donderdag 31 oktober 2019

Measles wipes out immune system's memory, study finds










Measles wipes out immune system's memory, study finds

Scientists say threat posed by measles is ‘much greater than we previously imagined’


 Science correspondent

 Thu 31 Oct 2019

Measles virusMeasles affects more than 7 million people a year and causes more than 100,000 deaths. Photograph: Cynthia Goldsmith/Centers for Disease Control/PA


Measles causes long-term damage to the immune system, leaving children who have had it vulnerable to other infections long after the initial illness has passed, research has revealed.
Two studies of unvaccinated children in an Orthodox Protestant community in the Netherlands found that measles wipes out the immune system’s memory of previous illnesses, returning it to a more baby-like state, and also leaves the body less equipped to fight off new infections.
Measles eliminated between 11% and 73% of children’s protective antibodies, the research found.
“We’ve found really strong evidence that the measles virus is actually destroying the immune system,” said Prof Stephen Elledge, a geneticist at Harvard Medical School and co-author of one of the papers. “The threat measles poses to people is much greater than we previously imagined.”
Globally, measles affects more than 7 million people each year and causes more than 100,000 deaths. Reduced vaccination rates have led to a nearly 300% increase in measles infections since 2018.
The UK recently lost its measles-free status because of the fall in rates of MMR (measles, mumps and rubella) immunisation. Coverage of 95% of the population is considered necessary to prevent outbreaks. Among children aged 24 months in England, vaccination dropped from 91.2% in 2017-18 to 90.3% in 2018-19, the lowest rate since 2010.
Measles is highly contagious and can be spread when someone with the virus coughs, sneezes or exhales. Once inside the respiratory tract, the virus penetrates immune cells that sit at the interface between the lungs and bloodstream. From there, the virus replicates and spreads to immune cells throughout the body.
Previously, scientists had inferred a longer-term impact on the immune system because deaths from other infections were seen to go up after a measles outbreak, and because the virus directly attacks the immune system. The latest work for the first time uncovers the extent of the damage.
The researchers recruited volunteers from three schools in the Netherlands. They took blood samples from healthy, un-vaccinated children aged four to 17 and followed up with 77 of the children who were infected in a measles outbreak in 2013 for repeat sampling.
The first paper, led by Velislava Petrova, of the Wellcome Sanger Institute and Cambridge University, says measles erodes two separate lines of defence of the immune system.
To tackle previously unseen infections, the immune system relies on constantly pumping out a diverse range of immune cells – thousands of different varieties, each with slightly different receptors on their surfaces, with a collective ability to recognise almost any pathogen.
“The more diverse range of them we have, the better,” said Petrova. However, after measles, the children had a far more restricted range.
The immune system also creates long-lived memory cells, which remain permanently in circulation, allowing the body to rapidly recognise and eliminate previously encountered infections.
However, after measles, a substantial proportion of immune memory cells had disappeared from the children’s blood, in what the scientists described as “immune amnesia”. This could even mean that children who become infected with measles may need to be revaccinated for previous diseases.
“We show that measles directly causes the loss of protection to other infectious diseases,” said Petrova.
The children in the study were followed up around six weeks after their measles infection, and so it has not yet been established how long it would take for the immune system to recover.
“One can speculate that it’s very likely to recover, based on recovery seen in people on immunosuppressive drugs,” said Velislava. “Maybe after five years you would recover.”
Elledge’s team looked at antibodies in the blood (the proteins produced by immune cells) and found that 11% to 73% of the antibody memory bank had been erased after measles.
The research found that the MMR vaccine itself did not produce immune suppression, meaning that recipients get the benefit of lifelong immunity to measles infection without the damaging effects of natural infection.
Petrova said that addressing scepticism around vaccines was a complex task. “We shouldn’t think that scientific data is enough to convince people,” she said. “We need to bring enough reliable information to people at the point of care. Not create polarisation in society around this.”
Jonathan Ball, a professor of molecular virology at Nottingham University, who was not involved in the work, said: “In our current climate of falling vaccine uptake rates, this serves as a timely reminder of why MMR immunisation is so important – not only to protect against the viruses the vaccine is designed to target, but also to prevent avoidable follow-on complications that can occur after measles infection.”
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Release of Vaxxed sequel prompts fears dangerous propaganda will spread again






Release of Vaxxed sequel prompts fears dangerous propaganda will spread again

Anti-vaccination film to premiere in theatres as several states have been battling against localised outbreaks of measles

A grassroots anti-vaccine campaigner in Atlanta, Georgia, who is featured in the film. A grassroots anti-vaccine campaigner in Atlanta, Georgia, who is featured in the film. Photograph: Screengrab/BBC


Thu 31 Oct 2019


Anti-vaccination campaigners are preparing to release the sequel to Vaxxed, the highly contentious film that has been used to spread the unfounded claim that vaccines cause autism and other developmental problems.
Vaxxed II: The People’s Truth will be premiered on 6 November in 50 venues across America. Its producers, led by Robert F Kennedy Jr, are keeping locations secret with tickets sold quietly in advance in the hope of foiling efforts to block the movie.
From 7 November, the film will be taken on the road in the same “Vaxxed” bus that was deployed in 2016 to disseminate the original film, traveling more than 50,000 miles from coast to coast of the US. The movie was a powerful propaganda tool for the anti-vaccination movement, which has seen a surge in recent years within certain religious communities and among parents worried about scientifically unproven so-called “vaccine injuries”.
Vaxxed II lands at a particularly anxious time in the US, where several states including California  and Washington have been battling against localised outbreaks of measles. The worst affected state, New York, only recently succeeded in bringing the disease under control.
Official figures compiled by the Centers for Disease Control and Prevention (CDC) show that in the first nine months of this year some 1,249 measles cases were reported in the US – the largest incidence of the disease in almost 30 years. Of those, one in 10 were hospitalized.
The explosion of cases of an illness once considered eliminated from the US has alarmed medical experts. They predict children will die unless anti-vaccination fears among parents are assuaged.
“If that level rises to 2,000 or 3,000 cases a year we will start to see children dying of measles once again. That’s the dangerous game that is being played here,” said Dr Paul Offit, a vaccine expert at the Children’s Hospital of Philadelphia.
Running to 92 minutes, Vaxxed II bears many of the hallmarks of the original Vaxxed movie. The film, which the Guardian has previewed, is slickly produced and carries considerable dramatic punch – making its message all the more potent.
Publicity for the film carries the tagline: “The film they can’t let you see”. The slogan is a reference to moves to restrict access to Vaxxed in the wake of public outcry against the spread of anti-vaxxer conspiracy theories. 
In March, Amazon decided to remove Vaxxed from its streaming service following protest by the Democratic congressman Adam Schiff. Similar moves have been made by social media sites, although NBC News last month found that money was still being raised for the Vaxxed bus through crowdfunding on Facebook.
When the original Vaxxed movie was released in 2016 it become the center of a public firestorm after Robert De Niro booked it for his Tribeca film festival, then pulled it following objections from doctors and scientists. The film’s producers claim the ensuing furore was the best thing that ever happened to the anti-vaccination movement as it drew attention to the cause and attracted hundreds of people to the Vaxxed bus.
Those individuals, who were filmed recounting their experiences on the bus, now form the core of Vaxxed II. The film makes no effort to address the scientific evidence that the parents’ experiences of autism in their children have nothing to do with vaccines, or the coincidence that symptoms of autism often appear between 12 and 24 months of age, exactly when the measles, mumps and rubella (MMR) vaccine is given.
In the absence of such context, the stories told on the bus and aired in Vaxxed II are heartbreaking, harrowing and deeply unnerving. The families’ narratives are accompanied by disturbing footage of non-verbal autistic children. There is a gallery of photographs of babies who died before their second birthdays – the film claims without offering any evidence that their deaths were caused by vaccines.
In a later section of the film, parents who have decided not to vaccinate their children speak to camera. They relate how their kids have never had a day’s illness or needed a course of antibiotics, and the film-makers imply they are also more intelligent than their vaccinated neighbors’ children.
Robert F Kennedy Jr, who is credited as an executive producer of Vaxxed 2, said the aim of the film was to give “vaccine-injured” individuals and their families a voice.
“Their stories are muzzled by the media, and the film in many ways is an effort to allow those families a chance to speak,” he said in an interview with the Guardian.
Kennedy is a son of Robert F Kennedy, the Democratic leader who was assassinated in 1968, and nephew of John F Kennedy. An acclaimed environmentalist who pioneered campaigns to clean up rivers, Kennedy has in recent years channeled his energies through his organization Children’s Health Defense into the anti-vaccination movement.
“I’m not anti-vax,” he insisted. “I am somebody who is skeptical of government and pharma, but I’m not anti-vax.”
Kennedy cited his father, a legendary figure among Democrats, as rationale for his hostility towards vaccines. “My dad told me when I was a little kid, people in power lie and if you want to live in a democracy you have to treat every government pronouncement with skepticism,” he said.
Kennedy described himself as being devoted to scientific truth. Yet many of the claims he makes in Vaxxed II and repeated to the Guardian have been thoroughly disproved over many years. His main allegation that vaccines cause autism has been conclusively countered (*) by 18 studies conducted in seven countries across three continents involving hundreds of thousands of children.
In his Guardian interview, Kennedy said that the current measles outbreaks occurred mainly among patients who had been vaccinated. “Seventy-nine percent of the cases in California this year were in adults where the vaccine had failed.”
In fact, the California department of public health has reviewed the 39 measles cases in the state this year where the vaccination status of the patients was known and found that 69% were partially or wholly unvaccinated. Nationally, CDC has recorded that 89% of measles patients this year were unvaccinated or had an unknown status – only 11% had received MMR.
The other character who appears prominently in Vaxxed II is Andrew Wakefield, the disgraced British former physician who was the first to generate public doubts about MMR. In 1998 Wakefield published a paper in the Lancet based on the histories of a mere eight children that put fear into the hearts of many parents by suggesting a possible link between MMR and autism.
The ripple effect of Wakefield’s study was a dramatic slump in vaccine uptake in the UK and US.
In 2010 the UK’s General Medical Council stripped Wakefield of his license to practice as a doctor on grounds of “dishonesty” in his vaccine work as well as multiple ethical breaches in the way he enlisted children to the study. Wakefield’s Lancet article was retracted a few months later.
Despite having been shunned by the British medical world, Wakefield has rebuilt his life in America as a celebrity figure revered by vaccine skeptics. He directed the first Vaxxed film and appears in Vaxxed II as an authority on the spurious science of “vaccine injuries”.
In the movie, Wakefield presents himself as uncowed and unashamed, David standing up to the Goliath of big pharma. “It can change and it will change, and we will win this battle,” he says.
He argues for a return to the days of herd immunity, in which almost all children got measles by the age of 15. “Herd immunity worked extremely well – exposure to measles protected you,” Wakefield says.
What he does not say was that until the measles vaccine was created in 1963, up to 4 million Americans contracted the illness each year. Of those, 48,000 were hospitalized and 1,000 suffered encephalitis – swelling of the brain.
Some 500 people, many of them children, were recorded to have died from the disease.
For a vaccine scientist like Offit, the idea of returning to the days of herd immunity is horrifying. “The public is sick and tired of the anti-vaccine movement,” he said. “Children are being admitted to intensive care units with severe measles and pneumonia – a clear line in the sand has been crossed.”
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Self-Criticism from an Israeli, American, and Orthodox Jewish Perspective



Jewish Voice for Labour
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The Magnes Zionist


Jeremiah Haber – a Jewish voice for our time





JVL Introduction

Self-description: “Jeremiah (Jerry) Haber is the nom de plume of Charles H. Manekin, an orthodox Jewish studies and philosophy professor, who divides his time between Israel and the US.”
For a long time now he has provided a series of crucially important, thoughtful and reflective blog posts on issues central to Zionism, morality and Jewish identity.
He hasn’t blogged for a while. Here he explains why not and gives a brief update on his current thinking.
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Self-Criticism from an Israeli, American, and Orthodox Jewish Perspective


Tuesday, October 29, 2019


Should I Revive This Moribund Blog?

Some of my readers may notice that I have not written much in the last two years. In fact, I haven't written anything.

About a year and a half ago, I started writing a post with the above title. I didn't write anything after the title. Apparently, the answer was, "No."

Who reads blogs anymore? I used to spend a couple of hours on each post, and then I thought, "Why not just post a status update on Facebook?" I did that until over a year ago, when I deleted my Facebook accounts. I don't tweet (well, once or twice every five years.) whatsapp is for family; I don't know how snapchat and instagram work. 

The real reasons that I stopped posting: a) I said almost all I had to say several times; b) the situation had become even more bleak since then for Palestine; c) the world got politically worse;  d) it's not about me, and who cares what I think?

Still if I add to my guilt the guilt of not writing anything, then I feel worse and worse. So here's a quick update of my thinking:

1. Zionism, as a movement to create a Jewish nation state, in the way it was created, cannot be morally justified. No people has a right to life, liberty, and self-determination at the expense of another people's right to life, liberty, and self-determination, especially when the latter people constituted the majority of the territory claimed by the former. A propos morality, I believe that the Palestinian Arabs and their leaders had a moral obligation to oppose Zionist resettlement of Jewish refugees, whose purpose was not to live in peace in a Palestian state, but to conquer the land for the Jews. Statist Zionism has succeeded for one very obvious reason: the Zionists were strong and the Palestinians were weak. That's a "tale as old as time..." To see religious significance in the founding of the state of Israel, in the way that religious Zionists do, is blasphemous. My God doesn't destroy an innocent people to make way for me. And you know what -- neither does the God of Abraham, Isaac, Jacob, Moses, or even Joshua.

2. The particular state of Israel founded in 1948, and whose ethos continues to the present day, is thus, in my mind, without moral justification. A necessary condition for its moral justification is regime change, i. e., the replacement of an ethnic-exclusivist state by a binational or bicultural state of all its citizens. Necessary, but not sufficient -- the Zionists, and, indeed, Israel and its supporters, have a collective responsibility to better the lives, liberty, freedom, and self-determination of the Palestinians -- a responsibility that will continue for decades into the future.

3. I can hope for such things, but they won't occur in my lifetime, at least. So what interests me now is how can people try to remain moral, or more moral, living in a political framework that is inherently immoral. What should they do? The easiest and most consistent answer is simply to move somewhere else. But that answer is unavailable to me for several reasons. First, as an economically well-off white male, I will enjoy privilege wherever I go. Second, and more to the point, my children and their families live in Israel. Third, Israel is my home. So staying in Israel, like staying in any inherently immoral regime where the prospects of significant change are remote, has challenges that people who care about these things need to face.

4. The best I can do -- and it is nowhere good enough -- is to donate time and money to causes that will make Israel/Palestine a more just society, to speak up and explain my position to others who support the Jewish state, to help alleviate specific suffering and inequality,to support individuals and groups who promote change, etc.  

5. None of the above relieves me of my feeling of perpetrator guilt. For me, the single most pressing challenge to Jews and Judaism today is the treatment of the Palestinians, past, present, and future, and I know of only a handful of people who would agree with me. What Jewish thinker is writing about it? We read about Jewish spirituality (especially in Israel) on the right, of tikun olam/social justice on the left, etc., but what deeply Jewish personality is at all bothered about this? And don't get me started on the rabbis....

6. So what gives me hope? Several things: first, sumud, Palestinian endurance, the refusal, indeed, inability, of the Palestinians to give up, get over it,  and move on. Second, the passing of time, and the passing of the hackneyed Zionist narrative, and, indeed, the weakening of support for a Jewish ethnic state  among thinking individuals who take liberty and equality seriously. Third, the aging and passing of my generation, the boomer generation , which was innoculated against common-sense morality by Zionist indoctrination, and ignorance of a Palestinian counter-narrative more consistent with the facts. 

7. I recently attended the opening evening of the J Street Convention, and the loudest cheers among the young people were for folks like Bernie Sanders, Ayman Odeh, and for notions of Israel-Palestinian civil equality and partnership. These are young Jews who may not wish to join the BDS movement, but see nothing wrong with it as a movement of Palestinian resistance. Yes, some of them  consider themselves Zionist, but they are willing to trade-in traditional Zionism for a weaker version, i.e., an Israel that fosters Jewish national and cultural aspirations but not at the expense of Palestinian national and cultural aspirations. Let's hope that they bend the arc of justice more than my generation has.

8. To call anti-Zionism or criticism of the Israeli regime "anti-Semitic" is not only false, but is also a hateful and hurtful slur, which should be condemned as such.  It often masks deep bigotry and ethnic prejudice. Wishing to see all Israelis dead is not anti-Semitic although it is an expression of anti-Israel bigotry, which, like all bigotry, should be condemned.  

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woensdag 30 oktober 2019

TOP U.S. TOXICOLOGIST WAS BARRED FROM SAYING PFAS CAUSE DISEASE IN HUMANS. SHE’S SAYING IT NOW.


Afbeeldingsresultaat voor The Intercept






TOP U.S. TOXICOLOGIST WAS BARRED FROM SAYING PFAS CAUSE DISEASE IN HUMANS. SHE’S SAYING IT NOW.




October 24 2019, 6:01 p.m.

THE WIDESPREAD ENVIRONMENTAL contaminants known as PFAS cause multiple health problems in people, according to Linda Birnbaum, who retired as director of the National Institute of Environmental Health Sciences and the National Toxicology Program earlier this month.
The statement may come as little surprise to those following the medical literature on the industrial chemicals that have been used to make nonstick coatings, firefighting foam, and host of other products. Thousands of scholarly articles have linked the chemicals to at least 800 health effects. Some of the health problems found in humans — including elevated cholesterol levels, liver dysfunction, weight gain, reproductive problems and kidney cancer — have been shown to increase along with the levels of the chemicals in blood. Extensive research also shows that children with higher levels of PFAS have weakened immune responses.
Yet while she was leading the NIEHS, a division of the National Institutes of Health, whose mission is “to discover how the environment affects people, in order to promote healthier lives,” Birnbaum was not allowed to use the word “cause” when referring to the health effects from PFAS or other chemicals.
“I was banned from doing it,” said Birnbaum. “I had to use ‘association’ all the time. If I was talking about human data or impacts on people, I had to always say there was an association with a laundry list of effects.” Birnbaum said this restriction “was coming from the office of the deputy director. His job hinged on controlling me.” Birnbaum also said that the Trump administration has recently begun coordinating its messaging on PFAS.
Association, the coincidence of a chemical exposure and disease, and causation, in which a health problem happens as the result of the exposure, are different. Because many factors, including chance and genetics and exposures to other substances, can influence the development of disease, the term “cause” is used rarely and cautiously in the field of environmental health.
But Birnbaum, who has studied PFAS compounds for decades, believes the global contaminants have cleared that high bar. “In my mind, PFAS cause health effects because you have the same kind of effects reported in multiple studies in multiple populations,” she said in a phone interview. Birnbaum pointed in particular to longitudinal studies, which follow populations’ exposures and health over time. “You have longitudinal studies showing the same effects in multiple populations done by multiple investigators and you have animal models showing the same impact,” said Birnbaum. In addition, she pointed to studies that show the mechanism through which PFAS chemicals cause harm in people.
“That is pretty good evidence that PFAS or certain PFAS can cause health effects in people. It is not as strong for every effect, but there are quite a number of effects where they’re strong enough to say ‘caused,’” Birnbaum said. She pointed in particular to the relationship between the chemicals and immune response, kidney cancer, and cholesterol in humans, saying, “That data is very clear.”
Birnbaum has been targeted by the chemical industry and politicians beholden to it on several occasions during her nearly 40-year career as a federal scientist, which included 19 years at the Environmental Protection Agency. In 2012, Republicans on the House Science Committee went after Birnbaum for writing that endocrine-disrupting chemicals in the environment were responsible for “a staggering increase in several diseases.”
She also faced backlash after the National Toxicology Program conducted screenings of formulations containing glyphosate, the main active ingredient in Monsanto’s popular weedkiller Roundup. “There were huge attacks on the institute and on me personally related to glyphosate,” said Birnbaum, whose office was flooded with FOIA requests that she said came from law firms. “I had to hire four to six people to work on the FOIA issue. We were up to having about 140 to 150 backlogged FOIA requests. You couldn’t deal with them quickly enough.”
Her run-in with Republicans on the House Science Committee last year may have had the most severe consequences. Reps. Andy Biggs and Lamar Smith accused Birnbaum of lobbying based on an editorial in the journal PLOS Biology. In it, Birnbaum wrote that “U.S. policy has not accounted for evidence that chemicals in widespread use can cause cancer and other chronic diseases, damage reproductive systems, and harm developing brains at low levels of exposure once believed to be harmless.” She called for more research on the risks posed by chemicals and noted that “closing the gap between evidence and policy will require that engaged citizens — both scientists and non-scientists — work to ensure that our government officials pass health-protective policies based on the best available scientific evidence.”
After that, “everything was scrutinized that I did. Everything I did required clearance. Even in my lab,” said Birnbaum. “All of a sudden, everything had to go up at least to building 1,” she said, referring to the Bethesda building that serves as the administrative center for the National Institutes of Health. Birnbaum was also denied a salary increase after the incident and became aware that her job was at stake. “I was told that they were trying to fire to me.”
At the same time, PFAS compounds were becoming the focus of intense scrutiny from both state regulatory agencies and Congress. As contamination from the chemicals was being discovered around the country, it became clear that both the companies that made and used the PFAS compounds and the military, which used firefighting foam that contained them, could face billions of dollars of liability.
Proving a causal connection between the chemicals and disease will be central to holding them accountable. In litigation over PFOA contamination in West Virginia, DuPont’s lawyers were forbidden from questioning the causal relationship between exposure to the chemical and six different diseases, including testicular cancer and kidney cancer. The company has paid out over $1 billion in that case and subsequently spun off its division that makes PFAS compounds to a new company, Chemours.

Despite the voluminous research on the health effects of the chemicals, 3M, the company that first developed both PFOA and PFOS and sold PFOA to DuPont for many years, still argues that the compounds do not cause health problems. In her testimony before the House Committee on Oversight and Reform in September, Denise Rutherford, 3M’s senior vice president of corporate affairs, said that “the weight of scientific evidence has not established that PFOS, PFOA, or other PFAS cause adverse human health effects.” The company also requested that The Intercept remove the word “cause” in a recent article about PFAS. That request was denied.
Even though she knew she was being closely watched, Birnbaum felt it was important to continue to make her institute’s science public. At a meeting this summer, she reported on the results of rat studies done by the National Toxicology Program that linked exposure of very low doses of PFOA to pancreatic cancer. Birnbaum said that, based on that data, a safe dose of the chemical would be about .1 parts-per-trillion, 700 times lower than the EPA’s safety threshold, as The Intercept reported at the time.
The gulf between the threshold suggested by the new cancer data and the actual number published by the EPA pointed to a schism between the federal agencies — and reveals the inadequacy of the government response to the threats posed by the chemicals. Along with the delay of a report on PFAS by the Agencies for Toxic Substances and Disease Registry, which also proposed lower safety thresholds than those set by the EPA, Birnbaum’s public discussion of the alarming rat study may be part of the reason that the White House’s Office of Management and Budget began holding regular meetings of federal agencies working on PFAS in recent months. According to Birnbaum, two groups of federal scientists have been gathering to coordinate the government’s science, policy, and messaging around PFAS. The White House office did not respond to inquiries about the group.
For her part, Birnbaum is now enjoying being able to speak about science free of the constraints that came with her job, which had worsened in recent years. By the end, “I couldn’t even give a welcome at a meeting without approval,” she said. Asked what she would have done differently had she not been under such intense pressure, Birnbaum responded that “I would have used the word ‘cause.’”
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zondag 27 oktober 2019

Far-right AfD surges to second place in German state election






Far-right AfD surges to second place in German state election

Leftwing Die Linke leads in state of Thuringia, but political landscape is fragmented



Bjoern Hoecke, AfD party leader. Bjoern Hoecke, Alternative für Deutschland (AfD) party leader and top candidate for the Thuringia state elections. Photograph: Axel Schmidt/Reuters


Sun 27 Oct 2019


Anti-immigrant populists beat Angela Merkel’s Christian Democrats (CDU) to second place in an election in the east German state of Thuringia yesterday, building spectacularly on their steady momentum since first entering the Bundestag two years ago.
According to exit polls, the Alternative für Deutschland (AfD) took nearly 24% of the vote, beating the centre-right CDU by one percentage point but, as expected, failing to oust incumbent leftwingers Die Linke. The AfD more than doubled its share of the vote. Despite that, it has no chance of entering power yet, as other parties have ruled out joining it in a coalition.
But the party’s national standing is boosted by the result, which was closely watched in Berlin, as is the status of its state leader Björn Höcke, considered Germany’s most controversial politician, who has been accused of stoking hatred with anti-Jewish rhetoric.
The state now faces months of protracted coalition negotiations. AfD’s showing means it will be impossible for Die Linke (30% of the vote), the left-of-centre Social Democrats (8%) and the Green party (5.5%) to repeat their coalition.
A minority government led by Die Linke is the most likely outcome, reflecting the increasing fragmentation of the political landscape across Germany in recent years.
The CDU, which rules at the national level in a coalition with its Bavarian sister party the CSU and the SPD, suffered its worst result in the state, losing more than 11 percentage points to take 22.5% of the vote.
The election campaign was characterised by Nazi slogans and death threats and overshadowed by the deadly attack on a synagogue in the city of Halle earlier this month.
Mike Möhring, the leader of the CDU in Thuringia.
Pinterest
 Mike Möhring, the leader of the CDU in Thuringia, received a death threat during the campaign. Photograph: Annegret Hilse/Reuters
Mike Möhring, the leader of the CDU in Thuringia, received a death threat during the campaign that quoted the Nazi greeting ‘Heil Hitler!’. Neo-Nazis threatened to stab him in the neck or attack one of his election rallies with a bomb if he did not end his campaign.
The CDU’s general secretary, Paul Ziemiak, said: “It is a bitter result for the CDU ... and this is a bitter day for the democratic centre of Germany in Thuringia.”
Bodo Ramelow, Thuringia’s current prime minister who is extremely popular in the state, has directly blamed Höcke for allowing people to identify with extremist parties.
Ramelow told broadcaster NTV he was proud of Thuringians, who had turned out in record numbers for the vote. He said he hoped that the result would encourage parties who had previously vowed never to work together with his Die Linke to recognise the necessity to do so.
“On a parliamentary level there are various themes on which we can all work together for the common good,” he said. But he was troubled by the AfD’s strong result. “It is painful that voters feel that they need to protest against the grand coalition in this way by choosing someone like Höcke ... But we need to deal with this at the same time, and respect the voters’ decision.”
Bodo Ramelow, state prime minister of Thurinigia.
Pinterest
 Bodo Ramelow, state prime minister of Thuringia, hoped the result would encourage others to work with his Die Linke party. Photograph: Annegret Hilse/Reuters
Speaking to jubilant party faithful on Sunday, Höcke hailed the result as “spectacular”. “I am almost speechless. We fought together, we were victorious together, and now it’s the time to celebrate together.”
The former history teacher, who was accused of contributing to the antisemitic sentiment behind the Halle attack, has drawn criticism for calling Berlin’s Holocaust Memorial a “monument of shame” and for demanding more attention be paid in schools’ history teaching towards ordinary Germans’ suffering in the second world war.
Höcke’s far-right stance is viewed critically within the party, with many AfD members accusing him of threatening its unity. But his ability to draw such an increase in support despite the criticism – even in a state that bears the scars of Germany’s Nazi past with Buchenwald concentration camp – is likely to only bolster support for his tactics.
The Greens’ co-leader Annalena Baerbock said she was disappointed at her party’s performance and that she was “devastated” by the huge gains made by the AfD, referring to it as “fascistic”. She said the result reinforced the need to invest more time and energy in civil society in eastern Germany.
The AfD was formed in 2014 as an anti-establishment force opposed to the euro. It quickly evolved to become an anti-immigrant party following the refugee crisis of 2015 when almost one million refugees arrived in Germany. More recently it has concentrated on highlighting the unjust treatment of eastern German citizens in the 30 years since the fall of the Berlin Wall.
Die Linke, described as radical left, was established in 2007, emerging from the successor party of the former communist governors of eastern Germany.

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