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Hilary's Desk

Trotman eats toe jam, yet again

Hilary Butler - Thursday, April 16, 2009

The Sunday Star Times has a magazine called Escape in which their regular medical columnist, Dr Paul Trotman, pontificates on a diverse range of medical issues. He is known for his vigorous denouncement of anything thought to originate from, or be, “anti-vaccine”. His latest contribution however, is remarkable for the utter stupidity of opening the mouth prior to opening the brain. Apparently, comments about overcrowding being the biggest “cause” of meningitis are dismissed as some “attitude” of anti-vaccination people. The column reads:


First, perhaps Dr Trotman can tell us what MMR has to do with the question asked, which was about meningitis.  Perhaps he thinks that MMR is the meningitis vaccine?  :scratches head:

Perhaps he could answer the question about overcrowded housing, and meningitis please?

To do so, wouldn't "rule number one" be to check out the facts in the medical literature and elsewhere?  To see whether such a "fantasy" is ONLY the province of antivaccine people?  People who, according to Dr Trotman, can “say and do what they like”, implying that their protection is courtesy of the vaccinated. The problem with such an implication is that, in the case of the recently used MenZB vaccine, a major facet of the relentless emotional blackmail campaign was that the MenZB vaccine could not, would not, and did not confer "herd immunity".  

Instead of wagging a fallacious finger at people who chose not to vaccinate... forgetting the three fingers pointing right back at himself... shouldn't Dr Trotman have checked out what his own colleagues had said in the past? In particular, those whose shingles read: “Ardent vaccine defender resides here.”

A few highlights from a lengthy list which could cure insomnia:

1)  TV 3, 60 minutes, "Meningococcal meningitis”, 11th April, 2005; 7.30. p.m.  Thirteen minutes and 26 seconds into the programme Dr Nikki Turner from IMAC, states that meningococcal B disease probably arose out of poverty and “poor, overcrowded housing in South Auckland.”

Nothing unusual there. After all, ESR Wellington/Auckland/Auckland Healthcare and Auckland University had just proved that, as announced by Annette King, who used that information to score political brownie points:

2) Hon Annette King

10 January 2000

Findings of Meningococcal Disease study.

Health Minister Annette King says the results of a study into meningococcal disease clearly demonstrate the link between the disease and poor housing and overcrowded living conditions. The case-control study was carried out by ESR Wellington, ESR Auckland, Auckland Healthcare and Auckland University from 1997-99, and was funded by the Ministry of Health and New Zealand Health Research Council. It aimed to identify potential modifiable risk factors for the disease in Auckland children….

"Members of this Government have been saying that for years, but the link was consistently denied by Jenny Shipley and members of her former government." (emphasis mine)

 

3) As published in the Listener (2.55 mb pdf) , 29 August 1987, “Meningitis campaign goes astray”, the majority of Meningitis A cases in the Auckland district between 1984-1987, were found among people living in areas of “poor housing”. When Finlay Macdonald discussed the medical literature linking meningitis, poor housing and poverty, with the then Director General of Health, Dr George Salmond replied that this and other ‘risk factors’ were something the Health Department would love to get an epidemiologist to study, but they didn’t have one; had been looking for one for years, but that, “they’re very rare birds to get and they’re much in demand.” None of which negates the fact that medical literature has linked overcrowded housing and meningitis for many decades. 

Better yet, had Dr Trotman done a search in the medical literature, he would have rubbed his nose in the article mentioned by Annette King, done by many of his colleagues: Baker M, McNicholas A, Garrett N et al. “Household crowding a major risk factor for meningococcal disease in Auckland children.” Pediatr. Infect. Dis. J. 2000; 19: 983–90.

A REALLY extensive search, would have shown huge numbers of different acute and chronic health problems associated with household overcrowding. Had Dr Trotman added up all those costs, gradually eliminating them from 22 years worth of taxpayer’s compulsory health budget contributions since the housing issues were first publicly discussed, the resultant savings might have made him a convert.

Except for one thing.

With fewer areas of poor housing and poverty; with far fewer acute and chronic illnesses for GP's and hospitals to treat, perhaps New Zealand would not be enduring the current shortage of doctors in 2009. 

Politicians might now be trying to work out what to do with the resultant doctor surplus, …. which might have included Trotman.


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