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Re: Re: Re: unusually, an interesting question is posed
 

Firstly, in response to Graeme Johnston's comments. 'Most people know that the alleged risk of mumps causing sterility is largely an "old wives tale".' Unfortunately most parents of today do not know that this is largely an "old wives tale", as this is one of the reasons given to them as to why they should have their children vaccinated. And because this sounds very worrying it has created a fear of mumps.

Graeme J. then comments: 'However, mumps can cause meningitis -- and mumps was therefore quite a common cause of permanent deafness before the vaccine was widely used.' Interestingly enough I asked Dr Mike Watson of Aventis Pasteur, about mumps meningitis as the issue was raised in a live Radio 4 discussion (2000) of which I was present. In 1992 two brands of the MMR used in the UK were withdrawn due to the mumps component causing mumps meningitis.

However in the mid 1990s one of the withdrawn brands was supplied to the Brazilian health authority to vaccinate the Brazilian children. This vaccine campaign resulted in a high number of cases of mumps meningitis occurring. When this was pointed out to Dr Watson he reacted as if it was no big concern, and said that mumps meningitis was a severe headache that would resolve itself without any treatment, and had no long term consequences. I also pointed out to Dr Watson, after the programme, that it is interesting that one minute mumps meningitis is a dangerous complication of mumps infection, but when the vaccine causes it, then it is only a bad headache.

As I have said in my last two responses complications of any nature for any of these childhood infections are due to poor health or mismanagement, ie suppressive treatments. If there are cases resulting in complications then one would need to know full details of the case to be able to understand why the complication has occurred.

Graeme then states: 'Magda Taylor asserts that "complications are more likely to occur from the general healthstyle of the individual or the mismanagement of the illness". How does she recommend that a patient with mumps avoids the complication of deafness? And what instructions would she give his/her doctor?' I do not recommend patients since I am not a health practitioner. I do however read widely on health and have a particular interest in naturopathic philosophy, and I have found using naturopathic methods in dealing with various ailments for myself and my family have been very successful. One particular book I have often referred to is from the 1930s 'The Hygienic Care of Children' by Dr Herbert Shelton. His suggestion for the care of a patient with mumps is: Rest in bed with warmth until the temperature is normal and the swelling is gone will hasten recovery. No food and no drugs should be given. There is nothing to the popular superstition that acids should not be taken during this time and if the child refuses to fast, orange or grapefruit juice may be used. As soon as the swelling has subsided fruit may be fed three times a day for the first three days, after which a gradual return to a normal diet may be made. 'Hygienic' care will prevent complications, but if these have developed before this care is instituted, the fast should continue until all swelling and pain are gone.'

I have not nursed a case of mumps myself, (I did have mumps myself in my childhood and sailed through it) but I have nursed chickenpox cases, and a severe case of tonsillitis. I used a very similar method for the tonsillitis case and it was extremely successful and the whole illness was over in 12 days. There was never any reoccurrence, and I did not go to the doctors, and I did not use any antibiotics. And in response to how do I instruct my doctor - I rarely go to the doctors, I have not been for a number of years for either myself or my children. But if I did feel the need to go then I would not be instructing anybody I would simply go for a possible diagnosis or to discuss possible ways of dealing with the situation.

The graphs in the Green Book do indeed look impressive but I find them limited. With the mumps meningitis graph - fortunately there were low numbers in the period indicated, but why were these cases occurring in the first place, what were the circumstances of those cases? How reliable are laboratory confirmed cases? Sometimes certain so-called 'disease-causing' microbes can not be isolated in a patient, and in other situations individuals can be 'infected' with microbes and yet not display any symptoms of disease. Interesting that from 1988 -1992 the age group receiving the MMR were developing more cases than the >4 year olds, you might have expected it to be the other way round. Also interesting that the mumps meningitis suddenly stops in 1992, the same year the two brands of MMR were withdrawn. Maybe all those cases from 1988 were caused by the vaccine? It is a pity that the immunisation status of the cases is not included in this data.

The other graph 'Annual incidence of mumps infections'is questionable, since mumps was not a notifiable disease until 1988, so how accurate are the figures pre-1988? As there is no reason why mumps infection would have behaved differently to other childhood infections then the number of cases would have been in decline anyway. Also absence of certain diseases after vaccination may not indicate health. Suppression of acute disease can lead to chronic conditions, so a rise may be observed elsewhere in other more chronic and long-lasting conditions. Additionally, measles, whooping cough, scarlet fever, diphtheria showed very similar trends in decline of cases and severity, from the mid-1800s to the present day, so if mumps had been notifiable then it is likely that mumps would have behaved in the same manner, regardless of vaccination. The Role of Medicine by Thomas McKeown is a useful source for looking at the morbidity and mortality of infectious diseases.

In response to Dr Lewis, I would also urge him to look at further graphs that cover much greater periods of time for the various diseases.

The outbreak in 1970s of whooping cough is often used as a fine example of the need to vaccinate. However there is a great amount of literature that highlights many aspects not included in the health department literature. For example, according to Professor Gordon Stewart during the 1978 epidemic of whooping cough the UK mortality rate was the lowest ever, and that a high proportion of cases were observed among fully-vaccinated children. I also understand that this epidemic was world-wide and not restricted to the UK. Countries with high uptake of whooping cough vaccine also experienced high number of cases, and indeed Sweden, with a reasonably high uptake withdrew this vaccination as a result of this epidemic. There is a great deal of very interesting information further to my brief comments, and I would only encourage Dr Lewis to research further.

I agree with Dr Lewis that parental choice should be permitted, but this unfortunately is not the case at present. GPs are under pressure to meet targets and many parents come under enormous pressure when either being selective or declining all vaccines for their children. A doctor on BBC radio last week stated that these target schemes were 'a good way to motivate GPs' to vaccinate. Why would GPs need any motivation, especially in the form of financial incentives, if all GPs are totally confident that vaccinations offer some benefit. Also, over the years, many parents contacting The Informed Parent have indicated to me that they were concerned by the limited knowledge on vaccination their practitioner appeared to have, and were unable to discuss the subject in any proper depth. This should not be the case.

As for Dr Lewis's questions - 'How long does MMR immunity last ?' 'How often will it need to be repeated ? ' 'Might it be better to encourage wild mumps in childhood ? ' I have been asking similar questions, especially as 'immunity' is still not understood. The WHO acknowledge that some individuals with high levels of antibody may still contract the disease, and equally an individual with no detectable antibodies may not develop the disease. In other words there is no precise relationship and therefore antibody levels do not equate immunity.

When MMR was first introduced the public was told that one jab would be lifelong protection, and then a few years later a booster jab was introduced. And how can the protection be established even if further boosters are added, if antibodies are not an indication? More should be investigated into the benefits of childhood infections, particularly the long-term benefits. I am aware of a study which indicates that women who have a history of mumps infection in childhood are less likely to contract ovarian cancer in adulthood (Epidemiological studies of malignancies of the ovaries. West R O, 1966, Cancer, July 1001-1007) This is indeed interesting and I wonder if there are any studies looking at men developing prostrate cancers and their history of mumps, maybe there will be a relationship there?

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Re: Re: unusually, an interesting question is posed
 

My question was simply a question. And there was no assuming about when mumps was made a notifiable disease, it was published in the Department of Health book 'Immunisation against Infectious Disease'- 'Mumps was made a notifiable disease in the UK in October 1988.'(Page 52, 1990 edition.) As regards to a mumps vaccine being around since 1948, stated in Dr Midgley's Rapid response. In 'Vaccines' by Plotkin and Mortimer 1994 edition, it states: An experimental inactivated vaccine developed in 1946 was tested in humans in 1951.' There appears to be no further discussion on that particular vaccine, and the text then leads to 1967 when a live virus mumps vaccine was introduced in the USA.

Interestingly enough it states that following the introduction of this vaccine that: 'the number of reported mumps cases in the United States decreased steadily, from 152,000 cases in 1968, to 2982 cases in 1985, a record. However, this downward trend was reversed in 1986-1987, when a relative resurgence of mumps occurred in the United States. The resurgence appears to have been the result of incomplete vaccination coverage of adolescents and young adults in the years following the introduction of the live virus vaccine, In 1991, 4264 cases of mumps were reported, a 67% decrease from 1987; this total still EXCEEDS the number of cases reported annually between 1983 and 1985.' (My emphasis.)

If one looks at all these childhood infectious diseases these declines were occurring regardless of when vaccination programmes were introduced. Measles, whooping cough, diphtheria are fine examples of this. Both the morbidity and mortality were in major decline well BEFORE vaccines were introduced, and had mumps been notifiable at an earlier time no doubt the same trend would have followed.

Interestingly, another point to note is that the textbook description of mumps in the pre-vaccine era was not alarmist, unlike its present day description. For example in The MacMillan Guide to Family Health, 1982 edition, it simply runs through the general description, with lines such as 'Mumps is generally a mild disease. The usual outcome is complete recovery within about 10 days.' Even regarding orchitis, it comments that this is more common in adults and that invariably the swelling goes down after a few days leaving no after effects, and that it is excessively rare for the swelling to cause sterility. And as I remarked in my previous Rapid Response complications are more likely to occur from the general healthstyle of the individual or the mismanagement of the illness.

As regards to 'satisfying conspiracists' I always find it puzzling that when anyone starts asking simple questions or making valid points, suddenly they become conspiracists. I am not interested in conspiracies, I prefer to study a subject in depth, which in turn provokes further questions. And to broaden my knowledge I like to ask questions. Why?...because it seems sensible, and it is!

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Re: Mumps
 

So now the threat of measles epidemics is taking a rest, mumps is in the spotlight. It is interesting that there is now so much concern and fear being promoted about mumps, if it is so bad then why did it not become a notifiable disease until 1988? Cases of measles, whooping cough, diphtheria, for example, were reported from the mid 1800s - why not mumps? Upto the introduction of MMR the majority of parents were not too worried about a case of mumps, it was mostly viewed as a benign childhood infection. However as soon as the MMR came into use, mumps suddenly became a more dangerous illness with a list of complications. All illnesses have the potential to lead to complications, but this is rare, and due to the state of health of the individual, ie their lifestyle, diets, physical and emotional stability etc., and also the mismanagement of the disease. If the illness is left to run it's course, without suppression, a reasonably healthy child will sail through mumps, as they would with measles and rubella. Mumps was known as a CHILDHOOD illness, and this would be the normal and appropriate time to be developing such a disease. Now it is occurring in UNDER immunised young adults, which seems to be another problem caused by vaccination programmes - shifting the age of incidence to an inappropriate time. So the push to give them another dose of MMR is presented as the answer. How many doses will be necessary before they will be classed as sufficiently immunised? And how will the authorities know, when even the world health experts of the day do not even fully understand immunity, it is certainly not simply about levels of antibodies. If, as the authors state, 'People born before 1982 are not susceptible, with up to 98% seropositivity rates, owing to early natural infection in the pre-MMR era,'then it appears that the MMR has not improved the situation, but instead may have suppressed the child's ability to develop mumps leading them to become susceptible as a young adult instead. Hardly an achievement!