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CONSPIRACY OF SILENCE, DENIALISM? THE FLARE AND CURE OF MERS?- MIDDLE-EAST SEVERE ACUTE RESPIRATORY- RENAL SYNDROME SARRS CORONAVIRUS OUTBREAK; AND EBOLA? : An Inconvenient truth? human (sunshine-) vitamins C+D DEFICIENCY syndrome facilitating a benign virus spread from eg camels (or mosquitos) to middlemen eg camelmen to human vit C/D deficient contacts- in whom the infection becomes lethal ?. Copyright reserved. A narrative diary journal since August 2013
ALWAYS READ IN CONCERT WITH avoiding-the-semmelweis-reflex-vitamins-c-d3-avoiding-vitamin-denialism
19 Nov 2014: HEALTH ADVISORY FOR VISITORS TO OR FROM MIDDLE & FAR EAST, EUROPE, AFRICA, the AMERICAS: The MERS infection outbreak slacks off: – down from the recent 2 cases a day to 1/d this month . No more exports reported from KSA since one returned home to Qatar last month. the quadrupled case rate since October has fallen back from 39 cases & 15 deaths a month ; – and deathrate (9 deaths) in October in KSA that doubled to 0.6/day is back to 0.33/day, still awesome for such a rich and sophisticated country,
though MERS is well below that of the ebola epidemic – some 5000 ie almost 40% deaths among 14000 cases so far- that is ravishing central west Africans impoverished by genocidal warlords; not to mention flu, cholera, HIV, TB, polio-and dengue-like illnesses . Two ebola- infected people from W Africa have died in USA, but 8 have recovered in USA from Ebola .
Latest evidence is that the current ebola epidemic is due to bats- human overpopulation causing massive deforestation, displacing ecologically vital bats (never mind vital bees and butterflies) from their natural habitat. Liberian workers who flew to USA and Germany with Ebola died; but 8 of 9 infected cases have recovered there; as have infected European health workers. .. . .
But West Africans are reportedly trying to flee to South Africa to escape the epidemic. and 9 out of 16 Medicine sans Frontiers staff who contracted ebola died. .Is ebola falling there? or are patients simply hiding, dying outside hospitals?
SO OPTIMIZE YOUR DIET, VITAMINS D3 & C DOSES, SUNSHINE, AND AVOID SELFSABOTAGE- SMOKING, SUGARS, ALCOHOLISM, AND RASH HYGIENE.
20 Nov 2014 Now 808 cases ie 18 this month, only 5 the past running week; with 9 deaths this month; so 12 cases under management.
13 November 2014 The rates pick up again- KSA declares 16 cases under treatment, 447cases recovered, 804 cases, 342 deaths; ie this month 15 cases and 5 deaths .
4 November 2014: KSA declares 15 Cases Under Treatment, 440 Cases Recovered, 793 Cases, 338 deaths, ie in the past week 13 new (9 Saudis, 4 expats) and 5 deceased cases of MERS.
22 Oct 2014: now the KSA declares 12 Cases Under Treatment, 431 Cases Recovered, 772 Cases, 329 deaths; ie 9 more cases in KSA past week ie 1.3/day. So thats 18 cases in 22days ie the case rate up to >0.8/day, with 10 deaths – all with previous chronic illhealth - this month ie mortality lately 55% (8 Saudi males age 51-69, a Saudi woman age 55 and an expat male age 40)….
14 Oct 2014 The first MERS case outside KSA was reported yesterday in Qatar, in a returnee from KSA, ie thats 5 cases this week contracted in KSA, reportedly bringing world total to 892 cases and 356 deaths. Crof says Over the past 30 days Saudi Arabia has reported 17 MERS infections, 9 of which were from the Taif region; which concurs with the HSA stats excluding the backlog of old cases reported last month… Four Saudi males this week with MERS in Jubail, Taif and now Riyadh , and deaths each in Riyadh and Taif.. so Saudi MERS cases there now 10 Cases Under Treatment, 429 Cases Recovered, 763 Total; and 324 deaths ie 43% death rate . In 14 days this month that’s 9 new cases in KSA, 5 deaths, 3 cases recovered; compared to September’s net ?12 new cases. The stats for September (incl 19 deaths) are blurred by the adjustments announced on 19 Sept (with previously unreported cases up to 3 June, with net 16 new cases after other corrections); so the new cases and deaths reported in August may be correct-4 new pts, 4 deaths; and July 9 new cases, 6 deaths; and June 28 new cases? .. .
So the MERS case rate in KSA so far this month has mushroomed from the 0.3/day in July, the nadir of 0.13/d in August, ? 0.4 in Sept, to 0.64/d this month; and the deathrate from 0.2/d in July to the nadir of 0.13/d in Aug to >0.6/d this month.
BUT 6/9 OF THE NEW CASES THIS MONTH HAVE BEEN IN THE GARDEN RESORT CITY OF TAIF 100 KM SOUTH OF MAKKAH- mostly in Saudi men with camel contact. perhaps this may be because of a resevoire of MERS in camels there. The climate may be favourable for humans BUT ALSO FOR MERS- October temps of 15 to 30c, humidity of 40%, 11 mm rainfall.’
MORE ON OPTIMAL VITAMIN D3 DOSE, AND THE DIFFICULTY OF ACHIEVING CLINICAL OVERDOSE: Four new reports highlight how difficult, and important it is to achieve adequate optimal bloodlevels of vitamin D with vigorous vitamin D3 supplements, let alone overdose with any significant adversity: note three used the recommended vitamin D3, not the long-condemned mislabeled Lennons/Aspen vitamin D2 (which is misleadingly labelled “caciferol” without disclosing that it is D2 not D3). Even a single 2 million iu overdose of vit D3 in nonagenarians had no adverse effect-since the bloodlevel was back to zero by 3 weeks, thats above 100 000iu/day on average…....continue..
8 Oct 2014 1st Ebola case diagnosed in Dallas USA in a Liberian visitor, who died today (one of > 4000 deaths in W Africa estimated so far); and a new case in Spain, the first infection outside Africa. Ebola anxiety spreads.. It is alarming that the MERS deathrate is not falling but rising there-5 new MERS cases already this month, vs 12 in Sept, 5 cases in August; and now 8 deaths in past 38 days..
VITAMIN D3 DOSE: We get excellent results in outpatient adults with loading oral dose of vit D3 of about 200 000 to 400 000iu depending on illness severity and body mass; then pro rata about 50 000iu per week till better, tapering to fortnightly when well; pro rata in kids...continue..
30 Sept 2014 another new Mers case in KSA, a 70yr old Saudi man in AlMadinah.
AND From: David Ponsonby September 29, 2014 http://healthimpactnews.com/2014/flu-vaccine-is-the-most-dangerous-vaccine-in-the-united-states-based-on-settled-cases-for-injuries/
“The last report issued December 2013 for the previous 3 months by the USA Department of Justice (Vaccine Court), for compensation made by the USA Services for people injured or killed by vaccines – available as a Power Point presentation - 139 claims settled , with 70 of them being compensated. So, just over 50% of the claims filed for vaccine damages were compensated during this period. Once again, the greatest percentage of damages compensated were for the influenza vaccine, and most of those were for Guillain-Barré Syndrome (GBS). Yet these facts, in a Department of Health website, are never reported in the mainstream media. Read the report yourself in the Power Point file here. Of the 70 cases compensated, 42 ie 60% were for the flu vaccine. The combined total of the other 40% of cases settled included the following vaccines: Hep B, Tetanus, HPV, DTaP, MMR, IPV, PCV, Hib, Meningococcal, Varicella, TD.
29 Sept 2014 MAJOR SAUDI UPDATE: FRESH MERS FLAREUP WORSENS: There have lately been 3 new cases, (2 Saudis and an expat), near Mecca; 2 in Riyadh- and now death of a 38yr old previously well Saudi woman in Riyadh.
Thats 3 MERS deaths; and 4 new cases – Saudis- in central KSA the past 10days, 11 this month; contradicting the puzzlingly optimistic comment this week from KSA health ministry’s Fakeih that “MERS is not an issue in Saudi anymore. We are doing all we can to have a safe Hajj for all our guests.” If MERS is not an issue, why is the new caserate there picking up, and the deathrate not falling?
the KSA Ministry‘s recent audit found some 19 previously unlisted MERS cases in the 10 week April -May 2014 surge – all but three of the cases were in Jeddah- plus some false positives , and changes of status..
The totals there now are 8 Cases Under Treatment, 426 Cases Recovered,753 Total; and 319 deaths ie 42% death rate .
But outside KSA there have been no further MERS cases or deaths reported for months, so thats apparently worldwide 885 cases , deaths 353 = 40%. But the deathrate outside KSA remains only 26%. and outside Arabia the deathrate remains 10/30 ie 33%.
Despite the surge in KSA in the ~10 weeks mid-March till early June, before the peak summer season in the Northern Hemisphere, the ongoing outbreak in KSA (14 cases there since the month’s lull till mid-August) contrasts with the last MERS cases reported outside KSA in early-mid-July about 10 weeks ago - 2 cases in Abu Dhabi ie the UAE, & 5 in Iran. .
So thats a total in KSA of 20 more new cases and 13 more deaths than was reported before the audit on 12 Sept. Of the KSA 749 total, 27% were healthcare workers; 65% were Saudis- the vast majority this season in Jeddah and Riyadh; 61% male; 4% under 16yrs, 45% between 16-45, 27% 45-60. and 24% 60+ years. ie approx 15% of all cases in every 15year age bracket from 16yrs up, but only 4% in the first 15 years. Deathrate was “only” ~18% in EACH OF the three 15year agebrackets up to 45 years, but 45% in the 46-60yr olds; and quadrupled to 80% over age 60years.Thus unlike eg flu, only in the KSA elderly is MERS par excellence a highly risky infection .
MERS IN KIDS: the likely number in KSA extrapolated from 4% of 749 cases is about 30 kids under 16yrs; but the new KSA bargraphs show ~18% deaths in kids ie about 5-6 died. so the child deathrate has doubled from 9% 1/11. In Dr Memish’s April paper there were only 11 pediatric cases positive by screening and confirmatory PCR for MERS-CoV reported from Saudi Arabia. Two patients were symptomatic and the other 9 cases were asymptomatic. The median age of patients was 13 (range 2-16) years. There were eight females and three males (2.7:1 ratio). One symptomatic patient died (1/11 = 9%) and the other symptomatic patient recovered. The diagnosis of patients was based on positive nasopharyngeal swabs on the majority of the patients. Most cases of childhood MERS-CoV infection was asymptomatic and tested positive during contact investigation of older patients. Severe disease can occur in children with underlying conditions.
So in KSA with a mean population age close to 20 years, the age distribution of MERS is roughly spread across adult lifespan, sparing (with both low incidence and low mortality) children who make up almost half the population. This is the opposite of the claimed swine flu severity in kids in the “pandemic” of 2009. Perhaps in KSA this is as expected since generally schoolchildren take more dairy products, get more exercise, sunlight, fresh produce and supplements, and wear less sun-exclusive clothing- supporting vit D+C deficiency evidence as the proximate cause of MERS-CoV susceptibility in KSA adults..
So despite repeated published warning from the top KSA scientists that their conservative (ie covered) dress and diet code puts Saudis at very high risk of known vitamins C & D & Zinc deficiency, the blackout on acknowledging this and promoting vigorous vits C and D3 & Zinc supplements continues, with 80% death risk for the elderly and 20% for every child who contracts MERS in KSA. Until proved otherwise by simple trial of vigorous supplements, this denial, omission in fact may be culpable homicide on the part of KSA authorities- especially as the KSA, with a mean annual income per head similar to UK and western Europe and with similar Caucasian origin population, notoriously has life expectancy 5 years lower than that of UK and much of the North Atlantic lands. .
16 Sept 2014 one new case today 31yr old expat male, prev chronic, in ICU Riyadh; yesterday 76yr Saudi male in the far south, prev chronic, in ICU. total thus 730, 29 active,… already 5 in 2wks this month.. as the Hajj picks up…
12 Sept 2014 Bad news strikes KSA with the Hajj in full swing- after 3 clear days, 2 new MERS cases but not in the eastern provinces like the last cluster, this time one each in Riyadh and the Mekkah region, both Saudis, both in ICU; but not the usual seniors- a 38yr old male with previous health issues; and 28yr old female, neither of them healthcare workers. So now the KSA numbers are 28 under care; 399 recovered; 729 total; 302 died.
8 SEPT 2014 after 9 case-free days, the 727th new case, 60y old male expat, in Jubail, in ICU…
31 August 2014 THE KSA MERS CASE RATE PICKS UP: 42% death- rate: another new case 29 Aug, a 34 yr old expat health worker in Jubail, ie 3 cases in past 7 days. another MERS-related death- a 69yr old Saudi man in Dammam- as usual, with preexisting disease. . So KSA has now 25 Cases Under Treatment; 399 Cases Recovered ; 302 cases died; total 726 Cases ie 42% died. 45% dead or impaired. 5 new cases past month. and apparently 4 deaths. KSA reporting does not allow analysis of duration of illness to assess the current mortality rate.
Yet Drosten, Memish ea from the international Corona Virus Study Group write in the NEJM this week: “Transmission of MERS-coronavirus in household contacts is only 5% in 26 MERS index patients and their 280 household contacts. Strategies to contain the MERS-CoV depend on knowledge of the rate of human-to-human transmission, including subclinical infections. The median time from the onset of symptoms in index patients to the latest blood sampling in contacts was 17.5 days (range, 5 to 216; mean 34.4d“.
This again confirms the obvious, that the virus, like the common cold, is low virulence and transmissibility EXCEPT in the frail and elderly – who (perhaps like many overworked hospital workers) in KSA who as reported there apparently get little sunshine, little vitamin D3, and likely little vitamin C. The rate of MERS in students, kids, farm workers, labourers remains very low, presumably because they get plenty of sunshine. And no article/report on MERS from KSA – where all adults are forced to cover up their skin outdoors- says that anyone is encouraged to vigorously top up their vits C and D3 levels.
OUTCOMES: triangulating cases scantily reported on the KSA MERS website with 30 new cases since mid-June, 5F (28-55yrs, 4 Saudis) and 25 men; there have been 8 deaths all in men between 38 and 80yrs old. The high deathrate in the men may be because their average age was about 59yr vs 41yr in the women.
August: 5 new cases (1 Saudi female; 1 male an expat HCW; 2 of the men- 69 and 72yrs, Saudis, chronics, died within 3 and 6 days respectively ),
July: 10 cases; 2 Saudi female; of the 8 men, 2 are HCW , 2 expats- one of whom died the same day aet 73yrs.
June: 24 cases. Reporting was upgraded 1 June, so stats before July- with the ~100 case undated backlog reported- are problematic. from mid June there were 15 cases reported, 3 females; 5 deaths (2 expats aet 38 & 42) in the 12 men; the Saudi deaths were aet 45-80yrs.
27 August 2014 2 new cases past 3 days, Saudi man and woman in Dammam.(one subsequently proven false +ve) 25 Cases Under Treatment, 399 Cases Recovered ; 725 Cases Total; 301 cases passed away .
24 August 2014: 12 days free of new MERS cases in KSA. but on 22 Aug the death of another male, a 66yr old expat, was reported in Riyadh, this totals 23 Cases Under Treatment, 399 Cases Recovered; 301 cases passed away, (May Allah have mercy upon them). * Total 723 Cases. 44.8% dead or impaired.
But Alghamdi ea from the KSA Govt & Universities, and Lincoln University UK have this week published The pattern of Middle East respiratory syndrome coronavirus in Saudi Arabia: from June 2013-May 2014 ie some 425 cases (before the recent June “discovery” of another 100+ cases there). This study deduces that the outbreak thrived especially in Riyadh and Jeddah with high temperature and low humidity ie summer desert conditions; older men being at much higher risk than their kinswomen. . But once again, the paper studiously avoids the obvious reasons why KSA is at the hub of the MERS storm. The authors like the KSA authorities totally ignore the repeatedly published studies by their own academics the past decade, and even by USA authorities like Prof Mike Holick, that Saudis have markedly low vitamin C and D and even zinc levels. And their increasingly orthodox overdress as they age and have more leisure time drastically increases their vitamin D deficiency.
This comes back to usual Media and Governmental Semmelweis denialism , persisting with the myth that good diet and prescription medicines are enough. In fact balanced nutrition with fresh natural produce is becoming a rarity even in stable progressive urban cities, and the resultant epidemics of infections let alone degenerative diseases are in most cases due, (apart from deliberate pollution especially with plastics, estrogenics , pesticides, endocrine disruptors eg phthalates, heavy metals including fluorides, bromates; dioxin etc, radioactivity, and high refined carbs, and inadequate fish oil and medium chain triglycerides and water intake), to micronutrient deficiencies especially of vitamins C, D3, K2, and crucial minerals like magnesium, zinc, iodine, selenium, chromium etc.
Modern infectious outbreaks like the resurgence of influenza, polio, TB, HIV and MERS, and hemorrhagic fevers like Ebola and Marburg, are arguably as others have proposed deficency diseases – eg scurvy, since all the severe infections listed, never mind acute bacterial infections, have been shown for almost a century to respond dramatically to highdose vit C, vit D3 and some zinc, and multivite (A,B), without antibiotics or much benefit from eg ARVs or tuberculostatics. .
As of 12 pm August 20, 2014: “now only 25 Cases Under Treatment; 398 Cases Recovered Total 723 Cases; 300 cases passed away”
19 August 2014 : KSA updated figures no new MERS cases past 7 days. BUT another death- a 72yr old Saudi man with previous chronic disease, in Riyadh on 17 Aug. so “As of 12 pm Aug 19, 2014: 723 Cases, 26 Cases Under Treatment; 397 Cases Recovered; 300 cases passed away (May Allah have mercy upon them).”. ie the death + impaired rate 326/723 has risen to 46.4%, deathrate 41.6%. ?? 855 cases, 334 deaths worldwide?
So thats 326 patients in KSA who died or are still impaired by MERS, who might have been spared by simple highdose vits (D3 + C) supplement-at trivial cost, no major adverse effects, but massive evidence of protection and cure against all serious diseases; in a population at long-known high vits C+D3 deficiency risks. .
The Zeitgeist occupation analysis of MERS cases to 4 June shows unchanged pattern: 164 Health workers, 150 retired persons, 23 children, 11 pilgrims, 3 tourists, 2 construction labourers, 1 butcher, 1 camelbreeder, 1 shepherd… (out of 838 cases reported till then- ie occupation was disclosed in only 44% ie 380 pts) . The reason for the majority nondisclosure is not given.
The question remains: why are (inter)national authorities ignoring all the published evidence linked below, that vigorous dose vitamin D3 supplement eg 5000iu/kg loading dose then 1500iu/kg/fortnight eg 100 000iu every two weeks , plus a few grams of buffered vitamin C a day, drastically reduces all diseases including virus infections?
12 August 2012 KSA reports (after a month free of new cases) despite peak summer there, two new previously chronically ill Saudi cases in two days: a 72year Riyadh man; a 59 year old man far south of Riyadh; and death of a previously reported apparently formerly well 74 year Riyadh Saudi man. But they dont say when these recent elderly Saudis took ill or died. Total in KSA now 723 cases, 41% deaths. 28 cases under treatment ie 45.2% dead or impaired. ..
To put MERS in perspective, Ebola in Central Africa this year has infected over 2000 cases, 50% deaths, probably worsening the >100 000 malaria deathrate per year in the region, globally >200 million cases a year with a million ie 0.5% deaths.. .. Mosquito-spread Chikungunya virus spreads from Africa/Asia to over 570 000 people across the central Americas .. … .
9 Aug 2014 still not over: NOT THE END OF THE ARABIAN MERS CoV OUT- BREAK- STILL MORE QUESTIONS THAN ANSWERS, : its now 30 days since the last reported MERS case - BUT the fact is that the KSA Bulletin chillingly reports “As of 12 pm 9 Aug, 2014: 1.” still 27 Cases Under Treatment 2. 396 Cases Recovered. 3. 298 cases passed away (May Allah have mercy upon them). total 721 case. so 30 days after the last recorded new case, 27 patients there are still suffering from MERS sequelae – for at least four weeks duration now, likely now permanent?. .
27 cases out of 721 total reported in KSA is only about 4%. But since these 27 cases remain under care a month after the last reported new case, they must now be at best approaching chronically impaired, if not on renal or respiratory assistance. ie the total of dead and impaired rises to 325/721 = about 45%. More important, KSA has apparently not yet released an analysis of the demography and primary and secondary causes of death of these cases- presumably by MERS definition, respiratory and renal . This analysis is urgently needed. All we know for certain is that there was a MERS outbreak apparently in one of their Dialysis units; and that the outbreak was especially bad in health workers especially hospital staff.
COMBINED SEVERE ACUTE RENAL AND RESPIRATORY FAILURE: Forty years ago we (Burman ND, Austin M, Thatcher GN ea) delivered a review of Groote Schuur Hospital experience at a local South African renal congress on the high mortality of combined acute renal and respiratory failure in the age of hemodialysis and ventilators, respiratory intensive care, antibiotics and immunosuppression. . Apart from the common major sepsis, trauma and allergic eg antibiotic causes, the obvious “primary” cause – which any virus eg MERS-CoV may mimic- , is the “autoimmune” hypersensitivity Goodpastures Syndrome GPS – which untreated has a mortality of ~80% but with modern treatment perhaps 20%. This is half the deathrate reported in KSA from MERS. There is no shortage of respiratory and renal ICU and dialysis, advanced medical specialists in KSA centres. So from GPS perspective, much better salvage might be expected.
“GPS is rare affecting about 1ppm (0.5-1.8 per million people) per year in Europe and Asia. The peak age ranges for the onset of the disease are 20-30 and 60-70 years. It is also unusual among autoimmune diseases in that it is more common in males , less common in blacks than whites. This may partly explain why the inhabitants of the dromedary-exporting Horn of Africa have been spared MERS outbreaks.
A recent review from Germany gives the mean time from onset of MERS to acute renal failure of only 11 +-2 days (c0mpared to 20 days in SARS). It is well reported that those contracting acute MERS are already sufferers from major chronic illnesses eg diabetic- cardiorenal-respiratory ie heavily predisposed to immune failure if not already in renal failure.
Humans have some four primary excretory/detox systems: hepato-gastrointestinal; skin; renal; and lung. In Arabia, water is scarce, the desert climate is hot and dry, and the obligatory dress for the observant almost total body cover by robes. So MERS SARRS is high risk especially as it knocks out the two main excretory systems- renal, respiratory, and in very high ambient temperatures also the skin; except for the affluent minority who have aircooled spacious private homes and offices; with often a reported element of viral gastroenteritis, akin to influenza. .
The mystery remains: why is the UAE reporting 73 cases/9.2million ie 8 per million, but only 12% mortality, compared to the adjoining KSA 721 cases/30 million ie 24 per million? with 93% of world MERS cases recorded from KSA and UAE, and all cases anywhere traceable back to the Arabian Peninsula. The KSA and UAE urgently need to publish an analysis of the demography and pathophysiology of their MERS cases. Is it mostly indigenous Arabs who are contracting and especially dying from MERS in these countries, or also many foreign workers, mainly malnourished labourers?
A major factor is likely demographic: Wiki says In KSA “There are 20 million Saudi citizens and 5 million foreigners living in Saudi Arabia. Most Saudis are Sunni Muslims, approximately 23 percent are Wahhabis, With the world’s second largest oil reserves , the Kingdom is categorized as a high income economy with the 19th highest GDP in the world. Saudi Arabia is an absolute monarchy. However, according to the Basic Law of Saudi Arabia adopted by royal decree in 1992, the king must comply with Sharia (Islamic law) and the Quran, while the Quran and the Sunnah (the traditions of Muhammad) are declared to be the country’s constitution. According to The Economist‘s 2010 Democracy Index, the Saudi government is the seventh most authoritarian from among the 167 countries rated.. The ethnic composition of Saudi citizens is 90% Arab and 10% Afro-Asian. Saudi Arabian dress strictly follows the principles of hijab (the Islamic principle of modesty, especially in dress).
In the UAE ie Emirates, Wiki says in 2013 UAE’s total population was 9.2 million; 1.4 million Emirati citizens and 7.8 million expatriate ie 16.6% Emirati (citizenry), 23% other Arabs, 54.4% Asians, and 6.0% other expatriates. Thus the relatively democratic & liberal UAE has only 40% Arab ie (majority also Wahhabi) Muslim population, compared to some 90% in the KSA. . in 2005, 76% of the total UAE population was Muslim, 9% Christian, and 15% other (mainly Hindu). Census figures do not take into account the many “temporary” visitors and workers while also counting Baha’is and Druze as Muslim. Among Emirati citizens, 85% are Sunni Muslim, while Shi’a Muslims are 15%.
The comparable life expectancy in the bigger but relatively poor mostly caucasian countries of Europe is 80 yrs (Portugal), 81 (UK) to 83yrs , and 84.6 in Japan. Why the richer KSA has so much lower life expectancy can only be due to combination of culture (overdress?) and perhaps genetics- but Israel, also a predominantly eastern mediterranean semitic people, like Europe has life expectancy of 82.1 years. on that tabulation, UAE expectancy is 79.2yrs, USA 79.8, but KSA only 74.3.
Comparison of Gross domestic product and per capita income for 2014 fail to explain the differences in life expectancy ie survival between the highest earning countries, with KSA, UAE, Israel and much of the middle east countries falling in the $30 to $40 000 per capita income bracket.
NO NEW CASES WORLDWIDE: 4 suspected MERS cases investigated in Hong Kong after arriving there via Dubai have proved negative for MERS.
while Ebola, AIDS, cholera, polio and bubonic plague spread despite major efforts at containment… with at least USA and UK preparing for ebola outbreak, and China for the bubonic plague.
8 August 2014 Ebola virus disease EVD update – West Africa Disease outbreak news Between 5 and 6 August 2014, a total of 68 new cases of Ebola virus disease (laboratory-confirmed, probable, and suspect cases) as well as 29 deaths were reported from Guinea, Liberia, Nigeria, and Sierra Leone. On Wednesday, 6 August and Thursday, 7 August, an Emergency Committee determined that the current outbreak constitutes a Public Health Emergency of International Concern. and advised that: it constitutes an ‘extraordinary event’ and a public health risk to other States; the possible consequences of further international spread are particularly serious in view of the virulence of the virus, the intensive community and health facility transmission patterns, and the weak health systems in the currently affected and most at-risk countries.
It was the unanimous view of the Committee that the conditions for a Public Health Emergency of International Concern (PHEIC) have been met. New cases and deaths attributable to EVD continue to be reported by the Ministries of Health in Guinea, Liberia, Nigeria, and Sierra Leone. Between 5 and 6 August 2014, 68 new cases (laboratory-confirmed, probable, and suspect cases) of EVD and 29 deaths were reported from the four countries as follows: Guinea, 0 new cases and 4 deaths; Liberia, 38 new cases and 12 deaths; Nigeria, 4 new cases and 1 death; and Sierra Leone, 26 new cases and 12 deaths.
As of 6 August 2014, the cumulative number of cases attributed to EVD in the four countries stands at 1 779, including 961 deaths. The distribution and classification of the cases are as follows: Guinea, 495 cases (355 confirmed, 133 probable, and 7 suspected), including 367 deaths; Liberia, 554 cases (148 confirmed, 274 probable, and 132 suspected), including 294 deaths; Nigeria, 13 cases (0 confirmed, 7 probable, and 6 suspected), including 2 deaths; and Sierra Leone, 717 cases (631 confirmed, 38 probable, and 48 suspected), including 298 deaths.- mortality rate so far 55%.
For a viral hemorrhagic illness, as for acute MERS and flu, Ebola treatment and prevention remains supportive, including plenty of fluids and salts, multivites incl K1, highdose vitamin C eg a few grams hourly to tolerance, vitamin D3 perhaps 300 000iu orally to start then 100 000iu weekly, iodine, zinc, selenium, garlic, ginger, ecchinacea and colloidal silver till out of the woods.. .
29 July 2014 the first Wiki update in weeks indeed shows no reported increase in KSA cases with 41% fatalities; but total Arabian Peninsula cases up to 825 with 321deaths ie 39% fatalities, and 96.3% of global – 855 cases and 331 deaths ie 39%.
28 July 2014 THE END OF THE ARABIAN MERS CoV OUTBREAK? its now apparently 18 days without new MERS cases reported from KSA , compared to 6 cases in the previous week… . so the Wiki figure of WHO-reported cases in the Arabian Peninsula (plus the 2 recent cases in UAE) totals 814/(835 globally ie 97.5% of reported world cases), with 315 Peninsula deaths ie 38.7% fatality rate- but only 13% in the far less coverup- restrictive UAE with its huge foreign worker population. . . supporting the studies of KSA scientists of more severe vit D deficiency in the most covered-up observant people, citizens of Saudi Arabia and its fellow ultra-observant Wahhabi bordering neighbour states (except the UAE) to the south and east. .
and now Ebola epidemic outbreaks kill hundreds in central Africa. The nocturnal fruit bat (that locals eat) is apparently the vector. There is strong reasoning that these could be prevented, successfully treated (humans if not bats) with safe highdose vits C and D3. Like humans, all tested families of bats, including major insect- and fruit-eating bat families, cannot synthesize vitamin C,. and have very low vit D levels, make vitamin D only if they roost in sunlight.
and Central Africans are very darkskinned, and the masses malnourished from rampant genocidal wars, so they will have the lowest levels of vitamins C and D3.
20 July 2014 MAYBE.. JUST LACK OF REPORTING? NO COMPLACENCY YET: Giuseppe Michieli‘s A Time’s Memory to 17 July shows 17 more reported MERS cases (all outside the KSA -still 721 cases, 297 deaths): globally 852 with 329 deaths; Arabia 829 with 319 deaths; ie rest of world 23 cases and 10 deaths- similar mortality 41% in Arabia compared to 43% in the 23 infected cases who returned to their own countries (middle east, north Africa, Europe, USA, Malaysia, Philippines) not on the Arabian peninsula- from their visit/working there or, rarely, contact with returnees. . So has the outbreak stopped in the past 10 day
ps the USAEBN radio website reports startlingly different case numbers in far fewer nations, especially tenfold more cases in Qatar and half the number in UAE. Time will tell. . this high occurrence in Qatar is not reported anywhere else? on 24 July it reports for KSA alone 834 Cases (897 in the Arabian Peninsula); 288 Fatalities. globally 873 cases with death rate only 35%. still the massive discrepancies with startlingly far more cases in Qatar and Philippines and far less in the UAE. This website claims, perhaps not implausibly, that “Government Organizations Do not want to publish total numbers of cases for fear of panic, USAEBN will be trying to track it.”
Virologist Dr Ian MacKay IN MID JULY puts the world total of cases at 846 in his informative analysis of age and gender demography.
But with neighbouring Iraq in civil war breakdown and even polio flareup, who knows how many there are suffering and dying from unmonitored MERS CoV.
14 July 2014 The UAE reports 2 new cases of MERS CoV – the first in a long time-, bringing their total to about 73 cases, 9 deaths ie 12% fatality. . KSA reported one new case 10 July ie 4 past week, and 5 in each of the the previous few weeks; with no deaths, tally now 721 cases, 295 deaths ie 41%. The UK Gov travel warning is about terrorism in the region, not MERS.
The vexed question of the method of spread of MERS CoV between animals- dromedary camels- and humans continues to be hotly debated between expert virologists and camelmen. The KSA has still not issued [ any restriction on camel imports from the suspected source of the MERSCoV- the Horn of Africa.
But the argument is irrelevant for practical purposes. Tradition, belief dies hard, like the strictly enforced hijab overdress, and camelkeeping: “Riyadh’s camel market stretches several miles along a highway out of the city. It’s not true. Camels occupy a special place in Saudi society, We live, sleep, eat and spend our whole lives with camels, we drink their milk, its a medicine.. There’s no disease,” said a trader at the market”. Its the story of 160 years ago, the cholera-spreading London’s Broad St water pump until Dr John Snow recognized and stopped the source of the cholera diarrhoea epidemic. This far more lethal KSA lung-kidney epidemic is simpler- encourage people worldwide to get plenty of free natural sunshine , or if living at far north darker latitude or practicing hijab and unable to sunbathe- especially over Ramadan- take at negligible cost vigorous supplement of vitamin D3 to a high safe bloodlevel .
8 July 2014 Spread of MERS CoV- Down but not out: from 15 cases a day in early May, now KSA has reported 8 new cases past 7 days; ie 720 total, 294 deaths- 4 new cases past 3 days, with 1 new death. 18 new cases in 24 days since 13 June. So the rate of new cases is not dropping there the past month – or simply more cases being tested and reported. Only sick cases who see doctors, and their contacts, and city health workers, are likely being screened.
The death rate in KSA since the outbreak 2 years ago remains 40%. why should this be? other than that Saudis do not benefit from the midsummer as do other populations- they remain shrouded in overdress and thus severely vitamine D deficient? and the virus seems to spread not airborne but by direct contact – human to human, or camel-(milk?)-human? and the KSA has not yet been reported to have stopped mass camel importation from the Horn of Africa for butchers to supply meat.
MERS CASES BY OCCUPATION: Shane Granger has tabulated more recent reported MERS cases by occupation where data is available - >375 cases:. Health Care Workers (HCW) the largest group – 161: includes all types of unidentified Health workers (i.e. Nurses, Doctors, hospital and clinic staff). Retired: also 161 (incl Pilgrims 11). Schoolkids 18 -third. Farmers 12 – fourth. . tourist 3; construction 2; Camelbreeder, butcher , shepherd one each.
The retirees are the elderly, generally frailer, probably more at leisure, more orthodox ie more ritually overdressed? and circulating /concentrated more through/in the cities especially Mekkah, Riyadh, Jeddah, and visiting the more frail and sick worldwide; thus more susceptible.
Healthworkers are obviously the most stressed and hardworking, exposed to concentration of symptomatic MERS cases and thus ingestion and surface (if not droplet) contamination .
The major surprise is the low occurrence in schoolkids, pilgrims, and non-health industry workers, teachers, clergy, armed forces, shop and office staff, non-healthcare govt workers, etc.
This also favours nutritional ( sunlight/vit D/C/zinc) deficiency as a significant factor in susceptibility of retirees and healthworkers to MERS. The general population (unless seriously ill with other disease) is largely immune to MERS, like flu and common colds, in them the MERS CoVirus seemingly causes nothing more.
4 July 2014 frail pilgrims should postpone the Hajj this year. the European Centre reports KSA 716 cases, 293 deaths; worldwide 843 cases (817 in Arabia incl now 4 in Iran), 322 deaths. in 21 countries, ie 21 cases outside the Middle East (ie outside the camel contagion area south-east across the Arab states that have had 791 cases so far) . So thats about 10 new cases over the mid summer in KSA the past 15 days so far. Only 1 new death. Case reporting from the rest of the world lags behind.
So the Philippines has advised its citizens to postpone Hajj to Mecca this year.
Certainly frail pilgrims – especially with diabetic and cardiorenal/respiratory diseases -all over the world will be wise to postpone. And the KSA is at last considering stopping import of camels (4.7 million a year mostly for human consumption, - mostly from Somalia, which has never reported a MERS case) – from the Horn of Africa- their main meat supply. This appears to be the source of the outbreak- simply camel colds that kill only sickly humans who unlike camels avoid sunshine by edict… . Up to April 2014, it was predominantly a disease of older men; (it appears that camels are men’s work); but by midMay the male dominance in human MERS cases was fading.
But is the core problem the well-camel MERS-Covirus carriers? It is in fact more likely that the prime cause is that the entire KSA population is at extreme risk – both because those who can afford it overdress by religious edict, especially upperclass Muslim women in total coverup and thus badly vitamin D deficient; and because the KSA imports vast numbers of mostly poor unskilled foreigners to do mostly manual work. Such poor labourers are usually undernourished, living in poor conditions, and with poor access to medicines and medical care until they collapse; and unless outdoor labourers, living and working long hours indoors, and hence also badly vitamin-D and C deficient. . The Wiki review Saudi Arabia “Foreign workers estimated them to number 1/3 of KSA residents recently. Saudi Arabia has become increasingly dependent on foreign labour, and although foreign workers remain present in technical positions, most are now employed in the agriculture, cleaning and domestic service industries. The hierarchy of foreign workers is often dependent on their country of origin; workers from Arab and Western countries generally hold the highest positions not held by Saudis, and the lower positions are occupied by persons from Africa, the Indian subcontinent, and Southeast Asia. the situation has persisted because of a reluctance by Saudis to take on menial work and a shortage of Saudi candidates for skilled jobs.[.. The Saudi economy has, therefore, remained dependent on importees for expertise in specialized industries, and on the Asian workforce for the construction industry, menial and unskilled tasks. Saudization is generally considered to have been a failure.
THE MERS-CoV CAMELTRAIN FROM AFRICA: This again begs the huge question: if camels carrying asymptomatic airways MERS CoV are indeed the virus vector from Africa – almost 5000 a year from Somalia alone- imported into KSA through Jeddah port, WHY ARE THE EXPORTING CAMEL- TRADERS and camel- breeders IN NORTH AFRICA NOT SUFFERING vastly from MERS respiratory-renal syndrome? They are likely Muslim if not black Africans; oil-rich Arabia employs vast numbers of overseas expats as labourers, and outside the KSA, Arabia especially the UAE hosts hundreds of thousands of non-Muslim professionals. But unlike say Indians and other Asians, Pinoys and Malaysians are mostly Muslim, so are more likely to observe cover-up dress code, and thus be more vulnerable to MERS. . This again supports the evidence that the current symptomatic serious MERS-CoV SARRS – Severe Acute Respiratory Renal Syndrome – that occurs in and kills almost exclusively vit D deficient frail observant Muslims - is due to conditioned sunlight deficiency. The north African camel breeders and traders, and the camel herders and camel men in Arabia ( like cowboys on the prairies and herders worldwide in hot climates), are unlikely devout well -berobed Bedouin of Arabia. Camelmen like cowboys get plenty of sunshine vit D, if only via bare faces and arms; and thus can with probable impunity, immunity against MERS, drink raw camel milk and travel with vast camel herds.
27 June 2014 update: (compared to 13 June 2014 KSA 702 cases, 292 death, worldwide 826 cases, 326 deaths): there are now reported in KSA 710 or 718 cases ie 8 -16 in 2 weeks, no more deaths; and globally 833 cases & 322 deaths. . Australian virologist Dr Ian Mckay postulates why vast camel imports (from Africa, via Jeddah port) for eating is likely the source of MERS in Saudi Arabia. He omits the obvious link in the chain, that the deathrate from MERS CoV is far lower outside Saudi Arabia because this sunny country is the strictest in the world for enforcing Wahhabi hijab total overdress code and thus profound acquired vitamin D deficiency even in men, and worse in females who in public – unlike men- must have even their heads and faces veiled by a niqab- and in pilgrims from other lands who as part of their holy pilgrimage undertake to follow permanently the strict hijab dresscode. Their simple option is to take effective permanent vitamin D3 orally eg 50 000 iu weekly.
IT IS COMMON CAUSE THAT ONE DOESNT, CANNOT PREVENT OR TREAT INFECTION BY POOR NUTRITION OR LOWDOSE ANTI- MICROBIALS- such policy is futile if not dangerous for breeding resistance as well as disease extension. The studies below confirm the obvious, (as Klenner, Pauling, Cameron ea showed the past 50 years with highdose vit C injection), that vitamin D3 orally also works as a multiantimicrobial agent if given as early as possible in safe very high dose and bloodlevel eg 600 000iu monthly (in the first month, – in Salhuddin’s Pakistan PTB patients (presumably also Sunni muslim) initially mean wt 45kg, thats vit D3 ~440iu/kg/d) for two doses ie a mean of 300iu/kg/day over 90days; not the current preventative recommendation of 80iu/kg /day to a safe blood level of around 50-60ng/ml. As Holick has said, with adequate water intake even 50 000iu vit D3 a day ie 1.5million iu/month for months causes no toxicity. Given the 40% mortality rate in the frail Saudi MERS patients, and in acute severe influenza and other serious viral infections, it can be expected that such highdose immediate vitamin D3 therapy orally with eg 600 000iu, combined with highdose vitamin C, zinc and some multivite, (never mind appropriate antibiotics in acute bacterial infection) will similarly virtually eliminate mortality.
But no KSA Govt website mentions this- except the Saudi Gazette a year ago which strongly urged vitamin D supplement in the KSA as even daily sun exposure does not bring most Saudi women above the vitamin D deficiency threshold. It says Since Muslim women can only reveal the hands and face, they may need to be out in the sun for longer than 30 minutes. But the review conspicuously fails to mention that in public outdoors in KSA, women must have even the head and face covered. It also propagates surprising dangerous nonsense that “severe deficiency needs monthly vitamin D injection – “Mom, have you taken your vitamin D injection this month?, when all it requires is an oral daily, weekly or fortnightly dose vitamin D3 at trivial cost.” It does stress “One of the main reasons why vitamin D deficiency is so common in the Kingdom is because there are very few food sources of vitamin D. Foods which have fairly good amounts of vitamin D are fish liver oil, sweet potatoes, egg yolks, vegetable oils, butter, and fatty fish such as salmon, sardines, and tuna,” said Dr. Rasha Jameel, a consultant in family medicine at a local hospital. In the United States, all milk and dairy products are fortified with vitamins A and D, but no such measures are in place in the Kingdom“.
This correlates with a new metaanalysis (in the BMJ this month) of observational studies from Europe and USA, that all-mortality hazard ratio over a mean of 10 years increases by 57% as vit D level falls from the highest to the lowest level. The KSA apparently chooses to ignore that, as this column reported recently from WHO data, despite apparently being the wealthiest country per capita of bigger populations in the world, KSA’s population life expectation is about 5 years lower than eg far less sunny Britain’s; ie KSA all-cause mortality rate is avoidably materially higher. Despite KSA medical professors having reported in studies that most of the KSA population is deficient in vits D and C, the KSA Govt website chooses to ignore this on official websites; unlike other even Middle-Eastern governments promoting vit D fortification or meaningful safe supplements costing trivial amounts.
Even a new study last year from KSA universities confirmed that ” Most commonly consumed food products by Saudi population which are supposed to be fortified by vitamin D are either not fortified or contain an amount less than (apparently from their table 2 ~ half of) recommended by guidelines set for US marketplace”. Even a UAE authority recently stressed “Can fortified milk fight Vitamin D deficiency? Shockingly low levels of D3 among UAE population cannot be rectified by milk alone.” As Holick ea, including a Turkish University 2010 trial report, oral vitamin D3 is far more effective , and safer than, either vitamin D2, or vitamin D injection -never mind much cheaper. This current ostrich-head-in-the-sand denialism by the KSA government is like that of the RSA govt under Presidents Mbeki and Zuma 10-15 years ago about preventing and treating HIV-AIDS – considering that the safe and beneficial daily intake of vitamin D3 is now universally recognized as 4000 if not 10 000iu/day (ie about 80iu/kg/day or pro rata up to perhaps fortnightly) , to a mean blood vit D level of about 60 to 80ng/ml. .
As Prof Mike Holick pointed out a few years ago, “Even in Saudi Arabia, Qatar and South Africa, more than 50% of the population is deficient in vitamin D, all because of their avoidance of sun. Based on some of the literature, it seems that we could probably decrease health care costs across the board by 25% if everybody had optimal vitamin D status.” As Al Faraj ea reported in Riyadh in 2003, Prof Zahid Naeem from a KSA university wrote in 2010, “Vitamin D deficiency is an ignored epidemic in KSA and globally“; confirmed by a KSA study by Ali ea in 2012: “Even in a sunny country like Saudi Arabia the prevalence of vitamin D deficiency in young female is high“.. One does not need to speculate why the KSA and all governments globally choose to ignore this inconvenient truth, downplay effective vigorous vitamin C and D3 (sunshine) supplements- such widespread vitamin D and C deficiencies, like cigarette smoking and alcohol abuse, suit governments and Big Pharma- the Disease Industry- in reducing populations growths and creating jobs for the highly profitable Disease Industry and it’s shareholders- for whom Only Disease Pays. Cheap safe natural Prevention Does not Pay since it at least halves sickness never mind disease industry jobs, taxes and profiteering in the global $multitrillion Disease and Diet and Vaccine and Invasive Screening Industry scams.
And Karen Hansen ea at Univ Wisconsin 2014 have just shown that giving vitamin D2 (not D3) 50 000iu fortnightly for a year is actually adverse – as Holick and others have show – IT DEPRESSES – perhaps halves – THE BIOLOGICALLY ACTIVE blood 25OHVIT D3 while boosting perhaps 5 fold the far less active blood 25OHvit D2 levels , and actually worsens rheumatoid arthritis clinically and serologically . One can speculate whether vit D2 actually blocks optimal function of VDRs vitamin D receptors. Trials published 2012 from Japan and Netherlands showed that vitamin D3 – blood 1,25(OH)2D3 (but not TNFalpha blockers) blocked inflammation (ie TNF tumour necrosis factor alpha activation of vascular calcification).
Salahudfin ea’s new randomized controlled trial from Pakistan Vitamin D3 injection accelerates clinical recovery from tuberculosis shows “impressive clinical (weight gain, chest xray and sputum clearing) improvement over 3 months on outpatient TB therapy (Directly Observed Therapy (DOTS) with 2months of 4 antituberculous drugs [Isoniazid, Rifampicin, Ethambutol and Pyrazinamide] followed by 6months Isoniazid and Ethambutol) with two doses 600 000iu vit D3 imi (vs placebo inj) a month apart- ie equivalent to about 7 000iu/day over the 3 months treatment period . This dose of vitamin D is as recommended for vitamin D supplement by the Pakistan Endocrine Society. Trough 25OH vit D levels increased from about 20 to 90ng/ml. After 12weeks, the vitamin D supplemented pts (mean 28 yrs, BMI 17.2kg, 85% moderate to far advanced lung disease) had significantly greater mean weight gain (kg)+3.75, (3.16 – 4.34) versus+2.61, p 0.009; lesser residual disease by chest xxray- 30% fewer zones involved 1.35 v/s 1.82 p 0.004, and 50% or greater reduction in cavity size 106 (89.8%) v/s 111 (94.8%), p 0.035. Vitamin D supplementation led to significant increase in MTBs-induced IFN-g secretion in patients with baseline ‘Deficient’ vitamin D serum levels (p 0.021). Patients in the vitamin D arm and serum < 30 ng/mL (‘Insufficient’ and ‘Deficient’ groups) at enrollment had significantly greater improvements in TB severity scores compared to patients with normal baseline vitamin D levels; p 0.014. This corresponds with the earliest reports of the benefits of vitamin D in TB patients published in 1848  that describes disease arrest, weight gain and reduction in mortality in patients with TB treated with cod liver oil compared to standard therapy alone. More recently, Martineau et al  demonstrated that a single oral dose of 2.5mg (100,000IU) of vit D2 significantly reduced growth of mycobacteria . A randomized, placebo controlled study on 67 Indonesian patients, by Nursyam et al , Jakarta  reported that pulmonary TB patients given 420,000IU of vitamin D over 6weeks ie 10 000iu/day had significantly higher sputum conversion rates as compared to placebo (p 0.002). Martineau et al.  showed that 100,000 IUs of 25-hydroxyvitamin D3 supplementation significantly improved sputum conversion rates in patients with the Taq1 25-hydroxyvitamin D receptor polymorphism of the tt genotype. .
As Salahuddin ea note, the good results in Pakistan in only 3 months with vigorous INITIAL dose vit D3 contrasts with Two recently published large randomised, controlled trials of conservative vitamin D3 over months that achieved far lower blood vitamin D levels found no difference in clinical outcomes or mortality: after 400,000iu of 25-hydroxyvitamin D3 or placebo were given by Martineau ea in London, UK to 146 pulmonary TB patients – where mean (trough or midpoint) vit D level (after 100 000iu vitamin D(3) or placebo at baseline and 14, 28, and 42 days after starting standard tuberculosis treatment) – was surprisingly only 40ng/ml at 56days – ie after a mean of 7000iu/d by 56 days, vs 10ng/ml on placebo)- less than half of the bloodlevel achieved on vit D3 in the Pakistan trial ;
and by Wejse et al 2009 in Guinea-Bissau to 365TB patients – who received 300,000 IUs of vit D3 ie only 100,000 IU or placebo at inclusion and again 5 and 8 months after the start of treatment, ie below 1000iu vit D3 per day over the 12 month trial period “. The Guinea-Bisseau pts thus might have achieved a mean blood vit D level boost of only 10ng/ml.. and now Havers ea (Baltimore) show Low 25(OH)D is common in diverse HIV-infected populations and is an independent risk factor for clinical and virologic failure; Low 25(OH)D was associated with high body mass index (BMI), winter/spring season, country-race group, and lower viral load. Baseline low 25(OH)D was associated with increased risk of human immunodeficiency virus (HIV) progression and death (adjusted hazard ratio (aHR) 2.13; 95% confidence interval [CI], 1.09–4.18) and virologic failure (aHR 2.42; 95% CI, 1.33–4.41). and Shepherd ea (Eurocoord) Low Vitamin D predicts short term mortality in HIV-positive persons Odds of death decreased by 46.0%( P = .04) for a 2-fold increase in latest 25(OH)D level.. In patients with current 25(OH)D <10 ng/mL, hsIL-6 concentration increased by 4.7%(95% CI, .2,9.4, P = .04) annually after adjustment for immunological/inflammatory markers, and no change in hsCRP rate was observed (P = .76)
19 June 2014 update no new cases reported from anywhere the past few days, may be because the KSA is not reporting regularly. so the great news is that more than 2 years after the onset of the MERS CoV outbreak in Arabia, no ongoing transmission has been reported from any of the 22 countries so far affected.
THE POLIO SPREADING GLOBAL EPIDEMIC This decline of the MERS outbreak with the heat of summer contrasts sadly with the now-declared global epidemic of wild natural poliomyelitis- which was hoped to be extinct by now, with Hindu- run India being declared polio-free; but now spreading out with mass refugees from wherever war and chaos are successfully ignited by profiteers and fanatics to neighbouring countries. Eg an expanding militant Islamic Wahhabi arc – ie ultraorthodox overdress code – predisposing to vitamin D deficiency? from Asia- Pakistan, Afghanistan, to middle east – Syria, Palestine, Iraq, Israel; to East/West Central Africa eg Somalia, Cameroon, Ethiopia, Kenya, Nigeria, Guinea-Bissau, - with 365 cases reported in 2013. Perhaps more important is zero natural virus cases in Niger and Chad but cases caused by the circulating vaccine derived virus. The wartorn DRCongo and Sudan are likely next polio outbreaks, while Angola has banned Islam because of its perceived militancy. …
And in February, never mind an outbreak of polio-like paralysis in northern California, a new case was reported in a South African neighbour- in Botswana – for the first time there in 20 years -; “Polio virus is endemic in five countries besides Nigeria: Afghanistan, Egypt, India, Niger and Pakistan. Scientists confirmed that the virus isolated from the boy in Botswana came from Nigeria by laboratory tests that showed it was genetically similar to the strain that has been infecting children in Nigeria . In the past 18 months, polio viruses genetically linked to northern Nigeria have caused new cases of polio in nine previously polio-free countries. Besides Botswana, they are Benin, Burkina Faso, Cameroon, the Central African Republic, Chad, Ghana, Ivory Coast and Togo.” So polio is likely to break out in RSA not because of Islamic overdress but because of the masses of war refugees absorbed by democratic dispensation from the polio-afflicted African states to the north, and poor water supplies, sanitation and nutrition, in so many areas in the northern provinces, despite mass polio vaccination. . In Cape Town’s poorer areas’ clinics, we see almost as many foreign pan-African refugees as we do local black Africans.
VITAMIN C & D AGAINST POLIO: but as with flu, HIV, TB and likely all infections, the rescue remedy that the Disease Industry firmly ignores is freely available also against polio (and all other infections - as shown so successfully by Dr Fred Klenner after WW2 with highdose vitamin C); and at least two published studies in modern times ie on Pubmed (FDA- Ivanov 2006 USA) shows the predictable enhancement by vitamin D3 as an adjuvant of immune response to vaccine against poliovirus- presaged by a 1949 paper from Foster ea Univ Pennsylvania . .
15 June 2014 new case reported in the 23nd country – Bangladesh, arrived from USA via Abu Dhabi airport. But now disproven. CRUCIAL EFFECTIVE VITAMIN D3 DOSING: TRIALS USING SUBOPTIMAL VIT D DOSES AND LEVELS ARE MISLEADING: A major new metaanalysis of the benefit of Vitamin D and Respiratory Tract Infections VIDARIS in PLOS 2013 by Sweden’s Karolinska Institute Bergman ea showed that in the 11 relevant trials (published between 2007 and 2012 ie done through the first decade of this century) using vit D3, “Overall, vitamin D showed a protective effect against RTI (OR, 0.64; 95% CI, 0.49 to 0.84). And the average vit D level at baseline was only 24ng/ml, but with the mediocre vit D3 doses used then of average 2000iu/d (300 – 4000iu/day) given for between 7wks and 3 yrs, the average bloodlevel achieved on replacement was only 50% higher at 36ng/ml”. This confirms more direct experience with higher doses that blood level increment, and benefit, is proportionate to vit D3 dose, at least up to the proven speculative safe upper dose of at least 10 000iu/day (whereas the proven safe longterm daily dose is> 50 000iu/day). “More important, the protective effect was larger in studies using once-daily dosing compared to eg monthly bolus doses (OR=0.51 vs OR=0.86, p=0.01)”. This concurs with our experience of major benefit against respiratory infection that is based on published studies giving a loading month’s dose of about 80-100 iu/kg/day ie ~3000iu/kg; then that monthly dose split conservatively eg 50 000iu every week or two depending on mass, and severity of ill-health; to a more successful blood-level of 60 to 100ng/ml. Similarly, the 2014 VIDA trial across USA- Effect of Vitamin D3 on Asthma Treatment Failures in Adults With Symptomatic Asthma and Lower Vitamin D Level, Castro ea, showed “Vitamin D3 for 28 weeks did not reduce the rate of first treatment failure or exacerbation in adults with persistent asthma and vitamin D insufficiency. These findings do not support a strategy of therapeutic vitamin D3 supplementation in patients with symptomatic asthma“. But this trial had the same severe limitation as the Swedish metanalysis of vit D3 benefit- it also used only 4000iu/d. “While all were vitamin D insufficient ie below 30 ng/ ml before the trial and half were deficient with levels below 20 ng/mL, supplementation brought levels above the 30 ng/mL threshold for 82% in that group – mean levels were 41.8 ng/mL at week 28 in the supplement group, while the mean stayed in the deficient range for those who got placebo. ” So 4000iu/day merely doubled the bloodlevel to only about 40ng/ml – only about half of the putative optimal dose. These recent studies force us to conclude that bad weather, and bad prevalent respiratory viruses, and especially with major acute, or chronic illness as in those with or at risk of serious infections eg major trauma or sepsis, MERS-CoV, Ebola, malaria, cholera, cancer, diabetics, smokers, asthmatics, bronchitics, AIDS-TB., pneumonia and old age sufferers, and especially hospital, laboratory and clinic- health workers- we should for an average 70kg adult give a loading dose of about 4000iu/kg, ie 300 000iu, then 10 000 iu/d, or 50 000iu every 5 days, or more simply 75 000iu (about 1.5ml of 100cws vit D3 powder) weekly; or at a stretch, 300000 if not 400 000iu monthly. . As the common imported vit D3 powder concentrate is 100 oooiu / Gm ie per 2 ml, it is simple to take the slightly sweetish powder up to 2 or more 4 ml teaspoons ie 200 000 -400 000 iu on the tongue. The majority of residents of developed countries now live urbanised with mechanized transport, and – especially in Muslim or cold countries- dont live and work / walk all day stripped in the sun. The poor malnourished peasants live crowded in ghettoes , and the poorest are generally the darker skinned and therefore make the least vitamin D3. So with rare exceptions, everyone needs the vigorous vitamin D 3 doses discussed above. But at the prevalent bulk vit D3 powder price of at most about US$0,o2 per 100 ooo iu, at a mean population age of around 20 to 25 yrs -outside Europe- it would cost a country of eg 50 million people perhaps $o.5 per head per year ie conservatively $25 million a year to prevent > 90% of common illnesses including drugging and violence consequences. Of course no government can tolerate such massive loss of jobs and taxes in a decimated disease industry that now turns over $ trillions annually – up to 18 % of national budgets. So it’s up to individual adults, especially householders, educators and employees , to see that the cheapest cure-all after clean water – vitamin D3 – at $2/citizen per year- is recommended and freely available.
13 June 2014 KSA now has apparently reported 702 cases, 292 deaths ie 14 more cases, 12 more deaths in past 11 days.. worldwide 826 cases, 326 deaths. And a new multinational vitamin D study confirms why vitamin D3 not D2 must be given. TIME TO SWOP FROM MISNAMED “STRONG CALCIFEROL” VIT D2 TO THE REAL VIT D3. 6 June 2014 on the 10th anniversary of the SARS epidemic , a new 2013 review (by Japanese epidemiologists) Remembering SARS-CoV: A Deadly Puzzle and the Efforts to Solve It brings home the lessons, the similarities between the two recent killer coronavirus outbreaks, in both outbreaks affecting only residents of closed communities (Arabia and China respectively), with carriage of the virus by travelers into their closed kin communities elsewhere. . Especially the problems of hospital confinement, and superspreaders. Sun-blocking culture among the Chinese whereever they live in their ethnic communities is also stressed in modern literature. Lu et al 2012 show very high levels of vitamin D deficiency in Shanghai. The obvious lesson of the past decades was not noted then or now- prevention is better than cure, as in AIDS and pneumonia and all other infections, simply by superboosting the immune boosters within sensible limits - sunshine/vitamin D3 and C, zinc, iodine, selenium; and for the likely deficient, appropriate iron .. 4 June 2014. Saudi Arabia reports confirm they have indeed uncovered many more cases, as tabulated by the Wiki report yesterday- 689 cases, 283 deaths. Shane Granger in his Random Analytics concurs. The graph by the KSA authorities shows that most of the unreported cases reputedly occurred from March through to the first week of May, and that that outbreak is almost over, down from a peak of over 100 cases a week ie at the end of their winter- when vitamin D levels are at their lowest- to about 25 cases a week. .They do not say when the excess MERS-related deaths occurred. Who knows how many more cases and deaths are underreported from the KSA, when the annual Hajj is imminent, and religious tourism is a vast industry for the KSA. This MERS outbreak is in contrast to the 8200 recorded case SARS (coronavirus) outbreak of 2002/3 in China, S.E.Asia, (Canada and USA) and sparsely across Europe – but only 1/4 of the MERS’ ie 9.6% mortality . Just one case was recorded in the middle east and Africa- in Kuwait. Although the SARS and MERS viruses were traced through mammals to bats, the affected populations were genetically different- Chinese versus Arabic ie Caucasian. But a decade after the SARS outbreak, Chinese in Shanghai also had 85% below the vit D insufficiency threshold (30ng/ml) at the end of winter. An International Osteoporosis Foundation study of 2009 showed very high prevalence of vit D insufficiency throughout Asia including China- but worse in Malays. Thus the susceptibility to and mortality from SARS and MERS in the respective races- like Swine flu susceptibility in the frail in USA and Mexico in 2009 and anywhere since- is likely due like any disease to the combination of both socioeconomic burden, genes and sunshine vitamin deficiency. But whereas socioeconomics; genes; and ethnic taboo on sun exposure as in strict Muslims, are not easily correctable, traditional micronutrient deficiency is- especially vigorous vitamin and mineral supplements, without offending cultural taboos.
3 June 2014 update : In the past 5 days, Google websites reported 2 new cases/d in KSA. BUT Wikipedia this evening reports the latest collation: in KSA, 688 cases with 282 deaths ie 41% mortality; this is far higher than in its close 7 Arab neighbours including Iran, with a total of only 89 cases but only 26% mortality. If these figures are accurate, there have apparently been 125 cases in KSA since 29 May ie 25 new cases/day there; but 96 deaths ie 19 per day. But this gross epidemic has not been reported on Google, so hopefully the Wiki MERS tabulation will be corrected- unless it because the KSA was not announcing cases. . Apart from the 8 Middle East nations counted above, the Wiki figures for the outside 16 countries in the rest of the world – 25 cases, 7 deaths ie 28% mortality, are more consistent with reports to date outside KSA, and moderately lower than the fatality rate reported in KSA . All MERS- confirmed cases were contracted in the Arabian peninsula (or from travelers from there). All adults in the KSA including visitors would by edict be almost totally robed when outdoors, the women also with hijab. On the other hand, observant pilgrims from non Arab countries are more likely both older- having chronic degenerative diseases ie more vulnerable- , but likely get more sunshine skin exposure at home, and taking protective supplements before and after; thus possibly explaining the lower mortality and low prevalence of carriage of MERS outside Arabia. The average Saudi Arabian is aged around 20years, but the young there presumably face the same policy against skin sun exposure, and apparently against protective micronutrient supplements. 31 May 2014 Mers update the past 2 days just one new case in Saudi Arabia, but 2 cases in Algeria back from KSA - the 21st country ; and now a total of 6 cases in Iran with 1 death.
29 May 2014: The 26 May Cape Town suspect’s deep nasopharyngeal swab screens have proved negative for Influenza A eg swine flu, and MERSCoV, and she is recovering. . The NICD says they have perhaps 5 requests for screening in returnees from KSA, all negative for MERS CoV. KSA reports 3 new cases past 48hrs , while of recent screened cases there, 4 more have recovered and gone negative. ie 565 cases , but 6 more deaths ie 186 died - 33%; Worldwide thus at least 680 cases / 215 died. But apart from KSA and Jordan (5/10 died= 55%) the fatality rate in the other 19 countries reported is thus also 22.6%, as low as 13% mortality in UAE if their figures are to be believed. The problem is we dont know how many subjects were screened in each country to get the perspective.. Perhaps UAE simply screened many more ‘well’ people with “flu’. of recent cases reported from countries outside Arabia, virtually all presented clinically with serious URTI. Only 2 MERS-COV cases have been finally confirmed in USA, both travelers back from KSA. Thus it is apparent from all the screening patchily reported the past 2 years that: 1. air/physical contact crossinfection between humans (as between camels and humans) is common; 2. but resultant actual colonization (ie the asymptomatic MERS CoV carrier- akin to say the common staph nasal carrier) is reassuringly low- likely in mildly immunocompetent people with suboptimal vigorous eg vit D3 levels and intake of vits C, zinc etc; and cleared naturally within days; 3. BUT of those colonized with invasive MERS CoV who actually present sick enough-ie with MERS- (generally those with comorbidities) to consult doctors, mortality may be > 50% (as eg in KSA, Jordan, Qatar, UK) – likely because they have poorly controlled diabetes, HIV, heart/lung/kidney disease; or very low vit D3 levels and very low intake of vit C, zinc etc. 4. So far survivors of MERS apparently do not stay carriers of the virus. These observations will be simple to affirm/ refute by storing, or immediately testing, all carriers’ and cases’ blood for 25OH vit D3 (albeit expensive) as well as the other obvious markers . But it is harmless and virtually cost-free to treat all such people anyway with vigorous vits D3, C and zinc against all latent/patent diseases. Parallel experience with seasonal flu/ common colds is that while the URTI may have been protracted till the patients consult, virtually all cases quickly resolve with vigorous supplements (vits C, D3, iodine, multivite, appropriate iron, and appropriate decongestants/ “vix” steaming. And of course it is simple and appropriate to deep-sniff pure vit C + D3 powder- as easy as using a nasal sprayer. . 27 May 2014 Jordan reports a fresh (10th) case; KSA now 562 cases -no new cases, but one more death; national school exams start there irrespective.. so global total now may be 650..now 2 in Iran. – - the 21st country?. Its not to say that >650 people have caught the illness, since apart from 30% who died of MERS , at least 20% were well, found only on viral swabs of contacts, ie by definition did not have the MERSyndrome that has killed 30%.. The global authorities have not revealed how many of the balance of 50% of those who screened positive actually developed any flu-like symptoms, as opposed to those who survived pneumonia & renal failure. Vigilance is necessary everywhere since both seasonal (H1N1) flu is spreading in the southern hemisphere, and MERS from Arabia with the recent peak there, and business, social and umrah travelers pouring through the Middle East hubs- especially to and from the worldwide Muslim diaspora , and trade hubs, . . “If you get sick within 14 days of being in the Arabian Peninsula, call a doctor and tell the doctor where you traveled.” said an NBC report earlier this month. 26 May 2041 Our first ‘ground zero’ MERS suspect returnee from Riyadh today screened in Cape Town?: after a weekend with my own flu attending a 3day medical congress here, and bad family news last night, I was caught flatfooted this morning at a walk-in local family practice clinic full of people with sudden flu/gastro gripes: the first lady in (robust, no chronic illness) with usual sudden overnight flu had after two weeks visiting her family in KSA, jetted back from there just two weeks ago, having sat behind a man coughing and spluttering. Before starting highdose supplements etc, she was deep nasopharyngeal swabbed for flu and MERS exam by our South African National Institute for Communicable Disease. Then we will, if she/her family prove positive, contact the airline to start tracing all passengers and contacts here. She is hardly in the risk category that has rocked the KSA. We dont know yet about her flight fellows..
25 May 2014: HOPEFULLY THE MERS SURGE IN KSA IS OVER? latest cumulative Saudi reports are of ~558 MERS cases in KSA, 179 deaths ie ~7 new cases detected a day (none elsewhere) . Thus in the 3 weeks since 3 May, unverified reports mainly from middle east websites are of about 101 new cases ie about 5 new cases a day, and 42 deaths in KSA ie 2/day- ~40% mortality. The rate of new cases presenting and being detected is down, but with the incubation time-lag (5 to 14 days till illness if any), assuming that all sick citizens are promptly tested, the mortality rate will fall next week from its peak a week ago. Tightening protective measures in the KSA and no doubt in all global air-hubs outside KSA are hopefully working- there has apparently not been another reported cases outside KSA the past week. 96% of all cases detected have been in KSA & UAE, with 90% of deaths from MERS being in detected cases there. The lack of new cases reported elsewhere suggests that the global figures are now about 641 cases and 208 deaths ie about 32% mortality. .
22 May 2014 update: in KSA 544 cases, 176 deaths ie so far 18 cases/million, 32% mortality; UAE 7/million; worldwide 661 cases, 207 deaths ie 32% globally. But excluding KSA and UAE, the occurrence of MERS in the rest of the world – including most of the >billion Muslims- has been 50 cases ie <1 / 100million; and all of these cases have apparently been direct human returnees from the middle east, or their immediate contacts. Has one non-Muslim died or been seriously ill from the virus? This information is not available on the internet. But there is No pandemic in sight. At least, as Australian observer Ian Mackay points out, the trend in new cases in KSA is downwards the past month. The common denominator in KSA appears to be that especially city Muslim women there must be virtually totally covered when outdoors in public view.. But as noted earlier in this column, repeated university studies there by their own specialists have shown that their people are especially vulnerable to vitamins D and C deficiency, so easily correctable , a testable hypothesis at trivial cost? This perhaps easily controllable plague is surely an unintended consequence for one of the most highly learned and religiously devout peoples in the world? Is the epidemic growing solely in the KSA because by strict custom, Saudi Arabian residents (and their pilgrim visitors-who also are likely ultraobservant) have to cover up maximally, Dress to Kill? In the rest of the Arabian peninsula the MERS incidence rate is only a fraction? although the deathrate is similar.
19 May 2014 update: KSA toll now 537 cases / 173 deaths ie 31% mortality. The total there was inflated by 19 patients in the Jeddah dialysis unit contracting MERS some time recently. It remains to be disclosed how many of these cases were diabetic, were on vigorous vits C/D supplements, and died? The global figures are now 620 cases tested positive and 202 deaths.
17 May 2014 including a 3rd case (by direct contagion from a newly arrived traveler) in USA, there are now about 650 MERS cases reported worldwide, 200 deaths ie 32% fatalities; 14 new cases daily globally the past 3 days; KSA 529 cases 168 deaths (ie 11 new cases a day; and 16 deaths the past 3 days). But 96% of all cases worldwide to date presented in the Arabian peninsula’s 80 million Arab population, and apparently all 27 outside cases were exports from KSA or their immediate contacts. .. The Wiki entry Tourism in KSA states plainly : “In December 2013, Saudi Arabia announced its intention to begin issuing tourist visas for the first time in its history. Restrictions and security : Visas are only issued for business, relatives of Saudis, transit to a third country, and Muslim pilgrims; general tourism is not allowed.” So effectively in KSA cities there are in public only heavily-garbed Muslims. Apparently now “non-muslim tourists can visit the KSA in a group organized by an accredited agency”, obviously provided they conform to local religious norms. But “A limited tourist visa programme was cancelled in March 2014. Saudi Arabia does not currently issue a visa for tourist travel. Hence apparently the KSA population especially in the cities is overwhelmingly Muslims conforming to orthodox Wahhabi Sunni outdoor attire- although there are apparently some 1 million christians (ie 1:30 of the population -presumably mostly professional/technician experts- in the big cities) in the KSA. Apparently there are over a million camels in the KSA, (apparently nearly 25million worldwide) with a lifespan akin to humans. “Camels come from neighboring Middle Eastern countries, in part, but also from countries in eastern Africa, including such already beleaguered places as Sudan and Somalia, Nigeria, Tunisia, Ethiopia. Just now online, not scheduled for formal publishing until this summer, is a brand-new CDC report finding widespread evidence of MERS-CoV in African dromedary camels too.” With the dromedary numbers (at least 1 per 30 Saudi citizens), camels’ huge stamina ie resistance to disease, including apparently the MERS virus they carry, their cherished role including as pets, meat, transport, racingstock, and supply of fresh warm milk in KSA society; and the reported low human vitamin D (and perhaps C) levels in the heavily-garbed city citizens, no wonder camels are an ongoing source of the hitherto unknown MERS coronavirus illness for immunodepleted citizens in KSA? whereas the camels themselves apparently suffer no more than a mild cold. A respiratory virus infection in a temperate climate is usually easily thrown off with symptomatic Rx, supplements and plenty of fluids; but on the other hand, in middle east desert temperatures and in all-over robes, hyperthermia and dehydration from MERS may more obvious cause of pneumonia and (pre)renal failure- especially in a population with high rate of sickle cell, diabetic, overweight, cardiovascular and hypertensive disease. Average temperature are about 29-330C ie mean peaks of 40C; with humidity 17% in Riyadh & Medina, but much higher in Jeddah; intermediate in Mecca..
And “Middle Eastern countries import tens of thousands of camels from eastern Africa annually. Many Saudi camels are imported. Scientists don’t yet know where the MERS virus originated or how camels got it, but it has been found in African countries and as far away as Spain’s Canary Islands, where a tiny population of camels lives for the past 400 years . ” Camels in the kingdom are like dairy cows, beef cows, racehorses, pulling horses, beloved Labradors, and living daily reminders of holy scripture, all in one. (Camels appear, honorably, in the Quran.)” As the latest report from Pulitzer Centre Prof Cynthia Gorney’s Nat Geographic account of MERS ends, “Fresh warm camels milk straight from the udder is “Very heavy, very sweet, very therapeutic” Ameer said, after I stopped shouting at him over the phone. If I were still in Saudi Arabia at this moment, I told him, I would be smacking him upside the head.” What likely gave Ameer his claimed immunity? that he had been years in USA?, and like Arabian desert camel-keepers probably lightly clothed and much in the sun- thus with good vitamin D levels?
A new report today from WHO chillingly details a party of at least 9 Umrah pilgrims since April 2014 who from Jeddah visited Mecca and Medina and then back via Jeddah to Amsterdam, Greece and USA with developing MERS – from the Jeddah sub-clade which has been identified in at least 30 cases there.. These linkages do not explain why the MERS outbreak has mushroomed solely in KSA residents – not in Muslim communities outside Arabia into which travelers flying home via Jeddah have imported the virus. The co-factor may be that, having inhaled/ingested the virus from human carriers in the KSA, these foreign travelers, often with co-morbidities, were also more vulnerable to the MERS virus because of their adherence to the same all-over dress orthodoxy, and dietary vitamins D & C and perhaps zinc depletion (with or without sickle cell trait) as has been reported prevalent in the KSA; and detailed with references below. A study is awaited of comparative skin shade, diet and skin sunshine exposure (ie degree of conformance to strict Sharia covering) between Saudi Arabians of longterm Arab descent, and their relatives and similarly conforming co-religionists in the distant diaspora Muslim overseas communities that send Umrah and Hajj pilgrims through Jeddah to Mecca and the other shrines. A current wiki-islam website stresses the serious health hazards (both skeletal- rickets and osteoporosis – and across all system diseases including immune-infection- protection) of full-cover Islamic ie hijab dress through sunlight vitamin D deficiency, unless vigorous vitamin D supplement is taken. It is no surprise that this is as much of a danger for hijab Muslims in high-sunshine desert latitudes as in bleak low-sunshine cities far north.. This might explain why the latest WHO population statistics (perhaps 2011 ie before the MERS outbreak) show that – despite being perhaps the richest per-capita nation (from oil reserves) in the world,- the KSA has expected survival age 5 years below that of UK, especially from combined (hypertension-diabetes-coronary heart- kidney ) disease rate of 375 in KSA vs eg 80 in UK. But even then, a different WHO website showed flu and pneumonia deathrate (before the MERS outbreak) 37 in hot, dry KSA ie 50% higher vs 23.7 in UK. and in about 2011, KSA had a mean population age of 20 years, with annual (agri-and seafood) imports ie dependence of US$17billion, due to its desert-limited agripotential; with predicted rapidly increasing urbanization . It will cost pennies, and a few weeks’ followup of supplement dispensing to KSA citydwellers, (and incoming pilgrims before they leave their diaspora homes for the KSA), of vigorous dose vitamins D3 + C and a multisupplement including the other vitamins , magnesium, zinc, iodine; and fish oil and virgin coconut oil (ie a blanket antioxidant, antiinfection, antihypertensive insulin-sensitizing umbrella supplement) to confirm if the emerging epidemic of MERS (let alone hypertension-heart-diabetes-kidney disease) in KSA is significantly slowed, as common infective and degenerative diseases are here in Cape Town, by such supplements. This simple prospective clinical monitoring of those receiving or not receiving the swine flu vaccine in 2009 was universally recommended, but Authorities refused to enforce such simple monitoring, so there is no clinical evidence that the swine flu vaccine significantly reduced morbidity from the outbreak, which was globally statistically trivial except in the Mexican source outbreak. Similarly, there is no evidence that the spread of MERS-CoV in KSA is epidemic considering that even in the four most densely populated cities – in the three abutting midwest provinces – containing almost half the national population, – the detected spread of MERS illness is still so low (except in the incubator hospitals). Even though camels are so widespread. it is intuitive that rural/desert citizens may take both more fresh (desert) crops (ie vit C) and more vit D- from both camel milk and more sun exposure from outdoor work with more skin exposure in such labourers. Some pictures of camel attendants apparently in the KSA on the internet show bareheaded men in vests. 16 May 2014 the latest KSA stats reported are 515 cases, 160 deaths ie 30% mortality. Globally 621, deaths 189 14 May 2014 now ~592 cases reported in 20 countries – the latest in the Netherlands, and a 3rd case in USA; with ~31% mortality (KSA 495 cases, 152 deaths ie 31%; with 20% asymptomatic). 12 May 2014: USA reports a 2nd case arrives there. a 5th death with MERS has been reported in Jordan. Saudi Arabia reports 8 new cases since yesterday, and 2 more deaths. But as expected, in the KSA eye of the storm , it appears that only contacts of patients are being screened- at least 20% of patients who screen positive for the virus have remained well. So the morbidity and mortality% are in fact very skewed, they are apparently not screening the local population for carriers. The ~28% death rate refers only to deaths in the cohort that were afflicted with MERS and their contacts.
11 May 2014 A new Reuters report today highlights the widespread intimate contact with camels in KSA. “Does the KSA want to control the uncontrollable“? “So far, the reported cases have all originated in Saudi Arabia or in the southeastern part of the Empty Quarter, in the UAE. There are no reports of those outside Saudi Arabia having transmitted the disease to others.“ the past week has seen another ~116cases ~15 cases a day- reported in the Middle East, and another 34 deaths there ie the total has reached ~578 cases (483 in KSA- Kingdom of Saudi Arabia) and ~163 deaths (142 in KSA). So the death rate has fallen to <28% overall. Lebanon and USA become the 18th/19th countries to report a case of a returning traveler. But virtually all identified cases originated in the KSA neighbourhood. The latest figures show that MERS originated and breeds exclusively in the Middle East- (cases per million ppm the past 2 years) in 16 ppm in KSA(483 cases total), 6ppm in UAE (53 total), 3.5 ppm in Qatar(7 total) and 1ppm or less in Jordan (9 total- the first reported cases, in April 2012)) or elsewhere. Apart from the frequency of camels, and the high prevalence of deficiency of vitamin D and possibly vitamin C reported below, ethnic culture may play a major role: In KSA, Qatar and UAE the great majority of citizens are Wahhabi Sunni muslims. By contrast, Yemen is only 65% Sunni, but Oman is distinctly different Sharia culture. Iraq and Iran are predominantly Shia culture.
Jordan on the other hand is a unique Hashemite culture although also 70% Sunni; so contrary to the Wahhabi countries, “ Jordan is one of the most liberal countries in the Middle East, with a secular government“. So the increasing prevalence of MERS in the Wahhabi Arabian peninsula peoples relates perhaps to the likely cluster of predisposing factors: well-covered male and especially female orthodox attire, if not also higher prevalence of sickle cell trait, and diet, which is associated with deficiency of vits D, C, A and E as referenced below. Feminist Muslim websites may correctly argue that Hijab does not cause vitamin D deficiency; but it likely contributes significantly to it’s spread via lowered vitamin D production in skin – with orthodox Muslim women arguing that such women can arrange private sunlight skin exposure. This trend to vitamin D deficiency from low oral and sunlight-mediated vitamin D is incidentally mirrored in new studies:. : from USA – The Vitamin D status of Prison Inmates- which confirmed that, on a ‘sufficient’ diet including vitamin D intake, the higher the security isolation of inmates (and therefore least sun-exposed), the lower the vitamin D status- especially in the darkest-skinned inmates; from Israel Effect of different dress style on vitamin D level in healthy young Orthodox and ultra-Orthodox students in Israel; and in southern Italian nuns.
So vit D deficiency in MERS may be like in AIDS: Vitamin D Deficiency in HIV: A Shadow on Long-Term Management)? (2014, London UK). But vigorous vitamin D charge – by sunshine and especially vit D3 supplement- as an immune and anabolic booster is one of the safest and cheapest preventions of all disease that there is. With the Ramadan Hajj to the KSA this year only 6 weeks away, intended pilgrims need to top up their vitamin D3 levels and multivites vigorously now, to boost both their infection resistance and improve control of all major diseases they have; and take plenty of vitamin C with them. So should their communities, contacts here as pilgrims return from the Hajj. SUNSHINE AND ORANGES: ANTIBIOTICs VITAMINS C AND D: like vitamin C, Vitamin D is hardly a new anti-infective agent as an Israeli study (Borella ea 2014) now confirms, since sunshine sanatoria were the only effective treatment of tuberculosis in the pre-antibiotic era even after WW2; and ” An association has been established between low levels of vitamin D and upper respiratory and enteric infections, pneumonia, otitis media, Clostridium infections, vaginosis, urinary tract infections, sepsis, influenza, dengue, hepatitis B, hepatitis C, and HIV infections“. Especially in this post-antibiotic age of rampant antibiotic resistance. Sunshine and Oranges - Empty Cradles- is ironically, the account of Britain’s infamous ruthless export- banishment to the Colonies -from the early to post WW2 20th C of thousands of surplus children of poor or orphaned families. Shades of the forced transport of ‘felons’ to Devil’s Island and the British outposts of previous centuries. Usually clad in scanty rags, in Australia they certainly had plenty of sunshine ie vitamin D , and the abundant local oranges (vitamin C); but like their surviving mothers, much grief and poverty – while from lack of these same nutrients, their kith and kin back in UK were ailing with infections and rickets . .
3 May 2014 four months later: MERS RESURGENCE: NOT A PANDEMIC BUT A DEFICIENCY SYNDROME? more precautions needed: With the recent flareup of MERS Middle Eastern Respiratory Syndrome in the Gulf States, the number of reported cases since New year has more than doubled to 457 ie to >24 cases a week there, but still only in residents/ travelers from/through the Middle East hub, and their contacts; in 17 countries including Europe, Egypt, Malaysia, Philippines and now a traveler from Riyadh to USA. The death toll has reached 133/457 ie the death rate has fallen steeply from 42% last December to 29% overall, understandably as more cases are detected by screening in the source, the Kingdom of Saudi Arabia KSA. Wiki and Reuters seem to give the most update (if not WHO-confirmed) stats. So the evidence so far is that, while camels are endemic carriers there, most recent sick cases have apparently been been traceable human to human transmission – apparently all among Muslims, and in the malnourished or chronically ill older, and health workers as in the case just reported in USA. So there is no apparent spread by other vectors eg bird and farmyard swine as in the case of influenza. Since the reports available indicate that the MERS virus is dangerous only in those already malnourished or with serious other systemic disease, it is like flu- pretty harmless in the well adequately nourished and housed. While frequent flyers are generally well off and well nourished, the same cannot be said for those in virtual ghetto slavery all over the world, eg migrant labourers working on contract in the Gulf States, who have apparently been among the latest victims . So as with the overblown Swine Flu non-pandemic of 2009, there is no good evidence to label MERS a deadly epidemic, it in fact seems to have low cross-infectivity compared to say influenza which spreads like wildfire- but with no more morbidity (except in Muslims?) than the common cold corona viruses.
WHY IS MERS LIMITED OVERWHELMINGLY TO AND SPREADING ONLY IN THE KSA and UAE? is it a unique genetic trait of Saudis? or is it micromalnutrition unique to this ultra-orthodox Muslim nation with unique almost total skin coverup outdoors? why was there no outbreak of MERS in the millions of pilgrims who did the Hadj to the KSA last year? the KSA is 100% muslim, whereas the UAE only 76%, with far more foreigners working and living there. It is common cause that peoples who keep well covered during daylight hours – as ultraobservant Muslim (and ultra-orthodox Jewish) women and men do, have much lower vitamin D levels. Those on restricted diets are also more prone to malnutrition including vit D deficiency, especially if low in dairy products. Common sense perhaps explains why Saudis – in the heart of Islam (Mecca, Riyadh, Jeddah, Tobuk) have low vitamin D and likely also low vitamin C and zinc levels, and thus more infections. Moderate to severe vitamin D deficiency was reported prevalent last year in Saudis by Al-Daghri, Sabico ea from King Saud University Riyadh- where Hasanato in 2006 reported low vitamins A, C and E and zinc levels in severe sickle cell disease. El-Hazmi ea from the Saudi College of Medicine also in 2011 reported that Saudi Arabia and Bahrain have the highest prevalence of sickle cell genes in the Middle East, at up to 18%. Bahrain has just opened a sickle cell hospital, but Bahrain has the tiniest population (1.3million) of the Gulf States although the highest population density, compared to the 38million of the KSA plus the UAE which have had over 90% of MERS cases. Most if not all the camels in Bahrain are in a zoo; whereas in the KSA camels are a favourite if not sacred possession and listed first as the domestic animal. So the absence of MERS in Bahrain is unsurprising.
The UAE on the other hand also has many camels as entertainment if not also for travel – with 5000 camels entered in a beauty contest there alone.. So, despite long days ie much sunshine exposure in Arabia, low fresh water availability likely reduces hygiene (washing and oral hydration) capacity for the masses let alone camels. And the well-covered dress code, and low availability of private sun-exposed balconies and courtyards (unlike apparently more liberal Muslim countries) mean that the Saudi masses do not have the opportunity to get much-needed sun exposure to even the face, neck and limbs let alone the torso.
Hence Saudis have as obvious major risk factors for MERS -not just the teeming MERS reservoir in their valued camels (also a staple milk supply), but more importantly endemic deficiency of vitamins C, D (and perhaps E, zinc) and water compared to relatively less clothed populations in other hot but also better water-supplied countries that also do not carry much sickle cell disease.
Camel meat is apparently no longer a staple in the KSA where staples now include Bread, hummus, rice, and Tabbouleh- a “salad” generally made of parsley, bulgur, tomatoes, garlic, and lemon; Kapsa: the national dish is chicken and rice with vegetables; and Kebab: a base of roasted lamb or chicken and vegetables in pita bread. There seems little vitamin D in that varied diet, especially not pita bread or rice.
The only good unfortified and unprocessed food sources of vitamin D are apparently oily fish, liver, mushrooms, and (if fortified), egg yolk and dairy products ; or else vitamin D3 supplements. ..
Finally, it is common cause from published studies and our local experience that infections eg HI, TB, influenza, herpes and the common (Corona virus) cold are easily treated and prevented by vigorous safe intake of vits C & D combined with the other multivites, zinc, iodine, iron and selenium. In advanced infection cases of eg HIV and TB (in trials from Central Africa and Canada), combining even modest doses of just 2 or 3 of these supplements with appropriate antivirals and antibiotics reduced dreadful morbidity and mortality by two-thirds. NATURAL PREVENTION/TREATMENT: with the theoretical double peril of influenza and MERS- (ie as with the looming Influenza A gastro-/respiratory season in the southern hemisphere), with no proven vaccines or antivirals reported or likely, those in contact with Middle East travelers- or any infection eg flu outbreak- are again reminded to boost their immunity and global health with safe effective lowcost NUTRITIONAL ANTIINFECTIVE supplements: 1.VITAMIN D3 CHOLECALCIFEROL 2500-4000iu/kg/month (not the weak vit D2 ergocalciferol falsely labelled “Strong” Calciferol tabs) most simply taken as a few scoops ie 50 000 to 250 000iu of vit D3 powder/MONTH at all ages (AND IDEALLY target BLOOD- LEVEL 80-100ng/ml depending on overall illhealth state. IT IS VIT D3 THAT IS STRONG CALCIFEROL, NOT VIT D2, since experts report that vit D3 is apparently four times more potent than D2. 2. MULTIVITES with zinc selenium and iodine (and iron for likely deficient eg kids, young women), but especially 3. buffered VITAMIN C ASCORBATE at least 3gm/d orally ( if not with bad infection symptoms – 10 or >30gms / day if not ivi) at trivial cost as powder; to tolerance; 4. with eg ecchinacea, melatonin, garlic, colloidal silver, sutherlandia and whatever other antiviral available locally. Since flu and colds disrupt both sleep and outdoor activity, nothing makes as much sense as co-supplementing both of the day and night hormones melatonin and vitamin D; as well as the other sunshine vitamin- ascorbic acid (solar-produced in abundance in eg fruit) – to improve both sleep, rest and immunity. For small kids/infants the vitamins and minerals can simply be taken as powder in liquid ie in feeding bottle or a glass. It is increasingly notorious how depleted modern breastfeeding mothers (on the industrial polluted fructose-sucrose- aspartame PUFA-antibiotic-hormone-glyophos- GMO laden food chain now prevalent) and baby formulae (unlike colostrum from pasture-fed eg New Zealand dairies) are in such lifesaving immune and anabolic anticancer boosters.
Ironically, recently Prof Zahid Naeem ea from the KSA Qassim University publicised in their university International Jnl of Health Science Vitamin D Deficiency- An Ignored Epidemic in 2010 and 2012 , with prevalence there of up to 80% in the KSA despite the abundant sunshine, thus urging vitamin D supplementation. . But such simple prevention – of all disease but especially wished-for megaprofit pandemics like flu and HIV- is anathema to the multinational Big Pharma and their lobbyists in the global Disease Industry, which employs millions worldwide and generates trillions in income for government and corporates. Prevention does not pay. Simple prevention suits no-one working in the disease and drug and hospital industry since it makes most health workers especially doctors and administrators and hospital largely redundant. It seems that public health officials choose to go on ignoring the deficiency epidemic even in the KSA- unlike Dubai, there is no website of the KSA Govt promoting vitamin D supplementation. The solution is too cheap – and embarrassingly simple. An anonymous blogger details the numerous reasons for endemic vitamin D deficiency in especially the Gulf States.. at least the Dubai Govt publicises the deficiency, and supplementation. Is it irony, or an indictment of the prevailing world-wide largely male-dominated -subservient female culture, that already back in 2001, there were strong warnings about Niqabs and Burqas as Impediments to Health? already in 2012, dairies in the UAE were fortifying milk with vitamin D; and in 2001 academics published a study showing the many reasons for prevalent vitamin D deficiency in the KSA. and Prof Mike Holick in 2010 published an authoritative review The Vitamin D Deficiency Pandemic: a Forgotten Hormone Important for Health urging vigorous vitamin D supplementation universally. As detailed elsewhere in this column last year, the prophet of vitamin D and melatonin the late Prof Walter Stumpf must be shaking his head repeatedly along with the late Prof Linus Pauling, about the neglect of authorities to promote and distribute vigorous supplements of vitamin C and D3 to the afflicted Arabian peoples let alone worldwide. But then we need to be reminded of the infamous Vitamin Murders, how Prof Sir Jack Drummond was mysteriously murdered with his family on holiday in France in 1952, when he and Linus Pauling were the leading vitamin discoverers and promoters of the 20th century (as Walter Stumpf was of melatonin and vitamin D). The Big Pharma Disease Industry combined with the might of the FBI and the FD could never shut Pauling up; but by whom and why the Drummonds were murdered remains unsolved, thus fertile conspiracy theory. Reading Drummond’s papers on the internet, one can understand why the burgeoning patent drug industry then as now hated natural lowcost unpatentable remedies, unbeatable natural safe antiinfective agents like vits C and D and iodine – each almost universal panaceas. . .
This universal truth about industry suppressing natural remedies is the Semmelweis Paradox, that had the leading obstetrician of his day murdered in his prime by his jealous rivals.
27 Dec 2013 the outbreak not over: 9 new cases; ie overall deathrate 42%, but past 2 weeks 4.5 cases a week just from the KSA.. : Since April 2012, the European Centre reports 175 laboratory-confirmed cases, including 73 deaths, of acute respiratory disease caused by Middle East respiratory syndrome coronavirus (MERS-CoV), have been reported by national health authorities. 27 December, Saudi Arabia confirmed nine cases (five asymptomatic healthcare workers and four patients suffering from chronic disease, two of whom had died). 24 Dec 2013 the score now stands at 166 (163 at 16 Dec) cases and 71 fatalities- 42% – in 18 months since the first identified case in June 2012; ie per week – 2 new cases and 1 fatality . No pandemic. No outbreak. Considering the duration of the awareness of the new virus in humans- apparently from bats/camels/swine, even after 18 months of millions of pilgrims visiting the Middle East, and far more foreign travelers flying through those hubs, and intensive surveillance on those routes east and west, the morbidity and mortality have been negligible with only a handful of perhaps related deaths in frail patients. Whether as with seasonal avian ie H1N1 flu from China to the West and south there will be a flareup of MERS-CoV cases in the pending winter from now on in the Middle East, remains to be seen..
12 November 2013 Considering that the Hajj has just ended with millions of pilgrims returning home, and vast numbers of multinational passengers transit through the Middle East hubs, its reassuring that (depending on which reports are duplicates and delayed) only 3 or 5 tested positive cases and 1 or 2 deaths have been reported the past week: especially since only serious flu-like cases are likely to be tested- but more so in the affluent who can afford to fly. So far no reports of MERS-CoV case are apparent in South Africa, although flu-like illness remains common here. Perhaps more people are heeding warnings to take multivites plus zinc plus vigorous vits C and D. The ECDC and OSAP and NowNews and GlobalAlert report As of 11 November 2013, there have been at least 154 laboratory confirmed cases of MERS CoV worldwide, including 65 deaths ie 42% in TESTED cases. All cases have either occurred in the Middle East or have had direct links to a primary case infected in the Middle East. Saudi Arabia has reported at least 125 symptomatic and asymptomatic cases including 53 deaths Jordan two cases both of whom died United Arab Emirates five cases, including one fatality Qatar five cases, including two deaths and Oman one case who has just died. Thirteen cases have been reported from outside the Middle East: inthe UK (4), France (2), Tunisia (3), Germany(2), Italy (1) and Spain (1). 31 Oct 2013 with the Hajj over, the latest score is 149 cases and 63 deaths ie 42%. http://www.who.int/csr/don/2013_10_31/en/index.html ie 5 new cases a week from the region, 30% deaths. http://gmggranger.wordpress.com/2013/10/29/quikstats-mers-cov-in-the-arabian-peninsula-nov-2013/ 17 Oct 2013 with the Hajj in full swing, the latest tally is apparently 139 cases and 60 deaths. So thats only 1 case reported a week the past 4 weeks, and no deaths in that time. Promising news, although we continue to see bad viral-like respiratory-gastro infections in adults locally with the volatile weather.
20 Sept 2013 with below a month to go to the Hajj, the latest Quickstats are 135 cases confirmed, and 60 deaths ie 44% mortality- all new cases and deaths apparently in KSA and the Gulf States. Thus in the past 7 weeks, 41 new cases have been reported ie 6 a week, all in the Gulf States; with unaltered mortality (44%) apparently restricted to the chronically frail. This as the drastically variable Cape Town weather alternates sunshine joy and freezing wet snow or hail, with high prevalence of both respiratory and gastroenteritis attacks, sometimes with protracted debilitating bronchitis; how much of this is local seasonal colds- coronavirus– or flu, orMERS-CoV, or the explosive Norwalk virus, is speculative and academic. Basically So What since management is symptomatic, and vigilant prevention crucially effective with hygiene, home rest and multivites but especially highdose vits D3 up to 10 000 (100iu/kg) iu/day or weekly equivalent plus buffered vit C up to tolerance >100mg/kg/day, zinc, selenium and for the malnourished, iron; perhaps safe plant immune boosters like sutherlandia, garlic etc; and avoidance of smoking, sugar and the likes- boozing and sweetened soft drinks (fructose, aspartame,sucralose).
11 August 2013 OUT OF AFRICA? no new cases of MERS-CoV have been reported the past week; but while camels (in Oman) are now also suspect hosts/ transmitters in the M E, there is some evidence that the MERS virus has the closest virus match yet found to bat CoV in South Africa. As a precaution, with upgrading of shrines in Mecca, KSA is actively reducing overcrowding by Hajj visitors by 20%, and warning the frail and elderly not to go this year. With the prevalent bad winter respiratory and gastroenteritis infections at least around densely populated and polluted Gauteng and KZ-Natal, and especially the floral mountain kingdom of greater Cape Town- all are encouraged to take vigorous doses of vitamins D3 and Superenhanced vitamin C with a broad multimineral-multivite - extra vits A, E, B & coQ10; the minerals zinc, selenium, iodine, colloidal silver, (and iron in the young commonly at risk of deficiency); probiotics ; rooibos or buchu or green honey and lemon tea, sutherlandia; licorice, St John’s wort, garlic, echinacea, olive leaf etc; including sniffing vitamin C ; and if snotty rhinitis/sinus/bronchitis symptoms, steaming with eucalyptus etc.. And during acute attacks especially of respiratory and gastro attacks, avoid sugar, fat, dairy and wheat intake.
2 August 2013 The Hajj to Mecca this year is in the third week of October. While over 15 million (of the world’s ~1.5billion) Muslims visit Mecca – Umrah- annually, some 3 million pilgrims worldwide make the seasonal Hajj visit trip, with pro rata from South Africa only 2000 (of our ~2.5million) apparently the quota of pilgrims allowed this year by Saudi Arabia . But increasing numbers of frequent flyers of all nationalities and races to and from South Africa – Europe fly via the Gulf States Emirates airline, if not commuting to work and visit family there – including professional sports teams for tournaments… So this week’s flood of warning bulletins on the Gulf State respiratory infection outbreak are cause for urgent caution and prevention, perhaps grim news for those who fly that ME route, and their families and close associates and neighbourhoods. The 49% deathrate reported in the now 94 cases- 3 more reported 1 August from KSA- so far from the MERS-CoV Corona Virus MiddleEast Respiratory Syndrome outbreak is alarming, that has spread the past 10 months from the Kingdom of Saudi Arabia KSA and the Gulf States to Tunisia, Europe – France, Germany, Italy- and UK . It is now being recognized as distinct not just from the common cold coronavirus but also from the Chinese Severe Acute SARS-CoV virus outbreak since 2003, of which over 8000 cases have been recognized , but the latter virus having a fatality rate of only <10%; and the current violent but selflimited Norwalk virus gastroenteritis (explosive vomiting and diarrhoea for 1 -3days; (fatality rate <0.1%) raging in UK, it recently is the commonest cause of foodborne infection in USA .
No clinically effective vaccine or synthetic drug treatment has yet been found for these coronaviruses . The same lack of specific antiviral therapy applies against gastroenteritis viruses and influenza, but the mythical 2009 swine flu ‘pandemic’ was even milder (than some seasonal flu outbreaks) with a proven mortality rate far below 1% considering how rapidly far and widely it spread. The reservoir if any of MERS-CoV may be cave bats, (and, ominously, perhaps swine – c/f the 2009 swine flu ‘pandemic’ that wasnt; shades of the deadly Nipah virus outbreak of 1999 – from bats to pigs to man).. But the fact that MERS-Co is spread human to human, and mainly men , has been attributed perhaps to women in strict sharia society being well veiled and thus shielded from inhaling (and transmitting) the air-born virus, never mind womens’ generally stronger immune systems and hygiene, self-care. So beware all those in close contact with recent air-travelers through the ME states and surrounding subcontinent airports – never mind the S-E-Asia airhubs of Hong Kong and Singapore: it maybe only a matter of weeks before cases occur on the other continents especially in city dwellers, public transport commuters, factory and office workers; and who knows, perhaps where bats and swine cohabit close to cities, as around South Africa.. .. Its cold comfort that the latest report yesterday and today, note that this stage is perhaps like SARS in 2002 and swine flu in 2009, the ‘bottom of the iceberg’, with only severe cases being admitted, tested, reported, in already chronically ill frail patients; especially diabetics and renal failure – to which older Muslims are particularly prone; while the virus spreads silently, mildly if not harmlessly in the well majority, as in two young well women health workers in contact with a chronically ill elderly female case in Riyadh, KSA … ANTI-INFECTIVE PROTECTANTS and advice are available from the Natural Remedies Centre, 15 Grove Bldg, Grove Ave, Claremont, Cape Town ph 002721-6831465 or -6717415: Fortunately all Health Shops are well stocked with the many almost 100% protectants against serious infections including fungi bacteria and viruses – colds (ie corona-) and flu’-virus (let alone against all others) afforded by the basket of locally available (although mostly imported) natural lowcost evidence-based nutritionals – supplements the past decades: safe hefty combinations of a number of immune-boosting vitamins, minerals and foods, herbs. This septuagenarian author has, touch wood, on this combination- increased at occasional times of suspected colds-fever- , despite great stress, and flu ‘pandemics’, and avoiding vaccinations, not had a bad infection lasting a day in the past 5 years despite working in the highest risk poor townships and acute hospital clinics with rampant HIV – multiresistant TB cases .