Mon Thru Fri Commentary By Nicholas Regush

Tuesday, October 09, 2001

MYSTERIOUS ANTHRAX VACCINE RESEARCH

Yesterday ABCNEWS.com published my commentary about the effectiveness of the anthrax vaccine to protect against aerosolized anthrax. (See my regular column, SECOND OPINION, in the health section, and additional thoughts on the subject posted here yesterday in the RED FLAG DAILY.) I concluded that the available scientific data were not impressive. I suggested that research begin immediately to find other ways to prevent a possible anthrax assault.

It troubles me that the Department of Defense puts so much stock in its anthrax vaccine efficacy studies with Rhesus monkeys. Here's an example of yet another downside to one of those studies.

The study is entitled, “Efficacy of a standard human anthrax vaccine against Bacillus anthracis aerosol spore challenge in rhesus monkeys.” It was presented at an international anthrax conference and published in 1996 in a special supplement to the Salisbury Medical Bulletin. Hats off to anyone who can easily find this medical bulletin in a library.

The authors of the study are from the United States Army Medical Research Institute of Infectious Diseases, at Fort Detrick, in Frederick, Maryland.

The point of the study was to test the efficacy of the anthrax vaccine. Adult monkeys were injected intramuscularly with the vaccine at 0 and 2 weeks. Controls were injected with a saline solution (phosphate-buffered saline), also at 0 and 2 weeks. The results were dazzling: All immunized monkeys survived the anthrax “challenge” at either 8 weeks or 38 weeks. Seven of the 8 animals survived an injection of anthrax at 100 weeks. On the other hand, the controls died 3 to 5 days after “challenge.” So everything is looking good for the vaccine. That is, until you check the way the study was actually conducted.

The researchers gave the monkey controls a saline solution. This was not enough. They also (at the very least) should have had a control group of monkeys who had been given a combination of the saline and a compound called “aluminum hydroxide.” And here’s why: Aluminum hydroxide (a so-called “adjuvant”) is used in the anthrax vaccine (and in other vaccines) as a means to kick start the immune system into action. The compound can trigger a strong NON-SPECIFIC inflammatory response in the body.

The goal of this anthrax vaccine efficacy study with monkeys was to determine whether the vaccine triggered SPECIFIC immunity against the anthrax spores. Without a control arm of monkeys given the adjuvant, it is not scientifically credible to make a claim on behalf of the vaccine for SPECIFIC immunity.

This study leaves me wondering about how important a contribution the aluminum hydroxide makes in fighting off the anthrax injections in the experimental group of monkeys.How much does it boost a response to the anthrax? And whatever effect there may be, it might not be easily extrapolated to humans. While recent laboratory research may have served to clarify some of the role of this adjuvant in vaccines, its function is still poorly understood. And again, that's why you need a control group with the adjuvant to help you figure this out.

(For those who would like more technical information on aluminum hydroxide’s potent effects, I recommend the following study: “The common vaccine adjuvant aluminum hydroxide up-regulates accessory properties of human monocytes via an interleukin-4-depdendent mechanism,” INFECTION AND IMMUNITY, February 2001, p. 1151-1159.)

Given the huge threat that anthrax presents, shouldn’t we have the best science available to test vaccines?

Monday, October 08, 2001

KNOWN AND UNKNOWN ANTHRAX DANGERS

Now that the United States has attacked targets in Afghanistan, many of us will be glued to our television sets to hear what the experts on military operations, Central Asia, Islam, the Middle East, home-front security and bio-terrorism will say about the progress of this campaign, its political and social implications, and possible repercussions. We all know, of course, or we should know, that much of that information will be speculative. But it will sometimes be difficult to determine who has new insight into the events as they unfold and who is blowing humid or hot air.

As some attention on the airways becomes focused on the likelihood of a retaliatory strike against Americans, one can, for example, expect experts to appear who hold strong views about whether a biological attack is feasible. If this past week of newspaper and internet articles and television stories are any indication of what’s to come, it’s clear that are two camps; one believes that the bio-terror threat is overblown; the other considers it highly plausible.

Because no group has been successful in using aerosolized lethal biological agents, some experts contest the likelihood that it can be done effectively. In the case of anthrax, which is not contagious, it is typically claimed that the chances are slim that terrorists could find a way to adequately release the “weaponized” anthrax in a wide plume, given the potential difficulties involved in finding a way to spray it, and the uncertainty of weather conditions. But other experts point out that this is all a lot of blather and that no one should underestimate the ability of a highly motivated group to develop ways to use anthrax as a weapon – and one that could potentially kill millions of people.

My reaction to this all-too-common type of debate which receives a ton of media attention is to ignore it. The blather comes from both sides. No one really knows – and won’t know, unless it actually happens. In this case, we should probably assume that an attack can be successful. We therefore should focus our attention on what we do know about our chances of living through it.

So what do we know, say, in the case of anthrax? We know that a vaccine exists, but that it remains unavailable to the general public. We also know that the production of this vaccine has stalled because the Food and Drug Administration (FDA) has refused to allow any further release of the vaccine, made by BioPort of Lansing, Michigan, because of a series of manufacturing violations. The United States military, which has been giving the vaccine to its Service Members, has pretty near shut down its anthrax vaccination program. In short, we know that a vaccine against anthrax is not in the cards for us anytime soon.

We also know that there is considerable debate about the vaccine’s safety. There are numerous reports associating an anthrax shot with a wide range of symptoms, including fatigue, nervous system problems, and signs of auto-immune disease. And while a reasonable amount of media play in recent years has been given to the safety issue, the media have shed relatively little light on whether the anthrax vaccine actually works. We need basic facts in order to arrive at realistic strategies for self-defense.

Well, today’s “Red Flag” is that the anthrax vaccine doesn’t have good science supporting efficacy. I’ve spent the last ten days digging into the details of the available science and have come away from it feeling that I’ve been conned by the FDA, the Centers for Disease Control and Prevention, a variety of medical bodies and the military about the vaccine’s effectiveness. For one thing, there are no human efficacy studies worth highlighting. And the animal studies, which include rabbits, guinea pigs, and Rhesus monkeys, at best, suggest the vaccine might be modestly effective. Even then, these rather inconclusive lab experiments hardly can be seen as representing war-like assaults. In fact, a weaponized anthrax attack might involve a genetically-engineered form of anthrax that the vaccine will be incapable of fending off.

ABC NEWS COLUMN: For details on the effectiveness of the anthrax vaccine, see my Second Opinion column today, which is posted at ABCNEWS.com

For other critical views of the anthrax vaccine, see: www.anthraxvaccine.org and www.majorbates.com

For the Department of Defense's latest report on the anthrax vaccine, go to: www.anthrax.osd.mil

WATCH THIS SPACE FOR FURTHER COMMENTS ON ISSUES REGARDING BIOLOGICAL WARFARE

Friday, October 05, 2001

GETTING BACK TO NORMAL?

Over the years, I’ve interviewed many people who were rushed to emergency for one serious reason or another. A heart attack. Very high blood pressure. Severe headaches. Breathing difficulties. Upon recovery, most vowed to make significant lifestyle changes. Eat healthy food. Exercise. Get plenty of rest. Be nice to friends and family. I’m sure you can guess the rest. It’s called getting back to normal.

There is even a lot of talk these days of life getting back to normal after the tragedies of September 11. Newspaper headlines speak of the renewed interest in Pop Culture. Even violent movies are making a comeback. Gossip is on the rebound.

Maybe many of us have a genetic endowment that makes us forget personal and social history. Just kidding, but we do seem programmed to repeat mistakes.

Which brings me to the explosion of interest in bio-warfare and how we’re likely to get back to normal on that issue too.

Even though U.S. Health and Human Services Secretary Tommy G. Thompson (See more on Thompson posted below) has foolishly tried to sell Americans on the idea that everyone is safe from a biological attack and that his medical swat teams can meet any emergency contingency, there has been considerable congressional attention focused on how to improve the entire infrastructure of the U.S. Public Health System.

The big political buzz this week is germ warfare and the lack of preparation for it, particularly in the nation’s hospitals. One must keep in mind that over the past several years there have been numerous reports (including one I produced for World News Tonight with Peter Jennings) on how many hospitals in the United States lack adequate or even basic infection control management. Should a major biological attack occur, any one of these poorly-prepared hospitals would probably be totally overwhelmed. Thompson can look to miracles from the crack squads of the Centers of Disease Control and Prevention to help contain a biological event, but this is not what is ultimately going to protect the public. A strong public health infrastructure will be vital in order to achieve that goal.

Easier said than done. The decline of public health in the U.S. and the reluctance to face facts has led us to this sorry state.

Meanwhile, Thompson has asked for about $1 billion in emergency anti-terrorism projects. What may in time get lost in the stampede for some of these and other special funds by well-intentioned, career medical spenders is the health-care system. The Government Accounting Office should begin very carefully tracking all new funding in this area. I expect that, with time, today’s political focus on building up local know-how in facing a biological attack will go the way of the Dodo.

Thursday, October 04, 2001

VERY SLOW MOTION

Finally. The Institute of Medicine released its report on childhood vaccines containing thimerosol. The message: The mercury-containing preservative should best be avoided. But there is no hard evidence linking it to autism and other developmental conditions. In other words, we don’t really know for sure because absence of evidence of harm doesn’t necessarily translate into safety. Unfortunately, Dr. Louis Z. Cooper, President Elect of the American Academy of Pediatrics (AAP), doesn’t get it. He stated in an AAP press release this week that, “Parents should be reassured about the safety of vaccines.” Well, no, Dr. Cooper, that’s not what the report is all about. Please consult the smarter experts in regulatory affairs (and preferably not at the AAP) and they will inform you that safety must first be proven before reassurance is invoked. (See yesterday’s “Red Flag” posted below for more on the AAP)

To be fair, the AAP did recommend in July 1999, along with the U.S. Public Health Service, that vaccines with the preservative should be moved off the shelves ASAP. That’s because it has become increasingly apparent even to the medical profession that high doses of thimerosol can be neurotoxic. And now the institute’s report does raise the possibility that vaccines containing thimerosol could lead to brain damage in children.

Thankfully, there has been a transition to vaccines free of thimerosol, including those against hepatitis B and haemophilus influenza, and a vaccine against diptheria, tetanus and pertussis. But not nearly quick enough. In fact, Congressman Dan Burton (R-IN) yesterday once again requested a recall of all vaccines containing thimerosol. In short, there is still enough stocked on shelves in the health care system for parents to remain concerned. What are the vaccine manufacturers waiting for? They should be the ones cleaning house!

If the AAP is so worried (as it appears) that parents will avoid vaccinating their children because of continuing fears about thimerosol, perhaps this group that represents some 55,000 primary care doctors and specialists “dedicated to the health, safety and well being of infants, children, adolescents and young adults” should bite the bullet and launch a major campaign to get doctors and clinics to rid their shelves of vaccine stock containing thimerosol.

Wednesday, October 03, 2001

MEDICINE’S ATTACK ON CHILDREN CONTINUES

Here we go again. Medicine renews its attack on defenseless children. How else should I characterize the latest guidelines for the treatment of attention-deficit/hyperactivity disorder (ADHD)?

The release this week of the American Academy of Pediatrics' pseudo-scientific report on treatment for ADHD solidifies my assessment that this organization needs a total overhaul. Most of all, the academy may need to rip itself away from the influence of the drug industry.

In reading the policy statement on the “Treatment of the School-Aged Child with Attention-Deficit/Hyperactivity Disorder," it should become transparent to any conscientious medical professional that the inevitable result of these guidelines will be wholesale medication of children with drugs such as Ritalin, Concerta and Metadate – and in many, if not most cases, quite likely unnecessary medication.

Let’s take this one step at a time. The academy’s policy is intended for primary care doctors. The idea is to get them to follow a series of recommended moves in dealing with ADHD. Essentially to set up “a treatment program that recognizes ADHD as a chronic condition,” and one that involves collaboration with parents and school personnel and specifies “appropriate target outcomes to guide management.” And then, “The clinician should recommend stimulant medication and/or behavior therapy as appropriate to improve target outcomes in children with ADHD.”

This, of course, is all predicated upon actually diagnosing ADHD accurately. So, let’s now turn to the academy’s guidelines published in May 2000 that hand-hold the doctor through a “Diagnosis and Evaluation of the Child with Attention-Deficit/Hyperactivity Disorder.”

The doctor is advised that he/she should begin an evaluation for ADHD if the child (ages 6 to 12) “presents with inattention, hyperactivity, impulsivity, academic underachievement, or behavior problems."

Now comes the intriguing part of the process when the enterprising doctor consults the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (psychiatry’s holy book) and determines whether the child meets the criteria for an ADHD diagnosis.

For example, one set of criteria for a diagnosis requires that six or more symptoms persist for 6 months and are considered maladaptive for the child’s “developmental level.”

Here are a few of the symptoms in this set:
a)often fidgets with hands or feet or squirms in seat
b)often leaves seat in classroom or in other situations in which remaining seated is expected
f) often talks excessively

Well, I’m sure you get the picture.

I can just see the average time-pressed family doctor running through this and other check lists and consulting at length with parents and school officials, as required by the diagnostic guidelines.

When you have as many as five million kids in the United States medicated to combat ADHD, it should be obvious that the so-called diagnostic guidelines are a sham. When about 12 per cent of all boys between the ages of 6 and 14 are being medicated for ADHD and, as one example, up to 20 per cent of kids in the fifth grade of a school are on medications for ADHD, you have to know that the academy diagnostic guidelines are sheer fantasy. Doctors under the gun from families, teachers and school boards and who are in way over their heads on this issue, have become drug pushers.

Some children may indeed require some form of medication, but the escalating numbers we have been seeing indicate that the real epidemic is drug pushing and not ADHD.

As for the so-called scientific reports touted by the academy that the drugs do the job in calming down children, well, surprise, surprise, yes, these stimulant drugs work effectively to neutralize spontaneous behavior. There is plenty of animal and human science to show that self-generated activities are reduced. There is less exploration, curiosity, socializing and playing. This is what the academy refers to as “evidence-based” medicine.

Then there are the side-effects of these medications. There is “evidence-based” medicine to show that these drugs are potentially harmful to the brain and every organ of the body. And these drugs can also be addictive.

If the American Academy of Pediatrics had any integrity, it would begin to focus more critical attention on ways that families and teaching institutions help shape and contribute to such behaviors as restlessness and inattention. Instead, it pretends it has some real pediatric science that singles out the brain for treatment.

The fact that the academy persists in its attack on children is a sobering reminder that medicine can be a brutal profession.

Tuesday, October 02, 2001

WE’RE SAFE, DON’T WORRY?

A disturbing television interview was broadcast on Sunday. There was Tommy G. Thompson, the secretary of the Department of Health and Human Services, telling Mike Wallace on 60 Minutes that, “We’ve got to make sure that people understand they’re safe. And that we’re prepared to take care of any contingency, any consequence that develops from any kind of bioterrorism attack.” Wallace is to be commended for his “you’ve got to be kidding me expression” that he wore throughout much of that segment.

Either Thompson truly believes the patronizing swill that he served up on national television and is woefully misinformed, and therefore ill-prepared to head the health department, or this was one of those precious little moments in federal health politics when the “leader” tries to calm his flock, even when he knows very well that he is providing information that is incomplete, if not downright dumb.

Thompson would have been on safer ground had he essentially informed viewers that mounting a biological attack is difficult for technical reasons and that his department was doing all it could at this time to gear up for the possibility that one could actually be launched effectively and rather dramatically in some region of the country. He might have indicated that unfortunately better vaccines and treatments were needed and that the eight staging areas around the country, each stocked with 50 tons of medical supplies, could help fight an attack, but could not be expected, given the multitude of possible scenarios, to necessarily contain the crisis. Instead, Thompson blew us away with a smug smile by telling us that we are all safe.

And to think that yesterday’s “Red Flag” focused on the issue of trust and how the medical Establishment is not living up to its obligations to be trustworthy.

Thankfully, 60 Minutes also turned to Connecticut Republican Christopher Shays, who has chaired congressional hearings on bioterrorism. Shays is far from convinced that we could grab the tiger by the tail. In fact, many experts in bioterrorism complain that the United States has not set up an appropriate public health infrastructure to confront an attack effectively. Thompson’s image of federal medical swat teams arriving on the scene from a “staging area” to limit the terror and help local authorities is pie-in-the-sky thinking. It's really a best-case scenario. Those teams will likely be helpful, but please don’t tell us that they will be able to take care of ANY contingency. That’s not information that I’m going to put my trust in, given the patchwork anti-bioterrorism system currently in place -and that includes hospitals that do not have personnel trained to deal with germ warfare emergencies. There is not even a controversy-free vaccine for anthrax that we can rely upon. And if we did want it, good luck to us. There isn’t much around. Nor are there adequate supplies of smallpox vaccine. Only about 15 million doses are available. Thompson thinks that would be enough, but that is mere guesswork based upon “conservative” theory, if not wishful fantasy.

The bottom line: The real degree of danger at this point is unknown. Thompson should know better than to try to snow us.

The “Red Flag” today is none other than Tommy G. Thompson.

MORE ON TRUST

Not too long ago, a prominent microbiologist bragged during a break in an interview I was conducting for ABC News that he could get his latest scientific paper on AIDS into a major journal very quickly, if he really wanted to, because he was such a hot shot. He also was chummy with the journal’s editor. I didn’t say too much about it, except to shake my head and say something like, “Well now, that’s one hell of a confession, isn’t it?” He laughed.

These days, many major medical journals are raising a bit of a ruckus about the methods the drug industry uses to get its sponsored or orchestrated studies into print (See yesterday’s “Red Flag” posted below) There are also growing concerns about how studies are actually selected to appear in the journals. The review process is known as “peer review,” which can, in the worst of times, mean that the old-boy network is alive and well. Even in the best of times, when the manuscript is sent out to so-called objective experts for review, the study’s authors usually do not learn who gave them the thumbs down.

One proposal now being tossed around by some journal editors is to have an “open” system. In other words, if Joe and Mary hate Fred and his theories and research focus and have participated in rejecting his manuscript, then Fred might eventually learn who did him in. It has even been suggested that such “openness” be extended to the reader. I, for one, as a medical reporter, would love to know who sucks up to, or sticks what, to whom. That’s because I already have an insider understanding of some of the nasty territorial battles that go on in everyday science. And these suck-up biases as well as hostilities are likely to surface during the peer review process.

Until there is an open review system, we should not trust the journals to play fair. An open system might also stop hot shots from calling up editor friends at journals and jockeying for fast-track publication.

Monday, October 01, 2001

TRUST

Perhaps we trust too much. We trust others to do their jobs. We trust governments to protect us. And we sometimes allow the trust we have in others to dull our senses to the realities of the world. To some degree, we live with blind trust.

One lesson we can learn from the horrors of September 11 is that we should be very careful about how we distribute our trust. We never should have placed so much of our trust in governments to protect us from terrorism. Ineffectual political policies with a dash of denial about terrorism’s growth and reach helped to pave the way for tragedy. And it certainly didn’t help matters that we have been indulging ourselves so frivolously in the cult of celebrity and have become enraptured with the mass media’s preoccupation with gossip, rumor, and all-round sleaze, often presented in the guise of news. All this at the grand expense of understanding the complexity of global problems. We have been living in a fantasy world.

Much the same point can be made about our relationship to the medical world. We have enormous trust in doctors, in scientists and in the honor of medical journals. It is often life and death trust. But it is often trust that is poorly invested. In due course, we shall discover yet another major price we have paid for our lack of vigilance.

Consider this important medical story that got lost because of the terrorist attacks: Thirteen leading medical journals decided to band together and accuse the pharmaceutical industry of distorting and corrupting scientific research. Those of us who do medical reporting and have not become toadies for the drug industry have pointed out repeatedly for many a year that the drug industry has many research-oriented doctors in its pocket; so this is not exactly shocking news. What is shocking is that some of the so-called “best” medical journals are only now beginning to focus more attention on how they do business with the industry and its for-profit sycophants.

Imagine, the journals now admit that they publish medical studies that are not really conducted by the “authors” of the studies. That, in fact, the drug companies themselves sometimes do all the work. The phony authors may not even have any input as to whether the studies should be published, particularly if the data do not suit the drug industry’s financial interests.

I particularly recommend the editorial in the British Medical Journal of September 15, entitled, “Editors Make a Move.” It begins this way: “We editors of medical journals worry that we sometimes publish studies where the declared authors have not participated in the design of the study, and had little to do with the interpretation of the data.”

They “worry.” Only now? Have these worried editors been asleep beside a YumYum tree? The editorial states, “It’s hard to know how often such problems arise.” Well, the journals should know, because they should been running a checking system to prevent such a violation of public trust.

These prominent journals (including The Lancet, the New England Journal of Medicine, and the Journal of the American Medical Association) have partly been caught napping by drug company use of private, non-academic research groups, so-called contract research organizations. These CROs are a little too comfortable with the drug companies and this relationship, according to the journals, greatly raises the odds of distorting the scientific record. Not very surprising, is it?

So, supposedly, the good news is that there are new publication rules in the works that are aimed at keeping out bad science that is manufactured for profit. The journals will seek assurances that the researchers whose names are on the medical reports actually had the freedom to analyze, interpret and report the data as they saw fit.

Why am I not excited by this push to make right? Well, the problem is that many medical journals do not even bother to stay true to their guidelines on disclosing financial conflicts. A recent Yale University survey suggests some journals do not adequately comply with this policy.

Also, according to the September 22 edition of the British Medical Journal, “…medical journals continue to be full of serious methodological errors, meaning that many studies reach false conclusions. The problem was identified many years ago, and yet there have been few improvements.”

For the patient who trusts a doctor, who, in turn, trusts the medical journal, this is not very encouraging news.

What is needed is a wholesale archeological dig into how journals perform their editorial functions. Some of the problems smell so bad that they begin to border on the criminal. Who is accountable? The publishers? The editors?

One major obstacle in the way of reform is the medical press. Routinely, medical reporting in the newspapers and on television involves ripping off medical journal press releases. There are relatively few medical reporters with the knowledge to probe the studies themselves. There is also far too little enterprise reporting that targets the process of delivering medical news to the medical profession and the public.

What’s it going to take to turn this medical fantasy world around?

Friday, September 28, 2001

TRACKING “EVIL”…OR “EVIL” TRACKING?

What next in the aftermath of the savage attacks of September 11? We worry about germ and chemical warfare, about getting on a plane and getting through the work day unscathed. And some of us are also concerned that the fight against terrorism will result in the erosion of some of our basic civil liberties, including free speech and privacy. In extraordinary times, beware the bigot, bully and the opportunist.

There is a lot of talk these days about crushing evil. That’s understandable, given the magnitude of the tragedies and the persistent threat of new terrorist attacks. But I wish people didn’t throw the term “evil” around loosely, especially these days, and particularly if they are apparently trying to stir up interest in a new high-tech product.

I was scanning the September 22 issue of New Scientist, and I came across a feature on the numerous new high-tech toys in the pipeline that will make it much easier to identify and track people. Everything from smart camera systems that can track specific individuals from one camera to another, to a variety of recognition systems, including those based on iris patterns, that can identify people. But the dilly of them all is the microchip that could be implanted under the skin. Under your skin and mine. It would be a way of keeping tabs on us, via wireless communications, both short-range and global.

The good news is that such a microchip “tag” could help make it possible to identify and track people who are lost, such as those with Alzheimer’s who go wandering and kids who go missing. But Keith Bolton, chief technology officer at Florida-based Applied Digital Solutions, told New Scientist after the terrorist attacks that, “Now there’s more of a need to monitor evil activities.” The company had previously decided not to develop the implantable form of the microchip, both for financial and ethical reasons, but went ahead with only a wearable watch-like version of the microchip product that, according to its press releases, will soon be launched. But now, in this new era of fear and calls to action, presumably those individuals suspected of being terrorists could one day be forced to have microchips implanted. Or, because microchips can be so tiny – about the size of a grain of rice - they could potentially be implanted by syringe surreptitiously. So what are the chances that this technology will be abused? What do you think? I suggest this is a RED FLAG if you care about civil liberties.

I was curious about the financial status of Applied Digital Solutions and so I checked it out. Not good. On September 11, the company said it would cut 300 jobs in the United States, Canada and Europe. Its operating expenses needed to be trimmed by more than $10 million. It also faces possible delisting by the Nasdaq if its stock does not climb back to $1 by October 10. But it trucks on, predicting its stock will rebound, and it places a lot of hope on its wearable microchip product. Its stock closed at 16 cents on Thursday. But should a series of devastating events make the implantable microchip appealing to governments and more acceptable to the public, I would imagine that Applied Digital Solutions and other companies with similar products may have one ring-ding of a market to exploit. On the other hand, there might be some legal hurdles.

It is possible that talk in the U.S. of a mandatory national identity card may one day give way to legislation making it mandatory to have a microchip implanted. It could be argued that mass implantation could result in an effective and foolproof identification program and that it is crucial to the common good. The legal issues would center on personal liberty and privacy. Mandatory implantation, after all, would be an invasion of the body and a permanent one at that. The body’s integrity would be at stake. Courts would have to determine the importance of such long-term intrusion and weigh that against individual rights.

Thursday, September 27, 2001

NEGLECTED THREAT

A short trip by car today from Canada to the U.S. gave me the opportunity to wind down a little. I’ve been really wired since the terrorist attacks of September 11 and everyone I know at ABC News in New York and Washington, D.C. and friends everywhere are tense. So this week, I filed my regular column ("Second Opinion") for ABCNEWS.com on the likelihood that chronic stress might make some people more vulnerable to illness. There is scientific evidence that chronic stress can shut down to some degree many of the immune system’s vital components. This raises a RED FLAG: the higher risk of becoming ill, and that includes being more vulnerable to infection. I made the point in the column that we tend to focus most of our attention on the psychological and emotional beatings we endure in times of crisis. Relatively little attention is paid by the public health system to the impact of chronic stress on our biology.

Which brings me to a related RED FLAG: the threat of a very much neglected virus known as Human Herpes Virus 6 (HHV-6) which can potentially damage, if not destroy the immune system, particularly if immunity has already been compromised.

By the time I reached my destination today, I had thought much more about the ways chronic stress might affect the body. I should tell you that I spent many years researching and finally writing THE VIRUS WITHIN (See “Books” section), a volume on the scientific unraveling of HHV-6’s ability to inflict damage. This old member of the herpes virus family has been strongly implicated as an important role-player in AIDS, multiple sclerosis, chronic fatigue syndrome, childhood brain and blood disorders and some cancers.

The essential point here is that active HHV-6 infection has been shown in people who have suffered some immune damage. For instance, people on immunosuppressive drugs after undergoing transplantation surgery, those receiving chemotherapy, and people with the immune deficiency known as AIDS.

And speaking of AIDS, HHV-6 has the ability to infect human white blood cells, known as T-lymphocytes, the same key targets claimed for HIV.

HHV-6 is also known to attack the nervous system. It can infect and destroy myelin- producing cells. Myelin is the coating that protects nerves. This is why active HHV-6 infection in patients with multiple sclerosis, a disease of destroyed myelin, is raising scientific concerns.

I too am concerned about HHV-6. This is not a virus that has been on the public health radar, even though evidence has been mounting steadily since 1986 (when it was first identified), that it can cause harm and even death in just a matter of days.

Most us have been infected with HHV-6B, one form of the virus that is typically transmitted from mother to child. This form can cause flu-like symptoms and has been strongly linked in children to blood disorders and seizures and even massive destruction of vital organs. But mostly, HHV-6 infects the body without causing apparent symptoms and becomes dormant. It lies quietly within but it can reawaken, become active and start replicating. So apparently does its cousin, a form known as HHV-6A, which can be contracted in late childhood or adulthood. To date, we know very little about how it is transmitted.

In fact, we still do not know the degree of chronic stress or immune damage it takes to trigger the reawakening process of either form of HHV-6.

So let’s consider this a wake-up call.

DO YOU REALLY NEED VIAGRA?

Did you know that a tumor of the pituitary gland, a pea-sized structure at the base of the brain, can affect the sex-drive? That’s because the tumor can lead to an over-production of the hormone, prolactin. The pituitary, the most important of the endocrine glands, regulates the secretion of the body’s hormones.

Why should the army of people who take Viagra make note of this? Maybe because research in this area is revealing that one in five adults has a (non-cancerous) pituitary tumor. Yes, ONE IN FIVE. At least one third of those tumors are causing significant health problems. Other than sexual dysfunction, they include infertility, growth retardation, diabetes, heart disease, irregular menstrual cycles, depression and insomnia.

The RED FLAG here is that many people are living with an undiagnosed hidden danger. The irony is that the condition is easily treated, either with medication or by the extraction of the tumor via the patient’s sinus passage without too much fuss. Dr. Shereen Ezzat of Mt.Sinai Hospital in Toronto, who is helping to spearhead this new research, also advises that detecting tumors might include tests for elevated hormone levels, which, by the way, are rarely done.

Back to sex. Ezzat says, “It makes one wonder just how often people out there with sexual dysfunction are wondering whether it’s the result of aging, stress, weight, some other environmental factors, when, in fact, there may be an important contribution from hormones."

And maybe a blood test might be a good idea before deciding to ask your doctor for a pill.

Wednesday, September 26, 2001

Human Brain, Culture, Suicidal Terrorism

These troubled times are perhaps more volatile than what we may be willing to imagine. In fact, one way to hide from terror is to assume it is possible to destroy it primarily with guns and missiles mixed in with some astute diplomacy.

I note that columnist William Safire of the New York Times thinks (September 17th) that one powerful weapon of radical Islam “is its ability to erase from the brains of recruits the basic will to live.” He goes on to state that, “The normal survival instinct is replaced with a pseudo-religious fantasy of a killer’s self-martyrdom leading to eternity in paradise surrounded by adoring virgins. This perversion of one of the world’s great faiths produces suicide bombers.”

Well, Safire’s take is somewhat incomplete. He doesn’t consider the potential power of the human brain to set the crucial stage for the cultural programming that directs someone to kill in the name of God. But this is not surprising. There is a widespread and irritating tendency to offer psychological explanations for events and to turn a blind eye to explanations that touch deeper roots in human biology.

There is another – and darker- way to look at the making of some suicidal terrorists. Michael Persinger’s way and it deserves our attention. He is a brain scientist and director of the Behavioral Neuroscience Laboratory at Laurentian University in Sudbury, Ontario. And, yes, he’s been very controversial, although, of late, other brain scientists have been following in his footsteps.

Persinger suggests there is a basic formula for spitting out a suicidal terrorist, one which is unfortunately being ignored by specialists in terrorist activity and the news media. That formula requires powerful religious experience, involving visions and emotions such as being in the presence of God or communicating with God, specific interpretation of that experience, and the strong verification and encouragement of those experiences by group members.

The result of these profound religious experiences and the follow-through of group support in a particular social or political context may result in the inclination to kill in God’s name.“ A person could end up feeling that he’s been specially chosen with the directive to kill,” Persinger says.

Now here’s the point that people really do not like to consider one bit: Violent terrorism in the name of God can potentially emerge wherever the formula can be successfully applied.

“I think we continue to underestimate the power of this potential because all it really takes is a singular event to change the world,” meaning, of course, that this event could be achieved by anyone who meets the criteria of the formula.

In his lab, Persinger has been conducting experiments with both healthy men and women and those who have experienced brain trauma. He has evidence from more than 600 subjects that he can turn on mystical experiences by stimulating regions of the brain electromagnetically.

The subject sits blindfolded on a comfortable chair in a sound-proof chamber. He or she wears a helmet outfitted with electrodes. The lights are turned off and the door is closed.

For about 20 minutes, selected portions of the subject’s brain receive irregular pulses of an electromagnetic field controlled by computer.

Some individuals get such a strong sense of a “presence” in the room and they even feel their bodies being grabbed or manipulated.

For Persinger, mystical encounters, are the “kernels around which religious beliefs and convictions have emerged.”

His work in this terrain focuses on electrical activity in the brain and the nature of seizures. Studies, for example, have shown that structures strongly associated with the regulation of emotional life, such as the limbic system’s amygdala, are highly unstable electrically.

Studies have also shown that, when the amygdala and the hippocampal region of the brain are stimulated in humans during surgery, patients report perceptions of strange beings and mystical encounters.

Persinger’s work suggests that subtle forms of microseizures in the right or left temporal lobe of the brain – neuron firings imperceptible to the individual – cause a brief disturbance in the normal processing of information in the brain.

This disturbance changes the way information flows from one brain hemisphere to the other. Normally, the two hemispheres are prevented from interferring and competing with each other by neurons in the cortex that send information across the band of fibers of the corpus callosum.

Persinger proposes that a microseizure temporarily disables this safety feature. When this occurs, a person’s sense of self, which emerges largely from language functions regulated by the brain’s left hemisphere, is suddenly altered. The right hemisphere’s sense of self briefly intrudes on the left side and creates an altered state or the feeling of another “self” or “presence,” including a vision of God.

It’s noteworthy that most people with brain injuries showing signs of microseizures who had suffered damage to the corpus callosum reported otherworldly experiences. One patient, for example, reported a God-like presence sitting by the left side of her body on most nights before she fell asleep.

According to Persinger, microseizures can be triggered by a wide range of events, including prolonged anxiety, emotional arousal, fasting, and various forms of stress.

Back in a 1983 scientific paper, Persinger had asked: Could the emotional residue of a microseizure (of the type he has been studying) “drive a person to kill with the conviction of cosmic consent?”

He now believes on the basis of his ongoing work that the answer is “yes,” when certain highly vulnerable individuals are strongly supported and motivated by their groups.

“What I think we’re dealing with when we consider suicidal terrorism is a situation in which an individual draws very little competition to his view of reality, particularly given the type of training a terrorist can receive.”

The reward to those who have become killers in the name of God is a future paradise. “This reward may be a powerful incentive to those who live in poverty and see little gain from their daily lives.”

In recent years, Persinger, who once charted this controversial scientific course mostly on his own, now sees other scientists targeting certain regions of the brain as being involved in the God experience.

For instance, Neuroscientist Andrew Newberg at the University of Pennsylvania, is mapping the brain for areas which are associated with religious feelings of “oneness.”

And scientists at the University of California at San Diego have been conducting research on the temporal lobes, long-considered the key areas for religious experiences.

The fancy term these days for this type of study is “neuro-theology.”

But what it all boils down to is this: The initiating experience which can potentially take someone on the road to violent terrorism appears to be part of the fundamental wiring of the human brain.

In other words, the potential to change the world begins from within and can be aroused, interpreted in certain ways and reinforced by culture to unleash terror and tragedy, particularly if the reinforcement is built upon hatred and despair.

Yes, guns and missiles might wreak havoc on some terrorist networks that otherwise might grow like weeds.

And yes, it is vital to try to stop the spread of fear and tragedy.

But things are not always as pat as some people would have us believe.

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