[Letters concerning BCG vaccine and TB vaccination Feb 2005 BMJ]

john lucas
Peter Flegg

Hilary Butler,
Peter Flegg,
Hilary Butler,
Hilary Butler,

Peter Flegg,
Hilary Butler,


Question for Flegg 21 February 2005
john lucas,

As we know responses from the Dept of Health are unlikely, I was wondering if you could tell us why we still use the BCG vaccine when it was shown to be worse than ineffective years ago in India?

This prompted the German government to withdraw it 27 years after that event, better late than never I guess. Also the USA doesn't use it, a sure sign. While the fact it is given to babies in France but older children here, is another mystery of vaccine "science".

The real reason for promoting high vaccine uptake is revealed by Dr Buchwald MD:

"The reason vaccinations are promoted with such intensity is to prevent people from realising that vaccines do not protect and also in the event of an outbreak or an epidemic the vaccinated are as much at risk of becoming infected as the unvaccinated. The truth can be kept hidden if people's vaccination status remains unknown and if everyone is vaccinated, making a comparison with unvaccinated people impossible. This is also the real reason for the relentless push to vaccinate as many children as possible."-- Dr Buchwald (The Decline of Tuberculosis despite "Protective" Vaccination by Dr. Gerhard Buchwald M.D. p101)

Also the real reason why vaccine status is so hard to find.

1. http://www.whale.to/vaccines/buchwald.html  

Competing interests: None declared

Re: Question for Flegg 24 February 2005
Peter Flegg,
Blackpool, UK FY3 8NR

Send response to journal:
Re: Re: Question for Flegg


At the risk of opening a whole new can of worms concerning another vaccine, I would just make a few comments in response to Mr Lucas' points about BCG vaccine.

BCG is a hodge-podge of attenuated mycobacteria strains. It is no doubt declining in overall efficacy as a vaccine, and there are intensive efforts underway to find better alternatives, which are sorely needed.

I do not recollect any studies where BCG being shown to be "worse than ineffective" in India. This may be what his favourite anti-vaccination web site claims, but a proper reference would be appreciated if it exists. Lucas may be referring to the TB Research Centre BCG trials in south India, which studied nearly two thirds of a million subjects (1).

In this trial, BCG was shown to be ineffective in preventing pulmonary tuberculosis in adults and it was of low efficacy in preventing TB in children. This is not quite the same thing as being “worse than ineffective”. Other recently reported long term trials have shown some protective efficacy against TB (2). BCG is still protective to a considerable degree against more invasive extra-pulmonary TB manifestations like meningitis and miliary TB, particularly in childhood, as demonstrated by at least two meta-analyses (3,4). BCG obviously has a very minor role to play in preventing transmission of TB as a public health measure, but it does reduce the complication rate and associated mortality.

Vaccine science can certainly have its mysteries, as Lucas refers to them, but the fact that some countries use different approaches to TB control is hardly surprising. There is logic behind the differing recommendations for BCG vaccination in different geographical regions, and this is mainly based on the epidemiology of TB. In areas with low TB prevalence such as the USA giving BCG is not felt to be beneficial. (Another reason is that in the USA, they prefer to use skin tests of reactivity to tuberculin for diagnostic purposes, and this is not feasible in patients who have had prior BCG). The UK saw a drop in cases of TB into the 1990s and phased out its BCG programme in response, but cases were already starting to rise at this time on the back of the burgeoning HIV epidemic and influx of people from high TB prevalence areas, hence the resumption of the programme (hiatuses in vaccine supply notwithstanding).

(1) http://www.trc-chennai.org/bcg1.pdf
(2) Aronson NE, Santosham M, Comstock GW, Howard RS, Moulton LH, Rhoades ER, and Harrison LH. Long-Term Efficacy of BCG Vaccine in American Indians and Alaska Natives: A 60-Year Follow-Up Study. JAMA. 2004:291 (17): 2086-91.
(3) Rodrigues LC; Diwan VK; Wheeler JG. Protective effect of BCG against tuberculous meningitis and miliary tuberculosis: a meta-analysis. Int J Epidemiol 1993 Dec;22(6):1154-8.
(4) Colditz GA; Brewer TF; Berkey CS; Wilson ME; Burdick E; Fineberg HV; Mosteller F. Efficacy of BCG vaccine in the prevention of tuberculosis. Meta-analysis of the published literature. JAMA 1994 Mar 2;271(9):698-702.

Competing interests: None declared

Further to Peter Flegg and the TB ref. 28 February 2005
Hilary Butler,
freelance journalist
home 1892, New Zealand.


Dear Sir,

Further to Peter Flegg's reply. From the first reference he gave us, which is indeed the study published in the Lancet (although other reports of this study include other information of relevance), I would draw Peter Flegg's attention to the following:

Page 64:

"the overall protection by BCG, for all ages was seen to be nil."

....for children 1 month to 9 yrs, was 27% for either strain, 25% for Danish strain and 17% for French strain, the levels of protection in all four instances being statistically not significant.

Again, the discussion on page 63 (and 65) is interesting, as they considered the protective level for 5 - 12.5 years to be 69 percent. Then, in discussing the discrepancy levels between that, and the two other groups, they consider it statistically insignificant as well. Perhaps that's because the confidence levels were so wide, and lie on either side of zero, if they looked too hard, they might come up with a different interpretation.

So they opted for the politically correct language, and said that the numbers should be interpretted "with caution".

In other words, "we don't really have a clue what we are looking at, because actually it looks pretty bad."

There was also noticed, in children, in a detailed discussion on page 63, excess cases of tuberculosis in the vaccinated children in the first five years of life, and again, between 12.5 - 15 years of age, a pattern also seen in another trial at Madanapalle, in South India, where more cases were seen among the vaccinated during the first three years, and after 9 years of age...

It is also noted that much of the article was spent trying to find reasons to explain away the results, and none were found.

The most telling remarks were on Pgs 67-68:

"Thus even if BCG offered protection in those initially uninfected (which it does not) the public health value of BCG can be only in preventing childhood mortality caused by disease resulting from haematogenous spread. The impact on infectious cases can at best be only marginal...

In conclusion.... has shown that BCG offer no protection against adult type bacillary tuberculosis. Consequently BCG cannot be expected to reduce the transmission due to tuberculosis. This observation of failure to protect could not be attributed to defects in methodology, inadequate sample size, prior exposure to environment mycobacteria or to most of the disease being a result of exogenous reinfection. These unexpected results have led to several studies which would eventually increase our understanding of the host responses and immune mechanisms in tuberculosis."

This last part in particular, underscores the little "can of worms" above, which Peter Flegg and others have studiously chosen to ignore.

Which is the fact that not only does Mr Flegg have little idea about neonatal immunity and the "differences" between neonates, adolescents and adults,, or how vaccines actually "work" inside the body apart from supposed final antibody response but...., as this study points out...., Mr Flegg also has little understanding about "host responses and immune mechanisms."

The problem is that this professional ignorance doesn't just stop with Tuberculosis.


Hilary Butler.

Competing interests: None declared

Flegg appealing to Authority

Re: Further to Peter Flegg and the TB ref. 3 March 2005
Peter Flegg,
Blackpool, UK FY3 8NR

Send response to journal:
Re: Re: Further to Peter Flegg and the TB ref.

Ms Butler accuses me of "professional ignorance", claiming I have "little idea about..immunity", or "how vaccines actually work" and "little understanding about host responses and immune mechanisms."

I shall have to defer to her superior knowlege on these subjects. She obviously must know more about these than I ever will.

Competing interests: 8 years undergraduate and postgraduate training and experience in Infectious Diseases in Africa, 9 years subspecialty training and experience in the UK in Infectious Diseases and Tropical Medicine, 3 years postgraduate research leading to an MD thesis on immune dysfunction in drug users, and 8 years experience as a consultant specialising in Infection, Immunodeficiency and HIV Medicine.

The benefits of experience - Peter Flegg 5 March 2005
Hilary Butler,
freelance journalist
1892, NZ, New Zealand.

Dear Sir,

Mr Flegg inferred early in these discussions above, that the medical profession, himself included, knows all there is to know about vaccines, how they work, how good they are, how they might, or might not affect the immune system, and how autism has nothing to do with MMR or any other vaccines.

The intimation is that because of their knowledge and expertise, parents should go along with all their recommendations, and now, because of the qualifications which he listed above.

My point is that there are referenced medical articles written by people with expertise in vaccinology put up on this thread, which consistently contradict both him, and Jamie Robertson, who also says he knows how vaccines work, but who also choses NOT to return to a debate which he started.

Does Peter Flegg (and Jamie Robertson) agree that their own medical literature, which conflicts with much of what he has said here, has something to offer to this debate?

If so, why will they not discuss these problems, rather than flick me off when I bring referenced anomalies to light?


Hilary Butler.

Competing interests: I have no qualifications whatsoever

Re: Re: Further to Peter Flegg and the TB ref. 5 March 2005
Hilary Butler,
freelance journalist
1892, home, New Zealand.

Dear Sir,

Mr Flegg wished to discuss BCG, and considers this vaccine worthwhile, at least in terms of complications and mortality, so I would value his input on the following:

Has Mr. Flegg read the most recent Indian trial of 366,625 people published in the Indian Journal of Medical Research, 1999; 110:56 which also found the BCG vaccine to be useless? If so, what did he think of it?

Has Mr. Flegg also read the Malawi Lancet study, March 14, 1992, Pages 636 - 639 which said in the abstract: "There was no statistically significant protection by BCG against tuberculosis in this population. These findings add to the evidence that BCG vaccines afford greater protection against leprosy than against tuberculosis."

Has Mr. Flegg also read the research led by Dr Annelies van Rie of the University of Stellenbosch in Tygerberg which found that people subsequently recovered from one TB infection, could acquire a new one, because strains in any country appear to change quite quickly.

Has Mr Flegg also read the editorial in the same issue of the New England Journal of Medicine (1999), in which he says:

>>>>" If natural infection does not confer protective immunity... the development of improved vaccines against tuberculosis will be especially challenging."<<<<

Paul Fine also says in "Epidemiologic Reviews", 1993, Volume 15, Number 2 page 294:

>>>>>>>>"natural immunity to tuberculosis is general associated with persistent, rather than self-limited infection...

.....There has been little discussion of herd immunity with reference to tuberculosis. A major reason for this silence is the rudimentary level of our understanding of the nature and implications of either natural or vaccine derived immunity to this disease.... there is no convincing evidence that the use of BCG vaccines has reduced the risk of infection with the tubercle bacillus in any population In the absence of greater basic understanding of the nature and implications of the immune response to tuberculosis , it is of questionable utility to ponder its theoretical herd implications."<<<<<<<

Mr Flegg has admitted that herd immunity isn't a consideration but I am puzzled why Mr Flegg considers vaccination of UK infants of much use in the context of the above.

As far as I know, the "understanding" of the medical profession on Mr Fine's points has not progressed that much further. Research appears to focus on more financially rewarding aspects of TB... like DNA vaccines, etc.

Could Mr Flegg comment on the above please in connection with the best way to assist both AIDS patients, immigrants and the UK population at large?

Has the infectious diseases unit which Mr Flegg is associated with made sure that the "importing" strains of TB into the UK are all DNA characterised, so that that can that be taken into account when chosing an appropriate vaccine?

In reference to Mr Flegg's comment that he cannot recollect any studies where BCG was shown to be worse than ineffective in India, there is another study I would like his comment on.

It is one of the several studies which the USA did, upon which it decided NOT to use the BCG vaccine at all.

Contrary to Mr Flegg's suggestion that the USA didn't use the vaccine because their TB levels were low, and they wanted to be able to use skin tests of reactivity to tuberculin for diagnostic purposes, I find that the USA would have used the vaccines had any of their studies showed solid demonstrable benefit. None did.

Looking that the USA's historical statistics of TB deaths and incidence, they appear pretty much as anywhere else in the world. I can't find any evidence that the two reasons stated by Mr Flegg are really valid.

Had there been such a low level of TB there, as alleged, why would the USA have bothered with any trials at all? It is hard to escape the conclusion that the principle reason for the non-use of the BCG in the USA was simply because the vaccine was of no benefit. And yes, in that context, it would very clearly blur the ability to diagnose any actual cases.

The particular study Mr. Flegg's comment is asked for, was reported in AJPH March 1974, Volume 64, No 3, pgs 283 - 291. It was called "Evaluation of BCG vaccination among Puerto Rican Children", in which a total of 191,827 were included in the study population in which the result was that the overall reduction in tuberculosis was less than 9 percent. There is an interesting comment on page 291, which says:

"...it is particularly tragic that the use of scarce resources to administer BCG must still be based on blind faith."

As an offshoot of this study, the same population was reported on in a second study called "Efficacy of BCG vaccination in prevention of Cancer: An Update : Brief communication." J. Natl Cancer Inst: Volume 60 No 4, April 1978 pages 785 - 788.

The comment made on page 785 is:

"Although no statistically significant protective effect of BCG could be demonstrated, the vaccinated group had a slight deficiency of leukemia cases and an excess of lymphosarcoma and Hodgkins disease."

Given that Mr Flegg says that the resumption of the UK vaccine programme is in part due to an influx of people from high TB prevalence areas (immigrants) and given that these are exactly the countries where the TB vaccine appears not to work... and given that it appears that strains vary hugely, even within one country, how does Mr Flegg believe that the use of "whatever" BCG vaccine will assist the general British population?

And can he guarantee that the use of BCG vaccines will not increase the rates of certain cancers as in the Puerto Rican study, or have any other unforeseen impact to children, in the future?

And given that a Finnish study (Am J Epidemiol 1999, Sep 15; 150(6) 632-641) showed that there is a lower tuberculosis incidence in subjects who consume more fruits vegetables and berries, and that they found a highly statistically significant inverse association between calculated vitamin C intake and the incidence of tuberculosis, what is that he, as an expert in infectious diseases, and infection, proposes to suggest to the UK population, as well as these immigrant people at high risk of tuberculosis as their best method of bolstering natural resistance?

I ask this, because my points raised above on "Nutrition, infection and immunity" also appear to have gone unanswered, which, given Peter Flegg's qualifications, I now find a strange omission.

Given the the admittedly complex nature of the BCG debate, and such uncertainty over which strains are in what BCG vaccine, it would seem to me that the issues of nutrition and their relevance to diseases, natural immunity, immune mechanisms and host responses might be worth a closer look.

Mr Flegg's expert comment would be welcomed.


Hilary Butler.

Competing interests: None declared

Re: Re: Re: Further to Peter Flegg and the TB ref. 9 March 2005
Peter Flegg,
Blackpool, UK FY3 8NR
I have no real wish for this debate on MMR/autism to be sidetracked into a discussion about TB and BCG vaccination, and so this response on the matter will hopefully be my last. Other respondents have already pointed out the uncontrolled nature of this debate and I don’t want to see it balloon completely out of control. Hilary Butler keeps asking questions on this topic – perhaps these will also be her last?

It appears that in her haste to rubbish the BCG vaccine, Butler has failed to read my original intervention on 24th February (Re: Question for Flegg). In this I stated that “BCG obviously has a very minor role to play in preventing transmission of TB as a public health measure”. So actually we have some common ground here, and perhaps she could even have used me as another reference for how “bad” the BCG vaccine actually is! (The window of opportunity for her to do this has gone however – because she also makes it quite plain she thinks that I have no authority in the subject matter whatsoever, despite my credentials).

However, the reality of the situation is a bit more complex. With a vaccine like BCG that has dubious protective efficacy, there are plenty of sources in the medical literature that will point out this fact (as Ms Butler has done). But she is being highly selective, and it is not at all hard to find many good studies confirming the benefits of BCG. Rather than list endless references to them, I refer instead to the meta-analyses that collate information from all the available trials (and not just the ones Butler wishes us to hear about). One meta-analysis screened 1264 articles on BCG, and included 14 prospective trials and 12 case-controlled studies in its analysis, including Indian trial data (1). Butler would do well to look at this analysis, as well as the CDC document on the role of BCG in the USA (2). The overall protective effect of BCG is estimated to be 50%, which is quite substantial. Data from the subsequent Malawian trials, which Butler cites, showed no protection (3). This study adds a new perspective to the problem, but it took place against a background of increasing HIV prevalence, and it did not control for previous TB (how can you demonstrate protection from a vaccine against something you may already have?).

Subsequent studies in the same part of Malawi demonstrate that blunted responses to BCG are likely to be due to priming with environmental mycobacterial antigens, as shown by IFN-gamma responsiveness attributable to different mycobacterial antigens (5). The same group conducted comparative trials of this phenomenon between Malawi and British adolescents, and showed higher IFN-gamma and DTH responses at baseline in Malawi than the UK, with higher post-vaccination IFN-gamma responses to BCG in the, supporting an effect for prior sensitization by environmental mycobacteria in Malawi (6). [Bottom line: there are several plausible explanations for the failure of the Malawi trial to show protective efficacy.]

Though there may remain some uncertainty about BCG’s protective role against TB acquisition, absolutely no-one in the medical field doubts that BCG has another, crucially important role – that of helping prevent serious complications in those with TB, something I referred to previously and which has been studiously ignored by the anti-vaccine lobby. The Colditz meta-analysis details this, with an overall protective efficacy against death from TB of 71% and against TB meningitis of 64% (1). Another major meta-analysis also confirms this, with BCG conferring protection against miliary or meningeal TB in 86% of randomized controlled trials and 75% of case-controlled studies (4).

A “school report” on BCG might well end with the exhortation “Must try harder”. It may be a poor vaccine for prevention of TB, but it reduces deaths and severe complications, and deserves a place in the protective umbrella we try and place over our more vulnerable populations. TB more than any other infection is primarily a social disease of deprivation and poor nutrition, but that does not mean we should neglect to lessen its effects by stopping BCG vaccination. Butler hopes to live in a fantasy world where all infections would cease to exist the moment we all eat up our greens. That world does not exist.

(1). Colditz GA, Brewer TF, Berkey CS, Wilson ME, Burdick E, Fineberg HV, et al. Efficacy of BCG vaccine in the prevention of tuberculosis. Meta-analysis of the published literature. JAMA. 1994;271:698-702.

(2). http://aepo-xdv-www.epo.cdc.gov/wonder/prevguid/m0041047/M0041047.asp

(3). Randomised controlled trail of single BCG, repeated BCG, or combined BCG and killed Mycobacterium leprae vaccine for prevention of leprosy and tuberculosis in Malawi Karonga Prevention Trial Group. Lancet. 1996;348:17-24.

(4). Rodrigues LC; Diwan VK; Wheeler JG. Protective effect of BCG against tuberculous meningitis and miliary tuberculosis: a meta-analysis. Int J Epidemiol 1993 Dec;22(6):1154-8.

(5). Black GF; Dockrell HM; Crampin AC; Floyd S; Weir RE; Bliss L; Sichali L; Mwaungulu L; Kanyongoloka H; Ngwira B; Warndorff DK; Fine PE. Patterns and implications of naturally acquired immune responses to environmental and tuberculous mycobacterial antigens in northern Malawi. J Infect Dis 2001 Aug 1;184(3):322-9.

(6). Black GF; Weir RE; Floyd S; Bliss L; Warndorff DK; Crampin AC; Ngwira B; Sichali L; Nazareth B; Blackwell JM; Branson K; Chaguluka SD; Donovan L; Jarman E; King E; Fine PE; Dockrell HM BCG-induced increase in interferon-gamma response to mycobacterial antigens and efficacy of BCG vaccination in Malawi and the UK: two randomised controlled studies. Lancet 2002 Apr 20;359(9315):1393-401.

Competing interests: None declared

Peter Flegg answer on TB 10 March 2005
Hilary Butler,
freelance journalist.
home 1892, New Zealand.

Dear Sir,

I would like to thank Peter Flegg for an answer which I found very helpful. It puts his position very carefully, and thoughtfully.

And though he may have missed it, I did acknowledge, early on, that Peter Flegg said that BCG wasn't much use as a public health measure.

As a freelance journalist, when we were "training", a lot of heated discussions took place about the "meaning" of "unbiased" articles. We were told that we have to present both sides even headedly. We were told to concentrate on the "truth".

It's a very difficult concept, if you accept that presenting both sides, means that at least some of either side might not be truth at all. In fact, balanced journalism involves at least 50% lies. Of course, journalists aren't supposed to make judgement calls on which half is lies, and which is the truth. We are supposed to leave that to the reader to discern. Which is tricky, since readers often discern from the position of conditioned bias.

Yes, I accept that I've ignored a lot of studies that say that BCG is wonderful. I do so, because I've got to the point of not being able to accept that everything is the truth. I've not been able to accept, either, that everything is lies. Obviously there are reason why certain vaccines don't work, in different places.

Right now, the New Zealand medical authorities are attempting to do creative immunology to "explain" why the pertussis vaccine here has (what they are now toying with as a new concept)~~~ "effective vaccination rate" ~~~~. I have yet to see a good definition of this, but never mind. But the "effective vaccination rate" for pertussis here, appears to be in the order of 33%.

Theor Biol. 2003 Sep 21;224(2):269-75. Estimation of effective vaccination rate: pertussis in New Zealand as a case study.

>>>"The obtained figures indicate that in New Zealand the effective vaccination rate against pertussis is lower than 50%, and perhaps even as low as 33% of the population. These figures contradict the medical statistics which claim that more than 80% of the newborns in New Zealand are vaccinated against pertussis (Turner et al., 2000). This contradiction is due to the mentioned unreliability of the available vaccine. The fact that the fraction of immune population obtained here is considerably lower than the fraction of vaccinated population implies a high level of vaccination failure. We believe that we can safely conclude that under the current conditions (with the present vaccine and the current vaccination practice) the effective vaccination rate against pertussis in New Zealand is considerably lower than is expected. Based on the present data it is perhaps lower than 50% of the population."

This is all very vastly different to that told to us in the past, though as mothers, we've all known it for years, since as I've said for years here, the practical reality of the vaccine is a joke.

But no doubt there will be many who will say that the use of the vaccine led to milder whooping cough, and fewer deaths. Which is a supposition. Since most unvaccinated kids (by choice) don't get badly sick, or die. Perhaps they eat their greens.

So yes. While the BCG may be valuable in preventing complications and deaths, I don't think that's definitive for everyone. And perhaps, those studies might actually be as useful as all the old tosh studies which said Pertussis had a 95% protective rate in this country when it didnt. We both agree that BCG isn't much use as a public health measure.

The bit about all this that perhaps Peter Flegg struggles with isn't the technicalities at all. We will never agree on that, because agreement relies on accepting that every study is true. Which we know its not. Even BMJ has published articles talking about the percentage of lousy medical articles. Trouble is, you can only work out that in retrospect. Just as the New Zealand medical people are only coming to grips with the fact that the pertussis vaccine here, is, and always has been of minimal value.

the key issue is this:

>>>>Butler hopes to live in a fantasy world where all infections would cease to exist the moment we all eat up our greens. That world does not exist.<<<<

He is very wrong.

The way I see it is this. Millions of people in this world, have never had the BCG, have been infected with tuberculosis strains, and probably more than one, and have gone on to lead long, happy and productive lives.

Same with pertussis. And tetanus. And measles, and mumps and chickenpox. All those people who never had the vaccine, never got complications and never die, prove that FOR THEM the vaccine would have been a waste of time.

Years ago, when BCG was foisted on my parents, they were told that it was the only thing that stood between "me" and the "white" death. Which was actually a load of emotional blackmail, and quite inaccurate

Parents today, are still not given enough information upon which to make a choice. They are still subjected to emotional messages which convey the impression that if they don't do it, their children will get seriously ill and die, if they don't. History shows that that isn't a matter of proven fact. Otherwise we'd have no ancestors to have got here in the first place.

The "fantasy" world that I would love to live in, isn't one where everyone scoffs their greens.

It's one where every medical book, publication or person will honestly disclose everything, discuss things rationally and allow me the democratic right to make choices, which, even if the medical people don't agree with, they agree with my right to make them.

And within that context, resist the urge to make me out to be a lunatic paraiah, and on the rare occasion when their services have been sought, to not be both precious and vindictive about it. Which is something I've been victim to more than once.

That is the only actual world I would like to live in.

And I fear it will never become a reality, because most medical people I know, subscribe to the theory that parents should just trust them, and do as they are told to do, according to the medical paradigm of the moment.

Whereas all I want is "democracy".


Hilary Butler.

Competing interests: None declared

Dr Flegg, diet and TB  
j lucas,

I wish I had as much faith in medical studies as Dr Flegg. I think it was Richard Smith, (past?) editor of the British Medical Journal, who pointed out that only one percent of the articles in medical journals are scientifically sound. I thank Hilary Butler for her analysis, it is thanks to her, Ed Yazbak and Viera Scheibner that medical men can no longer hide behind them without being called to task. Witness the studies used to "prove" MMR doesn't cause autism.

I think the acid test of BCG vaccine is the fact it is not used in Germany and the USA, or in the Netherlands.

"In the Netherlands BCG is never given to children...nevertheless, the incidence of tuberculosis in the Netherlands is the lowest in the world."--Dr. Tinus Smits

"Butler hopes to live in a fantasy world where all infections would cease to exist the moment we all eat up our greens. That world does not exist."

No matter how many times Dr Flegg repeats his view that nutrition diet plays no part or a small part in infectious disease, it just highlights his ignorance and reminds me of the good sense I had to do my own thinking, rather than relying on "experts". May I humbly suggest he reads Dr Sandler's book and see how the correct diet protects against infection.

"We see the same thing in Sweden, though to a less marked degree. The rise in tuberculosis mortality was recorded in 1914-1916, and in those years the consumption of bread and flour rose, whereas that of meat decreased. After 1916 we see a steady and continuous fall in tuberculosis mortality, and at the same time flour foods fell off while the consumption of meat and fish rose rapidly. It may be added too, that in England, a rise in tuberculosis mortality coincided with a lower consumption of meat and butter and an increased consumption of flour foods. ...There has been a similar rise in tuberculosis mortality in practically all belligerent countries in Europe during and since World War II and for exactly similar reasons, namely, a great reduction in the consumption of protein foods, such as, meat, fish, and eggs, along with an increased consumption of the more available and cheaper starchy foodstuffs."--Sandler MD (Diet Prevents Polio) http://www.whale.to/v/sandler.html  

"TB increased dramatically in Japan, shortly after the Japanese acquired a cheap source of sugar on the island of Formosa (aka, Taiwan), in 1910. Britain experienced a dramatic increase in deaths from TB during the 1700's, especially among workers in sugar factories and refineries." - --William Dufty (Sugar Blues p77)

We are now living in the age of the Food Giants, at the height of their power. The average consumption of the poison sugar is over 110lbs a year, plus the poison known as white bread, along with other junk foods poisons such as margarine (1), the staple diet of the majority. It has got to the stage where the caterer in some USA schools is McDonalds.. Plus pesticides, aspartame, and now GM foods. And they are not out to increase our health levels as Paul Stitt points out:

"There is a force in this country that's out to poison your food, to make it addictive, to manipulate your very body chemistry. This conspiracy wants to keep you overfed but undernourished. Who's behind this conspiracy? The food giants."--Paul Stitt, biochemist, a professional food processor for 4 years to 2 of the larger food giants in the US.

The decline in infectious disease is purely down to the decline in poverty, and diet plays a large part in poverty.

"It is only since 1955 that the German people as a whole have had enough to eat. This has made an enormous difference as regards tuberculosis and other infectious diseases.......In brief: never before have German citizens (and probably all other citizens of the European Union) fared so well as now, after over 50 years of peace. A living standard has been reached which in 1945 was unimaginable. These factors are the reason why the infectious disease have lost their significance and why "protective" vaccinations do not serve any useful purpose. Who deserves our gratitude for the decline?

The decline of infectious diseases is the result of

1. The farmers a) the production of quality food items at relatively low cost (especially potatoes)

b) the creation of tuberculosis-free herds

c) the production of quality milk

2. The untiring fight of workers' unions for quality accommodation. In people's minds the word "union" is associated with the push for "wage increases". It is often not realised that their efforts have been much more comprehensive.

3. The social democrats (regardless of which political party they belong to) who by means of various pieces of legislation have promoted a high standard of accommodation.

4. The engineers responsible for the supply of electricity and water and the disposal of waste water who have ensured the problem-free functioning in our municipal utilities in their respective areas of expertise.

5. The politicians of all political parties who by their dedication have contributed to the growth of our economy, the source of today's affluence.

Thanks to these achievements, there will be no return of "medieval epidemics" or "the dreadful infectious diseases of the past", an argument sometimes used to promote vaccinations. Such predictions are untrue. As long as the current favourable situation continues, the epidemics of the past will never return."--Dr Buchwald MD

So it is not just "greens", it is the bits below the ground along with meat, and avoiding the immune depleting poisonous junk foods which are so popular (not forgetting aluminium cookware (2), mercury amalgam, fluoride (in 10% of the UK water), chlorine, and the new proliferation of cell phone masts and panels).

1. THE MARGARINE HOAX by Dane A. Roubos, D.C. http://www.whale.to/a/roubos.html  2. Diseases Associated with Aluminium Intoxication-------H. Tomlinson, M.B., Ch.B., MRCS., LRCP

Competing interests: None declared