was informed by the doctor's in Markham, a city near Toronto, Canada, that someone in the waiting room had later developed measles – which can be potentially deadly to small children.
Both Jennifer and Griffin are now in isolation at home, waiting to see if he develops measles symptoms.
But while they await news, Jennifer made her feelings clear about people who don't get their children vaccinated against the illness.
Here is Jennifer's message in full:
"On February 9, I received a phone call from York Region Public Health, informing me that Griffin, alongside my mother and I, was potentially exposed to the measles virus while attending a newborn weigh-in appointment at my doctor's office in Markham on January 27.
"Griffin was 15 days old at the time.
"I was informed that someone who later developed measles sat in the doctor's waiting room between 1 hour and 30 minutes before we arrived. I was also informed that measles is regarded as 'airborne' and can stay in the air and on surfaces up to 2 hours after the infected person has left.
"I was then asked if I had had the measles vaccine. I had. Griffin. Griffin had not. Can not.
"I was advised to not be around small children. If I worked in such an environment I would be written off work. I do work in such an environment - my home. Where I now sit with Griffin and my three-year-old, Aurelia, who has only been able to get one MMR vaccine so far.
"She is now, technically, exposed too. We are to sit tight and watch for symptoms: fever, cough, runny nose. If we develop any of these we are to call my doctor and arrange to come in under official medical precautions.
"We are to wait at home, in isolation, until February 17, after which the 21 days of possible incubation will have passed and we are clear.
"So, Griffin is now Schrödinger's baby. Simultaneously with measles, and without it. Until he develops symptoms, or until a further seven days pass. One or other.
"And I'm angry. Angry as hell.
"I won't get angry at or blame the person in the waiting room. I would have likely done the same thing...you get sick, you go to the doctor.
"I have no idea what their story is and I will never know. But I do know one thing: If you have chosen to not vaccinate yourself or your child, I blame you. I blame you.
"You have stood on the shoulders of our collective protection for too long. From that high height, we have given you the PRIVILEGE of our protection, for free. And in return, you gave me this week.
"A week from hell. Wherein I don't know if my BABY will develop something that has DEATH as a potential outcome. DEATH.
"Now, let's unpack this shall we. All out on the table. You have NO IDEA what this 'potential outcome' means. NO IDEA. I do. Unfortunately, I do.
"You think you are protecting your children from thimerosal? You aren't. It's not in their vaccine.
"You think you are protecting them from autism? You aren't. There is no, none, nada, nothing in science that proves this. If you want to use google instead of science to 'prove me wrongp then I am happy to call you an imbecile as well as misinformed.
"You think you are protecting them through extracts and homeopathy and positive thoughts and Laws of Attraction and dancing by candlelight on a full moon? You aren't.
"I PROTECT YOUR CHILD. We protect your child. By being concerned world citizens who care about ourselves, our fellow man, and our most vulnerable. So we vaccinate ourselves and our children.
"You think you are protecting them by letting them eat their shovel full of dirt and reducing antibiotics and eating organic? You aren't.
"As an unvaccinated person you are only protected by our good graces. WE LET YOU BE SO PRIVILEGED thanks to our willingness to vaccinate ourselves and our children.
"You know what vaccines protect your children from? Pain. Suffering. Irreparable harm. Death.
"And you would be the first to line up if you had an inkling of what the death of a child feels like. You would be crawling through the streets on your hands and knees, begging, BEGGING to get that vaccine into your precious babies because that is what I would have done, if I could, to save my daughter.
"The fact is, there was no vaccine for her. Not for her illness. And she died. She died at age five and a half, and she is gone.
"And I watch these arguments trotted out on Facebook and twitter citing false science and long discredited 'studies' that just won't stop and Jenny McCarthy quotes and 'it's MY choice' to not vaccinate...and I think...what would you have done if your child lay dying?
"Would you give them a scientifically proven, safe and effective vaccine and risk the minuscule likelihood of a side effect? Or would you let them go, knowing that at least they won't develop autism (which they wouldn't even develop anyway because SCIENCE)?
"And don't you DARE tell me that you wouldn't vaccinate them then. Don't you dare. You have no idea what it feels like to go through what we went through.
"So, look at Griffin. Tell me why he gets to bear the brunt of your stupidity and reckless abuse of our protection? Tell me.
"Seven more days until I know that my baby is safe. Seven more days. How is your week going, anti-vaxxers?"
Jennifer's Facebook post and how her friends and followers responded is below. What do you think? Please share your comments below.
This is my son Griffin, and he may have measles.
On February 9th, I received a phone call from York Region Public Health, informing me that Griffin, alongside my mother and I, was potentially exposed to the measles virus while attending a newborn weigh-in appointment at my doctor’s office in Markham on January 27th.
Griffin was 15 days old at the time.
... See More
On February 9th, I received a phone call from York Region Public Health, informing me that Griffin, alongside my mother and I, was potentially exposed to the measles virus while attending a newborn weigh-in appointment at my doctor’s office in Markham on January 27th.
Griffin was 15 days old at the time.
... See More
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