New developments with Dr. Alson Sears' NDV treatment of Canine Distemper, and more worrying signs of quackery.

I posted about Dr. Alson Sears' treatment for canine distemper last year, and there have been some interesting developments since then that I thought should be addressed.  There is at least one new person involved who I believe genuinely cares about animals and who seems to be convinced that the treatment of canine distemper involving Newcastle disease vaccine is actually effective. Unfortunately, there is not any better evidence that the treatment is effective, despite two different groups collecting donations to support their efforts to have more dogs infected with distemper treated. Ed Bond, the journalism teacher is still promoting the treatment with his own website and a facebook group, and now someone named Jane, who has her own shelter/rescue operation and writes her own blog and a blog on the Houston Chronicle website is now collecting donations for "Project Hope" which is dedicated to producing Dr. Sear's serum using Newcastle's Disease Vaccine administered to dogs and treating distemper cases with it. While I am still convinced that everyone involved in promoting this unproven treatment means well, and that they truly believe that it works, there are some disturbing signs of "mission creep" in the diseases which they claim to be able to treat, and the attempts to prove the treatment effective look inadequate to provide the kind of proof which they would like. At this time, they are selling DVD's and taking donations to provide what is at best an unproven and experimental treatment, while presenting it as something that is a proven treatment. This raises some serious ethical and legal concerns as most of the dogs involved are coming from shelters, and in some jurisdictions it is not legal to experiment on shelter animals, and spending money on an unproven and possibly risky treatment may not be the most effective use of limited funds.

To review my last post, canine distemper is a viral disease that affects domestic and wild canines and some other wild species such as raccoons and mustelids and large cats such as lions and tigers (cats in the genus Felis-domestic cats, and small wild cats also including american mountain lions are not susceptible to canine distemper). The vaccine is very effective, and despite some problems with effectiveness about 20 years ago (1, 2, 3), canine distemper is very rare in vaccinated, well cared for dogs and puppies. It can be a serious problem in large populations of young, unvaccinated dogs, such as shelter populations. There seems to be an ongoing outbreak in shelters in the area in which I live, and there are apparently similar problems in other areas as well, which may be one reason people are looking for treatment options right now. The course of the disease in an infected dog varies depending on a variety of factors depending on the dog's age, immune/vaccine status, and the strain of virus causing the infection. Young puppies are most susceptible, especially during the period when their maternal antibodies are declining but before they have time to develop their own immune response from vaccination. The highest risk period is from 6-16 weeeks, but unvaccinated dogs can be infected at any age. Older dogs tend to have somewhat less severe infections and a higher survival rate. Once dogs do develop immunity, it is long lasting, 3-4 years at least (1, 2, 3). Severely infected dogs are susceptible to secondary, fatal infections such as bacterial pneumonia, and some dogs develop neurological complications that can cause seizures, paralysis and death. Sometimes these problems can occur months or even years after apparent recovery from the infection, and are caused by damage the immune system does in the nervous system while trying to get rid of the virus. It is difficult to predict when or if a dog with a mild or moderate case of distemper will develop neurologic symptoms.

Diagnosing distemper definitively can be more difficult than we would like. Indirect tests such as looking for distinctive inclusion bodies in cells collected from various locations are good, and PCR testing for viral antigen is better, but the standard PCR test does not distinguish between the modified vaccine virus and the wild strains, and it is unknown how often the vaccine virus causes inclusion bodies in cells. This means that vaccination can cause a positive test result for up to three weeks after vaccination. I don't doubt that most of the dogs being treated by these well-meaning people do have distemper, but it is certainly possible that some of the dogs who recover quickly have other types of infections and test positive because of vaccination. Most shelters vaccinate puppies as soon as they enter the shelter in an attempt to avoid problems, so many  of these puppies may have both vaccine and wild virus in their systems at the same time. Other infections like bacterial respiratory infections, canine influenza, and other viruses can all cause similar symptoms. Symptoms consistent with distemper and positive tests make it very likely that these dogs do have distemper, but specialized viral testing would be required to definitively prove that the dogs who recover did in fact have distemper and that the treatment actually killed the virus as Dr. Sears claims. This type of testing is normally only done in some virology research labs and at places like the CDC, where they analyze new strains of influenza and serious, unknown outbreaks of disease. Specialized immunology labs would also be required to confirm that the newcastle disease vaccine is having the effect Dr. Sears claims it has, which is stimulating a strong immune reaction in the donor dogs, such that a few milliliters of serum is enough to kill all the virus in an infected puppy.

There seem to be signs that the proponents of the treatment are using some selection bias when reporting the results of the treatment, and overstating the number of dogs which survive. I will provide some quotes from their sites that seem to illustrate this. Project Hope is named after a puppy that did not survive the treatment, and there seem to be quite a few similar cases when I searched through the discussion pages of the facebook group;

The serum treatment for distemper is nearly 100 percent--I don't know of any cases that failed but in medicine, there is never 100 percent of anything.
(May 5th, 2010 Jane's blog)

This is almost 6 months after "Hope" died despite treatment, and after other failures;

 SaveDogs FromDistemper  Sadly all 5 Croatian puppies died, but the adult with neurologic symptoms has recovered. They are calling it a miracle.
(December 19, 2009 at 7:17am Facebook Group)

There are others as well when you scroll through the discussion pages.

Since distemper is such a serious disease, dogs who recover often have an extended recovery. Despite claims that the Newcastles treatment is so effective, they have many cases where the dogs take a long time to recover. This (and their failures) is blamed on the secondary infections, or the treatment coming "too late", which is unfortunately something which happens all too often in defense of many unproven treatments.

She is a Project Hope serum puppy.  Three weeks ago, after being diagnosed with distemper at her vet, Brindy received Dr. Sears' NDV-induced serum, a treatment for distemper.  She had an advanced case of distemper--green crusty nose, green crusty eyes, pneumonia...and she had a skin condition of some sort. The distemper was dead in 24 hours according to Dr. Sears.  The other issues have yet to be cured.
(Feb. 15, 2010 Jane's blog)

Skin problems can be caused by distemper as well.

 It will take some weeks or even months (4 weeks to 4 months is what Dr. Sears tells me is a good rule of thumb) for the damage that was done to repair itself.                                    (March 19, 2010 Jane's blog)

They are also starting to make claims that the treatment works for a wide variety or other dieseases, with apparently no evidence whatsoever. Occasionally they contradict themselves, as Dr. Sears says at one point in a video clip that the serum does nothing against parvovirus, but claims otherwise elsewhere.

Dr. Sears is now including the NDV-induced serum in protocols to treat not only canine distemper, but parvo and herpes as well as several other diseases.  The first puppy testing positive with parvo had serum and within just several days, her fever went down and her recovery seems to be rapid.  This is making me think some.

First of all, having the serum is like having a life-insurance policy for our dogs/puppies.  As long as we act fast enough, and don't waste weeks with other vets getting ineffective treatments, the serum is very close to miraculous.  If I didn't know that serum was in Houston, I would be very nervous about the outbreaks of distemper and parvo.
(April 3, 2010 Jane's blog)

What is fascinating, is that this same disease model--what Dr. Sears' is using to treat distemper--can be used to eliminate human diseases like MS and maybe even cancer.  Yes, this is huge--and we have to do a little bit each day.  What we are learning and teaching, thanks to Dr. Alson Sears, will make a difference in this world.
(Feb 15, 2010 Jane's blog)

 Those are pretty remarkable claims, and I am sure Jane really hopes and believes they are true, but it does not seem to bode well for the scientific attitude toward the treatment they are promoting.
They seem to want to prove that the treatment is effective, which is a good thing, but they don't seem to have anyone with any scientific training working on it. Their claims of ties to Texas A&M seem to be limited to sending their diagnostic tests to the lab there. At this point there is no indication of involvement of the veterinary school there in researching this treatment.

This will be a publicly-funded project (donation-sponsored) and the serum will then be free to those who need it--and agree to participate in the screenings for distemper which are being sent to, and tested by, Texas A & M. It is our intention to get a peer-review article for vets all over to learn from what we are doing.  How often do we get a chance in our lives to do something that can change the world?

(February 28, 2010 Jane's blog)

 In conclusion, the evidence of their own websites, and the fact that they seem to be using the donations they receive honestly, indicates that Ed Bond, Jane, and others involved in this are honestly trying to help sick animals. Unfortunately, after 40 years of using this treatment, Dr. Sears still has nothing more than anecdote and testimonial to prove that the treatment works. While he has managed to convince some well meaning laypeople, the evidence is still inadequate to non-existent, and of all the people involved in this, he is the one who should understand this. Apparently he does not. If this treatment is ineffective, the effort and money they are spending could be much better used elsewhere. I would be happy to be wrong about this, but so far they have not presented anything to convince me that I am. If they really want to show that the treatment is effective, they need to establish that the treated dogs all actually had wild strains of distemper, and their tests are not being interfered with by vaccine strains of virus. Ideally, they could run a blinded, controlled trial to be sure that treated dogs survive distemper at a higher rate than dogs given standard, supportive care. They also need to keep meticulous and honest records of both positive and negative outcomes. It might be difficult to convince everyone involved to do this, since the primary promoters of the treatment already seem convinced that it works, and may be reluctant to not treat some dogs in a trial. However, if they really want to know if this treatment is effective, and produce evidence that other veterinarians would accept, that is what they need to do, even if the results are disappointing in the end. It is possible that the treatment is a false hope, which would be worse than the small hope available now to owners of severely infected puppies. If the treatment is ineffective, as I suspect it may be, then they can concentrate on helping dogs in more effective ways.

Addendum; 7/28/10;
For those who might be interested in another, science-based resource on shelter medicine and issues such as distemper problems in shelter animals, the UC Davis Koret shelter medicine program has an excellent website with a page on canine distemper. Related to the outbreak local shelters are experiencing, the use of the relatively new recombinant distemper vaccine produced by Merial can be useful as it does not cause false positive PCR tests. The use of this vaccine by those trying to demonstrate efficacy of Dr. Sears' treatment would be one thing that would help to increase the validity or their results.