Edition: International |
Published On: Fri, May 10th, 2013
The Vaccine Hoax is Over. Documents from UK reveal 30 Years of Coverup
Andrew Baker ( FFN),- Freedom of Information Act in the UK filed by a doctor there has revealed 30 years of secret official documents showing that government experts have
1. Known the vaccines don’t work
2. Known they cause the diseases they are supposed to prevent
3. Known they are a hazard to children
4. Colluded to lie to the public
5. Worked to prevent safety studies
Those are the same vaccines that are mandated to children in the US.
Educated parents can either get their children out of harm’s way or continue living inside one of the largest most evil lies in history, that vaccines – full of heavy metals, viral diseases, mycoplasma, fecal material, DNA fragments from other species, formaldehyde, polysorbate 80 (a sterilizing agent) – are a miracle of modern medicine.Freedom of Information Act filed in the US with the CDC by a doctor with an autistic son, seeking information on what the CDC knows about the dangers of vaccines, had by law to be responded to in 20 days. Nearly 7 years later, the doctor went to court and the CDC argued it does not have to turn over documents. A judge ordered the CDC to turn over the documents on September 30th, 2011.
On October 26, 2011, a Denver Post editorial expressed shock that the Obama administration, after promising to be especially transparent, was proposing changes to the Freedom of Information Act that would allow it to go beyond declaring some documents secret and to actually allow government agencies (such as the CDC) to declare some document “non-existent.”
Simultaneous to this on-going massive CDC cover up involving its primary “health” not recommendation but MANDATE for American children, the CDC is in deep trouble over its decades of covering up the damaging effects of fluoride and affecting the lives of all Americans, especially children and the immune compromised. Lawsuits are being prepared. Children are ingesting 3-4 times more fluoride by body weight as adults and “[t]he sheer number of potentially harmed citizens — persons with dental fluorosis, kidney patients tipped into needing dialysis, diabetics, thyroid patients, etc— numbers in the millions.”
The CDC is obviously acting against the health of the American people. But the threat to the lives of the American people posed by the CDC’s behavior does not stop there. It participated in designed pandemic laws that are on the books in every state in the US, which arrange for the government to use military to force unknown, untested vaccines, drugs, chemicals, and “medical” treatments on the entire country if it declares a pandemic emergency.
The CDC’s credibility in declaring such a pandemic emergency is non-existent, again based on Freedom of Information Act. For in 2009, after the CDC had declared the H1N1 “pandemic,” the CDC refused to respond to Freedom of Information Act filed by CBS News and the CDC also attempted to block their investigation. What the CDC was hiding was its part in one of the largest medical scandals in history, putting out wildly exaggerated data on what it claimed were H1N1 cases, and by doing so, created the false impression of a “pandemic” in the US.
The CDC was also covering up e financial scandal to rival the bailout since the vaccines for the false pandemic cost the US billions. And worse, the CDC put pregnant women first in line for an untested vaccine with a sterilizing agent, polysorbate 80, in it. Thanks to the CDC, “the number of vaccine-related “fetal demise” reports increased by 2,440 percent in 2009 compared to previous years, which is even more shocking than the miscarriage statistic [700% increase].
The exposure of the vaccine hoax is running neck and neck with the much older hoax of a deadly 1918-19 flu. It was aspirin that killed people in 1918-19, not a pandemic flu. It was the greatest industrial catastrophe in human history with 20-50 million people dying but it was blamed on a flu. The beginning of the drug industry began with that success (and Monsanto was part of it). The flu myth was used by George Bush to threaten the world with “another pandemic flu that could kill millions” – a terror tactic to get pandemic laws on the books in every state and worldwide. Then the CDC used hoax of the pandemic hoax to create terror over H1N1 and to push deadly vaccines on the public, killing thousands of unborn children and others. (CDC will not release the data and continues to push the same vaccine.)
The hoax of the vaccine schedule is over, exposed by FOIAs in the UK.
The hoax of the CDC’s interest in children’s lives has been exposed by its refusal to respond to a doctor’s FOIAs around its knowledge of vaccine dangers.
The 1918-19 pandemic hoax has been exposed by Dr. Karen Starko’s work on aspirin’s role in killing people.
And despite refusing to respond to FOIAS, the CDC’s scandalous hoax of a 2009 flu pandemic and its part in creating it, was exposed by CBS NEWS.
And the Obama administration, in attempting to salvage the last vestige of secrecy around what is really happening with vaccines, by declaring agency documents non-existent, has made its claim of transparency, non-existent.
But pandemic laws arranging for unknown vaccines to be forced on the entire country are still in place with HHS creating a vaccine mixture that should never be used on anyone and all liability for vaccines having been removed. Meanwhile, a Canadian study has just proven that the flu vaccine containing the H1N1 vaccine which kills babies in utero, actually increases the risk of serious pandemic flu.
Americans who have been duped into submitting their children to the CDC’s deadly vaccines, have a means to respond now. People from every walk of life and every organization, must
1. take the information from the UK FOIAs exposing 30 years of vaccine lies, the refusal of the CDC to provide any information on what it knows about those lies, and the Obama Administration’s efforts to hide the CDC’s awareness of those lies, and go to their state legislatures, demand the immediate nullification of the CDC vaccine schedule and the pandemic laws.
2. inform every vet. active duty military person, law enforcement people, DHS agents and medical personnel they know, of the vaccine hoax, for their families are deeply threatened, too, but they may not be aware of it or that they have been folded into agency structures by the pharmaceutical industry (indistinguishable from the bankers and oil companies) that would make them agents of death for their country with the declaration of a “pandemic” emergency or “bio-terrorist” attack. It is completely clear now that the terrorism/bioterrorism structures are scams so that any actions taken to “protect” this country using those laws would in fact be what threatens the existence of Americans.
It was aspirin that killed millions in 1918-19. Now it is mandated and unknown, untested vaccines with banned adjuvants in them that threaten the country with millions of deaths. At the same time, the CDC is holding 500,000 mega-coffins, built to be incinerated, on its property outside Atlanta. Not to put to fine a point on this, but it’s clear now that the CDC should not be involved in any way with public health.
Thanks to the Freedom of Information Act (FOIA), we know that vaccines are not a miracle of modern medicine. Any medical or government authority which insists vaccines prevent diseases is either ignorant of government documents (and endless studies) revealing the exact opposite or of the CDC’s attempts to hide the truth about vaccines from the public, or means harm to the public.
Thanks to the Freedom of Information Act (FOIA), we know the vaccine schedule is a hoax.
The health danger to American children and adults are vaccines.
Andrew Baker, Food Freedom News
Documentation
The vaccination policy and the Code of Practice of the Joint Committee on Vaccination and Immunisation ( JCVI): are they at odds?
Related articles:
Harvard Scientists warn about Epidemic of Side Effects due to Corruption
‘All Trials’: because no test should go unheralded
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About the Author
Wednesday 18 March, 2015
Tension Increases - Federal Judge Orders CDC to Produce Secret Documents...
The CDC Has Known All Along How Dangerous Vaccines Are - And Has Covered It Up... (Part Six)
The CDC Has Known All Along How Dangerous Vaccines Are - And Has Covered It Up... (Part Six)
Opinion by Consumer Advocate Tim Bolen
Friday, July 6th, 2012
This article is the sixth in a series about THE MOST IMPORTANT CASE ABOUT AUTISM currently being litigated - the Hooker v. United States Department of health and Humans Services, et al case.
Why is this the most important case?
Because of what happened in what was called the "Omnibus Autism Proceedings" (OAP) in 2010.
The special Vaccine Court created by the National Childhood Vaccine Injury Act (NCVIA), in 1987, had become overloaded with claims about 2007, and the Special Masters running the court simply did not want to have to trudge through the backlog of the 5,400 cases facing it over vaccine injuries.
There in 2010, a special Vaccine Court sub-set, called the OAP, decided six test cases - three from the MMR Vaccine causes Autism argument, and three from the Thimerosal (mercury) in vaccines causes Autism argument. Those cases were themselves, representing a backlog of the 5,400 cases, which, in turn, represented the interests of over 2,000,000 vaccine damaged children in the US. More, those cases, if won by the Plaintiffs, would have set the stage for relief for the families of the one in six children vaccine damaged showing neurological damage.
The OAP judges relied COMPLETELY, for all six cases, on the truth and validity of the five so-called studies ordered and run by the Center for Disease Control and Prevention (CDC).
Now you see the importance...
After reviewing Hooker's research it is easy to come to a conclusion - EVERY one of the CDC studies showing the so-called safety of mercury in vaccines has been intentionally faked, so as to lead the American Public, and every entity worldwide that relies on the CDC for information, to believe that mercury in vaccines is safe - it is not.
The case was a setup...
Brian Hooker sued the CDC to get copies of their internal memorandums, emails, letters, etc.
"In late 2004 Biochemist Scientist Brian Hooker PhD had had enough. He'd been looking, carefully, through the US Center for Disease Control and Prevention (CDC)'s so-called "Evidence" that Thimerosal was "Safe and Effective" as a preservative in vaccines. Having read all of the then available CDC studies making that claim, he, as a PhD Scientist, couldn't help but shake his head "NO." To him, none of the purported proof was anywhere near being scientifically adequate. Far from it.
So, like any math teacher would do to a student he began to communicate to the CDC his questions. In essence he was saying "Show me your work. Show me how you came up with these answers" - a reasonable question series among scientists, teachers and students, and frankly, the population of Planet Earth.
What was CDC's response? STONEWALL - a six year knock-down, drag-out brawl to get that information. Brian Hooker would not let up. Neither would the CDC
But Hooker and his team were playing a trick. They knew that the same people who would create fake studies would try to cover up their tracks any way they could. So, they set up a trap - and the CDC walked right into it.
What was the trap? Hooker had a good many of the documents, already, he was being denied. More, he knew where more of them were stored, and he had been promised access. So, they demanded documents, let the CDC reply that (1) there weren't any, (2) the documents didn't say anything pertinent, (3) blah, blah, blah.
And then they spring the trap with the Judge. As in "Gee Judge, these bastards are lying."
Why do this? To set them up for CRIMINAL Indictment. Period.
So, What's Happening?
I love the US court system sometimes. Not all the time, of course, but, frankly, quite often.
Smile now. Things are heating up in the Hooker v. United States Department of Health AND Human Services, et al federal court case. The federal judge in the case, has issued the following Order:
"Defendants are directed to deliver the documents withheld under 5 U.S.C. § 552(b)(5) to chambers for an in camera inspection to assist the Court in making a responsible de novo determination. In-Camera Submission is due by Friday, 7/13/2012. (jth)"
What the Judge's Order actually means...
FOIA Section 5 U.S.C. § 552(b)(5)authorizes agencies to withhold information related solely to the internal personnel rules and practices of an agency. The Judge is saying "show me where this rule applies in these communications."
In Camera inspection happens when a judge reviews evidence (depositions, documents, photos and the like) to determine whether it should be provided to other parties. This usually occurs when both sides in a case disagree about whether a certain, usually crucial piece of evidence should come in.
The Court will review non-jury cases de novo to determine if the agency came to a reasonable conclusion.
So, in short, the Judge isn't buying the CDC's arguments about why it is withholding information. The trap Hooker set paid off. It looks to me that the federal judge is beginning to smell the rat in the CDC's position.
Where is this going?
The search for documents, in this court case, is uncovering a pattern of criminal activity. Whoever is running, making the decisions to withhold documents at CDC, knows where all this is going. I am certain that within the walls of the CDC, right this minute, certain CDC employees - past and present, contractors, and consultants, etc. are quietly being told to personally "lawyer-up," and familiarize themselves on how to make claim to the Fifth Amendment provisions of the US Constitution (taking the Fifth).
Is there really criminal activity here?
You bet there is. Major criminal activity. The people involved in this denial of the effects of Thimerosal in vaccines, and the cover up of the real situation, are some of, perhaps, the worst criminals in the history of mankind. Just look at the numbers of children damaged, and the cost to society - worldwide. This is far worse than anything the NAZIs, or Stalin, did. This overshadows any genocide effort in the history of mankind.
This isn't about simple fraud, the marketing of vaccines, or some comparison of preservatives in vaccines. This is about major damage to children. And it is all coming out.
And that's the bottom line.
Stay tuned...
Tim Bolen - Consumer Advocate
- See more at: http://www.bolenreport.com/Mark%20Geier/foiasuit6.htm#sthash.yTiNZKX9.dpufTension Increases - Federal Judge Orders CDC to Produce Secret Documents...
The CDC Has Known All Along How Dangerous Vaccines Are - And Has Covered It Up... (Part Six)
The CDC Has Known All Along How Dangerous Vaccines Are - And Has Covered It Up... (Part Six)
Opinion by Consumer Advocate Tim Bolen
Friday, July 6th, 2012
- See more at: http://www.bolenreport.com/Mark%20Geier/foiasuit6.htm#sthash.yTiNZKX9.dpufThis article is the sixth in a series about THE MOST IMPORTANT CASE ABOUT AUTISM currently being litigated - the Hooker v. United States Department of health and Humans Services, et al case.
Why is this the most important case?
Because of what happened in what was called the "Omnibus Autism Proceedings" (OAP) in 2010.
The special Vaccine Court created by the National Childhood Vaccine Injury Act (NCVIA), in 1987, had become overloaded with claims about 2007, and the Special Masters running the court simply did not want to have to trudge through the backlog of the 5,400 cases facing it over vaccine injuries.
There in 2010, a special Vaccine Court sub-set, called the OAP, decided six test cases - three from the MMR Vaccine causes Autism argument, and three from the Thimerosal (mercury) in vaccines causes Autism argument. Those cases were themselves, representing a backlog of the 5,400 cases, which, in turn, represented the interests of over 2,000,000 vaccine damaged children in the US. More, those cases, if won by the Plaintiffs, would have set the stage for relief for the families of the one in six children vaccine damaged showing neurological damage.
The OAP judges relied COMPLETELY, for all six cases, on the truth and validity of the five so-called studies ordered and run by the Center for Disease Control and Prevention (CDC).
Now you see the importance...
After reviewing Hooker's research it is easy to come to a conclusion - EVERY one of the CDC studies showing the so-called safety of mercury in vaccines has been intentionally faked, so as to lead the American Public, and every entity worldwide that relies on the CDC for information, to believe that mercury in vaccines is safe - it is not.
The case was a setup...
Brian Hooker sued the CDC to get copies of their internal memorandums, emails, letters, etc.
"In late 2004 Biochemist Scientist Brian Hooker PhD had had enough. He'd been looking, carefully, through the US Center for Disease Control and Prevention (CDC)'s so-called "Evidence" that Thimerosal was "Safe and Effective" as a preservative in vaccines. Having read all of the then available CDC studies making that claim, he, as a PhD Scientist, couldn't help but shake his head "NO." To him, none of the purported proof was anywhere near being scientifically adequate. Far from it.
So, like any math teacher would do to a student he began to communicate to the CDC his questions. In essence he was saying "Show me your work. Show me how you came up with these answers" - a reasonable question series among scientists, teachers and students, and frankly, the population of Planet Earth.
What was CDC's response? STONEWALL - a six year knock-down, drag-out brawl to get that information. Brian Hooker would not let up. Neither would the CDC
But Hooker and his team were playing a trick. They knew that the same people who would create fake studies would try to cover up their tracks any way they could. So, they set up a trap - and the CDC walked right into it.
What was the trap? Hooker had a good many of the documents, already, he was being denied. More, he knew where more of them were stored, and he had been promised access. So, they demanded documents, let the CDC reply that (1) there weren't any, (2) the documents didn't say anything pertinent, (3) blah, blah, blah.
And then they spring the trap with the Judge. As in "Gee Judge, these bastards are lying."
Why do this? To set them up for CRIMINAL Indictment. Period.
So, What's Happening?
I love the US court system sometimes. Not all the time, of course, but, frankly, quite often.
Smile now. Things are heating up in the Hooker v. United States Department of Health AND Human Services, et al federal court case. The federal judge in the case, has issued the following Order:
"Defendants are directed to deliver the documents withheld under 5 U.S.C. § 552(b)(5) to chambers for an in camera inspection to assist the Court in making a responsible de novo determination. In-Camera Submission is due by Friday, 7/13/2012. (jth)"
What the Judge's Order actually means...
FOIA Section 5 U.S.C. § 552(b)(5)authorizes agencies to withhold information related solely to the internal personnel rules and practices of an agency. The Judge is saying "show me where this rule applies in these communications."
In Camera inspection happens when a judge reviews evidence (depositions, documents, photos and the like) to determine whether it should be provided to other parties. This usually occurs when both sides in a case disagree about whether a certain, usually crucial piece of evidence should come in.
The Court will review non-jury cases de novo to determine if the agency came to a reasonable conclusion.
So, in short, the Judge isn't buying the CDC's arguments about why it is withholding information. The trap Hooker set paid off. It looks to me that the federal judge is beginning to smell the rat in the CDC's position.
Where is this going?
The search for documents, in this court case, is uncovering a pattern of criminal activity. Whoever is running, making the decisions to withhold documents at CDC, knows where all this is going. I am certain that within the walls of the CDC, right this minute, certain CDC employees - past and present, contractors, and consultants, etc. are quietly being told to personally "lawyer-up," and familiarize themselves on how to make claim to the Fifth Amendment provisions of the US Constitution (taking the Fifth).
Is there really criminal activity here?
You bet there is. Major criminal activity. The people involved in this denial of the effects of Thimerosal in vaccines, and the cover up of the real situation, are some of, perhaps, the worst criminals in the history of mankind. Just look at the numbers of children damaged, and the cost to society - worldwide. This is far worse than anything the NAZIs, or Stalin, did. This overshadows any genocide effort in the history of mankind.
This isn't about simple fraud, the marketing of vaccines, or some comparison of preservatives in vaccines. This is about major damage to children. And it is all coming out.
And that's the bottom line.
Stay tuned...
Tim Bolen - Consumer Advocate
- See more at: http://www.bolenreport.com/Mark%20Geier/foiasuit6.htm#sthash.yTiNZKX9.dpuf
H1N1 vaccine linked to 700 percent increase in miscarriages
Wednesday, December 08, 2010 by: Ethan A. Huff, staff writerTags: vaccines, miscarriages, health news
(NaturalNews) Recent data presented to the U.S. Centers for Disease Control and Prevention's (CDC) Advisory Committee on Children's Vaccines has revealed some shocking information about the effects of the H1N1 / swine flu vaccine on pregnant women. According to the report, the rate of miscarriage among pregnant women during the 2009 H1N1 / swine flu pandemic soared by over 700 percent compared to previous years, pointing directly to the vaccine as the culprit -- but the CDC denies the truth and continues to insist nobody has been harmed.
According to the CDC, nearly 50 percent of all pregnant women were vaccinated with the H1N1 vaccine during the 2009 / 2010 influenza season. Those whose physicians instructed them to get a seasonal flu shot were three times more likely to get it, while those instructed specifically to get the H1N1 shot were ten times more likely to get it. And the numbers clearly show that along with the rise in vaccinations due to the H1N1 scare came the sharp increase in miscarriages, including a slew of actual reported adverse events.
But the CDC does not seem to care about the facts, as numerous reports indicate the agency has failed to report any of this vital information to vaccine suppliers. In fact, when presented with the data for the third time, Dr. Marie McCormick, chair of the U.S. Department of Health and Human Services (HHS) Vaccine Risk and Assessment Working Group, actually had the audacity to claim that there were no vaccine-related adverse events in pregnant women caused by the vaccine.
"This baseless and fallacious assessment by the CDC assessment group has given the green light to the CDC's Advisory Committee on Immunization Practices (ACIP) to continue their recommendation to give the 2010/11 flu shot to all people, including pregnant women," explained Eileen Dannemann, director of the National Coalition of Organized Women, presenter of the information.
"This upcoming 2010/11 flu vaccine contains the same elements that are implicated in the killing of these fetuses, the H1N1 viral component and the neurotoxin mercury (Thimerosal). Additionally, it contains two other viral strains -- a three-in-one shot for all people."
Overall, the number of vaccine-related "fetal demise" reports increased by 2,440 percent in 2009 compared to previous years, which is even more shocking than the miscarriage statistic. Meanwhile, the CDC continues to lie to the public about the vaccine, urging everyone, including pregnant women, to get it.
To read the report for yourself, visit: http://www.progressiveconvergence.com/H1N1-R...
Sources for this story include:
http://www.guerillahealthreport.com/post.php...
http://thepopulist.net/?p=6630
![]()
According to the CDC, nearly 50 percent of all pregnant women were vaccinated with the H1N1 vaccine during the 2009 / 2010 influenza season. Those whose physicians instructed them to get a seasonal flu shot were three times more likely to get it, while those instructed specifically to get the H1N1 shot were ten times more likely to get it. And the numbers clearly show that along with the rise in vaccinations due to the H1N1 scare came the sharp increase in miscarriages, including a slew of actual reported adverse events.
But the CDC does not seem to care about the facts, as numerous reports indicate the agency has failed to report any of this vital information to vaccine suppliers. In fact, when presented with the data for the third time, Dr. Marie McCormick, chair of the U.S. Department of Health and Human Services (HHS) Vaccine Risk and Assessment Working Group, actually had the audacity to claim that there were no vaccine-related adverse events in pregnant women caused by the vaccine.
"This baseless and fallacious assessment by the CDC assessment group has given the green light to the CDC's Advisory Committee on Immunization Practices (ACIP) to continue their recommendation to give the 2010/11 flu shot to all people, including pregnant women," explained Eileen Dannemann, director of the National Coalition of Organized Women, presenter of the information.
"This upcoming 2010/11 flu vaccine contains the same elements that are implicated in the killing of these fetuses, the H1N1 viral component and the neurotoxin mercury (Thimerosal). Additionally, it contains two other viral strains -- a three-in-one shot for all people."
Overall, the number of vaccine-related "fetal demise" reports increased by 2,440 percent in 2009 compared to previous years, which is even more shocking than the miscarriage statistic. Meanwhile, the CDC continues to lie to the public about the vaccine, urging everyone, including pregnant women, to get it.
To read the report for yourself, visit: http://www.progressiveconvergence.com/H1N1-R...
Sources for this story include:
http://www.guerillahealthreport.com/post.php...
http://thepopulist.net/?p=6630
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Salicylates and Pandemic Influenza Mortality, 1918–1919 Pharmacology, Pathology, and Historic Evidence
- Reprints or correspondence: Dr Karen M. Starko, 1515 Floribunda Ave, Burlingame, CA 94010 (karenstarko{at}gmail.com).
Abstract
The high case-fatality rate—especially among young adults—during the 1918–1919 influenza pandemic is incompletely understood. Although late deaths showed bacterial pneumonia, early deaths exhibited extremely “wet,” sometimes hemorrhagic lungs. The hypothesis presented herein is that aspirin contributed to the incidence and severity of viral pathology, bacterial infection, and death, because physicians of the day were unaware that the regimens (8.0–31.2 g per day) produce levels associated with hyperventilation and pulmonary edema in 33% and 3% of recipients, respectively. Recently, pulmonary edema was found at autopsy in 46% of 26 salicylate-intoxicated adults. Experimentally, salicylates increase lung fluid and protein levels and impair mucociliary clearance. In 1918, the US Surgeon General, the US Navy, and the Journal of the American Medical Association recommended use of aspirin just before the October death spike. If these recommendations were followed, and if pulmonary edema occurred in 3% of persons, a significant proportion of the deaths may be attributable to aspirin.
In February 1919…Edward's fever kept getting higher and higher…aspirin…was given to him by the 1/2-handful over and over…Edward sweated through his mattress…Dr.…could not save his patient.
—Clella B. Gregory, Pandemic Influenza Storybook, US Department of Health and Human Services [1]
The unprecedented overall mortality and the mortality rate among young adults during the 1918–1919 influenza pandemic are incompletely understood. Deaths in the United States peaked with a sudden spike in October 1918. Later, Wade Hampton Frost [2] studied surveys of 8 US cities and found that, for every 1000 persons aged 25–29 years, ∼30% were infected with influenza virus, and 1% died of pneumonia or influenza. This 3% case-fatality rate has been called, “perhaps the most important unsolved mystery of the pandemic” [3, p 1022].
Mortality was driven by 2 overlapping clinical-pathologic syndromes: an early, severe acute respiratory distress (ARDS)-like condition, which was estimated to have caused 10%-15% of deaths (sequential autopsy series are lacking) [3)]; and a subsequent, aggressive bacterial pneumonia “superinfection,” which was pres-ent in the majority of deaths [4, 5].
Factors that contributed to the severity of illness and death (eg, viral pathogenicity, bacterial colonization, immune response, smoking, preexisting conditions, and treatment) remain to be elucidated. Of most interest are those amenable to intervention, because fear of another 1918-like influenza pandemic drives pandemic planning today.
Recent studies suggest enhanced pathogenicity of certain influenza viruses as well as abnormal immune host responses. The 1918 influenza H1N1 virus, in contrast to a conventional human H1N1 influenza virus (A/Kawasaki/173/01), infected the lower respiratory tract, produced acute respiratory distress, and was associated with a dysregulated antiviral response in a cynomologous macaque model [6]. Also, the 1918 viral polymerase complex (PA, PB1, and PB2) promoted growth of the 1918 virus in the lower respiratory tract of ferrets [7]. Similarly, 2003 human H5N1 isolates, like 1997 human H5N1 isolates, induced overproduction of proinflammatory cytokines in human macrophages in vitro [8].
However, it is unlikely that the virus and immune responses alone were responsible for the 1918 deaths. As recently reviewed by Brundage and Shanks [4], most persons had self-limited disease with case-fatality rates of <2%, and mortality and case-fatality rates differed widely among populations. During the fall of 1918, death and influenza case-fatality rates ranged from 0.58% to 3.3% and 2.1% to 10%, respectively, in the 12 US Army camps with >10,000 cases of influenza or pneumonia each [9, 10]. Frost [2] noted that the wide variation in mortality rates between cities, some of which were close together, was not explained by climate, population density, preventive measures, or other environmental characteristics. These observations suggest the importance of factors related to location rather than the virus itself. Likewise, the unusual mortality rate among young adults remains unexplained. Salicylate has been suggested [3, 11, 12], and increased mortality rates have been found in ferrets exposed to influenza, aspirin, and an arginine-deficient diet, compared with each alone or in 2 combinations [13], yet mechanistic and epidemiologic evidence has not been fully explored.
The hypothesis presented herein is that salicylate therapy for influenza during the 1918–1919 pandemic resulted in toxicity and pulmonary edema, which contributed to the incidence and severity of early ARDS-like lungs, subsequent bacterial infection, and overall mortality. Pharmacokinetic data, which were unavailable in 1918, indicate that the aspirin regimens recommended for the “Spanish influenza” predispose to severe pulmonary toxicity.
A confluence of events created a “perfect storm” for widespread salicylate toxicity. The loss of Bayer's patent on aspirin in February 1917 allowed many manufacturers into the lucrative aspirin market. Official recommendations for aspirin therapy at toxic doses were preceded by ignorance of the unusual nonlinear kinetics of salicylate (unknown until the 1960s), which predispose to accumulation and toxicity; tins and bottles that contained no warnings and few instructions; and fear of “Spanish” influenza, an illness that had been spreading like wildfire.
More recently, influenza deaths have been attributed to salicylate. From the 1950s to the 1980s, thousands of deaths among children following influenza and other infections (eg, Reye syndrome) were unexplained until studies identified aspirin as the major contributor [14-16], and aspirin label warnings were followed by a disappearance of the condition [17]. Reye syndrome toxicity (vomiting, hyperventilation, delirium, and coma, with brain swelling and fat in the liver and proximal renal tubules) develops after ∼4 days of salicylate therapy [14] with reported mean daily doses of 25 mg/kg [18]. (Adults with salicylate toxicity present mainly with abnormal consciousness and respiratory distress [19].) Also, a recent avian influenza A-associated fatality involved Reye syndrome and aspirin use [20], and several autopsies of persons who had avian influenza revealed hemorrhagic lungs, fatty liver changes, and swollen kidneys [21] consistent with salicylate intoxication.
Four lines of evidence support the role of salicylate intoxication in 1918 influenza mortality: pharmacokinetics, mechanism of action, pathology, and the spate of official recommendations for toxic regimens of aspirin immediately before the October 1918 death spike. (Grains of aspirin used in older texts are converted to milligrams as follows: 1 grain equals 65 mg).
Aspirin Regimens (Dose and Schedule) Recommended in 1918 Are Now Known to Regularly Produce Toxicity
In 1977, a US Food and Drug Administration panel [22] recommended that the maximum safe daily dose of aspirin for the general population was 4000 mg, with a mean hourly rate of 167 mg/h, and that “dosing regimens exceeding either this total daily dosage or mean hourly rate provide a significantly greater risk without a compensating therapeutic benefit” (p 35360). As an example of the unusual nonlinear kinetics of salicylate, the panel noted that simulations show that, after increasing the dose from 2 to 4 g daily (given every 6 h), “the total amount of drug in the body at steady state will increase from 1.3 grams to 5.3 grams, a 400% increase.” In 2007, an evidence-based consensus guideline [23] recommended that anyone with an acute ingestion of 150 mg/kg or 6.5 g of aspirin equivalent, whichever is lower, warrants referral to an emergency department and recognized that, after multiple doses, it is difficult to generalize any dose associated with toxicity, because lower daily doses (2–3 g for several days) may lead to toxicity in some patients.
In the early 1900s, physicians treating serious conditions (eg, rheumatic fever) generally “pushed” salicylate until the appearance of toxicity and then backed off [24]. In 1918, dosing recommendations for pandemic influenza were similar to these high-dose, hospital-based regimens, except that the recommendations for influenza generally offered no instruction for dose adjustment if toxicity occurred.
French's historic 1920 report for the British Ministry of Health [25] on the pandemic states that the aspirin dose was “15 to 20 grains” (975–1300 mg). No frequency was given. One London doctor “drenched” his patient with salicin: 20 grains (1300 mg) hourly for 12 hours nonstop [26]. Others suggested sodium salicylate, 6 grains (390 mg) over 3 hours for several days [27]. Aspirin was recommended for pulmonary edema [28]. On 26 September 1918, the US Navy recommended a cathartic and 5 grains (325 mg) of aspirin, warning against large doses [29]. However, the Navy's Materia Medica stated that the maximum dose was 1300 mg [30]. On 5 October 1918, The Journal of the American Medical Association [31] recommended aspirin: “The acetylsalicylic acid may be given in a dosage of 1 gm. (15 grains) every three hours…or a smaller dose combined with 0.1 gm. (2 grains) acetophenetidin, until symptomatic relief is secured” (p 1137). These recommended doses (1000–1300 mg), with frequencies ranging from hourly to every 3 hours, resulting in daily doses of 8–31.2 grams, are above the maximum safe dose defined above and would lead to accumulation, as noted below.
Hints of unusual pharmacokinetics and individual variation were noted before the pandemic but largely ignored. In 1906, Langmeade [32] observed “great variation in the amount required” (p 1824) for toxicity and reported a hospitalized child (receiving 325 mg every 6 hours) who, on day 4, developed vomiting, fever, dyspnea, cyanosis, and coma and died. He recommended caution early in treatment so “the personal factor may be estimated.” In 1913, Hanzlik [24] studied records of 400 hospitalized persons treated with a common regimen, 10–20 grains of a salicylate hourly with sodium bicarbonate until toxicity occurred (headache, nausea, tinnitus or deafness, delirium, or hallucinations). He found that the mean toxic dose of aspirin for male persons was 165 grains (10,725 mg), a probable overestimation, because sodium bicarbonate greatly enhances salicylate excretion. The toxic dose of synthetic salicylate in males ranged from 1300 to 31,200 mg.
The development of tests to measure salicylate in the blood in the 1940s allowed Alvin F. Coburn [33] of the US Navy, while studying rheumatic fever, to find that a dose of 10 g daily led to levels that averaged 36 mg/dL on day 3 in 9 adults. In 1948, Graham and Parker [34] were among the first to correlate the blood salicylate level with symptoms of toxicity. First, after studying 58 individuals, they found considerable variation in the level at which symptoms developed, such as vomiting (16.3–38.6 mg/dL), hyperventilation (21–44.2 mg/dL), pulmonary edema (49.4 mg/dL), and severe dyspnea (46–53.6 mg/dL). They also studied 33 patients who attained levels of 35 mg/dL during the first 7 days of therapy and found the following severe toxicities: hyperventilation (in 33%), vomiting (in 30%), marked sweating (in 12%), headache (in 12%) severe drowsiness (in 12%), confusion (in 6%), severe dyspnea (in 6%), excitement (in 6%), epistaxis (in 6%), vertigo (in 3%), pulmonary edema (in 3%), and hemorrhage (in 3%). The incidence of these toxicities may be higher, because administration was halted when hyperventilation occurred. A retrospective study [35] of 56 salicylate-intoxicated adults, with intoxication defined as a peak salicylate level ⩾30 mg/dL, found 6 patients (11%) with noncardiogenic pulmonary edema. For adults aged >30 years, the incidence of noncardiogenic pulmonary edema was 35%. Interestingly, none of 55 consecutive intoxicated pediatric patients had pulmonary edema.
In the 1960s, scientists learned why toxicity occurs with intense aspirin therapy: salicylates have unusual and complex pharmacokinetic characteristics that predispose to accumulation, rendering both dose and schedule critically important. In 1965, Levy [36] showed that, when the amount of drug in the body reaches ∼360 mg, the half-life increases as elimination changes from first order to zero order. Later, Bardare et al [37], who studied children, observed half-lives of ∼5 h at a dosage of ∼50 mg/kg per day (3500 mg in a 70-kg person), of ∼15 h at dosages of 75–95 mg/kg per day, and of ∼40 h at dosages >100 mg/kg per day. Dosing at intervals of the half-life or less will lead to accumulation.
In addition to the saturable metabolism described by Levy and colleagues [36, 38, 39], accumulation of salicylate can occur for other reasons, including individual variation in elimination rate [38], reduced renal excretion [40], and low urine pH [41]. Higher doses, as mentioned above, slow elimination [42] and enhance the volume of distribution [43]. Acidosis [44] and hypoproteinemia [45] increase brain uptake and toxicity. The salicylate level [42] and the level at which toxicity occurs [24, 34] vary among individuals. Therefore, it is likely that severe salicylate intoxication, including pulmonary edema, developed in some persons who followed the recommended 1918 dosing regimens.
Salicylates Cause Immediate Lung Toxicity and May Predispose to Bacterial Infection by Increasing Lung Fluid and Protein Levels and Impairing Mucociliary Clearance
The occurrence of pulmonary edema in humans with salicylate intoxication is well documented [19, 35]. Increased pulmonary vascular bed permeability to fluid and protein, decreases in arterial pO2, and increases in postmortem extravascular lung water followed salicylate administration in sheep [46]. Salicylate also depresses the lung's mucociliary transport system [47].
The Pathology of the Early Deaths Is Consistent with Aspirin Toxicity and Virus-Induced Pathology
Autopsy reports by pathologists of the day describe extremely wet, sometimes hemorrhagic lungs in early deaths. On 23 September 1918 at Camp Devens in Massachusetts, 12,604 soldiers had influenza, and 727 had pneumonia; after examining the lungs of a dead soldier, Colonel Welch concluded, “This must be some new kind of infection or plague” [48, p 190]. What struck E. R. Le Count [49], consulting pathologist to the US Public Health Service, as most unusual was the amount of lung tissue actually “pneumonic” seemed “too little in many cases to explain death by pneumonia.” He saw a thin, watery, bloody liquid in the lung tissue, “like the lungs of the drowned,” as well as pleural exudates with small hemorrhages unlike those seen in “any other form of acute pneumonia of which I am familiar.” Importantly, he also noted the brain was “quite regularly swollen,” the kidneys were “regularly the seat of cloudy swelling,” and the liver had “superficial fatty change,” (changes noted in children with salicylate intoxication; see below). He concluded, “It is difficult to believe that a disease with so many distinctive features and…novelty…can fail to possess a correspondingly definite etiology.” Brain weight was increased by 100–200 g in ∼50% of persons, most likely indicating cerebral edema; cerebral bleeding was common [9, 10]. Wolbach [50], chief pathologist at the Peter Bent Brigham Hospital in Boston, Massachusetts, found bacterial infection in late deaths, yet a person dying on day 2 exhibited edema and congestion of the lung, a purpuric rash, and no bacterial growth. He surmised a natural progression from the early lesion to the bacterial lesions: “Two types of lungs stand out.” In early deaths, the lungs were “dark red and wet…dripping wet.” French [25] described the lesion as “albuminuous, non-cellular, coagulable.…One realized that this albuminous exudate…was the probable cause of the cyanosis.” The exudates were “so entirely unlike what is met with in any ordinary forms of pneumonia that they seemed to be essential importance, the other changes—haemorrhages, broncho-pneumonia and so on—being super additions.…”
Although these pathology findings have been induced with the 1918 influenza virus in models [6], they are also consistent with aspirin toxicity. A study of 177 adults with aspirin toxicity (and a 15% mortality rate) found the most common presentations were depressed consciousness (61%) and respiratory failure (47%), even “at therapeutic levels” [19]. Autopsy findings for patients with the 26 fatal cases were pulmonary edema (46%), ulcers (46%), cerebral hemorrhage (23%), and cerebral edema (31%). Coagulation disturbance or thrombocytopenia was found in 38%. A detailed autopsy of an adult with aspirin poisoning revealed cyanosis, pulmonary congestion, alveolar hemorrhage, subpleural and subepicardial hemorrhages, petechiae, cloudy swelling of the kidneys, and fatty degeneration of the liver [51, 52]. ARDS-like disease has also been reported [53]. Children with aspirin toxicity (or Reye syndrome) are less likely than adults to present with pulmonary edema [35], although in addition to brain swelling, fatty liver, and cloudy swelling of the kidneys [54, 55], some have pulmonary edema [55, 56], “frothy, blood-tinged fluid” [57], and lung hemorrhages [54].
A report from Camp Dix noted, “The disease was a veritable plague. The extraordinary toxicity, the marked prostration, the extreme cyanosis and the rapidity of development stamp this disease as a distinct clinical entity heretofore not fully described.…Pneumonia is an important but somewhat secondary factor” [58, p 1817]. Salicylate toxicity is often overlooked [59] because another condition is present, the dose is thought to be trivial, and the symptoms (hyperventilation, vomiting, sweating, headache, drowsiness, confusion, dyspnea, excitement [salicylate jag], epistaxis, vertigo, pulmonary edema, and hemorrhage) are nonspecific [34]. In 1918, differentiating progressive salicylate intoxication from infection pathologically or clinically, “the dyspnea lasts from a few hours to a day…followed by respiratory failure, circulatory collapse, convulsions, and death” [40], was almost impossible.
Aspirin Advertisements in August 1918 and a Series of Official Recommendations for Aspirin in September and Early October Preceded the Death Spike of October 1918
In May 1918, usual but highly contagious influenza was publicized in Spain (hence, “Spanish influenza”) [48]. In June, after 6 weeks of usual influenza in Europe, serious pulmonary lesions and deaths increased in those “admitted to the special inf luenza centres,” especially those with an “old-standing renal lesion” [60]. In July, increased mortality of young Londoners was documented [61].
Farbenfabriken Bayer's worldwide efforts had left few places lacking aspirin. In the United States, Bayer's giant factory produced aspirin under “American” management. After Bayer executives were charged with violating the Trading with the Enemies Act in August 1918, advertisements encouraged confidence in aspirin [62]. The “Spanish lady” came to the United States and struck 2000 Navy men in Boston in late August. The majority recovered, but oddly, 5%-10% developed a “very severe and massive bronchopneumonia,” which, in many, lacked an accompanying leukocytosis [63]. Influenza spread.
Official recommendations for aspirin were issued on 13 September 1918 by the US Surgeon General [64], who stated aspirin had been used in foreign countries “apparently with much success in the relief of symptoms” (p 13), on 26 September 1918 by the US Navy [29], and on 5 October 1918 by The Journal of the American Medical Association [31]. Recommendations often suggested dose regimens that predispose to toxicity as noted above. At the US Army camp with the highest mortality rate, doctors followed Osler's treatment recommendations, which included aspirin [48], ordering 100,000 tablets [65]. Aspirin sales more than doubled between 1918 and 1920 [66].
The number of deaths in the United States increased steeply, peaking first in the Navy in late September, then in the Army in early October, and finally in the general population in late October [67]. Homeopaths, who thought aspirin was a poison, claimed few deaths [11, 48]. Others may have suspected that aspirin was responsible. On 23 November, 1918, Horder [68] wrote in The Lancet that, for “intensely toxic cases…aspirin and all so-called febrifuge drugs must be rigidly excluded from the treatment” (p 695)
In summary, just before the 1918 death spike, aspirin was recommended in regimens now known to be potentially toxic and to cause pulmonary edema and may therefore have contributed to overall pandemic mortality and several of its mysteries. Young adult mortality may be explained by willingness to use the new, recommended therapy and the presence of youth in regimented treatment settings (military). The lower mortality of children may be a result of less aspirin use. The major pediatric text [69] of 1918 recommended hydrotherapy for fever, not salicylate; its 1920 edition [70] condemned the practice of giving “coal tar products” in full doses for reduction of fever. The occurrence of Reye syndrome-like illness before the 1950s is debated and consistent with the fact that children's aspirin was not marketed until the late 1940s. Varying aspirin use may also contribute to the differences in mortality between cities and between military camps.
To determine the proportion of virus-induced pathology, subsequent bacterial infection, and overall 1918 pandemic mortality attributable to salicylate, experimental models and analysis of primary consecutive individual treatment and pathology records are needed. Prospectively, aspirin should be investigated in countries where aspirin is used for influenza.
- Received March 29, 2009.
- Accepted June 25, 2009.
- © 2009 by the Infectious Diseases Society of America