The legacy of Frances Oldham Kelsey

JFK bestowing the Presidential Award for Distinguished Civilian Federal Service on Frances Kelsey

Frances O. Kelsey died last week, at the ripe old age of 101. You probably don’t recognize her name, but we are all in her debt for the role she played in events that hark back to the Kennedy era (an odd coincidence, given the subject of my last blog). But to tell the whole story we have to go back even further than that.

The 19^th century marked the heyday for patent medicines. “Snake Oil” – actually, mineral oil with flavorings – was energetically hawked to the American public, along with innumerable other products of equally dubious origin (see Chapter 14 of my book, “Sense and nonsense in the treatment of ASD,” for more). In 1906, largely in response to public outrage over unsanitary conditions in the meat-packing industry, congress passed the Pure Food and Drugs Act , over the bitter opposition from both the meat-packing and patent medicine lobbies. In the 1930s congress extended its original legislation to create the Food and Drug Administration. One of the FDA’s first measures was to ban radioactive quack medicines, in the wake of the 1932 death of Eben Byers, a wealthy industrialist and socialite who had consumed radium tablets that had been marketed as a health product. (If you find the idea of radium as a health food hard to swallow – no pun intended – I can’t blame you! But that’s the way it was.) Despite that early success, however, the FDA that young Dr. Kelsey joined in 1960 had only a handful of staff, and no statutory authority to require that proposed new drugs be tested for safety before coming to market. Read the rest of this entry »

Autism, Ebola, and the Will Rogers Effect

Dr. Coplan reflects on the history of autism, as it may relate to the Ebola epidemic.

I’m going to take a risk this week, and put in my 2 cents on a topic that’s outside of my primary area of expertise – Ebola Virus. What can a Neurodevelopmental Pediatrician contribute to this conversation, and what do autism and Will Rogers have to do with it? Read on….

One of the terms you hear in connection with Ebola Virus (EV) is “Case Fatality Ratio” (CFR). CFR is defined as the number of infected persons who die divided by the total number of persons who are infected. (CFR = Deaths / Total Infected). This ratio is murky for various reasons.

The numerator is the easier value to discover: Death from Ebola is dramatic, and hard to miss. Even the numerator, however, is never 100% accurate: If you are living in the bush, and there are no healthcare workers to document your demise, your death may go uncounted. Or, in non-epidemic situations, an isolated death here or there, even in a medical setting, may go undiagnosed. But in epidemic settings, especially when healthcare workers are on the scene, the numerator can be tallied within a tolerable level of error.  Read the rest of this entry »