A few questions for Mr Kirby.
(All originally posted in the comments section of the above blog post)
You state that a study has recently been completed that:
showed that a few minutes of exposure with even miniscule amounts of thimerosal can damage dendritic cells, causing immune dysfunction and cytokine-induced inflammation, both of which are found in autism.
I’m aware of the study you are referring to but I am unsure of which study you draw your conclusion from that cytokine-induced inflammation is found in autism. You also fail to mention if it is a typical or rare phenomenom. Certainly it fails to appear in the diagnostic criteia for autism and a Google Scholar search for “”cytokine-induced inflammation” autism” reveals nothing. The same is also true for your claim that immune dysfunction appears in autism. You fail to state whether this is a common or rare occurance and yet again, it fails to appear in the diagnostic criteia for autism. Based on those facts, I fail to see what worth your interpretaton of this study has.
You are a staunch believer in the mercury/autism connection despite their being no symptomatic connection between merucry poisoning and autism except for that published in the oft-refuted ‘Mercury: a novel form of mercury poisoning’ paper.
Further, In the New York Times in 2005 you stated:
Because autism is usually diagnosed sometime between a child’s third and fourth birthdays and thimerosal was largely removed from childhood vaccines in 2001, the incidence of autism should fall this year.
The rates of autism did not fall that year.
A couple of months later you told blogger Citizen Cain:
if the total number of 3-5 year olds in the California DDS system has not declined by 2007, that would deal a severe blow to the autism-thimerosal hypothesis
I was puzzled enough by the discrepancy of you adding on two years to email you to ask you to clear it up. You replied to me:
Many thanks for your note. The Times misquoted me. I actually asked for a correction, but did not receive one. What I told the reporter is that we should know in the next few years.
In the interests of being thorough, I prevailed upon the two reporters for the NYT for their version of events. Reporter Gardiner Harris replied:
Prior to publication, we read the entire passage relating to this matter to Mr. Kirby. He approved it.
And reporter Anahad O’Connor said:
…we stand by that quote. David Kirby was interviewed at length, and we verified that quote and additional information with him before the article was published. He certainly did not object to that assertion at the time.
It is hard to escape the conclusion Mr Kirby, that you misled me and that you further tacked on a couple of extra years when the autism rates failed to decrease to support your original assertion. Will you now stand by your original statement that the incidence of autism should’ve fallen in 2005?
You attempted to use California DDS data to back up your continued assertion that autism rates had climbed throughout peak thimerosal useage periods and then dropped after thimerosal removal from the majority of vaccines. However, when blogger Citizen Cain pointed out you were using the data incorrectrly you conceeded:
…that total cases among 3-5 year olds, not changes in the rate of increase is the right measure.
Even a cursory glance at current and past CDDS data reveals that according to CDDS data, that cohort is still actively rising. Do you see that as another indicator that thiomersal plays no role in autism as you implied in your NYT interview?
In the course of this blog post you have made repeated mention of thimerosal still being in vaccines in the form of the flu shot. I wondered if you knew of the total mercury burden over time of mercury in vaccines?
US pre-thimerosal removal: 187.5 µg Hg.
US just flu shot: 25 µg Hg.
UK pre-thimerosal removal: 75 µg of Hg.
The US and UK have almost identical prevalence rates for autism. Given that we have very different thimerosal rates, how do you reach the conclusion that thimerosal can cause autism? Given those stats, shouldn’t US children have far more ‘full syndrome’ autism than UK children? How do you also account for the fact that even though US children are now recieving approx 7.5 times less thiomersal than they were at the height of thiomersals use the rate of autism amongst the 3 – 5 cohort is still climbing if we examine CDDS data – data that you refer to as the ‘gold standard’?
You are also a stauch proponent of the idea of there having been an epidemic of autism. You don’t base this on any science but rather what you claim to be an abscence of adults. Indeed on this very blog you asked:
But if autism is purely genetic (without an environmental “trigger”) and has always been prevalent at the same constant rate, then where are the 1-in-166 autistic 25-year-olds (those born in 1980)? Where are the 1-in-166 autistic 55-year-olds? Why can’t we find them?
You may remember that I mailed you a PDF report (http://www.scotland.gov.uk/Resource/Doc/1095/0001881.pdf) from the Scottish government of a 2004 ‘audit’ of autism. One of the questions they asked the Health authorities, Trusts etc under the national banner was:
Research tells us that prevalence rates of autistic spectrum disorder represent an underestimate. To what extent do you consider the numbers above to be an accurate reflection of all those who live in your area?
Approaching 45% of all councils/executive/NHS Trusts questioned responded that the prevalence for adults was grossly underestimated, badly reported and that a lot of these adults exist without diagnosis. A typical response was:
Figures for adults reflect the national findings that the numbers known to services/diagnosed represent a significant underestimate of those individuals likely to be affected. For example day centre managers locally consider a number of people to be on the spectrum who have had no formal diagnosis. _(Perth & Kinross Council)_
I apologise for mentioning this here but you failed to respond to my email regarding this matter.
Thanks in advance for your comprehensive answers.
UPDATE: Mike Stanton has found yet more evidence of your ‘hidden horde’:
_Liam Byrne, the health minister, said that 6,170 children under 16 had been diagnosed in England last year, compared with 3,100 in 1997-98. The number of cases including adults rose from 4,220 to 9,170 in the same period._
_So autism diagnoses for children have nearly doubled in 8 years from 3100 to 6170. Meanwhile adult diagnoses have nearly tripled in the same period from 1120 to 3000._
UPDATE No. 2: I just remembered an interesting quote from a New Scientist feature on the autism ‘epidemic’:
This view (that there are many children today diagnosed with autism who would not have been labelled as such in the past) is difficult to substantiate, but in 2001 a team led by Helen Heussler of Nottingham University, UK, had a crack. They re-examined the data from a 1970 survey of 13,135 British children. The original survey found just five autistic children, but using modern diagnostic criteria Heussler’s team found a hidden hoard of 56. That’s over a tenfold rise in numbers, which puts the California figures in perspective. Heussler and her colleagues concluded that estimates from the early 1970s may have seriously underestimated the prevalence.
Left Brain Right Brain 
Hi Alyric
I consider myself a moderate, that try to analyze all the points of view with care. I do not stick personally to a certain definition, only moderate. In this sense, I am not a “chelanionist” although I consider that chelation properly used and after proper, safe and adequate testing is an option to consider-and I did.
Thank you for the link to the epidemiological study, very clear. However, the conclussions are important for me
Citing
“Case-control studies are particularly susceptible to bias but can be used to examine rare adverse outcomes
Cohort studies provide relatively strong evidence of causal relationships, but confounding may be difficult to exclude, and such studies have low power to detect rare adverse outcomes
Randomized controlled trials provide the strongest evidence of causation”
Considering the enourmous amount of confounding factors at an individual level, conclussions from epidemiology are very difficult to obtain. Randomized controlled trials provide the strongest evidence of causation and I would include if the question to answer is well formulated, if you allow me.
MarÃa Luján
CCDS only have information on epilepsy and MR?
In the report you’ll find other diagnoses, such as Cerebral Palsy and Severe Behaviors. CDDS must have more data in their evaluation reports, such as speech delay, which might be possible to obtain at $80/hour.
Let’s just see what kind of reasoning is contained in one of these supposed rebuttals:
http://www.safeminds.org/research/docs/Hviid_et_alJAMA-SafeMindsAnalysis.pdf
“Since autism is considered a life-long disorder, and very few cases in the registry are in older age groups who are likely to die, any case that is entered into the registry should remain there”
Nuff said? Basically, they see that there were 97 5-9 year olds in 1995, but only 75 10-14 year-olds in 2000, and somehow they are surprised by this, and claim that 22 autistics went “missing” and therefore the registry data is invalid.
Hi Joseph
Thank you. I remember you mentioned before the cost of further information. I wonder how the numbers of speech delay and Severe Behaviors have changed in years.
I understand your point and imagine that you are saying but it is clear for me that the problems is the use of these data to have conclussions of any kind. You can obtain some information but not for me the kind of information that can prove or disprove something. Obviously only my opinion.
Considering all, the problems with registrations,the changes in law, the populations changes, the home schooled children, the change in environmental insult that can be confounding, the lack of data in the case of speech delay-that can be a first sign of a child being in the spectrum- do you think that these data can be used in a negative/positive asseveration?
How?
MarÃa Luján
I wonder how the numbers of speech delay and Severe Behaviors have changed in years.
Speech delay would be an excellent marker. Severe Behaviors is dropping as well, but not as fast as the others. However, I think the reasons it doesn’t drop as fast are: (1) The general-population prevalence of “severe behaviors” (however that’s defined) could be relatively high; (2) A diagnosis of “severe behaviors” alone is probably not sufficient for CDDS eligibility. In other words, the “severe behaviors” caseload is probably on the rise, just not as much as the autism caseload, unlike epilepsy and other diagnoses which have always matched population growth.
Hi
I think this manuscript shows a very worrisome picture about environmental pollution and impact
http://www.pubmedcentral.gov/articlerender.fcgi?tool=pubmed&pubmedid=16507471
MarÃa Luján
Hey Maria
You are’nt going to prove causation from epidemiological data as your citations very correctly point out, but that data, if there’s enough of it and in this case, there’s more than enough can for all practical purposes rule it out of even weakly likely causation. What good epidemiology does is show you where to look. They looked and found exactly zilch. So now, the chelationist, there’s gold in them thar ‘ills brigade, is looking under every stone for biological plausibility. Well, what else can they do really?
David H
Yep, the US study is not flawed and it’s neutral, which doean’t help you one bit. This you actuallly referenced under the CDC study that said there was maybe a link, which lead to the Verstraten study that brought that down to neutral. The Danish study is still there as is the UK study. How many hundred of thousands do those two studies cover? Can’t remember, but it’s in the hundreds of thousands.
The Danish study isn’t flawed just because Blaxill says so and what he says is weak. The Madsen study was well regarded by the IOM – and note the standing of the IOM. I lnow it’s fashionable in the US to claim government corruption and no dpubt that’s actually possible given the unreconstructed capitalism of the US. But the IOM is as independent as any organisation can be, because it has the best collective of independent expertise in the US. The RFK jnr reading of the Simpsonwood transcript should go down in history as the most blatantly dishonest piece of reporting ever foisted on the general public. Really quite disgusting.
i can’t be certain – perhaps somebody read the same thing and remenbers where it is, but someone, Swedish I think was very surprised that ‘inpatient’ automatically meant that outpatients weren’t counted. Since all the diagnosing is done in hospital clinics, sure the outpatients aren’t counted because there aren’t any. Question is – did Safeminds know this?
David Andrews coud probably shed some light on what happens in the Nordic countries.
Alyric: “David Andrews could probably shed some light on what happens in the Nordic countries.”
Well… we don’t actually have an issue of this sort in Finland or in the wider Norden area. The whole issue of this Hg-poisoning hasn’t occurred here.
Hasn’t really taken off so well in the UK; to my knowledge…
Regarding Nordic things on outpatients – we don’t really have much of a thing about out-patient things here… if you go to hospital, they usually admit (personally, I don’t like this); but this really is how it is here… the patient is admitted to hospital… even if it isn’t for very long.
While I appreciate the lengths to which you went to try to debunk this in detail, and I regret that I lack the time to address every point in your post, I must begin with saying that aspects of your post disturb me. Mind you, I don’t appreciate it because I think your thinking is correct. I think it’s borderline criminal in fact, but I do appreciate that if you were going to say what you said, that you at least put a good deal of thought into it.
Several times, you posed the question of whether or not autism is as prevalent as Mr. Kirby suggests. You asked if autoimmune failings in autistic children are common or rare. This was a repeated approach to your argument. I find this a very disturbing way to examine this issue. Do you deny the possibility that some children, let’s say for the sake of argument that it is a very small number, might have autoimmune conditions that make vaccines dangerous for those children? My daughter, I can tell you, has various autoimmune issues, my autistic daughter incidentally, because I have seen the lab results. Are you suggesting that if, again, for the sake of argument, my child was a rare one in a million to whom vaccines might be damaging, that it is acceptable to think of this happening to her as being statistically irrelevant? Why so? Because your child is fine? That would certainly be an incredibly selfish and insensitive position to take. I do hope that isn’t your motivation.
Indeed, studies conducted recently show that so prevalent is toxic pollution at this point that children are being born polluted ( http://www.emagazine.com/view/?2745 ). Given that study, it is not reasonable to conclude that many more than a few rare babies increasingly are born damaged from the perspective of autoimmunity?
The odd argument about autistic adults is a red herring. I don’t recall if Mr. Kirby actually said there was no such thing as autistic adults. I did a word search on “adult” on the blog page for his artlcle and never hit the word “adult” until your post. I can tell you that I’ve never heard such a comment. Of course, if there are autistic children, there are autistic adults. The current rates of autism are predicated on the increase in autism diagnosis rates, not whether or not there are autistic adults. The rate increase has occurred during the years when autism has been known to be autism and not some other affliction, thus it is not just that more cases are being diagnosed because they now know what it is.
Incidentally, much as you might be a bit broader in your investigation of this topic, don’t try one Google search and if nothing appears under your parameters, then nothing exists. I entered the term “cytokine-induced inflammation†and got quite a few results. Did you enter this without the quotes? That worked when I did it. Allow me save you a few keystrokes:
http://www.google.com/search?hl=en&q=cytokine-induced+inflammation&btnG=Google+Search
I simply don’t understand people who will only research this topic to prove the vaccine connection to be a myth, or who go so far as to call the autism epidemic ‘a hoax.’ What could your payoff possibly be?
I submit that if one child in a million develops autism from a vaccine, it is one child too many. It is time to stop suppressing legitimate scientific inquiry into the matter so that perhaps we can develop a system of testing that will let us know before we vaccinate a child if the vaccines are a risk to THAT child. Attitudes such as yours are a barrier to that ever happening. If you are mistaken, let the affliction of every child that develops autism because you didn’t care to entertain the possibility, be on your head.
_”Several times, you posed the question of whether or not autism is as prevalent as Mr. Kirby suggests. You asked if autoimmune failings in autistic children are common or rare. This was a repeated approach to your argument. I find this a very disturbing way to examine this issue. Do you deny the possibility that some children, let’s say for the sake of argument that it is a very small number, might have autoimmune conditions that make vaccines dangerous for those children? My daughter, I can tell you, has various autoimmune issues, my autistic daughter incidentally, because I have seen the lab results. Are you suggesting that if, again, for the sake of argument, my child was a rare one in a million to whom vaccines might be damaging, that it is acceptable to think of this happening to her as being statistically irrelevant? Why so? Because your child is fine? That would certainly be an incredibly selfish and insensitive position to take. I do hope that isn’t your motivation.”_
Then allow me to reassure you – it isn’t. However, when someone (Kirby in this case) explicitly links immune dysfunction and autism then we need to look beyond the surface of such a statement to examine its validity. Asthma is also ‘found in’ autism. Something being found in something else is, taken on its own, pretty meaningless without context.
_”Indeed, studies conducted recently show that so prevalent is toxic pollution at this point that children are being born polluted ( http://www.emagazine.com/view/?2745 ). Given that study, it is not reasonable to conclude that many more than a few rare babies increasingly are born damaged from the perspective of autoimmunity?”_
No, it isn’t. You can theorise and you can investigate but you cannot ‘conclude’. You certainly (which is my point) cannot conclude that such a thing is causatively linked to autism.
_”The odd argument about autistic adults is a red herring. I don’t recall if Mr. Kirby actually said there was no such thing as autistic adults. I did a word search on “adult†on the blog page for his article and never hit the word “adult†until your post. I can tell you that I’ve never heard such a comment.”_
This is because you haven’t read around the issue thoroughly – something I’d recommend doing. In a previous Huff Post entry, Kirby said:
_”When it comes to autism, here is one of the key questions we should be asking: if autism…..has always been prevalent at the same constant rate, then where are the 1-in-166 autistic 25-year-olds (those born in 1980)? Where are the 1-in-166 autistic 55-year-olds? Why can’t we find them?”_
The ‘hidden horde’ argument is one of the key points of Kirby’s stance. I’m amazed you haven’t read about it.
_”Incidentally, much as you might be a bit broader in your investigation of this topic, don’t try one Google search and if nothing appears under your parameters, then nothing exists. I entered the term “cytokine-induced inflammation†and got quite a few results. Did you enter this without the quotes? That worked when I did it. Allow me save you a few keystrokes:”_
Thanks for the lesson on how to use Google. Now, could you go back to your results and tell me which of those indicate cytokine-induced inflammation is ‘found in autism’ as Kirby states and I countered?
_”I simply don’t understand people who will only research this topic to prove the vaccine connection to be a myth, or who go so far as to call the autism epidemic ‘a hoax.’ What could your payoff possibly be?”_
Whereas I simply don’t understand people who will fail to research properly at all, or obviously fail to read (or understand) the source article or response to it. I can only conclude you’re new to this whole debate.
_”It is time to stop suppressing legitimate scientific inquiry into the matter so that perhaps we can develop a system of testing that will let us know before we vaccinate a child if the vaccines are a risk to THAT child.”_
What research has been suppressed and by whom?
_”Attitudes such as yours are a barrier to that ever happening. If you are mistaken, let the affliction of every child that develops autism because you didn’t care to entertain the possibility, be on your head.”_
You don’t even seem to know the stated positions of those you want to defend. You clearly failed to read or understand Kirby’s Huff Post blog entry and you failed to grasp my response to it. I would submit that attitudes such as yours that are based on ignorance and innuendo are ridiculous and simplistic and define the dumbing down of the whole debate that turning this into a media circus has instigated.
What autism _does not_ need is more simplistic ignorance and conspiracy theory. What it _does_ need is objective science.