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Dr Rachael Dunlop

 

Rachael Dunlop is a medical doctor and researcher based in New South Wales, Australia.  She works primarily in ALS and neurodegeneration research and is also a regular guest on the SkepticZone podcast as Dr Rachie.  In 2010, she won the Shorty Award for health.

The only way that we can really counteract misinformation online is to put out good information.

On working in medicine

My focus at the moment is motor neurone disease, which is also known as Lou Gehrig’s disease because there was a famous baseball player in America named Lou Gehrig who died of this disorder.  It’s also called ALS, or amyotrophic lateral sclerosis, which is a bit of a mouthful, but people probably know of it because Stephen Hawking has a form of motor neurone disease or ALS. So it’s a disease that causes the extremities and the neurones that control the muscles in the extremities to die off and so over time, a very short period of time actually, about two and a half years, you end up being not able to breathe, you can’t speak, your brain still functions but your muscles basically die.  There’s no known cure, in fact there’s no known cause at this time, we have some genetic links but there’s no specific gene that causes this disease.  So I’m looking at the environmental triggers, and this is a fascinating area because we’re looking at blue green algae.   

Now, most people are familiar with algae it forms big blue green carpets on lakes and rivers and in the ocean as well, and we found a link between blue green algae and motor neurone disease because there was an indigenous population in Guam and they’re called the Chamorro people and they love to eat fruit bats.  This is one of the delicacies and it’s something they love, they have a voracious appetite for fruit bats.  So they would capture fruit bats and cook them up in a coconut broth and they would eat the whole bat, they would eat the wings, the skin, the fur, everything, and the broth as well.  And they ended up getting a higher incidence of this motor neurone type disease and when ethnobotanists went looking at what they were eating, they discovered that the fruit bats were feeding on the seeds of a tree called the Cycad and in the roots of that Cycad tree was growing algae.  And that algae was making a toxin that’s toxic to neurones and so what was happening is, it was concentrating through the food chain.  So it would concentrate in the seeds of the tree, the bats would eat the seeds, the humans would eat the bats and they’d get a massive dose of this neurotoxin and that would cause this disorder.  So this algae was growing in tree roots in Guam but it also grows in lakes, it grows in rivers and it grows in the ocean and so we have done studies now showing that it concentrates in fish.  So you can find it in types of fish, you can find it in mussels because mussels concentrate, they filter seven litres of water an hour and anything that’s in that water, they retain in their flesh.  Prawns in Washington Bay have been found to have very high concentrations of this neurotoxin, seafood is particularly susceptible and we think, based on some studies that we’ve done looking at epidemiology, that this could trigger motor neurone disease.

What led to a career in science and medicine

Well, I had a really good high school chemistry teacher, actually, and he was a little bit crazy but one of those kind of good crazy, you know, he would come to class and he would get on the benches in the chemistry lab and tap dance on the benches and he had those kind of pants with holes in them from sodium hydroxide burns and acid burns, you  know, but he was so enthusiastic and he really encouraged me to get involved in science and he sort of, I guess, started a…he sort of lit the flame for me in interest.  And I actually did very badly in science at school, I didn’t do very well in chemistry and I had to go back and do extra classes after school which he would coach me in, but eventually I decided that I wanted to do it at uni and I remember telling my science teacher this, I’d left school at the time and I saw him at the shopping centre and I was really excited, I was like, ‘I’m going to go to uni and do science’ and he looked very, very frightened, he sort of went a little bit pale and a little  bit grey and he was like, ‘Oh, OK’.  But you know I did…in fact, I did art before I did science, I was an artist for a long time; I worked in graphic design and I actually wrote radio commercials, directed TV commercials and worked as a copywriter in advertising back in the nineties when there was lots of money in advertising, the sort of halcyon days of, you know, the big money.  And then I worked as a graphic designer for a long time and then I got bored and I went back to university and did science and went straight through, so I did an undergrad, an honours degree and a PhD so that was eight years of just full on study, came out at the end and was just fascinated by biology and diseases and viruses and that led me into looking at motor neurone disease, which is what I do now.

On the anti-vaccination movement

So today [at QED] I’m going to be talking about vaccination and specifically the anti-vaccination movement in Australia.  I became interested in this about four or five years ago because there was a television programme in Australia which depicted the story of a baby who was too young to be vaccinated, only four weeks old, and she died of whooping cough.  And this was in an area of Australia which is, um, very low levels of vaccination across the community, so what we call herd immunity or community immunity had eroded.  So there was a little pocket where viruses or bacteria could take hold and spread around.  And when it comes to people who haven’t been vaccinated, maybe they’re too young or they haven’t had all of their vaccinations, they might have an immunosuppressive disease, like they might be getting chemo, they might have cancer, these people are very susceptible and so this child who was four weeks old contracted whooping cough and died.  And I became aware as a result of this that there’s a bunch of people that are opposed to vaccination.  And I honestly couldn’t believe it, I thought that’s really…knowing what I know about science and medicine and public health, and that vaccination is one of the most successful and effective and cheapest mechanisms we have of preventing vaccine preventable diseases, I was shocked that people would be against that.  

So I started to do some research and I found that there is a bunch of very noisy, quite small, but very noisy and quite effective people who campaign against vaccination.  And, of course, this extends across the world and it’s not new, the anti-vaccination movement is as old as vaccination, you know, back in the days of Jenner, there were, um, depictions of people getting smallpox inoculations and then getting half of a head of a cow and turning into beasts because they were turning into cows.  So it’s not a new thing but it’s a very interesting psychology that people have and in the first world it’s particularly interesting because I guess it’s kind of a first world problem, you know, you go to the third world and people aren’t arguing that vaccines contain toxins or that they have side effects, they just…because they see the diseases every day in front of them.  So, vaccines are kind of a victim of their own success in that way, because we don’t see people in calipers from polio anymore, we don’t see people in iron lungs anymore; these diseases have largely been controlled by a combination of things and that’s sanitation, fresh water and vaccination.  So we become complacent and some people become paranoid and there’s a lot of conspiracy theories surrounding anti-vaccination too which is really fascinating and they involve things like, big pharma is trying to control us so that they can make us sick and then we can buy more of their drug and, the government is implanting mind control chips through needles, that chemtrails are being sprayed from planes so when you see contrails in the sky they’re actually chemicals the government’s spraying on you to control your mind.  So it goes from just the very basic idea that, um, vaccines are toxic and might cause brain damage, to it’s a mind control thing; it’s a very, very fascinating area of research.   But unfortunately, the impact it has is real and it’s not a conspiracy and we are seeing more people getting ill from vaccine preventable diseases and in particular children, and right now [April 2013] in the UK there’s a huge outbreak of measles in Wales. Um, so we see that this happens if people stop vaccinating, we get resurgence of vaccine preventable diseases and people die. 

On the evidence for the success of vaccines

So there are quite a lot of common arguments that anti-vaccine people use when they argue against the need for vaccination.  One of those is that prior to the introduction of vaccinations the death rate from vaccine preventable diseases was already on the decline.  Now this is true, because as I said before, water, clean water, and sewerage has controlled the spread of vaccine preventable diseases as well, but what we have seen since the introduction of vaccination is not just a reduction…further reduction in deaths, but a further reduction in people getting long term complications and a long term disease.  So, you have to consider two things about getting diseases: you might die, but you probably won’t die, but if you get whooping cough, you’ll probably end up with a hundred days of coughing, you’ll end up with broken ribs, you can end up with hernias, if you’re a child you can end up with brain damage, and you can end up with asthma later on because you can get damage to your lungs.  So there’s long term effects that we have now been able to eliminate because of vaccinations, so those things that – for example, kids that got polio, only some of them would’ve died from polio but many of them would’ve been crippled and paralysed – that we have been able to completely eliminate with the use of vaccination.  And I think that’s really important because, just because a lot of people, um, death is one certainly, but long term complications and suffering is another thing that has to be considered, and anti-vaxxers don’t seem to care about that.

On the small risks associated with vaccinations

So, one of the other things that anti-vaxxers will say is that there are side effects from vaccines, and that’s absolutely true and nobody is hiding that.  We know that people can get bad reactions but in terms of, say, measles, let’s take that as an example, if you contract measles you have about a one in a thousand chance  of getting encephalitis which is, um, swelling of the brain, which can be very serious.  If you get the MMR vaccine, you have about a one in a hundred thousand chance of getting encephalitis from the vaccine, so we’re talking magnitudes of difference.  So the risk associated with the disease is much, much greater than the risk associated with any adverse effect you’ll get from the vaccination, so when you look at a thousand fold difference, it’s a no brainer that you would get the vaccine.  Now we know that people do have, um, do get side effects  and those are commonly things like a sore arm, people commonly think you get the flu from the flu vaccine because you might get a headache, you might get the chills, you might get a bit of a fever, in fact that’s a good thing, because that means your immune system is working, its responding to the vaccine, and it’s producing antibodies, so you’ll get a response that is indicating that the vaccine is working, but it’s not the flu because you cannot get the flu from the flu vaccine, it’s not a live vaccine.  

On spreading the right message about vaccinations

Spreading the word about the benefits of vaccination in this day and age is hard and the reason for that is because we have this thing called the internet now.  And, as much as I love it and as much as everyone has a lot of access to it, is it unregulated, which means anyone can go on there and write whatever they like, and it’s very difficult for people who are looking for information to be able to filter out what is right and what is wrong.  This is particularly important when it comes to health claims because so many people now…for example, about one in two people turn to Dr Google to do research and to self-diagnose which is even more scary and also even to self-medicate, so people will just Google their symptoms, get something that’s diagnosed by Dr Google and then even go and buy pills to medicate themselves, which can obviously have some terrible consequences.  So, the only way that we can really counteract misinformation online is to put out good information.  So there’s a lot of people that are doing really good work in this area with blogging, with social media like Facebook, with Twitter, the only way you can do it is to counteract it so you need to be active and you need to write stuff, you need to get out there and do this stuff.  There’s lots of tools online as well that allow you to vote pages up and pages down, um, and just be active and contribute, I think, is the most important thing to get the message out there.

On a science hero

Yeah…so, um, there’s a lot of people in science now that I admire and I think, um, the one person that I never ever thought I’d say this about, because I really had issues with this person initially, but I have to say it’s Bill Gates.  And I’d have to say the reason for that is because he has made a huge amount of money from making terrible software but he is spending that money so well now with his Foundation and he’s pledged ten billion dollars in the last couple of years for the next decade to, um, introduce vaccination into the third world and to go about ways of developing better vaccines and getting more people out there to vaccinate children.  And this is a really important thing for the third world because, although we talk about um, the three things that will reduce vaccine preventable diseases, one being clean water and sewerage, the cheapest by far and the most effective and the easiest to do is vaccinate everyone.  So, you’ll find people saying, ‘Why don’t we just give the third world clean water?’  Well, you know what?  We would, but it’s really hard and it’s really expensive.  So one thing that Bill Gates is also looking into is developing technologies of vaccines that…we don’t have to refrigerate them anymore, cause one of the problems now with delivering vaccines to the third world is you have to keep them cold.   There are new technologies coming in now where they’re just patches that you can keep at room temperature and that will allow us to get to communities that are isolated that really need polio vaccines for example.  And Bill Gates has pledged to try to eliminate polio completely from the world in the next decade and then he’s going after measles as well.  So this would be great, and he’s got an opportunity now where he can really make a difference to public health of people who are most in need and I think that’s really admirable.  He’s not a scientist, but I think he’s doing great scientific work. 

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