Eliza Jane Scovill
Encyclopedia
Eliza Jane Scovill was the daughter of AIDS denialist, the late Christine Maggiore
Christine Maggiore
Christine Joy Maggiore was an HIV-positive activist who promoted the view that HIV is not the cause of AIDS. She was the founder of Alive & Well AIDS Alternatives, an organization which questions the link between HIV and AIDS and encourages HIV-positive pregnant women to avoid anti-HIV medication...

, an HIV-positive activist who publicly questioned the link between HIV and AIDS
AIDS
Acquired immune deficiency syndrome or acquired immunodeficiency syndrome is a disease of the human immune system caused by the human immunodeficiency virus...

, and supported HIV-positive pregnant women who want to avoid taking anti-HIV medication. Eliza Jane's May 16, 2005 death from AIDS at the age of three and a half sparked a social and legal controversy over her mother's decision not to take precautions during her pregnancy to prevent transmission of the virus, and her parents' decision not to have her treated for HIV infection during her life.

AIDS diagnosis and death

In 1992, Eliza Jane's mother, Christine Maggiore, tested positive for HIV
HIV test
HIV tests are used to detect the presence of the human immunodeficiency virus , the virus that causes acquired immunodeficiency syndrome , in serum, saliva, or urine. Such tests may detect antibodies, antigens, or RNA.- Terminology :...

. She subsequently became involved in volunteer work for a number of AIDS charities, including AIDS Project Los Angeles, L.A. Shanti, and Women at Risk. However, following an interaction with prominent AIDS denialist Peter Duesberg
Peter Duesberg
Peter H. Duesberg is a member of the United States National Academy of Sciences and a professor of molecular and cell biology at the University of California, Berkeley...

 in 1994, she began to question whether HIV causes AIDS. Maggiore came to believe that her positive test may have been due to flu shots, pregnancy
Pregnancy
Pregnancy refers to the fertilization and development of one or more offspring, known as a fetus or embryo, in a woman's uterus. In a pregnancy, there can be multiple gestations, as in the case of twins or triplets...

, or a common viral infection.

Maggiore chose not to take antiretroviral drugs or other measures which reduce the risk of mother-to-child transmission
Vertical transmission
Vertical transmission, also known as mother-to-child transmission, is the transmission of an infection or other disease from mother to child immediately before and after birth during the perinatal period. A pathogen's transmissibility refers to its capacity for vertical transmission...

 of HIV during her pregnancies. Maggiore also breast-fed her children, despite evidence that breast-feeding can also transmit HIV from mother to child. Her youngest daughter, Eliza Jane, was never tested for HIV, nor did she or her older brother Charlie receive any of the recommended childhood vaccines.(Maggiore later reported Charlie to have tested HIV-negative three times.) Maggiore discussed her beliefs as an AIDS dissident on Air America Radio
Air America Radio
Air America was an American radio network specializing in progressive talk programming...

 in March 2005, stating that "...our children have excellent records of health. They've never had respiratory problems, flus, intractable colds, ear infections, nothing. So, our choices, however radical they may seem, are extremely well-founded."

Several weeks after this interview, in April 2005, Eliza Jane became ill with a runny nose. She was seen by a physician from the family's pediatric practice, who documented a normal physical exam. Several days later, Maggiore took Eliza Jane to see another pediatrician, Jay Gordon, who felt she had a mild ear infection. Reportedly, Gordon was aware of Maggiore's HIV status, but did not have Eliza Jane tested for HIV. According to the hospital report, filed just after Eliza Jane's death and based upon an interview with Maggiore, Eliza Jane "had been diagnosed with pneumonia" in the weeks preceding her death.

When Eliza Jane failed to improve, Maggiore took her to see Philip Incao, a holistic practitioner and board member of Maggiore's AIDS-denialist organization Alive & Well AIDS Alternatives
Alive & Well AIDS Alternatives
Alive & Well AIDS Alternatives is a 501 non-profit organization of AIDS denialists...

. Incao stated that Eliza Jane appeared "mildly ill... no way I considered her in danger... she did not act as a patient acts if she's severely ill or in danger." On May 14, 2005, Incao prescribed amoxicillin
Amoxicillin
Amoxicillin , formerly amoxycillin , and abbreviated amox, is a moderate-spectrum, bacteriolytic, β-lactam antibiotic used to treat bacterial infections caused by susceptible microorganisms. It is usually the drug of choice within the class because it is better absorbed, following oral...

 for a presumed ear infection
Otitis media
Otitis media is inflammation of the middle ear, or a middle ear infection.It occurs in the area between the tympanic membrane and the inner ear, including a duct known as the eustachian tube. It is one of the two categories of ear inflammation that can underlie what is commonly called an earache,...

.

The following day, Eliza Jane became lethargic and vomited several times. While Maggiore was on the phone with Incao, Eliza Jane collapsed and stopped breathing. She was rushed by ambulance to Valley Presbyterian Hospital in Van Nuys, California. Physicians attempted to resuscitate Eliza Jane, but were unsuccessful. According to the hospital report, a "chest x-ray revealed pneumonia," and Eliza Jane was pronounced dead at 5:40 AM on May 16, 2005.

Cause of death

An autopsy
Autopsy
An autopsy—also known as a post-mortem examination, necropsy , autopsia cadaverum, or obduction—is a highly specialized surgical procedure that consists of a thorough examination of a corpse to determine the cause and manner of death and to evaluate any disease or injury that may be present...

 was performed. The Los Angeles County coroner
Coroner
A coroner is a government official who* Investigates human deaths* Determines cause of death* Issues death certificates* Maintains death records* Responds to deaths in mass disasters* Identifies unknown dead* Other functions depending on local laws...

 found that Eliza Jane was markedly underweight and underheight
Failure to thrive
Failure to thrive is a medical term which is used in both pediatric and adult human medicine, as well as veterinary medicine ....

, consistent with a chronic illness, and that she had pronounced atrophy
Atrophy
Atrophy is the partial or complete wasting away of a part of the body. Causes of atrophy include mutations , poor nourishment, poor circulation, loss of hormonal support, loss of nerve supply to the target organ, disuse or lack of exercise or disease intrinsic to the tissue itself...

 of her thymus
Thymus
The thymus is a specialized organ of the immune system. The thymus produces and "educates" T-lymphocytes , which are critical cells of the adaptive immune system....

 and other lymphatic organs. Examination of her lungs showed infection with Pneumocystis jirovecii
Pneumocystis jirovecii
Pneumocystis jirovecii is a yeast-like fungus of the genus Pneumocystis. The causative organism of Pneumocystis pneumonia, it is an important human pathogen, particularly among immunocompromised hosts. Prior to its discovery as a human-specific pathogen, P. jirovecii was known as P...

, a common opportunistic pathogen
Opportunistic infection
An opportunistic infection is an infection caused by pathogens, particularly opportunistic pathogens—those that take advantage of certain situations—such as bacterial, viral, fungal or protozoan infections that usually do not cause disease in a healthy host, one with a healthy immune system...

 in people with AIDS and the leading cause of pediatric AIDS deaths. The post-mortem examination of Eliza Jane's brain
Brain
The brain is the center of the nervous system in all vertebrate and most invertebrate animals—only a few primitive invertebrates such as sponges, jellyfish, sea squirts and starfishes do not have one. It is located in the head, usually close to primary sensory apparatus such as vision, hearing,...

 showed changes consistent with HIV encephalitis
Encephalitis
Encephalitis is an acute inflammation of the brain. Encephalitis with meningitis is known as meningoencephalitis. Symptoms include headache, fever, confusion, drowsiness, and fatigue...

; protein components of HIV itself
P24 capsid protein
p24 is a component of the HIV particle capsid. There are approximately 2000 molecules per virus particle, or at a molecule weight of 24 kDa, about 10^4 virus particles per picogram of p24.-References:...

 were identified in Eliza Jane's brain tissue via immunohistochemistry
Immunohistochemistry
Immunohistochemistry or IHC refers to the process of detecting antigens in cells of a tissue section by exploiting the principle of antibodies binding specifically to antigens in biological tissues. IHC takes its name from the roots "immuno," in reference to antibodies used in the procedure, and...

.

Based on the clinical information, the immunohistochemical documentation of HIV in Eliza Jane's brain, the evidence of pronounced immunosuppression, and the isolation of the opportunistic pathogen
Pathogen
A pathogen gignomai "I give birth to") or infectious agent — colloquially, a germ — is a microbe or microorganism such as a virus, bacterium, prion, or fungus that causes disease in its animal or plant host...

 Pneumocystis jirovecii from Eliza Jane's lungs, the coroner concluded that Eliza Jane had died of Pneumocystis pneumonia
Pneumocystis pneumonia
Pneumocystis pneumonia or pneumocystosis is a form of pneumonia, caused by the yeast-like fungus Pneumocystis jirovecii...

 in the setting of advanced AIDS. This conclusion was described by the coroner as "unequivocal".

Maggiore rejected the coroner's conclusion, ascribing it to political bias and attacking the personal credibility of the senior coroner, James Ribe. Maggiore retained a board member of Alive & Well AIDS Alternatives
Alive & Well AIDS Alternatives
Alive & Well AIDS Alternatives is a 501 non-profit organization of AIDS denialists...

, Mohammed Al-Bayati, to review the autopsy report. Al-Bayati holds a Ph.D.
Ph.D.
A Ph.D. is a Doctor of Philosophy, an academic degree.Ph.D. may also refer to:* Ph.D. , a 1980s British group*Piled Higher and Deeper, a web comic strip*PhD: Phantasy Degree, a Korean comic series* PhD Docbook renderer, an XML renderer...

 in comparative pathology (the pathology of animal diseases). He is not a medical doctor, nor is he board-certified in human pathology. He is the author of a book entitled Get All The Facts: HIV Does Not Cause AIDS.

Al-Bayati released a report concluding that Eliza Jane had not died from AIDS or pneumocystis pneumonia, but from an allergic reaction to amoxicillin
Amoxicillin
Amoxicillin , formerly amoxycillin , and abbreviated amox, is a moderate-spectrum, bacteriolytic, β-lactam antibiotic used to treat bacterial infections caused by susceptible microorganisms. It is usually the drug of choice within the class because it is better absorbed, following oral...

. Maggiore embraced Al-Bayati's conclusion that a reaction to amoxicillin was responsible, stating, "I believe the unfortunate irony in this situation is that the one time that we were asked to and that we complied with mainstream medicine, we inadvertently gave our daughter something that took her life."

Al-Bayati's report has been dismissed as both biased and medically unsound. Both the L.A. Times and ABC PrimeTime Live
Primetime (TV series)
Primetime is an American news magazine show which debuted on ABC in 1989 with co-hosts Sam Donaldson and Diane Sawyer and originally had the title Primetime Live.-Early history:...

 consulted independent experts in pathology about Eliza Jane's case; these experts agreed unequivocally with the coroner's conclusion that AIDS and resultant Pneumocystis pneumonia were the cause of death, and rejected Al-Bayati's report.

Criticism and controversy

Following Eliza Jane Scovill's death, Maggiore's beliefs and advocacy became points of controversy. Maggiore had held fast to her belief that HIV does not cause AIDS, and that Eliza Jane died of a reaction to amoxicillin. She submitted a letter to the LA Times alleging factual errors and omissions in their articles on Eliza Jane; the Times did not print the letter, stating that "If facts in an article are wrong, a correction would be published. However, no correction is warranted in this case."

Others point to the evidence which indicates that Eliza Jane acquired AIDS from Maggiore perinatally or via breast feeding, that Eliza's HIV infection might have been prevented had Maggiore taken antiretroviral drugs or avoided breast feeding, that Eliza Jane's death was due to complications of AIDS, and that her death may have been preventable with proper medical care.

John Moore, a prominent HIV/AIDS researcher speaking at the 16th International AIDS Conference
International AIDS Conference
The International AIDS Society is the custodian of the International AIDS Conference, the largest regular conference on any health or development issue. These conferences provide a forum for the interaction of science, community and leadership, and are claimed to strengthen an evidence-based...

, described Eliza Jane's death as a concrete example of the human harm that can result from pseudoscientific
Pseudoscience
Pseudoscience is a claim, belief, or practice which is presented as scientific, but which does not adhere to a valid scientific method, lacks supporting evidence or plausibility, cannot be reliably tested, or otherwise lacks scientific status...

 beliefs such as AIDS denialism:
Maggiore's inclusion as an exhibitor at the 13th International AIDS Conference
International AIDS Conference
The International AIDS Society is the custodian of the International AIDS Conference, the largest regular conference on any health or development issue. These conferences provide a forum for the interaction of science, community and leadership, and are claimed to strengthen an evidence-based...

 in Durban
Durban
Durban is the largest city in the South African province of KwaZulu-Natal and the third largest city in South Africa. It forms part of the eThekwini metropolitan municipality. Durban is famous for being the busiest port in South Africa. It is also seen as one of the major centres of tourism...

, South Africa
South Africa
The Republic of South Africa is a country in southern Africa. Located at the southern tip of Africa, it is divided into nine provinces, with of coastline on the Atlantic and Indian oceans...

 has been criticized by AIDS activists.

Maggiore's influence on Thabo Mbeki's decision to block funding of medical treatment of HIV-positive pregnant woman was criticized following her death, with medical researchers noting a Harvard study which estimated "330,000 lives were lost to new AIDS infections during the time Mbeki blocked government funding of AZT treatment to mothers."

The journalist and AIDS denialist Celia Farber
Celia Farber
Celia Ingrid Farber is an American print journalist and author, best known for her part in the campaign which denies that AIDS is an infectious disease...

 wrote an article in June 2006 in the independent paper Los Angeles CityBeat
Los Angeles CityBeat
Los Angeles CityBeat was an alternative weekly newspaper in Los Angeles, California, debuting June 12, 2003. The publication ceased production with the March 26, 2009 issue. LA CityBeat was available every Thursday at more than 1,500 distribution locations throughout the Los Angeles area, with an...

, arguing Maggiore's case and alleging incompetence, conspiracy
Conspiracy theory
A conspiracy theory explains an event as being the result of an alleged plot by a covert group or organization or, more broadly, the idea that important political, social or economic events are the products of secret plots that are largely unknown to the general public.-Usage:The term "conspiracy...

, and coverups on the part of the coroner, the mainstream AIDS community, the mainstream media, and the medical community. In particular, Farber's article claimed that the coroner's office had not disclosed the records of Eliza Jane's HIV serology test, and quoted another denialist who claimed Eliza Jane's total lymphocyte count
Lymphocyte
A lymphocyte is a type of white blood cell in the vertebrate immune system.Under the microscope, lymphocytes can be divided into large lymphocytes and small lymphocytes. Large granular lymphocytes include natural killer cells...

 was elevated at the time of her death.

Legal ramifications

The death of Eliza Jane was investigated by the Los Angeles Police Department
Los Angeles Police Department
The Los Angeles Police Department is the police department of the city of Los Angeles, California. With just under 10,000 officers and more than 3,000 civilian staff, covering an area of with a population of more than 4.1 million people, it is the third largest local law enforcement agency in...

 and the Los Angeles Department of Child Protective Services
Child Protective Services
Child Protective Services is the name of a governmental agency in many states of the United States that responds to reports of child abuse or neglect. Some states use other names, often attempting to reflect more family-centered practices, such as "Department of Children & Family Services"...

 as a possible case of medical neglect or child endangerment. On September 15, 2006 the LA County District Attorney's office announced that it would not file charges against Christine Maggiore, noting that Maggiore did take her sick child to several physicians.

In September 2006, the Medical Board of California filed charges of gross negligence
Gross negligence
Gross negligence is a legal concept which means serious carelessness. Negligence is the opposite of diligence, or being careful. The standard of ordinary negligence is what conduct one expects from the proverbial "reasonable person"...

 against one of these physicians, Paul Fleiss
Paul M. Fleiss
Paul Murray Fleiss M.D. is an American pediatrician, breastfeeding advocate, and anti-circumcision activist based in Los Feliz, California....

, a convicted felon
Felony
A felony is a serious crime in the common law countries. The term originates from English common law where felonies were originally crimes which involved the confiscation of a convicted person's land and goods; other crimes were called misdemeanors...

 who was Eliza Jane's pediatrician, alleging a failure to test Eliza Jane for HIV (or to document her parents' refusal of testing), a failure to counsel Maggiore to avoid breast-feeding at any time during the three years Maggiore breast-fed her daughter, given the risk of transmitting HIV, and similar violations of standard medical practice in Fleiss' care of a second HIV-positive child.

In September 2007, the Medical Board of California issued its decision in the Fleiss case, effective October 8, 2007. The Board revoked Fleiss' medical license, but stayed this action in favor of a 35-month probation period during which Fleiss must submit to regular monitoring, pay costs, notify insurance and hospitals of the decision against him, and take continuing medical education (CME) classes and record-keeping courses. He is not permitted to supervise Physician's Assistants and has affirmed the practice of referring HIV-positive patients to a specialist.

In an admonition letter dated September 13, 2007, an Inquiry Panel of the Colorado State Board of Medical Examiners issued its finding that Philip Incao's "care and treatment and lack of timely documentation" in the case of Eliza Jane Scovill "falls below the generally accepted standards of medical practice". The Panel warned Incao that any further instances of such behavior could result in "formal disciplinary proceedings against your license to practice medicine".

Maggiore and her husband, Robin Scovill, sued Los Angeles county in 2007 for allegedly violating their daughter's civil rights and privacy by releasing her autopsy report, which indicated that she was HIV-positive. A settlement was reached in 2009.

External links

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