RACHEL LEWINSOHN

NNo one would be surprised if the scandalous report about President Lula's alleged alcoholism appeared in the “brown press”. But the publication of this article in the august The New York Times was an unpleasant surprise, not only because of the rudeness and disrespect for a head of state, but also because the report came from a reporter with dubious backgrounds (professional and political), and from sources highly suspicious. The whole, shocking especially due to the conduct of the NYT editor, irreducible in his arrogance, resulted in terrible journalism, offering sensationalism instead of information.

My reaction, like everyone else's, was shock – but not surprise. This is because, a few months ago, I came across an article that opened my eyes to the quality of NYT journalism. I never imagined that brown scientific journalism could exist; Now, after reading this article and its “correction” (see below), I no longer have any doubts: it exists.

In October 2003, my article Prophet in his own country: Carlos Chagas and the Nobel Prize appeared, in Perspectives in Biology and Medicine (Chicago-USA). The publication concluded a year and a half of productive and highly rewarding collaboration with the magazine's editor-in-chief, Dr. Robert Perlman, physician and professor at the University of Chicago, who demonstrated great sensitivity and understanding of our country's problems during the preparation of my text for publication. Of course we became friends. It was he who alerted me on 18/11/03 to an article by DGMcNeil Jr. about Chagas disease in the USA, published that day in the NYT, whose content, style and implications revealed journalism and an attitude exactly opposite to that of Dr. Perlman and Perspectives. Here are some excerpts (the whole would not fit in this space):

“Rare infection threatens to contaminate blood.

“A parasitic disease common in Latin America threatens US blood supplies, say public health experts, who are very concerned because there will be no test to [detect it in] donated blood until next year at the earliest. The infection is Chagas disease, still rare in this country. Only 9 cases have been...transmitted by transfusion or transplant in the US and Canada in the last 20 years. But hundreds of blood recipients may be silently infected...and there is no effective treatment for them. After a decade or more, 10 to 30% of them will die when their hearts or intestines, weakened by the disease, explode (sic)... Still little known in the US, it is... one of the biggest threats to blood supplies; but it is an emerging threat...” (Itál.RL) (Statistics on the risk of contamination from transfused blood, in Miami and Los Angeles, are the most recent from 1998.)

“Currently the only survey method is a series of questions asked of blood donors: whether they come from or have visited a country where the disease is endemic, whether they have ever slept in a thatched hut...(the honesty of the answers is a factor of uncertainty )... Since 1989, despite several recommendations to the FDA-USA that all donated blood be tested for Chagas, no test has yet been approved. In 2002, the FDA invited diagnostic industries to create a test...But there is no pressure or deadline...The Abbott test could be ready in 2004...(Further statistics on the incidence in Latin America follow [of questionable accuracy—RL ]). Around 30 tests are applied in several countries,...none approved by the FDA.

“The disease, described by Carlos Chagas in 1909, is caused by Trypanosoma cruzi, which infects humans in a particularly disgusting way (sic). The kissing bug falls from the thatched roof, follows the trail of carbon dioxide to the mouth of the sleeping individual, and sucks his blood, depositing his feces full of the parasite, which are introduced [into the skin] when the person scratches the bite...

“The failure of the blood industry...to develop a test, [although] endorsed by the Blood Products Advisory Committee in 1989, appears to be a combination of bureaucratic inertia and divided responsibility... Dr. Hira Nakhasi (FDA) agrees that neither the blood banks nor the FDA have been very aggressive. Things move when 'the public and the media exert pressure,' he said.

“Interest in disease appears to be growing...because advances in biogenetics make it easier to attack disease and because the Bill and Melinda Gates Foundation's interest in Third World health 'puts many diseases on the radar screen'.”

On 23/11/03, restricted to the space imposed by the NYT, I sent the following letter to the editor: “Your article of 18/11/03 requires some corrections. Chagas heart disease kills through arrhythmia or congestive heart failure, not through an explosion; victims of untreated megaesophagus, unable to swallow even liquids, die from cachexia. People sleeping in thatched houses are bitten by the barber wherever they find uncovered skin, often near the eye. Transfusional Chagas disease, an emerging threat in the USA? It has been known as such for more than a decade, a fact corroborated by an abundant literature (including numerous American publications). There are many excellent blood tests — in Brazil, ELISA, immunofluorescence and passive hemagglutination, among others, have drastically reduced the risk of using contaminated donor blood. Getting FDA approval is a political problem, not a technical one. But I'm happy to know that... Bill Gates will save the blood stored in the USA.

Rachel Lewinsohn, MD, Ph.D. (Professor of Clinical Medicine and Tropical Diseases at Unicamp, Brazil. Author of the book 'Three Epidemics-Lessons from the Past', about Chagas disease and other epidemics; and of an article about Carlos Chagas in Perspectives in Biology and Medicine, 2003, 46/4: 532-49).”

It was no surprise that the NYT did not publish my letter. But on 2/12/03 he published “Correções”, without mentioning any reader letters. Parts:

“An article in the Science section (NYT 18/11/03) about...the rare blood infection known as Chagas disease, included an inaccurate summary of Dr.H.'s opinion. Nakhasi...(FDA), about the lack of a test to detect the disease in the blood;...he did not say that the FDA and the blood industry were not very aggressive in the search...

“The article and graph also contained errors regarding the Red Cross estimates of the risk of contracting Chagas disease through blood transfusion. The estimates – 1/9.000 in Miami, 1/5.400 in Los Angeles (1998) and 1/25.000 in the nation as a whole – referred to the risk that a given blood donation contains antibodies against the disease, not the risk of that blood infect the recipient. (The Red Cross states that some blood with antibodies does not contain T.cruzi, and that some parasites are not infectious.)

“The graph also made mistakes in the estimates, coming from the journal 'Transfusion', of the rates of blood donations in Los Angeles with antibodies against Chagas disease. The numbers were 0,010% in 1996, 0,014% in 1997, and 0,018% in 1998, not 0,16%, 0%, and 0,24% respectively. ..."

Both the original article and the “correction” are examples of the worst kind of scientific journalism, emphasized by the apparent transmission of information, when its real objective is disinformation. What I find most offensive in all of this is being taken for an idiot. Are you an editor at the NYT and receive a letter from a reader who doesn't agree with what he wrote? Here's what you should do: pretending to correct inaccuracies, preferably in indifferent details, ignore any pertinent comments; nor mention patent errors or absurd statements. What, did I make a mistake? No way. Throw a bunch of disjointed statistics in the public's face; Asshole that he is (in the NYT's opinion), he will certainly be impressed by his “documentation”. What difference does it make to him if his risk of contracting Chagas disease is 1/9.000 or 1/25.000 or 1/one million? Or if there are antibodies or beer in 0,018% of donated blood? It should be noted that the NYT statistics are contradictory and say nothing about the true situation, described by many authors (including Americans), while the description of the transmission and evolution of the disease is simply ridiculous. How to interpret this caricature of scientific journalism? An obvious advantage is the subtle induction of popular pressure for preventative measures, in anticipation of huge profits from any drug or new blood test. Have you ever imagined the millions that can be made from the panic of a disease that causes the person “kissed” by the barber to explode?

The encouragement of prejudice against Latin Americans is also obvious. This takes us back to the beginning of these comments, and the conduct of the NYT editor. Does he find it difficult to forgive President Lula for pulling himself out of the mud of his origins by his own hair? Does it hurt to remember the overwhelming majority – almost 53 million votes – that elected him, compared to the somewhat different way in which Bush managed to insinuate himself into the White House? Or does encouraging this prejudice also have its profitable side?

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