Thursday, April 30, 2009

containment not economically feasible...,


NYTimes | “Containment is no longer a feasible option,” Dr. Keiji Fukuda, deputy director general of the World Health Organization, announced Monday night in Geneva after a meeting of the agency’s emergency committee on the spreading swine flu virus. “The world should focus on mitigation. We recommend not closing borders or restricting travel.”

Many countries are still ignoring that advice. The globe is a confusing welter of bans, advisories and alerts on some pork and some people.

On Wednesday, Homeland Security Secretary Janet Napolitano was heavily pressed in Congressional hearings to ignore the advice and close the border with Mexico. She defended her decision not to do so, saying it “would be a very, very heavy cost for what epidemiologists tell us would be marginal benefit.”

President Obama defended it too, telling a reporter that it would be “akin to closing the barn door after the horse is out.”

Experts on the global movement of flu say Dr. Fukuda, Ms. Napolitano and Mr. Obama are right. The world, they say, must bow to the inevitable: closing borders would not only fail to stop the virus, but would also cause economic collapse and possibly add to the death rate.

“But it’s wrong to think we’re throwing up our hands and saying ‘Let ’er rip and let’s hope for the best,’ ” said Dr. Martin S. Cetron, director of global migration and quarantine for the Centers for Disease Control and Prevention in Atlanta. “This has all been in the national pandemic flu plan since 2007.”

Closing borders is dangerous because many goods needed in a pandemic are made abroad, said Dr. Michael T. Osterholm, director of the Center for Infectious Disease Research and Policy at the University of Minnesota, including most masks, gowns and gloves, electrical circuits for ventilators and communications gear, and pharmaceutical drugs and the raw materials to make them. (For example, most suppliers of shikimic acid, the base ingredient in the antiviral drug Tamiflu, are in China.)

“You cut those off and you cripple the health care system,” he said. “Our global just-in-time economy means we are dependent on others.” Much of our food is from overseas. “A Kellogg’s Nutri-Grain bar has ingredients from nine countries in it,” he noted.

The fallback position, experts said, is mitigation, the use of “nonpharmaceutical measures.” They include personal ones like washing hands and wearing a mask, occupational ones like working from home or arranging care for children who are sick or whose schools close, neighborhood-level ones like closing theaters, museums or restaurants, and metropolitan-wide ones like shutting a school system or canceling a major league ballgame.

mapmaker discusses the spread thus far...,

from phase 4 to phase 5

WaPo | The World Health Organization took the unprecedented step yesterday of warning that the world is probably on the verge of a pandemic, as new cases of swine flu mounted, the first death was reported in the United States and the dangerous virus appeared to arrive just outside the nation's capital.

The WHO's action came after the agency convened an unusual "global virtual science meeting" involving several hundred experts and officials to help assess the situation. The agency raised the alert from "phase 4" to "phase 5" two days after elevating it for the first time because the never-before-seen virus was spreading in Mexico.

Saying influenza viruses are "notorious for their rapid mutation and their unpredictable behavior," WHO Director General Margaret Chan told reporters: "This is an opportunity for global solidarity as we look for responses and solutions that benefit all countries, all of humanity. After all, it really is all of humanity that is under threat during a pandemic."

The new alert level could prompt a variety of measures, including more intensive efforts to identify cases and stricter measures to prevent the illness's spread, such as discouraging or banning public gatherings.

With the virus now clearly being transmitted person-to-person in the United States, WHO officials said the outbreak appeared to be on a trajectory toward the highest alert level -- "phase 6" -- which is marked by sustained transmission in at least two regions of the world. That would mark the beginning of a pandemic -- a global spread of the virus.

"It's clear the virus is spreading, and we don't see any evidence of this slowing down at this point," said Keiji Fukuda, the WHO's interim assistant director general for health security and environment.

While there is a chance that the epidemic could stop on its own, officials said that such an outcome is impossible to predict and that governments around the world should plan for the worst.

"There may be a possibility that the virus will die out and stop, and that would be the best for us. But it can turn the other way. So the important point for us is to continue to maintain our vigilance and track its movement," Chan said. "Influenza pandemics must be taken seriously precisely because of their capacity to spread rapidly to every country in the world."

call 1 800 CDC - INFO



This podcast, intended for the general public, demonstrates how to put on and take off disposable respirators that are to be used in areas affected by the influenza outbreak.

centers for disease control on youtube


In this video, Dr. Joe Bresee with the CDC Influenza Division describes swine flu - its signs and symptoms, how it's transmitted, medicines to treat it, steps people can take to protect themselves from it, and what people should do if they become ill.

Wednesday, April 29, 2009

flu may have spread within new york city

NYTimes | The swine flu outbreak in New York may have spread beyond one school in Queens — where victims now are estimated to number in the hundreds — to pockets across the city, including at least two other schools, officials said on Tuesday.

At Public School 177, a school for autistic children in Fresh Meadows, Queens, 12 students had fever or other symptoms that could indicate swine flu. The school, at 56-37 188th Street, which was closed as a precaution, is about half a mile from St. Francis Preparatory School, at 61-00 Francis Lewis Boulevard, where the first cases were detected several days ago. Tests of students there have not been completed.

About half a dozen children at Ascension School, a Roman Catholic school on 108th Street near Broadway in Manhattan, have come down with fever. That school was not closed, but health officials will test students for swine flu on Wednesday.

Mayor Michael R. Bloomberg said at a news conference that two people had been hospitalized with suspected swine flu — a young boy just admitted to a hospital in the Bronx, and a woman treated on Sunday at a hospital in Brooklyn. Both had family members who had traveled to Mexico, he said.

There were also unconfirmed reports of cases at Ernst and Young, an accounting firm in Times Square, and at Teachers College at Columbia University.

Though the symptoms of the virus in the New York cases have been mild so far, Mr. Bloomberg and Dr. Thomas R. Frieden, the city health commissioner, raised the possibility for the first time on Tuesday that people in the United States could die from the spreading outbreak, even as they urged New Yorkers to keep calm.

“It is here, and it is spreading,” Dr. Frieden said.

The big puzzle, Dr. Frieden said, is why the symptoms of those who have fallen ill so far in New York are mild, and whether the virus will just fizzle or get worse over time, becoming more like the outbreak in Mexico.

like you'd take it anyway....,

NYTimes | Federal officials said it would take until January, or late November at the earliest, to make enough vaccine to protect all Americans from a possible epidemic of swine flu.

And beyond the United States and a few other countries that also make vaccines, some experts said it could take years to produce enough swine flu vaccine to satisfy global demand.

Although production is much faster than would have been possible even a few years ago, it still may not be in time to avert death and illness if the virus starts spreading widely and becomes more virulent, some experts said.

In this country, the biggest problem is that despite years of effort, the country is still relying on half-century-old technology to make the flu vaccines.

Federal authorities have spent years and more than a billion dollars trying to shift vaccine production to a faster, more reliable method — one that involves growing the vaccine viruses in vats of cells rather than in hen’s eggs, the old technology. And there are numerous small companies developing totally new approaches that might allow for the production of huge volumes of vaccines in a matter of weeks.

But the cell-based production is not quite ready, and some of the newer techniques are not proven enough to satisfy many experts.

“Those are all great technologies, but it isn’t going to happen in time,” said Dr. Greg Poland, head of the vaccine research program at the Mayo Clinic.

when can the government quarantine its citizens?

Slate | When someone has been exposed to diphtheria, infectious tuberculosis, yellow fever, viral hemorrhagic fevers, SARS, and a new strain of influenza with pandemic potential. That's the federal government's list, which changes only by executive order; states may have their own. Patients who have actually been infected, like the Atlanta man [Andrew Speaker], are technically under "isolation," not quarantine.

The federal government took responsibility for isolating Speaker because his plane travel made his case an interstate and international health threat. Normally, the states have primary responsibility for quarantine and isolation. Some state laws specify which illnesses require quarantine, while others focus on public-health threats in general. In Louisiana, health officials need permission from a judge before confining a patient. Any people in Minnesota who lose their jobs because of a quarantine or isolation can sue their employers.

States have been broadening their public-health powers in recent years because of bioterrorism and pandemic fears. Sometimes a state will amend its laws to deal with a specific crisis. For instance, Alaska had to pass an amendment during the SARS scare to be able to quarantine and investigate a docked ship.

In certain states, disobeying a quarantine or isolation order can put you behind bars. A 27-year-old man in Arizona diagnosed with the same deadly strain of [tuberculosis] has been quarantined in a prison hospital ward for the past 10 months; state officials said they put Robert Daniels there because he failed to take his medicine and endangered others by going out and entertaining friends without wearing a mask.

But in general, the government rarely has to exercise these powers, because most of the time, citizens cooperate. In fact, until this recent situation, the CDC hadn't issued such an order since 1963, when it quarantined a woman for smallpox exposure.* Even during the SARS epidemic in 2003, officials relied mostly on voluntary isolation and quarantine. And the last large-scale quarantine in the United States took place during the Spanish flu epidemic of 1918-19.

Bonus Explainer: What happens in isolation? A patient often lives in a room with negative air pressure to prevent disease from spreading; an ultraviolet light may kill potential pathogens as they're sucked through a HEPA filter. Visitors must wear masks or, in some cases, sterile full-body suits.

authorities study differences in flu's severity

WaPo | Health authorities raced yesterday to unravel the many mysteries about the ominous new swine flu spreading around the world, including how widely the virus might cause the severe form of illness that so far has been restricted to the epicenter of the outbreak in Mexico.

As the number of confirmed infections in the United States jumped again and cases were confirmed for the first time in Britain, New Zealand and Israel, researchers searched for clues as to how readily the virus causes the pneumonia that has hospitalized and killed patients in Mexico. Only a handful of patients in the United States and elsewhere outside Mexico have been hospitalized, severe complications have been relatively rare, and no one has died.

"We still do not have a good explanation for why the pattern of cases in other countries appear relatively mild while the pattern of cases in Mexico appear to be much more severe," said Keiji Fukuda of the World Health Organization. "This will be the object of a great deal of research and attention, but at this time, we can't say why there appears to be a difference."

Experts said there are several possibilities: Victims in Mexico may be more vulnerable because of nutritional deficiencies, other infections or some other factor; medical care may be better in the United States and elsewhere; the virus could be weakening as it spreads; or too few cases may have occurred outside Mexico for severe illnesses to emerge.

"This is the mystery," said Arnold Monto, an influenza expert at the University of Michigan. "You could speculate about so many things. It's an incredibly important question."

little boy at the center of a viral storm

WaPo | One person who may have helped launch a rapidly spreading flu outbreak likes to draw hearts and flowers in the dirt outside his home. He likes to climb trees and give hugs and play with his soccer ball. And despite a persistent cough, he does not, he insists, feel sick.

"Not anymore," said Édgar Enrique Hernández, a smiling 5-year-old Mexican boy who tested positive for the deadly new strain of swine flu in this windswept valley surrounded by pig-breeding farms. "I feel good."

Although authorities have not determined that swine flu started in La Gloria, a village of about 2,500 people in the state of Veracruz, Édgar, who got sick in late March, is the earliest confirmed case of the virus in Mexico. He was just one of several hundred people from La Gloria and surrounding areas that fell ill around that time in an unexplained outbreak that left two children dead and prompted authorities to fumigate the entire village.

"I don't have words, I don't have answers," said Édgar's mother, María del Carmen Hernández, as she cried under a portrait of Jesus in her living room. "I feel terrible about all of this, because the people are thinking that this was all my son's fault. I don't think this is anyone's fault."

This dust-strewn hamlet of dirt streets surrounded by desert cactus and scrub brush has become a focus of attention for the spread of the virus because of the prevalence of pig farms in the area, and because of Édgar. But the link is far from certain, and infectious-disease specialists stressed that no one has located a pig infected with this particular virus, so proximity between people and pigs may not be all that's required to contract the disease. The strain appears, in fact, to be Eurasian in origin, further adding to the mystery of where it began.

folk medicines and herbs to use and avoid with flu

Health Gazette | Below is a list of foods that are said to contain substances that are natural antivirals, immune boosters or they decrease cytokines TNF-a and IL-6.

Alternative medications that are most likely to help us during a severe pandemic:

Garlic (allicin) - Very effective antiviral. Best if fresh (raw) and crushed. Must be consumed within 1 hour of crushing. Dosage is initially 2 to 3 cloves per day but later reduce until no body odour occurs. No toxic effects noted. (Pubmed PMID 9049657)

Vitamin C - Boosts the immune system and is an antiviral by blocking the enzyme neuraminadase. Viruses need neuraminadase to reproduce. There are anecdotal stories of people taking large amounts of Vitamin C (children ½) surviving the Spanish Flu. Research shows that it may reduce the production of cytokines TNF-a and IL-6. A study on 470 people involved giving the test group 1000 mg hourly for 6 hours and then 1000 mg 3 times daily after reporting flu symptoms. Symptoms decreased by 85%. (Pubmed PMID 10543583, 634178, 16169205, 12876306)

Green Tea (possible Tamiflu/Relenza alternative)- Very effective antiviral. Also decreases the production of the cytokine (catechins) TNF-a. Inhibits neuraminidase. May have antiviral activity that is equal to other antivirals such as Tamiflu. (Pubmed PMID 16137775)

St Johns Wort (Hypericum) - Very effective antiviral. Also decreases the production of the cytokine IL-6. Hypericum is an extract from St John’s Wort. There have been some very successful field trials in commercial flocks infected with H5N1 in Vietnam. (Pubmed PMID 7857513, 11518071, 11362353, 7857513, 11518071)

Vitamin E - Immune booster. Also decreases the production of the cytokine TNF-a. (Pubmed PMID 155882360, 10929076) Experiments involved using mice. Very suitable for immune compromised people, especially the elderly. Effects enhanced when taken with Vitamin C.

Apple Juice - Antiviral. Fresh apple juice including the pulp and skin has greater antiviral activity than heated commercial apple juice. More research is needed. Effectiveness on H5N1 is unknown. (Pubmed PMID 32832, 12452634)

Resveratrol - Antiviral. In addition to inhibiting neuraminidase, Resveratrol also sends a message to cells to stop manufacturing viruses. This is a proven antiviral found naturally in red wine, peanuts, mulberries, Japanese Knotwood root (richest source), raisins and red grapes. Resveratrol supplements are relatively inexpensive, are more stable than wine and is available in liquid form for absorption in the mouth. No toxic effects noted. (Pubmed PMID 1583880, 12817628, 15985724)

Scuttellaria (Skullcap) - Antiviral. A herb used as a tea. It has no side effects and is also a mild tranquilliser. Research suggests neuraminidase, which is a substance needed by the H5N1 virus to reproduce, may be inhibited.

Cranberry Juice - Early research shows that it may be an antiviral, making viruses less able to invade or multiply. Effectiveness on H5N1 is unknown. (Pubmed PMID15781126)

Cat’s Claw (Uncaria tomentosa) - Decreases the production of the cytokine TNF-a. Also boosts immune system. The number of white blood cells was significantly increased during treatment. No toxicity was noted. (http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?CMD=search&DB=pubmed) Active constituents can be found in the leaves, bark, vine, and roots. Water extraction from bark used. Children and pregnant women are to avoid. Has a potentially damaging effect on the DNA of proliferating cells. (cancers, foetuses, growing children)

Curcumin (Tumeric Spice) - Decreases the production of the cytokine TNF-a. This is the yellow compound in turmeric spice. Research shows that this may be very good for preventing a cytokine storm although this is not proven. Must be taken with food or gastritis or peptic ulcers may occur. Pregnant women and feeding mothers should avoid this. The medicinal properties of curcurnin cannot be utilised when used alone due to rapid metabolism in the liver and intestinal wall. When combined with Piperine found in black pepper the absorption is increased with no adverse effects. Obtainable from health stores in tablets, liquid, capsules already combined with piperine. Dosage is 500mg to 4000mg daily.

Astragalus root (Astragali Radix) - Boosts immune system. (Pubmed PMID15588652)

Tea tree Steam Inhalation - Reduces the cytokine TNF-a. Add 2 drops of tea tree oil in a bowl of steaming water. Cover head with a towel and inhale for 5 to 10 minutes. Relieves congestion and fights infection. Its effectiveness is unknown. (Pubmed PMID 11131302)

The following substances may be best to avoid during a H5N1 pandemic

Elderberry juice (Sambucal) - AVOID - Increases production of cytokines TNF-a and IL-6. This substance is very effective against the common flu but may not be desirable for the H5N1 virus. Increases in these cytokines may trigger a lethal cytokine storm. (Isr Med Journal2002 Nov;4:944-6)

Micro Algae (Chlorella and Spirulina) - AVOID - Increases production of cytokine TNF-a. (Pubmed PMID 11731916)

Honey - AVOID - Increases production of cytokines TNF-a and IL-6. (Pubmed PMID12824009)

Chocolate - AVOID - Increases production of cytokines TNF-a and IL-6. (Pubmed PMID 12885154, PMID 10917928)

Echinacea - AVOID - Increases production of cytokines TNF-a and IL-6. Although it is often used for normal flu, research shows that it may increase the chance of cytokine storms for H5N1. (Pubmed PMID 15556647, 9568541)

Kimchi - AVOID - Increases production of cytokines TNF-a and IL-6. (Pubmed PMID15630182)

Dairy products & Bananas - AVOID - These foods increase mucous production.

Tuesday, April 28, 2009

source of the infection?

LATimes | Swine flu is suspected in at least 149 deaths and 1,995 cases, with nearly all states reporting infections. Officials look at what is thought to be the first case, near a pig farm in Veracruz.

Reporting from Mexico City — With the death toll climbing, Mexican authorities at the center of an international swine flu epidemic struggled Monday to piece together its lethal march, with attention focusing on a 4-year-old boy and a pig farm.

The boy, who survived the illness, has emerged as Mexico's earliest known case of the never-before-seen virus, Health Secretary Jose Angel Cordova said Monday. It provides an important clue to the unique strain's path.

The boy lived near a pig farm run by a U.S.-Mexican company, Granjas Carroll, in the municipality of Perote, in Veracruz state on the Gulf of Mexico. He contracted the disease on April 2, Cordova said, one of a group of residents who came down with what was at the time labeled a particularly bad case of the flu.

Only one sample from the group, that belonging to the boy, was preserved. It was retested after other cases of the new strain were confirmed elsewhere in the country, Cordova said. The boy had the same disease. It is unknown how many more of the hundreds of people who fell sick in Perote also were infected by the strain.

In an ominous disclosure, officials said the first confirmed fatality of the disease, a 39-year-old woman from an impoverished state neighboring Veracruz, worked as a door-to-door census-taker and may have had contact with scores of people.

In Perote, residents of the hamlet known as La Gloria have complained since mid-March that contamination from the pig farm was tainting their water and causing respiratory infections. In one demonstration in early April, they carried signs with pictures of pigs crossed out with an X and the word "peligro" -- danger. Residents told reporters at the time that more than half the town's 3,000 inhabitants were sick and that three children under the age of 2 had died.

Local health officials mobilized when the outbreak was first reported, but they gave a different account: The infection may have started with a migrant farmer who returned from work in the U.S. and gave the disease to his wife, who in turn passed it on to other women in the community.

(Smithfield) Granjas Carroll, which claims to be Mexico's leading pig farm at a million head a year, issued a statement Monday saying none of its employees had shown any signs of illness and noting that the sick are people who had no contact with its pigs. It is but one of numerous farms in the region.

The United Nations' Food and Agriculture Organization announced Monday that it was sending a team of experts to inspect pig farms in Mexico. The agency's chief veterinary officer, Joseph Domenech, said the teams would attempt to determine whether the new strain was circulating among pigs and then trace linkage to human populations.

The first officially confirmed fatality from the disease occurred April 13. Maria Adela Gutierrez died in the southern city of Oaxaca, capital of the state of the same name.

Gutierrez was a door-to-door census-taker for the tax board, meaning she could have had contact with scores of people at her most contagious point, before being hospitalized. But Martin Vazquez Villanueva, the regional health secretary in Oaxaca, denied local news reports that said she had infected 20 people, as well as her husband and children.

andromeda strain...,

The Scientist | As reported cases of swine flu continue to accumulate (as of today, 40 had been reported in the US) and mainstream media outlets dust off their foreboding music tracks and positively scary taglines, a biotechnology company in Maryland says that its approach may speed development of a successful vaccine.

Researchers at Novavax have been developing vaccines for the H5N1 strain of avian flu, along with other strains of influenza, over the past few years using an approach built around virus-like particles (VLP)--viral membrane proteins in a matrix of lipids. Researchers from the company, with scientists from the Centers for Disease Control and Prevention (CDC), published a study last month in which they successfully protected mice against a reconstructed virus from the 1918 Spanish flu outbreak through intranasal immunization with H1N1 VLPs.

A new strain of H1N1 is likely causing the current outbreak of swine flu in North America, which this weekend led both the World Health Organization and the CDC to declare a public health emergency.

Gregory Poland, an immunologist and head of the Vaccine Research Group at the Mayo Clinic in Minnesota, said VLPs and other novel approaches to vaccine development, for combating influenza are exciting but untested. "The issue, from the perspective of influenza, is that none of these is approved," he said. In fact, the only FDA-approved VLP-based vaccines on the market are those developed to protect women from human papillomavirus.

hurricanes, tornados and plague, OH MY!!!

The Scientist | A much-contested plan to build a $450 million government biodefense research lab has hit another snag: A group of Texas research organizations that lobbied for San Antonio to house the lab says it will sue the Department of Homeland Security (DHS) over its choice of site -- Manhattan, Kansas.

The Texas Biological and Agro-Defense Consortium earlier this week (April 22) filed a notice of its intent to sue DHS, a required step for suits against the government. They argue that the choice of Kansas for the site of the National Bio and Agro Defense Facility (NBAF), which would handle the world's most dangerous pathogens, was based on political machinations and overlooks the danger frequent tornadoes would pose to the facility.

John Kerr, chairman of the group, said that locating NBAF in Manhattan, Kan., would be "grossly irresponsible, the equivalent of playing Russian roulette with Mother Nature," according to the Associated Press.

Kerr argued that although DHS had initially ranked the Texas site slightly higher than Kansas, the agency's secretary in charge of choosing the site, Navy Admiral Jay Cohen, gave Kansas preference -- due to ties with Kansas officials involved in the process -- by making numerous visits there, the AP reports. Kansas officials deny the claim of political preference.

Kansas Bioscience Authority president Tom Thornton said in a statement: "...the Department of Homeland Security deserves commendation, not litigation, for the extremely comprehensive and fair process it undertook to ensure the success of the National Bio and Agro-Defense Facility. Only Kansas offers a credible pathway to jumpstart the NBAF's critical mission."

We earlier visited the intrinsic foolishness of situating a BSL-4 pathogen research and containment facility in the middle of hurricane alley, that goes double for tornado alley...,

Monday, April 27, 2009

"ism" and the unconscious immune system

Discover | Over the past few years, Mark Schaller, a psychologist at the University of British Columbia, has been developing an intriguing theory that behavior can be just as effective as microbiology at warding off disease. According to this theory, we have what Schaller calls a “behavioral immune system.” It’s a way of responding to the outside world, and to the people around us, that is so deeply embedded in our minds that we are hardly aware of it.

Schaller and his colleagues have been busily running psychological experiments to test his hypothesis. The results so far are preliminary but provocative. If Schaller is right, this behavioral immune system may prove to have a big influence on our day-to-day lives. It might even influence human nature on a global scale, shaping cultures around the world.

If the familiar, biological immune system were foolproof, it would be pointless to evolve a behavioral immune system too. In reality, however, our defenses are far from perfect. Some pathogens can disguise themselves well enough to go unnoticed, and others breed so fast that our immune systems cannot keep up. Then again, sometimes our immune system succeeds too well, using such overwhelming force against pathogens that it damages our own tissues in the process.

Not getting infected in the first place is a far safer alternative. Scientists have discovered a wide variety of animal species that use behavioral strategies to avoid becoming sick. Some caterpillars blast their droppings like cannons so that parasitic wasps that lay eggs in the droppings won’t be able to follow their scent. Sheep instinctively avoid grazing on grass near their own manure, advantageous because many sheep parasites release their eggs in the animals’ droppings. A female mouse can smell the difference between a healthy male and one infected with intestinal worms. She will avoid the latter and mate with the former.

Our closest living cousins, the chimpanzees, also display behavioral responses to signs of disease. When the primatologist Jane Goodall observed chimps in the 1960s, one of her subjects was a male she called McGregor, who suffered from polio. He dragged himself around by his arms after his legs became paralyzed, and his loose bladder attracted clouds of flies. Before McGregor got sick, he enjoyed hours of grooming from other chimpanzees, who picked out fleas, mites, and other parasites from his fur. But Goodall watched in amazement as the other chimpanzees stayed away from him once he became ill.

murder by injection?

Excerpted from the text:
Medical historians have finally come to the reluctant conclusion that the great flu “epidemic” of 1918 was solely attributable to the widespread use of vaccines. It was the first war in which vaccination was compulsory for all servicemen. The Boston Herald reported that forty-seven soldiers had been killed by vaccination in one month. As a result, the military hospitals were filled, not with wounded combat casual­ties, but with casualties of the vaccine. The epidemic was called “the Spanish Influenza,” a deliberately mis­leading appellation, which was intended to conceal its origin. This flu epidemic claimed twenty million victims; those who survived it were the ones who had refused the vaccine.

Ten years earlier, Eleanora I. McBean, Ph.D., N.D. had written a similar account in her book, Swine Flu Expose:

I heard that seven men dropped dead in a doctor’s office after being vaccinated. This was in an army camp, so I wrote to the Government for verification. They sent me the report of U.S. Secretary of War, Henry L. Stimson. The report not only verified the report of the seven who dropped dead from the vaccines, but it stated that there had been 63 deaths and 28,585 cases of hepatitis as a direct result of the yellow fever vaccine during only 6 months of the war. That was only one of the 14 to 25 shots given the soldiers.

When doctors had tried to suppress the symptoms of the typhoid with a stronger vaccine, it caused a worse form of typhoid which they named paratyphoid. But when they concocted a stronger and more dangerous vaccine to suppress that one, they created an even worse disease which they didn’t have a name for. What should they call it? They didn’t want to tell the people what it really was - their own Frankenstein monster which they had created with their vaccines and suppressive medicines. They wanted to direct the blame away from themselves, so they called it Spanish Influenza. It was certainly not of Spanish origin, and the Spanish people resented the implication that the world-wide scourge of that day should be blamed on them. But the name stuck and American medical doctors and vaccine makers were not suspected of the crime of this widespread devastation - the 1918 Flu Epidemic. It is only in recent years that researchers have been digging up the facts and laying the blame where it belongs.

Vaccines have dubious efficacy because the immune system is not designed to respond to injected microbes. The first line of defence is the mucosal membranes in the mouth and gut. If a microbe enters the body through injection, it triggers an antibody response but crucially, it bypasses the cellular immune system altogether and actually suppresses its function. The same microbe will become far more virulent if it is injected, hence the numerous accounts of epidemics amongst vaccinated populations in the medical literature.
This is not an endorsement of Mullins or of any of the many conspiracy-centric things he's written. In this case it just happens to be one of those topically pertinent things with a high potential to make you go hmmm....,

Sunday, April 26, 2009

flu suspected in new zealand

Voxy NZ | An Auckland school group is being tested for swine flu after returning from Mexico with flu-like symptoms.

More than 80 people in Mexico are believed to have died and over 1300 are sick as a result of catching swine flu. Cases have also been reported in New York, California and Kansas and a British Airways pilot has been hospitalised in London with flu symptoms after returning from Mexico.

Three teachers and 22 senior students at Rangitoto College, New Zealand's largest secondary school, on Auckland's North Shore, yesterday returned to Auckland on a flight from Los Angeles, after a three week trip to Mexico .

Auckland Regional Public Health Service (ARPHS) said today some had symptoms of an influenza-like illness and were remaining in home isolation as a precaution while tests to exclude or confirm swine influenza were carried out.

One student was believed to be in hospital.

Ministry of Health spokesman Michael Flyger told NZPA the results of tests were expected this evening.

He said at this stage other passengers on the flight were not being sought and the next step would depend on what the tests showed.

"We don't believe at this point that there is a need for that.

"We might get no positives, we might get one, we might get all of them. It's a pretty big step to be taking (and) it's something that would be considered."

In the meantime the students and teachers had been told to stay at home in isolation and ARPHS was briefing their families and the school on infection control precautions.

While the virus' spread was considered serious enough for WHO declare a health emergency, Mr Flyger said hit had proven responsive to drugs.

"It is concerning for sure. You've just got to look at the WHO's advice on this, but it has shown it reacts to treatment so it's not as bad as it could be.

"We're not looking at (the horror film) 28 Days Later."

flu on the ground in mexico...,

BBC News | I'm a specialist doctor in respiratory diseases and intensive care at the Mexican National Institute of Health. There is a severe emergency over the swine flu here. More and more patients are being admitted to the intensive care unit. Despite the heroic efforts of all staff (doctors, nurses, specialists, etc) patients continue to inevitably die. The truth is that anti-viral treatments and vaccines are not expected to have any effect, even at high doses. It is a great fear among the staff. The infection risk is very high among the doctors and health staff.

There is a sense of chaos in the other hospitals and we do not know what to do. Staff are starting to leave and many are opting to retire or apply for holidays. The truth is that mortality is even higher than what is being reported by the authorities, at least in the hospital where I work it. It is killing three to four patients daily, and it has been going on for more than three weeks. It is a shame and there is great fear here. Increasingly younger patients aged 20 to 30 years are dying before our helpless eyes and there is great sadness among health professionals here. Antonio Chavez, Mexico City

1918 flu pandemic


Wikipedia | The 1918 flu pandemic (commonly referred to as the Spanish flu) was an influenza pandemic that spread to nearly every part of the world. It was caused by an unusually virulent and deadly Influenza A virus strain of subtype H1N1. Historical and epidemiologic data are inadequate to identify the geographic origin of the virus. Most of its victims were healthy young adults, in contrast to most influenza outbreaks which predominantly affect juvenile, elderly, or otherwise weakened patients. The pandemic lasted from March 1918 to June 1920, spreading even to the Arctic and remote Pacific islands. It is estimated that anywhere from 20 to 100 million people were killed worldwide, or the approximate equivalent of one third of the population of Europe, more than double the number killed in World War I. This extraordinary toll resulted from the extremely high illness rate of up to 50% and the extreme severity of the symptoms, suspected to be caused by cytokine storms. The pandemic is estimated to have infected up to one billion people: half the world's population at the time.

The flu probably originated in the Far East. The disease was first observed at Fort Riley, Kansas, United States, on March 4, 1918, and Queens, New York, on March 11, 1918. In August 1918, a more virulent strain appeared simultaneously in Brest, France, in Freetown, Sierra Leone, and in the U.S. at Boston, Massachusetts. The Allies of World War I came to call it the Spanish flu, primarily because the pandemic received greater press attention after it moved from France to Spain in November 1918. Spain was not involved in the war and had not imposed wartime censorship.

Scientists have used tissue samples from frozen victims to reproduce the virus for study. Given the strain's extreme virulence there has been controversy regarding the wisdom of such research. Among the conclusions of this research is that the virus kills via a cytokine storm (overreaction of the body's immune system) which explains its unusually severe nature and the concentrated age profile of its victims. The strong immune systems of young adults ravaged the body, whereas the weaker immune systems of children and middle-aged adults caused fewer deaths.

pandemic in the u.s.

NYTimes | Tests show that eight students at a Queens high school are likely to have contracted the human swine flu virus that has struck Mexico and a small number of other people in the United States, health officials in New York City said yesterday.

The students were among about 100 at St. Francis Preparatory School in Fresh Meadows who became sick in the last few days, said Dr. Thomas R. Frieden, New York City’s health commissioner.

“All the cases were mild, no child was hospitalized, no child was seriously ill,” Dr. Frieden said.

Health officials reached their preliminary conclusion after conducting viral tests on nose or throat swabs from the eight students, which allowed them to eliminate other strains of flu. Officials were also suspicious since some St. Francis students recently had been to Mexico, where the outbreak is believed to have started.
UPDATE: New York Mayor Michael Bloomberg says that the Centers for Disease Control and Prevention has confirmed that students at a city high school were infected with swine flu.

New York officials previously had said they were eight "probable" cases, but tests later confirmed that it was indeed swine flu. Bloomberg stressed that the cases were mild and many are recovering.

The city is awaiting the tests of additional samples to see if more St. Francis Preparatory School students were infected.

About 100 students complained of flu-like symptoms at the school. Some students went to Cancun on a spring break trip two weeks ago.
The president in Mexico assumed emergency powers to deal with the crisis, which has killed at least 81 people and infected about 1,300 others. All public gatherings have been banned, including more than 500 concerts and sporting events and the popular bicycle rides on closed boulevards.

Dr. Margaret Chan, the director-general of the World Health Organization, said the events in Mexico “constitute a public health emergency of international concern.”

The W.H.O. convened an emergency meeting of experts on Saturday, but the panel adjourned without raising the global pandemic alert level, saying it wanted more information. Some experts expressed surprise that no action was taken since the Mexico outbreak seems to meet the definition of a Level 4 alert — sustained human-to-human transmission of a new virus. The alert has been at Level 3 for years because of small clusters of human cases of avian flu.

In the United States, so far, at least 11 swine flu cases have been confirmed. Seven were confirmed in San Diego and Imperial Counties in California and two in Kansas. In Texas, two 16-year-old students at Byron Steele High School in Cibolo, near San Antonio, were confirmed to have swine flu, and one of their classmates was suspected to have the virus. There have been no deaths, and officials said most of the 11 seemed to be recovering.

fighting pandemic?

Associated Press | Mexico's president assumed new powers Saturday to isolate people infected with a deadly swine flu strain as authorities struggled to contain an outbreak that world health officials warned could become a global epidemic.

New cases of swine flu were confirmed in Kansas and California and suspected in New York City. But officials said they didn't know whether the New York cases were the strain that now has killed up to 81 people in Mexico and likely sickened 1,324 since April 13, according to figures updated late Saturday by Mexico's health secretary.

Tests have confirmed swine flu as the cause of death in 20 of the cases.

Mexican soldiers and health workers patrolled airports and bus stations as they tried to corral people who may be infected with the swine flu, as it became clearer that the government may have been slow to respond to the outbreak in March and early April.

Now, even detaining the ill may not keep the strain — a combination of swine, bird and human influenza that people may have no natural immunity to — from spreading, epidemiologists say.

The World Health Organization on Saturday asked countries around the world to step up reporting and surveillance of the disease and implement a coordinated response to contain it.

Saturday, April 25, 2009

sixty swine flu fatalities in mexico confirm pandemic start

Recombinomics | A rare outbreak of human swine flu has killed at least 60 people in Mexico and spread to the United States where authorities are on alert, the World Health Organisation said on Friday.

"To date there have been some 800 suspected cases with flu-like illness, with 57 deaths in the Mexico City area," Chaib added.

Twenty four suspected cases and three deaths were also recorded in San Luis Potosi in central Mexico.

The above comment confirm that the swine H1N1 in southwestern United States (see updated map) is the leading edge of a H1N1 pandemic that appears to be centered in Mexico.

These deaths should increase the pandemic phase to 6.

Release of sequences from fatal cases in Mexico would be useful.

Mexico is cancelling classes for millions of children in the heart of the country today after influenza killed 60 people. Mexican Health Minister Jose Angel Cordoba said schools and universities in Mexico City and the surrounding area would be temporarily closed and advised people with flu symptoms to stay home from work.

exotic respiration...,

The Scientist | Members of a microbial community from a pool of water deep under the Arctic ice power their metabolism by "breathing" iron, a study in this week's Science reports. The previously unknown mechanism may explain how microbes survived during a period 600 million years ago, when the earth's oceans were covered in ice, the authors say.

The identification of the bacterial ecosystem's oddball respiration is a "remarkable discovery," said Alan J. Kaufman, a biogeochemist at the University of Maryland in College Park, who was not involved in the study. It's impressive, he said, that the group was able to "look with such detail at the microbiology of the consortium of organisms that is basically eking out a living in an environment where there's no new food."

Jill Mikucki, a geomicrobiologist at Dartmouth College in Hanover, NH, who led the research, first discovered the microbial community several years ago in a pool of marine brine seeping out from Blood Falls, a frozen, rust-laced waterfall at the mouth of the Taylor Glacier in East Antarctica.

In this study, Mikucki's team investigated the microbes' metabolism by studying their use of different minerals.

carcinogenesis revisited...,

The Scientist | Fifteen years ago, John Dick, a molecular biologist at the University of Toronto, discovered that not all cancer cells are created equal. Specifically, he showed that only a small population of self-renewing leukemia cells could create tumors, dubbing these cancer stem cells (CSCs). So, scientists asked: Can we wipe out cancer by targeting just these few rogue cells?

The model really took off in 2003 when Michael Clarke, Max Wicha, Sean Morrison, and their colleagues at the University of Michigan discovered CSCs in breast cancer—the first evidence of the cancerous supervillains in a solid tumor. Since then, CSCs have been reported in various other human tumors, including brain, lung, colon, and pancreatic cancers. "You practically can't pick up a major science journal now without seeing an article about cancer stem cells," says Wicha.

In 2007, the CSC hypothesis was thrown for a loop, however, after a team led by Kornelia Polyak, of the Harvard Medical School and Dana-Farber Cancer Institute in Boston, probed a bit deeper into the Michigan team's findings. In this month's Hot Paper, Polyak's team compared the genetic profiles of the putative breast CSCs with other more differentiated cells, and found several genetic differences between the two cell populations. This "raises doubts about whether they are direct descendents of one another," says Polyak.

The findings imply that cancer cells are moving targets, Polyak argues, which is more in line with the "clonal evolution" model of tumor generation—the long-standing idea that normal cells mutate to become cancerous, and abnormal descendants transform again, creating a mass of competing, genetically-varied cancer cells. Thus, eliminating the so-called CSCs might not be sufficient to halt cancer dead in its tracks, because the remaining cells might be able to fuel tumor growth and develop drug resistance, too.

Friday, April 24, 2009

pre-empting the inevitable?

LATimes | The Obama administration agreed late Thursday to release dozens of photographs depicting alleged abuses at U.S. prisons in Iraq and Afghanistan during the Bush White House.

The decision will make public for the first time photos obtained in military investigations at facilities other than the Abu Ghraib prison in Iraq. Forty-four photos that the American Civil Liberties Union was seeking in a court case, plus a "substantial number" of other images, will be released by May 28.

The photos, examined by Air Force and Army criminal investigators, are apparently not as shocking as those taken at Abu Ghraib, which became a symbol of U.S. mistakes in Iraq. But Defense Department officials nevertheless are concerned that the release could incite another backlash in the Middle East.

Some of the photos show U.S. service members intimidating or threatening detainees by pointing weapons at them, according to officials who have seen them. Military officers have been court-martialed for threatening detainees at gunpoint.

"This will constitute visual proof that, unlike the Bush administration's claim, the abuse was not confined to Abu Ghraib and was not aberrational," said Amrit Singh, a lawyer for the ACLU, which reached the agreement as part of a long-running legal battle for documents related to anti-terrorism policies under President George W. Bush.

The decision comes as President Obama is trying to quell a drive to investigate Bush-era practices, which was spurred in part by his release last week of Justice Department memos detailing the Bush administration's legal justifications for harsh interrogations. But the photos and other possible disclosures stemming from the ACLU lawsuit threaten to stoke the controversy.

Other disclosures to be considered in the weeks ahead include transcripts of detainee interrogations, a CIA inspector general's report that has largely been kept secret, and background materials in a Justice Department investigation into prisoner abuse.

In each instance, Obama and his administration are being forced to decide whether to release the material entirely, disclose it with redactions, or follow the lead of the Bush administration and fight in court to keep it classified.

illegal, unnecessary, and useless

WaPo | As President Obama met with top advisers on the evening of April 15, he faced one of the sharpest policy divides of his young administration.

Five CIA directors -- including Leon E. Panetta and his four immediate predecessors -- and Obama's top counterterrorism adviser had expressed firm opposition to the release of interrogation details in four "top secret" memos in which Bush administration lawyers sanctioned harsh tactics.

On the other side of the issue were Attorney General Eric H. Holder Jr., Director of National Intelligence Dennis C. Blair and White House counsel Gregory B. Craig, whose colleagues during the campaign recall him expressing enthusiasm for fixing U.S. detainee policy.

Defense Secretary Robert M. Gates had said he supported the disclosures because he saw the information's release as inevitable and because the White House was willing to promise that CIA officers would not be prosecuted for any abuse. Joint Chiefs of Staff Chairman Mike Mullen sided with Gates.

Seated in Chief of Staff Rahm Emanuel's West Wing office with about a dozen of his political, legal and security appointees, Obama requested a mini-debate in which one official was chosen to argue for releasing the memos and another was assigned to argue against doing so. When it ended, Obama dictated on the spot a draft of his announcement that the documents would be released, while most of the officials watched, according to an official who was present. The disclosure happened the next day.

Obama's aides have told political allies that the last-minute conversation, which ended around 9:30 p.m., demonstrated the president's commitment to airing both sides of a debate that was particularly contentious. But it also reflected widespread angst inside the White House that a public airing and repudiation of the harsh interrogation techniques that the last administration sought to keep secret would spark a national security debate with conservatives that could undermine Obama's broader agenda.

Several top aides had argued, for example, that the question of whether to release the memos should be put before a "truth commission," effectively postponing resolution of the issue for months. But Obama vetoed the idea on the grounds that it would create the divisive debate his closest advisers feared -- a viewpoint he reiterated at a meeting with lawmakers yesterday. Craig also argued persuasively, other officials said, that the federal judge in New York overseeing a lawsuit seeking the memos' release was unlikely to approve any significant delay.

Now Obama is being lashed by former Bush appointees and is facing growing pressure to accept such a commission. Some liberal activist groups presented petitions with 250,000 signatures to Holder at a House hearing yesterday, asking him to appoint an independent prosecutor to investigate the originators of the interrogation tactics. Meanwhile, debate is swirling in Washington not only about the merits of the techniques but also about the wisdom of Obama's decision to exercise his unique authority to instantly transform the "top secret" documents into public ones.

This account is based on interviews with more than a dozen officials, some of whom spoke on the condition of anonymity because they are not authorized to talk about the internal deliberations

they've been ignoring bacteria...,

NYTimes | In 1971, flush with the nation’s success in putting a man on the Moon, President Richard M. Nixon announced a new goal. Cancer would be cured by 1976, the bicentennial.

When 1976 came and went, the date for a cure, or at least substantial progress, kept being put off. It was going to happen by 2000, then by 2015.

Now, President Barack Obama, discussing his plans for health care, has vowed to find “a cure” for cancer in our time and said that, as part of the economic stimulus package, he would increase federal money for cancer research by a third for the next two years.

Cancer has always been an expensive priority. Since the war on cancer began, the National Cancer Institute, the federal government’s main cancer research entity, with 4,000 employees, has alone spent $105 billion. And other government agencies, universities, drug companies and philanthropies have chipped in uncounted billions more.

Yet the death rate for cancer, adjusted for the size and age of the population, dropped only 5 percent from 1950 to 2005. In contrast, the death rate for heart disease dropped 64 percent in that time, and for flu and pneumonia, it fell 58 percent.

economic depression's sharp edge


In the economic crisis, public hospitals are needed now more than ever. If you're down on your luck without insurance, the county hospital can be your last resort.

Recently thousands of letters went out across Las Vegas telling cancer patients that the only public hospital in the state was closing its outpatient clinic for chemotherapy.

It's the next thing in the recession - communities cutting back on services like schools or cops or public hospitals because tax revenues have fallen with the economy.

Thursday, April 23, 2009

so busted....,

NYTimes | FOR seven years I have remained silent about the false claims magnifying the effectiveness of the so-called enhanced interrogation techniques like waterboarding. I have spoken only in closed government hearings, as these matters were classified. But the release last week of four Justice Department memos on interrogations allows me to shed light on the story, and on some of the lessons to be learned.

One of the most striking parts of the memos is the false premises on which they are based. The first, dated August 2002, grants authorization to use harsh interrogation techniques on a high-ranking terrorist, Abu Zubaydah, on the grounds that previous methods hadn’t been working. The next three memos cite the successes of those methods as a justification for their continued use.

It is inaccurate, however, to say that Abu Zubaydah had been uncooperative. Along with another F.B.I. agent, and with several C.I.A. officers present, I questioned him from March to June 2002, before the harsh techniques were introduced later in August. Under traditional interrogation methods, he provided us with important actionable intelligence.

We discovered, for example, that Khalid Shaikh Mohammed was the mastermind of the 9/11 attacks. Abu Zubaydah also told us about Jose Padilla, the so-called dirty bomber. This experience fit what I had found throughout my counterterrorism career: traditional interrogation techniques are successful in identifying operatives, uncovering plots and saving lives.

There was no actionable intelligence gained from using enhanced interrogation techniques on Abu Zubaydah that wasn’t, or couldn’t have been, gained from regular tactics. In addition, I saw that using these alternative methods on other terrorists backfired on more than a few occasions — all of which are still classified. The short sightedness behind the use of these techniques ignored the unreliability of the methods, the nature of the threat, the mentality and modus operandi of the terrorists, and due process.

strangely unsurprising.....,

WaPo | At a time when the Justice Department is deciding whether former officials who set interrogation policy or formulated the legal justifications for it should be investigated for possible crimes, the timeline lists at least a dozen members of the Bush administration who were present when the CIA's director or others explained exactly which questioning techniques were to be used and how those sessions proceeded.

Rice gave a key early green light when, as President George W. Bush's national security adviser, she met on July 17, 2002, with the CIA's then-director, George J. Tenet, and "advised that the CIA could proceed with its proposed interrogation of Abu Zubaida," subject to approval by the Justice Department, according to the timeline.

Abu Zubaida, a Saudi-born Palestinian whose real name is Zayn al-Abidin Muhammed Hussein, was captured in Pakistan in March 2002. He was the first high-value detainee in CIA custody, and the agency believed that the al-Qaeda associate was "withholding imminent threat information," according to the timeline.

Rice and four other administration officials were first briefed in May 2002 on "alternative interrogation methods, including waterboarding," the timeline shows. Waterboarding is a technique that simulates drowning.

A year later, in July 2003, the CIA briefed Rice, Vice President Richard B. Cheney, Attorney General Ashcroft, White House counsel Alberto R. Gonzales and National Security Council legal adviser John B. Bellinger III on the use of waterboarding and other methods, the timeline states. They "reaffirmed that the CIA program was lawful and reflected administration policy."

"This was not an abstract discussion. These were very detailed and specific conversations," said Jameel Jaffer, director of the National Security Project at the American Civil Liberties Union. "And it's further evidence of the role that senior administration officials had." Interrogation timeline.....,

trickle-down torture

Wednesday, April 22, 2009

ignorant and enthusiastic...,

NYTimes | In a series of high-level meetings in 2002, without a single dissent from cabinet members or lawmakers, the United States for the first time officially embraced the brutal methods of interrogation it had always condemned.

This extraordinary consensus was possible, an examination by The New York Times shows, largely because no one involved — not the top two C.I.A. officials who were pushing the program, not the senior aides to President George W. Bush, not the leaders of the Senate and House Intelligence Committees — investigated the gruesome origins of the techniques they were approving with little debate.

According to several former top officials involved in the discussions seven years ago, they did not know that the military training program, called SERE, for Survival, Evasion, Resistance and Escape, had been created decades earlier to give American pilots and soldiers a sample of the torture methods used by Communists in the Korean War, methods that had wrung false confessions from Americans.

Even George J. Tenet, the C.I.A. director who insisted that the agency had thoroughly researched its proposal and pressed it on other officials, did not examine the history of the most shocking method, the near-drowning technique known as waterboarding.

The top officials he briefed did not learn that waterboarding had been prosecuted by the United States in war-crimes trials after World War II and was a well-documented favorite of despotic governments since the Spanish Inquisition; one waterboard used under Pol Pot was even on display at the genocide museum in Cambodia.

They did not know that some veteran trainers from the SERE program itself had warned in internal memorandums that, morality aside, the methods were ineffective. Nor were most of the officials aware that the former military psychologist who played a central role in persuading C.I.A. officials to use the harsh methods had never conducted a real interrogation, or that the Justice Department lawyer most responsible for declaring the methods legal had idiosyncratic ideas that even the Bush Justice Department would later renounce.

The process was “a perfect storm of ignorance and enthusiasm,” a former C.I.A. official said.

rumpus rooms readied early..,

WaPo | Intelligence and military officials under the Bush administration began preparing to conduct harsh interrogations long before they were granted legal approval to use such methods -- and weeks before the CIA captured its first high-ranking terrorism suspect, Senate investigators have concluded.

Previously secret memos and interviews show CIA and Pentagon officials exploring ways to break Taliban and al-Qaeda detainees in early 2002, up to eight months before Justice Department lawyers approved the use of waterboarding and nine other harsh methods, investigators found.

The findings are contained in a Senate Armed Services Committee report scheduled for release today that also documents multiple warnings -- from legal and trained interrogation experts -- that the techniques could backfire and might violate U.S. and international law.

One Army lieutenant colonel who reviewed the program warned in 2002 that coercion "usually decreases the reliability of the information because the person will say whatever he believes will stop the pain," according to the Senate report. A second official, briefed on plans to use aggressive techniques on detainees, was quoted the same year as asking: "Wouldn't that be illegal?"

Once they were accepted, the methods became the basis for harsh interrogations not only in CIA secret prisons, but also in Defense Department internment camps at Guantanamo Bay, Cuba, and in Afghanistan and Iraq, the report said.

Fuck Robert Kagan And Would He Please Now Just Go Quietly Burn In Hell?

politico | The Washington Post on Friday announced it will no longer endorse presidential candidates, breaking decades of tradition in a...