I gave a response to a newspaper article about diphtheria and the following question arose from my initial post:
But Trevor, there is nothing in your response regarding the fact that this kid did not have the vaccine and he died, and the only other case in London was in 2008 and also affected an unvaccinated child. So, I am just wondering, does this vaccine work, did the kid have any underlying conditions, is this one of the diseases you do need to vaccinate against? How would you protect an unvaccinated child from diphtheria? Just want to hear your side of the story
Yes, it can be a little challenging to get an overview of what is happening and to understand the detail. Your question raises a very important issue … being unvaccinated doesn’t protect you from disease! … So what’s the alternative?
First, a look at the detail
In the UK according to government figures, between 1986 and 2013, five people have died from diphtheria and there have been 257 notified and confirmed cases of diphtheria … this will also be an underestimate because cases aren’t always detected and notified, (even the patient in the UK that died in 2008 was not notified as a case of diphtheria, it was only from results of tests obtained after the death did the diphtheria death get notified). Additionally, cases of pharyngitis where diphtheria bacteria are detected but do not produce the toxin and without the characteristic membrane in the throat, are not classified as diphtheria (Commun Dis Public Health 1999: 2: 250-7.) i.e. there are mild cases of diphtheria that do not get classified as diphtheria.
In Spain, the newspapers report that prior to the recent case of diphtheria the last case of diphtheria in Spain was in 1987. I don’t have Spain’s notification figures, but this obviously seems extremely low compared to the UK figure of 257 cases reported since 1986, (a comparable country in terms of disease notifications). It’s possible that this newspaper report is inaccurate and perhaps not the last case but the last death was in 1987 or the last case of a specific form of diphtheria was in 1987.
What is diphtheria?
Diphtheria is associated with bacteria that colonise the nose and throat (it can also colonise the skin) … in the throat a membrane can form which is made up of bacteria, dead skin and other immune products. Some bacteria (only some) can also produce a toxin that can enter the blood and affect the heart and nervous system. Severe forms of diphtheria are usually due to the membrane obstructing the airways (not due to the toxin), or the toxin entering the blood, affecting the nerves and heart; both of these types of severe cases can lead to death.
The diphtheria vaccine stimulates the body to produce antibodies to the toxin, so that if a case occurred wherein the toxin is produced, the patient would hope to be protected from the toxin entering the blood. But it is important to understand that there are forms of the disease (the majority) that do not produce a toxin (e.g. non-toxigenic C diphtheria). These other forms can also produce severe symptoms including the formation of the membrane that can obstruct the airway and can be fatal.
Experiments using non-toxic strains also produce disease symptoms indicating that the pathogenicity of C. diphtheriae could not be fully attributable to the toxin.
Infection & Immunity. 2010 Sep; 78(9): 3791–3800.
The above report in 2010 also describes experiments showing that the anti-toxin does not help those symptoms and, therefore, the vaccine does not either. There are also other forms of diphtheria that produce a different toxin than the one used in the vaccine e.g. toxigenic C. Ulcerans and currently there is little evidence that the vaccine or anti-toxin can help these patients.
… the evidence that “up-to-date immunization with a diphtheria toxoid vaccine will prevent diphtheria and diphtheria-like illness caused by C. ulcerans” is scanty.
Pitfalls with Diphtheria-Like Illness due to Toxigenic Corynebacterium ulcerans
Clin Infect Dis. (2008) 47 (2): 288.
Stories promoting the effectiveness of the vaccine state that since the vaccine’s introduction in the1940s, the incidence of diphtheria has declined. But the incidence had been declining for the last 100 years prior to the use of the vaccine; it also took many years to get the greater proportion of children vaccinated and so other factors must have been involved in the decline of diphtheria. For example in 1944 compulsory education and free school meals contributed to the decline of many illnesses.
BUT the most important issue to realise is that the vaccine doesn’t stop the growth or the spread of the bacteria, therefore, doesn’t stop someone from developing diphtheria, and so the vaccine is not responsible for the decline in cases of diphtheria.
Even though the following is repeatedly reported in the newspapers.
Diphtheria vaccination rates in Spain are between 90 and 95 percent following systematic public health campaigns that began in 1945. Thanks to these efforts, the dangerous disease had been eradicated in the country.
El Pais, 5 June 2015
So the decline in the actual incidence of diphtheria is due to factors other than the vaccine, factors that promote general health. Additionally, studies from notified cases of diphtheria show that many people in close contact with these confirmed cases of diphtheria are carriers of the bacteria and have no symptoms. We also know that diphtheria bacteria can be transferred between animals and humans (e.g. dogs, cattle and pigs.)
So, there are many people that do not carry the diphtheria bacteria but are in contact with humans and animals that do harbour the diphtheria bacteria, and there are also many people that carry the diphtheria bacteria that have no symptoms at all – remember there is no vaccine protecting these people from actually developing diphtheria.
Additionally there are many people that have chosen not to be vaccinated that do not get diphtheria or do not develop problems from the toxins associated with diphtheria bacteria. If you have, as the authorities estimate, vaccine coverage of 90-95% that leaves 5-10% not vaccinated, in a place like the UK or Spain with approx. 50 million people that’s 2.5 to 5 million people unvaccinated against diphtheria … so clearly we have an innate immunity that protects us from developing diphtheria and protects the unvaccinated from developing symptoms from the toxin.
So the question is; why do some people develop diphtheria?
It is interesting that some scientific journals admit that very little research has been conducted on the issue of what makes someone susceptible to diphtheria in the first place.
The mode of action of the toxin has been extensively studied. (BUT) In contrast to research and application involving diphtheria toxin, our understanding of other factors and mechanisms underlying C. diphtheriae infections remains largely deficient.
Infection & Immunity. 2010 Sep; 78(9): 3791–3800.
However, a striking resurgence of epidemic diphtheria in the Newly Independent States (NIS) of the former Soviet Union has drawn attention to our lack of a full understanding of the epidemiology of the disease.
J Infect Dis. (2000) 181 (Supplement 1): S2-S9.
Why have we invested so little in researching why individuals contract diphtheria?
Because the pharmaceutical industry have a tendency to want to address disease as though it were simply a case of a bacteria or a poison being the sole cause of the illness, so that a simple magic bullet can be developed and marketed. Whilst the broader and real question as to why so few people develop a condition from bacteria that millions of us are exposed to, gets ignored.
You would, of course, sell far more drugs and vaccines if everyone feels they are at risk. But to identify the factors that predispose individuals to an illness empowers individuals to make choices that reduce their real risk of developing disease and points the finger at how we operate in our lives and our relationship to the environment around us. Regarding the emerging epidemics of diphtheria in the former Soviet Union;
Many adult patients were alcohol users and belonged to low socioeconomic groups. The stress and anxiety that followed the collapse of the Soviet Union and difficulties in day-to-day life may have contributed to the development and maintenance of the diphtheria epidemic.
J Infect Dis. (2000) 181 (Supplement 1): S2-S9.
Similar patterns of susceptibility have been found in Europe, Scandinavia and USA; poor living conditions, mal-nutrition and alcohol use. We also find a type of diphtheria that affects the skin amongst this group of susceptible individuals.
It has also been reported that:
From 1989 to 1992, SDRU (Streptococcus and Diphtheria Reference Unit) received a total of 95 nontoxigenic isolates of C. diphtheriae, most from cases of severe and often recurrent throat infections.
UK Public Health Laboratory Service – Streptococcus and Diphtheria Reference Unit
The less obvious story from the above, as far as the public is concerned (but very apparent to many people involved in holistic medicine) is that recurrent throat infections are often treated with antibiotics and this approach has a way of killing bacteria that are only present because of an underlying toxicity and susceptibility. Killing bacteria may alleviate symptoms and give you time, but it doesn’t address the underlying issues, furthermore, antibiotics deplete the body’s important colonies of essential bacteria and therefore antibiotics can pre-dispose one to future illness. Diphtheria can be considered to be a severe form of tonsillitis.
However, one may think that if living conditions decline, the vaccine will protect us, BUT according to the The Journal of Infectious Disease’ (01/02/00 Vol.181, B.I.Niyazmatov et al) after the collapse of the Soviet Union in 1990 and the reduced vaccine uptake that followed from 1993,
the epidemics affected mainly the vaccinated; 96.7% of the 1,227 cases were in older people that were vaccinated in the era when there was high vaccine uptake.
The issue of susceptibility is paramount in addressing disease; vaccines do not address socio-economic status, poor living conditions, malnutrition, alcohol use and the over-use of antibiotics. Vaccines appear to work but merely shift illnesses from one form to another with the basic susceptibility unchanged, so for example The lancet April 4, 1981 (765) reports that vaccinated individuals may not be affected by the vaccinated illness but go on to die of another infection so overall death rate does not change. Indeed, a similar scenario exists with the diphtheria vaccine.
… It has been postulated that non-toxigenic strains occur more frequently in people who have been immunised. Non-toxigenic strains have been reported (albeit rarely) to cause systemic disease, both in the UK and overseas, which makes the apparent increase in non-toxigenic biotypes of concern.
Commun Dis Public Health 1999: 2: 250-7.
In addition some studies in developing countries even suggest that the vaccine could be making things worse, for example Ines Kristensen, Peter Aaby, and Henrik Jensen, published research in BMJ 9/12/00, (321:1435) showing that DPT (Diphtheria, pertussin and tetanus) and polio vaccines were associated with increased death rates in children.
“… Recipients of one dose of diphtheria, tetanus, and pertussis or polio vaccines had higher mortality (death rate) than children who had received none of these vaccines”
Unfortunately in spite of the care taken to research this issue the WHO saw fit to ignore these results and publish more positive figures that researchers say are not supported by the data. (Aaby and Jensen – BMJ 9/12/00)
So it certainly is difficult to determine how effective the diphtheria vaccine is and whether risks of the vaccine are worth taking. We also have to bear in mind that there are other known risks of vaccines in for example allergies. Because vaccines inject antigens in the body with a chemical adjuvant designed to provoke a large antibody response, IgE antibodies are known to be created, which means the patients have become sensitised to the components of the vaccine.
The rise in incidence and severity of allergies are less reported; there are for example 4 deaths every single day in the UK from asthma alone. But one death in 6 years from diphtheria makes headline news.
So to the detail
If we look at the records of the 5 diphtheria deaths in the UK, the records show the one death in 1994 was either C ulcerans or non-toxigenic diphtheria, in 2000 one death due to C Ulcerans, in 2006 one death due to C ulcerans, in 2008 one death stated as C diphtheria (unusually records don’t mention whether this is toxigenic form or not) and in 2011 one death due to C ulcerans. So of the possible 5 deaths one may have been due to the diphtheria toxin that we vaccinate against.
It is possible that none of those deaths could have been avoided by the vaccine and the only unvaccinated case that I have been made aware of was the 2008 case. So are we to assume that the others were vaccinated? Would the vaccine have saved that one person that apparently wasn’t? Obviously nobody knows that.
BUT the question remains … why did those 5 people die of an illness that most people don’t get and when people do, it also treatable with antibiotics?
The potentially toxigenic corynebacteria are usually susceptible to penicillin and macrolide antimicrobials; these are the agents recommended by WHO for antimicrobial treatment of cases and carriers. All strains isolated from epidemic areas in Eastern Europe were susceptible to erythromycin, penicillin, ampicillin, cefuroxime, chloramphenicol, ciprofloxacin, gentamici and tetracycline.
Laboratory guidelines for the diagnosis of infections caused by
Corynebacterium diphtheriae and C. ulcerans
So over the course of 30 years, why did 5 people develop an illness, that eventually led to issues affecting and invading the internal systems of the body leading to their death?
This issue lies at the hub of the vaccine critique; our bodies are designed to harbour bacteria and viruses on the outer membranes of the body, (skin and mucous membranes of digestive tract, respiratory tract and genitourinary tract), in fact we cannot function without them. However, there are a whole host of reactions that are designed to keep these elements out should we become ill, as well as the possession of a functionally intact skin and mucous membrane (that incidentally we don’t just get given at birth, this has to develop from childhood to adulthood).
Part of the problem with a pharmaceutical approach to health-care is that symptoms (which are effectively reactions) are treated as the problems, many symptoms that we try and stop are in fact attempts of the body to heal, eliminate and to learn, e.g. coughs, nasal discharges, vomiting, diarrhoea, inflammatory reactions, etc, these initially start on the outer membranes of the body.
If elements get into the blood they are eliminated, we see illnesses such as measles, chicken pox, scarlet fever, rubella and a whole host of eliminatory skin rashes (non-specific viral rashes many of which we don’t have names for).
The symptom is the reaction to the problem
If we don’t address the problems and root causes, suppressing reactions (with pharmaceutical medication) and killing bacteria, leave the real problems unresolved and eventually create more problems. Then short-lived acute reactions become recurrent and/or chronic e.g. recurrent throat infections becoming diphtheria, whooping cough vaccine predisposes to asthma. A more holistic understanding of the body in disease is a prerequisite to understanding how to treat and prevent illness.
Being vaccinated may not protect you from disease because it doesn’t address the reasons people get ill which is why vaccinated children in developing countries still go on to die of illnesses other than those illnesses that they are vaccinated against., in developed countries polio paralysis replaced with echo and coxsackie viral paralysis, meningitis shifting from C to B to Y to W. Additionally, due to the toxic nature of vaccines they also create other serious side-effects that governments pay out large sums of money in vaccine compensation.
BUT here’s the rub, being un-vaccinated doesn’t protect one from disease either!
Not vaccinating means you cannot get the damaging effects of the vaccine BUT on its own does very little for disease prevention, the key to disease prevention is in understanding how to deal with what your body is reacting to, (i.e. what are the real problems, not just the symptoms of the problem) and using effective ways to help the body’s reactions in disease as opposed to the comprehensive suppression of reactions with pharmaceutical drugs, which leads to recurrent, chronic and eventually invasive consequences.
Vaccines play a small and sometimes significant part in the creation of chronic and invasive illness BUT obviously other things do as well. If all one does is to not vaccinate BUT then uses pharmaceutical medication indiscriminately suppressing reactions of the body, leaving the issues pertaining to susceptibility unchanged, you may have escaped the adverse consequences of a vaccine but may have essentially changed very little in addressing your susceptibility to disease.
The most significant events in the lives of you and your loved ones often relate to your times of crisis, your illness.
Pharmaceutical drugs can be useful in very limited circumstances, but they generally suppress your attempts to eliminate and resolve issues that are problems to your mind and body. Illnesses are inextricably linked to physical and emotional stresses that need to be resolved; they are also linked to your development in ways that are essential for your future survival. Vaccines do not address susceptibility but do in fact make things worse, they sensitise you to the contents of the vaccine (i.e. creating allergies) and predispose individuals to invasive problems that may eventually affect the brain and nervous system.
Therefore this is not a vaccine issue but this is an issue to do with an approach to health-care, which is why people can get so defensive, touchy and emotional, because it feels like a wholesale condemnation of orthodox medicine which it also isn’t. LIKEWISE there is no one anti-vaccine movement, any more than there is ‘a science movement’ ‘a religious movement’ or ‘holistic health movement’ they are many and varied.
Clearly lots of people vaccinate and don’t vaccinate for different reasons, being afraid of vaccines may help you avoid a damaging vaccine but it won’t of itself address the deeper and more significant problem of understanding when to use suppressive medication, when to use what therapies that stimulate and how to address the underlying reason for your reaction in illness.
So, would the child, who recently died in Spain, have survived if vaccinated, obviously I don’t know, but there are some pertinent questions that need to be answered:
Why did that child develop an illness that hardly anybody gets in developed countries and even fewer die of, what form of diphtheria did he have, why did the child not respond to antibiotics, why did the infection become invasive i.e. were there any predisposing factors? … because experience suggests that there must have been. These are questions that are not being raised in the press because they want to sell the story that we all need to be vaccinated because there are no pre-disposing factors that we can do anything about to stop this kind of illness other than vaccinate.
And so the question for me, on hearing this story, would I vaccinate my child to stop those things happening? I certainly would not … I would choose and do choose to do health-care entirely differently … are my kids going to get seriously Ill? … I don’t know, BUT I’m not worried about that and consequently neither are they, and I know when certain signs and symptoms occur I’m going to do my best to address the root causes, help their reactions, have faith in my children and imbue a sense that my children can have faith in themselves.
We don’t know what life brings and so I am grateful that I am not in bereavement at this point in my life and have every sympathy for the family of that young Spanish boy, but we all do our best, some of that is based on the information we have available and I dearly like to share information that helps people to make more effective health choices, information that I know has helped me and others in my care.
Some people may say trust those that don’t vaccinate and others say trust those that do and I say trust in what works as you develop your knowledge and intuition of dealing with life and illness now, I say get on your health and healing journey now, don’t wait until you get sick, make small steps with small issues, you will see what works and how to make the seemingly difficult decisions simpler.