Amalgams and PN not associated! [peripheral neuropathy i.e. no Line Dancing]

Discussion in 'Dental Archive' started by Joel M. Eichen D.D.S., Oct 3, 2003.

  1. ..... Epidemiology would establish it if it were. Please see today's
    NYT article on smallpox vaccine and heart attack. The same
    epidemiologic approach applies to amalgam, peripheral neuropathy, and



    Checking City's Archives to Solve a Medical Mystery

    Published: October 3, 2003

    Centers for Disease Control and Prevention

    Morbidity and Mortality Weekly Report

    Institute of Medicine

    Medicine and Health

    It was a medical mystery with national policy implications. New York
    City says it found the solution buried in its archives.

    Last spring, the Bush administration's campaign to vaccinate half a
    million health workers for smallpox hit a new snag. Two civilians and
    a National Guardsman died of heart attacks shortly after being

    Of all the things that could go wrong with the program, this was not
    supposed to be one of them. The literature on smallpox vaccination
    pointed to possible complications like brain inflammation, severe
    lesions in people with certain skin conditions, and uncontrolled
    spread of vaccinia pox, a related disease. Heart trouble was not on
    the list, but who knew?

    New York City health officials said there was a way to find out. Using
    their records from a 1947 crash program to inoculate most of the city,
    they found no evidence of a rise in heart attacks.

    "While we cannot be certain that there is no association between
    smallpox vaccine and the cardiac deaths that occurred nationally in
    2003, our data tell us that the likelihood of smallpox vaccination
    causing cardiac deaths appears to be extremely low," Dr. Thomas R.
    Frieden, the city health commissioner, said yesterday.

    The results, actually compiled in April and presented then to the
    federal Centers for Disease Control and Prevention and to a conference
    of health experts, were published this week in the centers' Morbidity
    and Mortality Weekly Report.

    Whether the findings will revive the moribund vaccination program,
    intended to provide a measure of protection against the potential use
    of smallpox as a biological weapon by terrorists, is another matter.

    Even before news of the heart attack deaths, doctors, nurses,
    paramedics and others were reluctant to volunteer for the
    vaccinations, and the program lagged far behind the pace health
    officials had hoped for. The notion that the vaccine could cause heart
    problems seemed like the final blow. The pace of vaccinations dropped
    sharply, then continued to decline, and all but stopped by summer.
    Half a million military people, who had little choice in the matter,
    received the vaccine as planned, but fewer than 40,000 civilians did.

    No one had ever before detected a link between the vaccine and heart
    trouble, but neither had researchers looked for one.

    Until 1972, smallpox vaccination was routine in this country, but it
    was done mostly on infants. Mass vaccinations were rare and
    vaccination of adults was spotty, at best. Then, for three decades,
    smallpox inoculations dropped nearly to zero. (The disease was
    declared wiped out in 1980.)

    Before this year, the last mass vaccination in the United States took
    place in New York City in 1947. It was one for the record books. The
    city experienced the nation's last domestic outbreak of smallpox ?
    defined as one person transmitting the disease to another on American
    soil, as opposed to someone arriving here already infected. Twelve
    people developed the disease, and two died.

    In a span of just three weeks, the city Department of Health
    vaccinated 6.3 million people.

    "This was the most intensive vaccination campaign in history,
    anywhere," said Dr. Farzad Mostashari, an assistant health

    On the day in April when news spread that some people died just after
    being vaccinated, Dr. Frieden's aides say, he reasoned that if there
    were a link to cardiac arrest, that 1947 mobilization would hold the
    proof, with enough inoculations all at once to produce a measurable
    rise in fatal heart attacks.

    He ordered all the death certificates from 1946 through 1948 pulled
    from the city archives, to compare the year of the smallpox outbreak
    with the year before and the year after.

    There were more than 81,000 such records, all on paper, that had to be
    reviewed by hand and entered into a computer database.

    "We had about 100 people doing data entry, and there was a core group,
    about five of us, who put together the analysis," Dr. Mostashari said.

    By the next week, the city was ready to show the results to the
    Centers for Disease Control and Prevention. But the news did not
    spread much beyond the public health field; newspaper articles
    continued to refer to the suspected link to heart attacks. Some state
    and local health departments officially dropped a vaccination program
    they had found to be unpopular, expensive and unsuccessful. Others
    simply let it wither quietly.

    The paradox was that this might have been the safest smallpox
    vaccination campaign ever conducted. The rate of complications, minor
    or serious, lagged far behind historical averages, in part because
    government officials were careful not to inoculate people who were at
    high risk of having adverse reactions.

    Last month a panel of scientists, convened by the Institute of
    Medicine and advising Congress, said smallpox policy should move from
    mass vaccination toward alternatives like developing quick responses
    to an outbreak. The scientists concluded that the risk of an outbreak
    was too small to justify the vaccination campaign.

    Joel M. Eichen, .
    Philadelphia PA



    Dental health-related material
    is provided for information purposes
    only and does not necessarily
    represent endorsement by or an official
    position of the SciMedDentistry gang
    or any other official agency either
    actual or fictitious or Steve Mancuso.

    Advice on the treatment or care
    of an individual patient should
    be obtained through consultation
    with a dentist who has examined
    that patient or is familiar with
    that patient's dental history.

    Joel M. Eichen D.D.S., Oct 3, 2003
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