Research suggests that Vitamin D might help build bones, strengthen the immune system, and fight off heart disease, cancer, hypertension, kidney disease, and diabetes. It’s a nutrient that the body makes from sunlight and that is also found in fish and fortified milk. But thanks to skin cancer awareness programs, sunscreens, and poor diets (and likely many other reasons), as many as half of all adults and children are said to have less than optimum levels and as many as 10 percent of children are highly deficient, according to a 2008 report in The American Journal of Clinical Nutrition.

Like a number of my colleagues, I have begun testing Vitamin D levels more frequently. But this is where the confusion begins. There is controversy about what the best blood level of Vitamin D is, as well as what level constitutes a deficiency worthy of treatment. In general, people are considered to be deficient if they have blood levels below 15 or 20 nanograms per milliliter. But many doctors now believe vitamin D levels should be above 30. The ideal level isn’t known, nor is it known at what point a person is getting too much vitamin D, which can lead to kidney stones, calcification in blood vessels and other problems.

People’s vitamin D levels are influenced by the color of their skin, where they live, how much time they spend outdoors and by fish and milk consumption. To raise vitamin D without supplements, you can increase sun exposure for 10 to 15 minutes a day. Eating more fish can help — a 3.5-ounce serving of wild fresh salmon has 600 to 1,000 I.U.’s of vitamin D — but it would take a quart of milk a day to get the recommended dose of vitamin D.

Personally, I’m not taking vitamin D supplements yet. Science needs to catch up with the hype. Although numerous studies have been promising, there are scant data from randomized clinical trials. Little is known about what the ideal level of vitamin D really is, whether raising it can improve health, and what potential side effects are caused by high doses. The data is mostly from observational research, so it may be that high doses of the nutrient don’t really make people healthier, but that healthy people simply do the sorts of things that happen to raise vitamin D.

There is now a major study over the next five years that should provide answers to these questions and more. The nationwide clinical trial is recruiting 20,000 older adults, including men 60 and older and women 65 and older, to study whether high doses of vitamin D and omega-3 fatty acids from fish-oil supplements will lower risk for heart disease and cancer. (If you qualify, consider taking part in the study at www.vitalstudy.org)

In the meantime, I think it’s best to continue checking levels more frequently than we have in the past, eat more fish, and get some outdoor exercise.

…with John Cleese

–from the NIH Images in Medicine Library.

Just a quick, and remarkable, graph:

They work.

(from the National Library of Medicine Images From the History of Medicine gallery)

The United States spends more on medical care per person than any country, yet life expectancy is shorter than in most other developed nations and many developing ones. Lack of health insurance is a factor in life span and contributes to an estimated 45,000 deaths a year. Why the high cost? The U.S. has a fee-for-service system—paying medical providers piecemeal for appointments, surgery, and the like. That can lead to unneeded treatment that doesn’t reliably improve a patient’s health. Says Gerard Anderson, a professor at Johns Hopkins Bloomberg School of Public Health who studies health insurance worldwide, “More care does not necessarily mean better care.” —Michelle Andrews

(from National Geographic’s Blog Central)

The most amazing thing about the H1N1 flu vaccine manufacturing process is that it takes 1,200,000,000 chicken eggs required to make the 3 billion doses of vaccine that will be required worldwide. There are entire chicken farms in the US and around the world dedicated to producing eggs for the purpose of incubating influenza viruses for use in vaccines. No wonder it takes six months from start to finish. But we’ll get to that in a minute.

The most commonly used process for manufacturing an influenza vaccine was developed in the 1940s — one of its co-inventors was Jonas Salk, who would go on to develop the polio vaccine — and has remained basically unchanged since then. The process is coordinated by the World Health Organization and begins with the detection of a new virus (or rather one that differs significantly from those already going around); in this instance, the Pandemic H1N1/09 virus. Once the pandemic strain has been identified and isolated, it is mixed with a standard laboratory virus through a technique called genetic reassortment, the purpose of which is to create a hybrid virus (also called the “reference virus strain”) with the pandemic strain’s surface antigens and the lab strain’s core components (which allows the virus to grow really well in chicken eggs). Then the hybrid is tested to make sure that it grows well, is safe, and produces the proper antigen response. This takes about six to nine weeks.

An antigen is any substance that causes your immune system to produce antibodies against it. An antigen may be a foreign substance from the environment such as chemicals, bacteria, viruses, or pollen. An antigen may also be formed within the body, as with bacterial toxins or tissue cells. So, when the H1N1 vaccine gets inside your body, the pandemic strain’s surface antigens will produce antibodies against it.

At roughly the same time, a parallel effort to produce what are referred to as reference reagents is undertaken. The deliverable here is a standardized kit provided to vaccine manufacturers so that they can test how much virus they are making and how effective it is. This process serves to standardize vaccine doses across manufacturers and takes four months to complete. WHO notes that this part of the process is “often a bottleneck to the overall time-line for manufacturers to generate the vaccine”.

Once the reference virus strain is produced, it is sent to pharmaceutical companies (Novartis, Sanofi Pasteur, etc.) for large-scale production of the vaccine. The companies fine-tune the virus to increase yields and produce seed virus banks that will be used in the bulk production.

And this is where the 1.2 billion chicken eggs come in. A portion of the seed virus is injected into each 9- to 12-day old fertilized egg. The virus incubates in the egg white for two to three days and is then separated from the egg.

For the shot vaccine, the virus is sterilized so that it won’t make anyone sick. It’s got the pandemic virus antigens that make your body produce the antibodies to fight the virus but the virus is inactive so it won’t make you ill. For the nasal spray vaccine, the virus is left alive and attenuated to survive only in the nose and not the warmer lungs; it’ll infect you enough to produce antibodies but not enough to make you sick. Either way, the surface antigens are separated out and purified to produce the active ingredient in the vaccine. Each batch of antigen takes about two weeks to produce. With enough laboratory space and chicken eggs, the companies can crank out an infinite amount of purified antigens, but those resources are limited in practice.

You may have heard that the H1N1 vaccine has been difficult to find in some places. The vaccine manufacturers have said that the Pandemic H1N1/09 virus when combined with the standard laboratory virus does not grow as fast in the eggs as they anticipated. The batches of antigens from each egg have been smaller than expected, up to five or even ten times smaller in some cases. Hence the slow rollout of the vaccine.

The purified antigen is then tested against the aforementioned reference reagents once they are ready. The antigen is diluted to the required concentration and placed into properly labelled vials or syringes. Further testing is performed to make sure the vaccine won’t make anyone ill, to confirm the correct concentration, and for general safety. At this point clinical testing in humans is required in western Europe but not in the United States. Finally, each company’s vaccine has to be approved by the appropriate regulatory body in each country — that’s the FDA in the case of the US — and then the vaccine is distributed to medical facilities around the country.

Sources and more information: WHO, WHO, WHO, WHO, CDC, Time, Washington Post, The Big Picture, Influenza Report, kottke, and 60 Minutes.

Amy Wallace’s Wired feature, “An Epidemic of Fear: How Panicked Parents Skipping Shots Endangers Us All” looks at the life and times of Paul Offit, vaccine inventor and advocate, and the anti-vaccine pseudo-science he battles as he attempts to convince parents not to give in to fear and disinformation, and to follow the science that will keep their kids safe.

At this year’s Autism One conference in Chicago, I flashed more than once on Carl Sagan’s idea of the power of an “unsatisfied medical need.” Because a massive research effort has yet to reveal the precise causes of autism, pseudo-science has stepped aggressively into the void. In the hallways of the Westin O’Hare hotel, helpful salespeople strove to catch my eye as I walked past a long line of booths pitching everything from vitamins and supplements to gluten-free cookies (some believe a gluten-free diet alleviates the symptoms of autism), hyperbaric chambers, and neuro-feedback machines.

To a one, the speakers told parents not to despair. Vitamin D would help, said one doctor and supplement salesman who projected the equation “No vaccines + more vitamin d = no autism” onto a huge screen during his presentation. (If only it were that simple.) Others talked of the powers of enzymes, enemas, infrared saunas, glutathione drips, chelation therapy (the controversial — and risky — administration of certain chemicals that leech metals from the body), and Lupron (a medicine that shuts down testosterone synthesis).

Offit calls this stuff, much of which is unproven, ineffectual, or downright dangerous, “a cottage industry of false hope.” He didn’t attend the Autism One conference, though his name was frequently invoked. A California woman with an 11-year-old autistic son told me, aghast, that she’d personally heard Offit say you could safely give a child 10,000 vaccines (in fact, the number he came up with was 100,000 — more on that later). A mom from Arizona, who introduced me to her 10-year-old “recovered” autistic son — a bright, blue-eyed, towheaded boy who hit his head on walls, she said, before he started getting B-12 injections — told me that she’d read Offit had made $50 million from the RotaTeq vaccine. In her view, he was in the pocket of Big Pharma.

An Epidemic of Fear: How Panicked Parents Skipping Shots Endangers Us All

On October 26th, 1977, a hospital cook in Somalia named Ali Maow Maalin was diagnosed with smallpox. What makes this so remarkable is that no naturally-occurring cases of smallpox have been diagnosed in the 32 years since.

The global eradication of smallpox was certified, based on intense verification activities in countries, by a commission of eminent scientists on 9 December 1979 and subsequently endorsed by the World Health Assembly on 8 May 1980[10][48] as Resolution WHA33.3. The first two sentences of the resolution read: “Having considered the development and results of the global program on smallpox eradication initiated by WHO in 1958 and intensified since 1967 … Declares solemnly that the world and its peoples have won freedom from smallpox, which was a most devastating disease sweeping in epidemic form through many countries since earliest time, leaving death, blindness and disfigurement in its wake and which only a decade ago was rampant in Africa, Asia and South America.”

Smallpox once killed millions of people every year, and may have been responsible for up to 500 million deaths in the 20th century. National vaccination programs began in the early 1800s, but it was a global push by the World Health Organization begun in 1958 that finally led to the eradication of the disease worldwide.

Link -via Bad Astronomy Blog