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Dr John Briffa is wronger than wrong on vaccines and Hannah Poling

30 May

Media nutritionism is a crowded field, but John Briffa has managed to carve out a niche for himself. And Briffa’s take on vaccines stands out, even among media nutritionists. JDC takes a broader look at Briffa’s take on autism, but I’m going to focus on Briffa’s claim that:

the US Government recently looked at such evidence relating to just one girl (Hannah Poling) and concluded that vaccination had contributed significantly to her autism.

As readers of this blog can probably spot, almost every word of that statement is inaccurate: impressive work, indeed. Continue reading →

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Rodier on Bernard et al. and environmental causes of autism

25 May

The idea that mercury poisoning causes autism was first put forward in a paper by Sally Bernard and others entitled Autism: a novel form of mercury poisoning.

This was published in a journal called Medical Hypotheses. As you might tell from the title, Medical Hypotheses presents hypotheses-not proven ideas. The journal has no peer review process. Instead, they basically print “…will publish radical ideas, so long as they are coherent and clearly expressed”. If you write well and pay to publish, it will likely get in. Keep that in mind with any paper from “Medical Hypotheses”.

In this paper, the put forth the hypothesis that mercury causes autism. To support this idea, they compare the symptoms of autism and mercury intoxication.

In the Autism Omnibus Proceedings, Dr. Patricia Rodier spoke on specifically the Bernard paper. Dr. Rodier has a unique position in the United States, and likely the world: she is an expert on both mercury poisoning and autism. Below is a rough transcription based on the audio recording of that testimony.

She starts out by stating that she has many criticism of the Bernard paper. She also mentioned a response to that paper had already been published by Nelson and Bauman. That paper is worth reading, and it’s free on the Pediatrics website.

Dr. Rodier then discusses the comparisons made between mercury poisoning and autism, based on her experience with both. If you want the short version: there is no comparison.

First, many of the symptoms or characteristics that are discussed in the Bernard paper are not specific to either autism or mercury poisoning. These include, nausea, vomiting, irritability and temper tantrums. Basically, these are things that happen for all of us at times.

Other symptoms are common across many disabilities: mental retardation, depression and abnormal gait. Again, these are not specific to either autism or mercury poisoning.

Almost all the symptoms used for mercury poisoning are taken from “Mad Hatter’s” disease: the result of a very high exposure to inorganic mercury vapor. Only a few symptoms listed were from ethyl mercury exposure. Since the exposure from vaccines is due to ethyl mercury (thimerosal breaks down to ethyl mercury) that would be the valid comparison.

Dr. Rodier, in her testimony, then discussed how the Bernard paper doesn’t actually do what it purports to do. The comparison isn’t valid since the actual symptoms of autism and mercury poisoning do not match up in a comparison.

She then goes on to discuss many of the comparisons made by Bernard, et al., and show that the comparisons are not valid.

1. Under psychiatric disturbances, the paper discusses depression, flat affect, depressive traits, mood swings, impaired face recognition

1a. Depression is a symptom of acrodynia. This is an exposure to inorganic mercury, not ethyl mercury. While some, possibly many, autistics suffer from depression, it is not a characteristic of autism.

1b. Mood swings are a characteristic of Mad Hatters disease. Again, this is not an autism symptom or characteristic.

1c. Flat affect is a diagnostic trait for autism but not mercury poisoning . Also, this is the opposite of mood swings, a characteristic of mercury poisoning noted in ii, above.

1d. Impaired face recognition occurs in autism, but hasn’t even been tested in any kind of mercury poisoning.

So, in this first group of four: there is no overlap for the above 4 ‘symptoms’. If it happens in mercury poisoning, it doesn’t happen in autism and vice versa.

2. Under speech and language deficits, the paper describes:
2a. Verbalizing and word retrieval. This is a problem is observed in Mad Hatters disease but not autism. But, this is compared to ecololia and word use and pragmatic errors. These never happen in mercury poisoning. It is an autism trait.
3. Again under psychiatric disturbances, the paper lists “Lacks eye contact”, and “impaired vision” under mercury toxicity, compared to “problems with joint attention” as the ‘similar’ autism trait
3a. “lacks eye contact” is a symptom of autism, but not of mercury poisoning. Likewise, impaired visual fixation is a symptom of methyl mercury poisoning-the brain control of the eye muscles are impaired which doesn’t allow you to fixate on something-but is not a symptom of autism. Joint attention has nothing to do with vision. It is not a feature of any kind of mercury poisoning. It is a social impairment, not a vision issue.

4) Under CNS structure, they compare “progressive microcephaly” for mercury poisoning with “progressive microcephaly and macrocephaly” for autism.
4a. progressive microcephally is given as a symptom of mercury poisoning. The idea of ‘progressive’ is incorrect here. Also, microcephaly is a sign of methyl mercury toxicity prenatally, not postnatal exposure. Children are born with it.
4b. Progressive macrocephally is a sign of autism. However, it has never been reported in mercury poisoning.

5) Under Neurochemistry, they list “Causes demyelinating neuropathy” under mercury poisoning.

5a. Demyelinating nerorpathy results from a chronic exposure to inorganic mercury. It is not reported in autism.

5b) They list “demyelination in brain” as a characteristic of autism, but no one has ever listed this in autism and the reference doesn’t address it.

Dr. Rodier posed the question: since the authors are trying to show a connection between thimerosal containing vaccines and autism, why don’t they compare autism and ethyl mercury poisoning? Keep in mind, there are various forms of mercury (ethyl and methyl being two types of organic mercury). In their comparison, Bernard et al. have picked from ethyl, methyl and inorganic mercury symptoms. Dr. Rodier suggest the reason they didn’t stick to purely ethyl mercury symptoms because “It doesn’t make a good story”.

1) For example, in a paper by Zhang , 41 people were exposed to ethyl mercury from tainted rice. They knew dose from how much rice they ingested. The authors documented the symptoms. Doses varied from mild to death.

1a) The three most comment symptoms documented by Zhang were:

1a.i) Muscle Weakness

1a.ii) Loss of appetite

1a.iii) Dizziness

Dr. Rodier notes that “those don’t sound much like autism”.

1b) The next 10 symptoms listed by Zhang are

1b.i) nausea

1b.ii) abdominal pain and diarrhea

1b.iii) fever

1b.iv) numbness of the extreminties

1b.v) peresthesia and ataxia

1b.vi) vomiting

1b.vii) thirst

1b.viii) unsteady gait

1b.ix) ringing in the ears

1b.x) headache

Dr. Rodier: again, none of these sound like any of the symptoms of autism that are used in diagnosis.

Dr. Rodier stresses at this point: there is really no correspondence between the symptoms of ethyl mercury poisoning and autism

The government’s attorney asked: the current hypothesis is that low levels of inorganic mercury cause oxidative stress or an inflammatory process which cause autism. Does that make sense? Dr. Rodier answered quite directly, “no”. In the opinion of that autism and mercury poisoning expert, the logic does not work.

She went on to point out that scientists try to disprove hypotheses, not just find support for their given hypothesis. (author’s note here: this is quite true. You need to test a hypothesis and make sure it doesn’t fail, not just collect the evidence that implies it is correct).

She points out that there is one piece of evidence that completely refutes the Bernard et al. hypothesis. There have been autopsy studies performed on people with acute ethyl mercury poisoning. While they indeed had high levels of organic mercury after the ethyl mercury was gone, these people recovered from the mercury toxicity symptoms after the ethyl mercury was gone and the had inorganic mercury was left.

This was the end of the discussion on the Bernard paper and mercury. It is pretty clear when an expert in both fields-mercury toxicity and autism-speaks on the comparison. Compare this to the authors who wrote the paper. Of the three, only one had a background in medicine. That is Lyndelle Redwood, a nurse. None of them are researchers, none experts in either autism or mercury poisoning.

From the above it is pretty clear: the hypothesis put forth by Bernard et al. was a poorly formed and is definitely incorrect.

In the Omnibus Proceeding, the discussion then moved away from mercury directly and into the question of environmental causes of autism. The question was posed: when does autism begin? The answer was that it almost always is determined pre birth.

This led to a discussion of known environmental factors that lead to autism. Dr. Rodier listed them and listed when the exposure has to occur to result in autism.

The known environmental causes are: Rubella, thalidomide, valproic acid, ethanol, misoprostol. All are involved during gestation. The timing of exposure to increase autism risk is:

1) Rubella (German measles): before the 9th week

2) Thalidamide: week 3 and 4

3) Valproic acid: week 3 and 4

4) Ethanol: week 3-5

5) Misoprostol: week 6

She noted that tuberous sclerosis is an example of autistic symptoms developing after birth as the tumors progress.

Terbutaline has been brought up a number of times by the plaintiffs (petitioners) in the Omnibus as an example of an environmental cause of autism. The question was raised as to why Dr. Rodier didn’t discuss this. She described that it is not an environmental cause study, but a genetic study.

Twin pairs were studied. Some were exposed to terbutaline and some were not. They compared the concordance: the rate of one twin having autism if the other did not. No significant increase was found in general in this study. So, the authors looked at a smaller subset, and still found no increase. Then, they looked only at male twins, where no autistic siblings were present in the family. In that case only, they found a significant effect.

Dr. Rodier goes on to discuss that even interpreting this part is difficult because we don’t know if the increased risk was due to the terbutaline, or the fact that the children were at risk of being born early (terbutaline is given to prevent premature delivery).

The judge (Special Master in this court) asked if this was because without the terbutaline the children would not have survived to be born. Dr. Rodier agreed and pointed out that the interpretation the plaintiffs are supplying is further confused because low birth weight is also an increased risk factor. This is from a very recent paper in Pediatrics. Since the turbutaline twins were low birth weight, that could be a factor in the increased autism risk found.

The plaintiffs lawyers have been using a study on rats as an example of a post-natal environmental exposure. The government lawyer asked if this was a valid interpretation. Could this be used to suggest a post-natal exposure could cause autism in humans? Dr. Rodier answered that this is not valid. Newborn rats are more developmentally immature than newborn humans. Newborn rats have closed eyes, no hair, and in other ways are very much more developmentally like prenatal humans. The study would compare better to late-gestation humans.

There was much more in her testimony, but that gets even farther away from the Bernard paper, so we can end this discussion here and let others pick up the rest of her testimony.

Dr. Brent – Toxicologist at the Autism Omnibus hearing

25 May

Listening to Mr. Williams (lawyer for the parents) cross examine Dr. Brent the toxicologist (from May 19, Day 6) was difficult most because after 45 minutes of discussion of the toxicokinetics of ethyl-, vs. methyl, vs. inorganic-mercury all I could hear was “Blah, blah, don’t you agree that the Charleston monkey adult brain study showedgreaterinflammationoftheinorganic glutamaturgicneuron silvergrainsBurbacherinfant paper? Blah blah and further, isn’t it true thattheVahtergroup onlygave80milligramsperkilogramsperdayofmercuricchloride because the defensereferencemasterlist 436page8 indicatesthatSeychellesIslanders spoke at the IOM?”

Nevertheless, I forced myself to listen to portions of it again and again until I thought I understood what they were talking about exactly. There were several times, maybe 8 or 10 even where it seemed obvious to me that Dr. Brent had totally demolished the point that Mr. Williams was attempting to make and Mr. Williams continued on as if it was of no consequence. I kept getting this picture of King Arthur and the Black Knight from Monty Python and the Holy Grail after King Arthur has sliced off the Black Knight’s arm:

ARTHUR:
Now stand aside, worthy adversary.
BLACK KNIGHT:
‘Tis but a scratch.
ARTHUR:
A scratch? Your arm’s off!
BLACK KNIGHT:
No, it isn’t.
ARTHUR:
Well, what’s that, then?
BLACK KNIGHT:
I’ve had worse.

.

The following is more of my rough transcribing of the audio. I have no idea what that word is that sounds like “AT-trib-ated.” If you know I’d be happy to correct my spelling of it. I believe this first paper he’s referring to is one of the Charleston or Vahter adult monkey studies where they gave very large doses of methyl mercury to the monkeys every day, orally. Click here to hear this segment of the cross examination of Dr. Brent.

.

Mr. Williams: It’s says: “the microglia population is a responsive cell type. Once damage has been repaired following activation after injury microglia are known to return to a quiescent state. However, the number of attribated (sp?) microglia remained elevated … in the monkeys of the clearance group which were kept unexposed for 6 months following 12 months of methyl mercury exposure . This group had very low concentrations of methyl mercury, but retained elevated concentrations inorganic mercury at levels comparable to the 12 month exposure group and this suggests that inorganic mercury may be the proximate species of mercury responsible for microglial activation…” a situation similar to that proposed for the cortex study we already looked at. Now, do you agree that normally microglia have a protective role, they come in and clean up whatever’s there and then they return to their quiescent state?

Dr. Brent: To the extent that I understand microglia… which is limited, I would say, yes.

Williams: And if they stay activated then they can become toxic to neurons and astrocytes.

Dr. Brent: Once again, my, my understanding of microglia is more limited than other people who will be testifying later… my understanding is that microglial activations is not necessarily a bad thing and that … the effects here are not necessarily indicative of any neuropathology.

Once again, you know, we are talking about inorganic mercury effects at the concentrations they give here, and if the inorganic mercury is causing adverse effects at the concentrations, then it’s the seafood and the chicken that people are eating and not the vaccines because that’s where the far greater exposure comes from. And that doesn’t make any sense, because everyone is eating seafood and chicken, including children who are getting mercury via breast milk, and we don’t think of breast milk as a neurotoxin!

Williams: If we go down the column on the same page to about 4 sentences above… yeah about where you have it highlighted…
It says: “Further loss of astrocytes would be expected to have deleterious effects on the neuron population, for example through a excitotoxic mechanism. You were here when Dr Kinsbourne testified that that was his … understanding of the mechanism that could likely be at work here that you would have astrocytes no longer able to take up glutamate, so yyou’d have excess of glutamate and have neurons get over excited. Right?

Dr. Brent: Once again your getting a little out of the mercury area, so my answer here is going to be quite limited, what I took away from Dr. Kinsbourne’s testimony was that he was hypothesizing it was excitotoxic mechanism, related to astrocyte effects. But here for example it says, “further loss of astrocytes,” in this study there wasn’t even that much loss of astroycytes! And certainly, uhm, well we talked about the exposure scenario, so I won’t bring that up again …

Williams: And although, you want to talk about the methyl mercury dose here, you recall that the authors of the infant monkey study made a point of saying that the levels of inorganic mercury in these adult monkeys was only 5 times higher on average than the levels they found in those infant monkey brains, right?

Dr. Brent: That’s right, and that’s very good evidence therefore, that the inorganic mercury is not acting as a neurotoxin, or else we are being poisoned every day, and we are having autism being formed every day, from breastmilk, from seafood, from chicken.

Williams: (Clears throat.)

.

I don’t know if it’s immediately obvious to those who haven’t followed the discussion closely, but basically, Mr. Williams had pointed out that inorganic mercury is the “proximate” cause of damage to brain cells. Which is to say that, it doesn’t matter if the original source of the mercury was methyl-, ethyl- or inorganic mercury, because the mercury doesn’t hang around in the brain as either methyl- or ethyl-mercury. Those forms get changed into inorganic mercury, and it’s the inorganic mercury that hangs around. Inorganic mercury (referred to sometimes in the hearing as “Hg-plus-plus,” Hg++) is the same stuff whether or not it started out as methyl-, ethyl-, thimerosol, breast milk, or chicken. And the exposure to breast milk and chicken for the infant and toddler set is much higher than their exposure to thimerosal from vaccines, now or ever. Dr. Brent had said earlier in the cross examination that over the course of 6 months and infant gets “about 250 micrograms of methyl mercury.”

macaque monkey

Besides that the PSC keeps bringing up these studies where macaques were given significantly higher doses, even massively higher doses, of mercury, either thimerosal or methyl-mercury, than babies ever got. The monkeys in the Vahter study were given 50 mcg per kilogram per day of methyl mercury, which Dr. Brent explained is the equivalent in a 70 kg person getting 3,500 mcg a day of methyl mercury. The average diet for that 70 kg person would expose him or her to 11,000 mcg a year. A year! So essentially, the monkeys got a level of mercury in 3 days what they’d get in a year if they had been eating a typical American diet. But some of the monkeys were fed like this for a year. That’s the “12 month exposure group” referred in what I transcribed (above).

And even though they had had that large continual dose of mercury for a year and many of their brain cells were pretty much impregnated with mercury, the monkeys were normal behaviorally. Even if you wouldn’t expect them to become autistic because they were exposed as adults, surely they’d show some outward sign of brain damage if that much mercury were extremely dangerous to brain function.

It was also interesting to me that Burbacher had used 3 or 4 times the amount of thimerosal to dose his infant monkeys as humans got. Had Burbacher used the equivalent amount of thimerosal in the human vaccine schedule the outcome would likely have been that the levels of mercury in the monkey’s brains would have been so low that it wouldn’t have been detectable. (Clears throat.)

There was also some fun discussion about how there’s no increased autism in the Faroe and Seychelle’s islands in spite of the fact that infants have high levels of mercury in their brains (from maternal diet). Mr. Williams stated that “fish is very good for brains” as if that was a point for his side.

Dr. Brent was the first of the respondents expert witnesses to testify in this portion of the Omnibus hearing. He also had testified in the Cedillo hearing. Some of the points about Kinsbourne’s hypothesis regarding astroglial activation, glutamate excess, and cell death were dismantled by Dr. Johnson, and by other experts who testified in the past weak. Dr. Deth’s hypothesis about autism being the result of oxidative stress was pretty much smithereened by two or three of the petitioners experts. I’m still catching up with listening to all of their testimony, but of extensive portions I’ve listened to so far, well, I think it’s looking really bad for dead parrot hypothesis.

Dr. Johnson testifies in the Autism Omnibus Hearing

24 May

Dr. Johnson’s testimony was fabulous and I think it’s safe to say that it wreaks more devastation on the petitioners'(the parents) case. As of this moment, I can’t give you a lot of detail about Dr. Johnson’s qualifications, unfortunately. For some reason a portion of the audio recording (MP3) that would have included Dr. Johnson’s statement of his qualifications is missing.

One thing I think is important to point out here is that the respondents experts’ (written) reports, and even the list of the respondents’ experts has not been posted to the Autism Omnibus docket. The parents’ lawyers (the Petitioners Steering Committee, or PSC) do have their experts list posted to the docket. Some time ago (I think it was more than a year ago) the Department of Justice attorneys asked the Special Master if the Federal Court would refrain from posting the lists of the respondent’s experts for fear that their experts would be subjected to harassment. That request doesn’t seem to be on the docket now, but it used to be. It’s likely that after the experts were listed the first time the experts for the government were harassed. This would be in keeping with the way different experts, and even parents such as myself and Kevin Leitch and others, have been harassed by “mercury parents” or their friends. You can see from the Autism Omnibus Proceedings Docket Here: http://www.uscfc.uscourts.gov/node/2718 that the there are no more postings of lists of respondents’ experts after mid 2006. There’s an entry from March of 2007 that is called, “Respondent’s Notice of Expert Witnesses,” but there’s no document now linked to that entry.

The point I’m trying to make about the missing expert list is: I can’t pull up the list of expert witnesses for the respondents (the US government, essentially) for this hearing because it’s not available. So I can’t find out easily who Dr. Johnson is, though he is a professor at university, and has a lab, and has published on neurophyisology and neurodegenerative diseases, and he uses tissue slides and tissue cultures. Worse, “Johnson” is a very common name so if you go looking for experts named Johnson who publish in neurodegenerative diseases, you’ll find 3 or 4 of them in pubmed. The DoJ lawyer here is one of Mr. Matanoski’s team of attorneys. As far as I can tell the junior attorneys on the team are Bo (Beau?) Johnson, Ms. Ricciardella, Ms. Renzi and Ms. Espinoza (Espinosa?).

I don’t know which lawyer is examining Dr. Johnson. From her voice, I’m guessing (again) that it’s Ms. Renzi. Again this is my transcribing of what was said, some of it is word for word, some of it is a close paraphrase of what was said you can find the following somewhere around 8 minutes 43 seconds on the second MP3 file from Day 7 (May 20). Here is some of the very interesting testimony from Dr. Johnson:

Ms. Renzi: Dr. Deth cited a paper by Mady Hornig in support of his arguments. You mentioned that the mouse strain Dr. Hornig used was selected because it had a stronger immune response, but took issue with Dr. Deth’s explanation of the rationale behind the use of the strain. … Deth said hers was a mouse strain harboring genetic deficits in redox related enzymes… What strain of mouse was used?

Dr. Johnson: It was an SJL-J mouse. (Dr. Deth) was inferring that there was a redox enzyme differential, or some kind of differential (in this strain) and that’s absolutely not true. The mice have a this increased immune response and that’s why they were selected. … There’s absolutely no data supporting the fact that there is a redox enzyme differential. Now I can understand the reason that it’s in there because it supports his hypothesis… but it’s not an accurate representation of these mice.

Renzi: Do you have confidence in Dr. Hornig’s reported results?

Johnson: Uh, no.

Renzi: Part of that has to do with the hippocampal sections, correct?

Johnson: The quality of the images,… I’ll point this out, (the sections from the Hornig paper) .. What you can see is when you look at these images–to me these images are absolutely awful, now the staining here is hematoxylin and eosin, and it’s supposed to stain for architecture and cell integrity and a variety of other things. The pictures are diffuse, there’s no clear neuronal fields. Right here there is weak staining. … If you look here, the cells that are dark right there, those are the neuronal fields. The quality is just extremely low. … Quality of the sections themselves are low. … Let’s put it this way, I’ve seen this in my lab before. I’ve seen people come to me with sections stained like this. I’ll say: Something’s wrong. OK? The tissue wasn’t prepared right. There’s something definately wrong here. Because these do not maintain the nice cellular architecture that you should see if the experiment is done right and the tissue is harvested correctly.

Renzi: Problems with these slides led you to doubt the findings of the Hornig paper? Has a recent paper contradicted Hornig’s findings? …

Johnson: The… comparable fields in the Berman paper. To me they are absolutely beautiful. … It looks very, very, very good.

Renzi: … What dose of thimerosal was used in the Berman paper?

Johnson: …They also used a does that was 10 times higher…

Renzi: Did both studies (stain with antibodies)?

Johnson: There is a distinct difference between Berman and Hornig studies’ slides… If you look at the architecture of the tissue in the Berman study…. (there is) nice staining in the hippocampus….

Special Master:… (interrupt for clarification)

Johnson: … Berman sections are the two sections on the left side… What you can see is there’s very nice staining in the field, the neuronal field are not staining intensely (which is what they are expected to show)

Now if you look at the upper 4 panels on the right side these are from the similar panels from the Hornig study. The first thing that I want to point out is that if you look at the tissue, it’s full of holes… Look at this enhanced image right here, the bottom two panels C and D from the Hornig. You can see that the tissue almost looks like it’s disintegrating, It’s breaking down. There’s holes all over in the tissue.

I know from experience when you see tissue like this the amount of nonspecific staining by antibodies could be intense.

Basically, if someone came to me with this kind of staining in my laboratory I would say to go back and do the whole experiment again,… I would not want… for one these are unpublishable to me, and two the potential for artifactual data to be generated from this kind of (poor quality tissue) is extremely high. … This is very important. You know, you can do whatever you want after you’ve got the tissue, but it’s the process of getting the tissue so that the quality is extremely good. You need to start with high quality tissue.

… The Berman tissue was absolutely perfect. … The sections are beautiful.

One thing I took away from Dr. Johnson’s testimony is that there’s no way that the Hornig paper should

have made it past a competent peer review and into a “peer reviewed” publication. The Hornig paper has a few other problems that have been discussed before, but these problems never been reported in into a letter to the journal that published that paper, Molecular Psychology, as they should have. (Click here to download a copy of that paper from the SAFE MINDS website.)

Hornig wrote that paper with her main squeeze, Ian Lipkin, and with David Chian. This research was funded by the UC Davis MIND Institute, SAFE MINDS and by part of an NIH grant of Ian Lipkin’s. Surely someone knew how bad those tissue slides were even before it was submitted to the journal. Surely someone at the journal should have had a person with some kind of expertise review the article. Surely in 2004 some person with expertise would have noticed the problems with the degraded and uninterpretable tissue slides in the Hornig paper. I didn’t notice any problems with the slides when I read the paper because I don’t know what stained tissue of mouse hippocampus is supposed to look like and neither would most of the mercury parents who have tried to use this paper to show that their own child was made autistic by vaccines containing thimerosal.

The MIND Institute scientists must have seen the problems with Mady Hornig’s study, but they invited her to come speak about her thimerosal-causes-susceptible-mice-to-become-mindlessly-violent-killers hypothesis at the conference I call the “MIND’s mini-DAN!”. Video of her speaking at that conference is still available on the MIND’s website here: http://www.ucdmc.ucdavis.edu/mindinstitute/events/toxicology_recorded_events.html

And you can see video of John Green speaking there, too. He was described in the most glowing terms by Dr. Robert Hendren. Maybe Dr. Hendren didn’t know about the “earthworm eggs” and “fecal implantation enemas” that Dr. Green had prescribed to some of his patients. After Green spoke, Dr. Hendren knew about the problems with Green’s citing of a provoked urine toxic heavy metals lab result from Doctor’s Data Inc that was in Dr. Green’s slides, because I told Dr. Hendren about the problem with that lab report. As far as I could tell, Dr. Hendren wasn’t particularly worried about that. The video of Dr. Green “explaining” what that lab test meant to him is still on the MIND’s website. I have a problem with that, since parents can watch those videos and make poor treatment decisions for their children based on them. On the other hand, those videos seem to stand as a testimony to something less than scientific that seems to be going on at the MIND Institute. To UC Davis’ credit however, the Berman (2008) study that totally contradicts the Hornig (2004) study was also conducted at UCD.

Dr. Johnson has plenty of interesting things to say about Dr. Richard Deth and his neuroblastoma cell line experiments. Apparently, Dr. Deth will be back to testify again in the autism omnibus. Perhaps he will explain why he seemed to cut his experiments short (time-wise) and why he called neuroblastoma cells “neronal cells” when they should not be called neuronal cells, and why he didn’t show critically important “dose response curves”.credit: taminsea

I may have to devote a separate post to the issue of Deth taking data from (but not citing) a 1958 paper (pdf) that reported the level of cystathionine in duck brains (besides duck, also, human, cat, rat, guinea pig, horseshoe crab, chicken, cow and monkey).

Autism Omnibus – Vas Aposhian

16 May

Vas Aposhian is – like Sander Greenland – an expert witness for petitioners (the families) and a professor of molecular and cellular biology as well as a professor of pharmacology.

On Day 2 and 3 he testified as to what seemed to be the main hypothesis behind the whole thiomersal/autism idea.

The basic idea is that some people are genetically predisposed to something called _mercury efflux disorder_ (plain english, they can’t get rid of mercury as well as most people can, it crosses the blood brain barrier and triggers autism). Mercury Efflux Disorder is itself an unproven hypothesis but Aposhian passionately believes in it.

He came under heavy cross exam (I won’t go through his performance whilst testifying to his own ‘side’ – we all know the basic hypothesis), that compromised a lot of day two and most of the morning of day three (the audio is released slowly so I’m a couple of days behind). The part I’m writing about today starts about an hour and a half into day three (NB: I’ve downloaded all the MP3’s and stitched them into one file).

Aposhian says that the mercury efflux hypothesis is supported by six papers:

…each piece of evidence alone leaves some doubt but taken all together the evidence implicates thimerosal/ethylmercury as the likely precipitating agent in the etiology of some of the autism spectral disorders.

Respondent counsel referred to these six papers as ‘pillars’ supporting the hypothesis. Aposhians’s pillars are:

First, Adams et al. (2007) demonstrated that teeth from autistic children contain more mercury than those from non-autistic children.

Respondent counsel asked Asphosian what he thought he could criticize about these papers he says ‘implicate thiomersal’. Regarding Adams et al, Asphosian said (and I’m paraphrasing slightly after scribbling notes furiously):

1) The number of controls should’ve been increased.
2) There were too few test subjects
3) When asked if raised mercury level was an indicator of toxicity, Asphosian answered “I don’t know”.
4) When asked if he would’ve expected mercury concentrations to vary depending on gender, Asphosian answered “Yes”.
5) When asked if Adams controlled for gender Asphosian answered, “No, he doesn’t control for gender”.
6) When asked if lead concentration of a tooth affected mercury concentration of a tooth, Asphosian answered, “I don’t know”.
7) Asphosian was asked, given the fact that the thiomersal hypothesis depended on the role of _ethyl_ mercury, what type of mercury did Adams et al measure in the teeth? Asphosian’s answer was “…did not do speciation” – in other words, he didn’t separate the types of mercury out. He recorded it all.
8) When asked if mercury levels in teeth tell you anything about amounts of mercury in the brain Asphosian replied that he didn’t know as no one had ever done that study.

These are fairly damning failings in what Asphosian’s assumptions were regarding the quality of that study. Of course, there is more wrong with the Adams paper than just the above, but these points are pretty damning. The failure to control for gender, the paucity of subjects and the fact Adams et al didn’t concentrate on ethyl-mercury raise serious questions over what exactly this study can add to the so-called Mercury Efflux Disorder.

I’ll keep appending to this post as I work through the rest of the audio.

Adults, Autism and Scotland

10 May

I have been thinking recently how nice it is that the online autism community has moved on from the quarterly analyses of the CDDS data. For those who are blissfully unaware–the California Department of Developmental Services (CDDS) publishes statistics on the people it serves. They do this every three months.

These data are a favorite of people who would like to promote the idea of an autism ‘epidemic’. Mr. David Kirby has a book and enough power point slides for three debates which are filled with (mis)interpretations of these data.

For the past year or so, every three months the CDDS publishes the data followed by people stating, “The CDDS autism count has gone up, this proves there is an epidemic” and “the CDDS autism count has gone down, this proves the epidemic”. Both seemingly contradictory statements being made on the same dataset. These were quickly followed by multiple bloggers pointing out that the interpretations made were incorrect.

Three things happened that made for a break. (1) Mr. Kirby declared that he was moving on from autism, (2) the CDDS is on a break while they rework the way they compile the data and (3) A case was conceded in the Autism Omnibus which shifted the debate (and ended item (1)).

I was very happy to see the CDDS phase of the autism discussion end.

Then, much to my dismay, the same arguments started up again. This time it is data from Scotland, not the CDDS being misused. Otherwise, it is the same old arguments and the same bad analyses. Well…almost. Some new bad analyses have been added.

Mr. Kirby has a discussion of the Scottish data on another blog. Let’s avoid the conceptual mistakes (such as assuming that somehow everyone is properly identified and receiving services). Before we get to the real implications of this, let’s take a break and look at the math errors, shall we?

Mr Kirby takes this graph of data from the Scottish report:

And states:

Let’s look at the numbers. There are approximately 34,000 young people with autism in Scotland, born during the 16 years from 1987-2002. That is an average of 2,125 cases per birth cohort. But among older people, born during the 31 years between 1955 and 1986, there are only about 600 reported cases, or just over 19 cases a year.

Based on this, he has determined that if the true incidence of autism is constant, about 1 in 110 of the adults are missing from the count.

OK, go back and click on that image for me. I know you skipped over it, but, go take a look at the bigger version.

Did you see it? Yep, the number is not 34,000, but 3,400 adults with autism in the Scottish survey. A factor of 10. Don’t worry if you missed it. Mr Kirby (who spent some time ‘analyzing’ the data) and at least 20 people who responded to his post missed it too.

At this point, I can hear the screams of “So what, that’s just a small mistake. You are trying to distract us all from the big picture.” Because, in the end, even though Mr. Kirby is off by a factor of 10 and there aren’t 100 times more kids than adults receiving services with an autism label in Scotland, there is a roughly factor of 10 difference in the administrative prevalence of autism.

A factor of 10 is still big. I’d argue it’s huge. In fact, I’d scream right back at the people who are trying to use this for political gain.We can argue back and forth whether it’s real. But, consider some of the possibilities for the Scottish survey:

  1. the numbers are correct, all autistics are correctly counted.
  2. People are getting appropriate services, but some are under the wrong label (e.g. intellectual disability).
  3. Some people are getting the wrong services because of an incorrect label (e.g. schizophrenia).
  4. People who really should be getting services and supports are not getting any.

Let’s face it, if there’s a chance that people are getting the wrong services, we should be looking. And, yes, it is a very real possibility. Remember the big stink some people made when it was implied that some adults with the label of Schizophrenia might actually be autistic? Well, David Mandell is scheduled to talk about this at IMFAR this year in his paper: Evidence of autism in a psychiatrically hospitalized sample.

A £500,000 project to look for adults with Autism in the UK has been recently announced. To quote one of the researchers on this project:

“Adults with autism and Asperger’s syndrome are too often abandoned by services with their families left to struggle alone. Equally, people are frequently missaprorpriately referred to either mental health or learning disability services

“This study will inform the development of a national strategy designed to ensure that adults with autism and Asperger’s syndrome are supported to have full lives.”

“We still don’t know enough about autism, but we do know that left unsupported, it can have a devastating impact on those who have the condition and their families. One of the key gaps in our knowledge is simple – we don’t know how many people have the condition in any given area. That is why I am ordering a study to address this. “

It sounds like a really tough project. I don’t know if this study can really be accomplished. But, I have hopes that it could help improve the lives of adult autistics.

Now, as long as we brought up the Scottish survey, why not look at some of the details that were missed by others?

One question was how many of the individuals had “other behavioural or biomedical conditions?”. For the adults, this was 30% of the total. For the children, this was 3% of the total. Is this an indication that the kids being identified today actually have less severe symptoms than the adults? Even without that, only 1% have “other…biomedical conditions”?!? Where are all the kids with all the conditions like bowel problems that some groups claim define autism?

Another interesting fact from the survey is that over 50% of the children are in mainstream schools.

Yet another factoid: about 32% of the children in the survey have Asperger syndrome. Of those, half are listed as having ‘no learning disabilities’. For adults, only 14% are listed as having Asperger syndrome.

Surveys of those getting services are prone to a lot of errors–as has been discussed in the past for the CDDS data many times. So, these data should not be taken as hard epidemiological counts of the actual number of people in Scotland with autism. However, these data do not support the idea that the younger generation of autistics have greater challenges than the adults had to overcome.

I am actually glad that the subject came up of autism in Scotland. Why? Because in looking for some of these data, I found the website for the National Autistic Society Scotland. I particularly liked this page: I Exist: the message from adults with autism in Scotland.

For me, I have just finished a box of McVitie’s HobNobs while writing this. I don’t know if they are Scottish, but I love them. Perhaps I’ll open the other box to celebrate a study of adults with autism.

Additional

Sullivan’s catch of David’s maths error is good but I thought to myself as soon as I heard about this Scottish report that I’d heard about it before. I had. I blogged on this audit three years ago. One of the most fascinating aspects of the paper was when local authorities were asked for their opinions on the following question:

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?

The answers were very interesting. About 45% of the areas questioned said that the prevalence for adults was grossly underestimated, badly reported and that a lot of these adults exist without diagnosis. For example:

Argyll & Bute Council
It is believed that the figures represent a significant under-representation of those with ASD in Argyll and Bute. This was thought to be due to a historical under-diagnosis and the absence of clearly defined referral pathways and multi-agency assessment processes for adults.

East Renfrewshire Council, NHS A&C and Greater Glasgow NHS

…as a result of changing patterns of diagnosis over recent years there are likely to be substantial numbers of adults with ASD who are not known to services and are not diagnosed as having ASDs.

AYRSHIRE AND ARRAN
It is apparent that information collection and collation for adults is almost non existent.

DUMFRIES AND GALLOWAY
There is little doubt that this number is far short of the actual number of adults in Dumfries & Galloway with ASD.

GRAMPIAN
There is low diagnosis for longstanding clients, whom workers are aware have autism as well as a learning disability.

HIGHLAND
It is believed that these figures comprise a significant underestimate due to the lack of a diagnostic process particularly for adults. It is believed that the figures for younger children are accurate due to the development of diagnostic tools for children are accurate due to the development of diagnostic tools for children and the establishment of multi-disciplinary partnerships which include education.

LANARKSHIRE
The estimated numbers provided for the pre-school and primary school ages are thought to be a reasonably accurate reflection of the true picture. However the estimated number of secondary school children is less accurate and the estimated number of adults with ASD is likely to be a considerable underestimate of the true prevalence.

ORKNEY
Figures for children are an accurate representation of needs. One or two children may yet be diagnosed. Figures for adults are under estimated as diagnosis has not been made and access to specialists is variable.

Perth & Kinross Council
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.

Pretty interesting stuff I think you’ll agree. This means that about 45% of the areas questioned said that the prevalence for adults was grossly underestimated, badly reported and that a lot of these adults exist without diagnosis. The two really stand out quotes for me were:

There is low diagnosis for longstanding clients, whom workers are aware have autism as well as a learning disability……day centre managers locally consider a number of people to be on the spectrum who have had no formal diagnosis.

So as well as the excellent points Sullivan raised, I’d also like to ask how it is possible to place any kind of interpretation of the data when the fact that adult prevalence is grossly under-reported is so well established?

Please don’t vaccinate

18 Apr

After all, whats the death of a baby from a vaccine preventable illness huh?

The baby was 9 months old, his birth weight was 8 lbs 5 ounces. At six months he weighed just shy of 20 pounds. Today he weighed 15 pounds – he was a skeleton and he was dying.

Mom had brought him in after treatment by his naturopath had failed. Constant coughing had made it impossible for him to take in adequate nutrition and starvation, coupled with a raging bacterial pneumonia were conspiring to shortly end his very short life.

We worked feverishly. Intubation, IV boluses, major antibiotics, vasopressors. All futile.

At 9:03 pm, after 30 minutes of cardiopulmonary resuscitation we pronounced him dead.

This boy had pertussis. His mother choose not to vaccinate him. I won’t enter that debate. Anyone who has ever watched a child die or become permanently disabled from a preventable illness supports vaccination.

A naturopath a mother who elected not to vaccinate and decreasing herd immunity – what could go wrong there? Lets hope there’s no other people as *fucking stupid* as to go around blathering about not vaccinating, using naturopaths instead of doctors and insinuating that vaccine preventable diseases are nothing and vastly preferable to something like…oh I dunno….autism for example.

Vaccines = bad, vitamin supplements = good

17 Apr

A fascinating mini-storm has been quietly bubbling away in the UK over the last couple of months concerning the vitamin and mineral supplement industry. It has a tie in to autism these days as one of the features of the more extreme forms of biomed is an increase – sometime to megadose levels – of vitamin and mineral supplements.

Here’s a video from BBC News yesterday. And if you can’t get the video, here’s the online report.

A review of 67 studies found “no convincing evidence” that antioxidant supplements cut the risk of dying.

Scientists at Copenhagen University said vitamins A and E could interfere with the body’s natural defences.

“Even more, beta-carotene, vitamin A, and vitamin E seem to increase mortality,” according to the review by the respected Cochrane Collaboration.

The report reported a neutral finding for Vitamin C but it already established that mega-doses of Vitamin C:

….can cause nausea, diarrhea, kidney stones and inflammation of the stomach lining (gastritis).

These vitamins and minerals are routinely recommended by extreme biomed practitioners for autistic children. There is no scientific evidence of any kind that they do anything to alleviate any autistic symptoms.

I blogged yesterday about a paper called ‘Trusting blindly can be the biggest risk of all’: organised resistance to childhood vaccination in the UK which whilst fascinating in its own right, makes mention of attitudes towards vaccines as risks ‘of the unknown’.

The Vaccine Critical groups rely heavily on a discourse of unknowns in order to challenge and undermine the rationality of vaccination. For example, a majority of the groups make the argument that we do not know the effects of vaccination because of insufficient safety trials, both pre- and post-licence.

And yet, these same groups are more than happy to ply themselves and their children with supplements that have also had little to no safety trials.

There is a huge cognitive dissonance at work here that is worth a sociological study in its own right. Why is it OK to administer some things with no trials and not others? Another idea that anti-vaccine groups tend to espouse is the idea that because ‘we’re all different’ we need to tailor what we’re given to us individually.

We’ve got to actually make sure that what we’re giving is right for the individual child. The Department of Health are not good at determining whether a child shouldn’t have something. They treat them all as exactly the same (JABS).

And yet, once again, we seem to have non-individualised plans (such as the so called Yasko diet, or the GFCF diet or the recommendation to take huge doses of mineral supplements) when it comes to biomed. Why is it OK for one set of treatments and not others?

I think there is more going on here than the authors of the ‘Trusting blindly…’ paper realise. I genuinely believe that for some people it really is a pathological hatred of vaccines . There is no rhyme or reason for it but I’m sure it is there.

An Open Letter To The Poling’s

12 Apr

Dear Poling family,

Let me first start by saying that your little girl is beautiful. I am father to two girls (as well as one boy, young man now actually) so I know how great it is to have such wonderful little people around.

I read Jon Poling’s commentary in the AJC and I have to say that I was very disappointed by the level of accuracy in the piece. For example, he says:

On Nov. 9, 2007, HHS medical experts conceded through the Department of Justice that Hannah’s autism was triggered by nine childhood vaccinations administered when she was 19 months of age…

Now I have taken a keen interest in your families case since it became clear what the situation was. I _think_ I have read most of the newspaper reports available online as well as (more importantly) the HHS document itself and (even more importantly) the case study co-authored by Andrew Zimmerman and Jon Poling.

Nowhere, I repeat, nowhere, have I seen anyone from either the HHS, CDC, US Government, or even the Zimmerman/Poling case study say that ‘Hannah’s autism was triggered by nine childhood vaccinations’.

I have seen David Kirby refer to this several times. I have heard lots of people refer to these statements as if they are true and now I hear you doing it too.

But where is this concession?

In what legal, scientific or medical document does it state unequivocally that ‘Hannah’s autism was triggered by nine childhood vaccinations’?

You are a family on the cusp of storm. You need to take more care with your statements. People all over the world are listening. The *fact* as of right now is that no one has conceded ‘Hannah’s autism was triggered by nine childhood vaccinations’. Simply stating it as if it were true does not make it true.

The HHS expert documents that led to this concession and accompanying court documents remain sealed, though our family has already permitted release of Hannah’s records to those representing the almost 5, 000 other autistic children awaiting their day in vaccine court.

Now this confuses me on two levels. Firstly, Special Masters have already said that:

….in the case that is the subject of the media reports, if the parties who supplied documents and information in the case provide their written consent, we may then be able to appropriately disclose documents in the case.

It sounds to me like Dr Poling is trying to turn something around onto the HHS without justification. Maybe your legal team haven’t told you about this news. I understand they’re very busy of late.

The second part of Dr Poling’s statement that confuses me is the allusion to the records being released ‘to those representing the almost 5, 000 other autistic children’.

I thought that you wanted your documents to be made entirely public? Are you now saying you only want the legal teams of the other omnibus lawyers to have access to them?

I would also like to draw your attention to the email I sent to Terry Poling on March 5th asking why the Poling family had not cleared Dr Andrew Zimmerman from speaking publicly about the case. Does the Poling fmaily have any intention of lifting that embargo any time soon?

Dr Poling goes on:

Emerging evidence suggests that mitochondrial dysfunction may not be rare at all among children with autism. In the only population-based study of its kind, Portuguese researchers confirmed that at least 7.2 percent, and perhaps as many as 20 percent, of autistic children exhibit mitochondrial dysfunction. While we do not yet know a precise U.S. rate, 7.2 percent to 20 percent of children does not qualify as “rare.” In fact, mitochondrial dysfunction may be the most common medical condition associated with autism.

This is very disingenuous Dr Poling. I am not sure if you are purposefully distorting the truth or simply not as knowledgeable as you think. In point of fact the figure of 7.2% is from a 2005 study ‘Mitochondrial dysfunction in autism spectrum disorders: a population-based study‘. This is _not_ (as you state) ‘the only population-based study of its kind’. It was in fact a precursor to a _second_ follow up study by the same lead researcher correcting his own data.

This second study (published October 2007) is called ‘Epidemiology of autism spectrum disorder in Portugal: prevalence, clinical characterization, and medical conditions’.

This study declares a 4.1% figure. It is disingenuous in the extreme to refer to old science when newer, more accurate science exists on the subject (and by the same author no less!).

Further, as far as I can tell, the figure of 20% has but one source – a non published summary for attendees of a 2003 LADDERS conference in Boston, USA. Therefore it has not been subject to any kind of peer review. That’s not to say the figure is wrong, merely that it hasn’t been verified or undergone any kind of the usual scientific checks and balances a published piece of work must undertake to ensure quality. This is not ’emerging science’ Dr Poling. Its a set of program notes.

Further, as I understand it from talking to people involved in all three of these different items, the percentages you talk about are expressed percentages _of regressive autism only_ . Now I might have that wrong but I’m pretty sure that’s what was communicated to me.

Taking this into account, when Dr Poling states that:

In fact, mitochondrial dysfunction may be the most common medical condition associated with autism..

and he goes on to suggest population numbers between 10,000 (1%) , 72,000 (7.2%) and 200,000 (20%) of the autistic population he estimates at one million in the US, he is incorrect.

However, if I have understood what is said to me then we need to look at regressive autism numbers only, which are estimated to account for 25%-30% of autistic people. Therefore we are looking at not 7.2% or 20% (one is incorrect, one is not scientifically justified) of one million. We are actually looking at 4.1% (the only scientifically valid number) of between 25 – 30% of one million. Lets take the upper figure of 30%. This gives us a population of 300,000 for regressive autism. Applying the 4.1% estimate we can see that – at best and only if this data is all correct – mitochondrial autism may affect about 13,000 autistic people – 1.3%. If we took the lower range of 25% for regressive autism, we barely get over 1% (10,250).

Secondly, it should be noted that approximately 40% of autism can be accounted for genetically. This already makes it the single largest established cause(s).

Dr Poling goes on to say:

Today there is no doubt that mitochondrial dysfunction represents a distinct autism subpopulation biological marker.

This is true. However, prefacing this sentence with the word ‘today’ gives the highly misleading impression that autism has been associated with mitochondrial disorders and/or dysfunctions only since Hannah Poling came into out collective conciousness. This is far from the case. I can find instances in the scientific literature going back to 1986, over 20 years ago discussing mitochondria and autism and a PubMed search for ‘mitochondrial autism’ yields 34 quality papers published over a 20 year period. This is hardly a new thing Dr Poling.

As a neurologist, I have cared for those afflicted with SSPE (a rare but dreaded neurological complication of measles), paralytic polio and tetanus. If these serious vaccine-preventable diseases again become commonplace, the fault will rest solely on the shoulders of public health leaders and policymakers who have failed to heed the writing on the wall (scribbled by my 9-year old daughter).

I fear that this is projection. You are very close to pushing an anti-vaccine agenda Dr Poling and indeed Terry Poling was active an the Yahoo Group ‘Recovered Kids’ from at least Summer 2001 where she says things like:

Really, the only way to obliterate a disease is to vaccinate everybody – or at least so “they” say

Sept 2001.

Had I told the hospital staff she was autistic they would not have believed me. The same held true for a (sic) educational consultant who came to evaluate hannah the day before the fever started. She said in her report she saw absolutely no autistic behaviors.

Nov 2001.

She has mitochondrial disease which causes her autism.

March 2004.

I do know docs that speak for drug companies but they cover all the meds for a particular disease in their talks with other docs. If they do not agree that the drug is best for certain conditions on the whole they say so.

Feb 2003.

…it [autism] is a DSM set of symptoms. When the symptoms disappear you cannot say the child still has autism…..

Oct 2001.

So Dr Poling when you try to lay the blame for vaccine preventable injuries increasing at the foot of those agencies assigned to try and stop them reappearing I think that is farcical. To me it is clear that the main responsibility lies with those who shun what are by and large safe safe vaccines on the strength of a hypothesis that is nowhere _close_ to scientific truth. I urge you to read this article and the comments left by readers. Its clear who they see as responsible. For example:

Don’t want to vaccinate your kids? Fine with me. Just don’t send them to school where they then put my kids at risk because of your decision.

You are deluding yourself if you think you can turn responsibility for shunning vaccines back on health agencies Dr Poling.

All in all Dr and nurse Poling I think that your public use of misinformation and erroneous science to make your point will serve you no good in the long run. I also continue to be puzzled by your refusal to ‘ungag’ Andrew Zimmerman. I hope you can start to realise that what has ‘happened’ to Hannah is far from remarkable. Best wishes from one autism parent to another.

Dear CDC

26 Mar

I read with interest Dr Schuchat’s opinion piece in the AJC today.

Whilst it is gratifying to see someone of Dr Schuchat’s calibre responding to previous claims regarding vaccines in autism I would like to make a few points to Dr Schuchat and the CDC in general.

Firstly, this level of response is around eight years too late. What have you been doing on the media/PR front over the last eight years? I’ll tell you what your ‘opponents’ have been doing – they’ve been conducting protests outside your offices, outside the offices of the AAP etc. They’ve been setting up and organising vaccine/autism groups and heavily marketing them via the use of organic and paid for web based advertising.

The only people who have made any kind of attempt to counter these groups and the misinformation (deliberate or not) they publish is people like myself. I am not attempting to aggrandise myself at all. I am attempting to convey to you how one sided the ‘battle’ has been over the last few years.

Where were you? You were needed. You could’ve helped. Instead you sat back and hoped this would all go away. It didn’t. It won’t.

Secondly, the level of Dr Schuchat’s response is very close to condescending. Simply stating that:

Kirby’s column included many inaccuracies related to childhood vaccines. As such, it illustrates that when it comes to immunizations, child development and specific medical conditions, the best source of guidance is the child’s health care provider.

is patronising in the extreme. The level and quality of the debate has moved on in the last eight years. Bland assurances won’t cut it. You need to be specific and offer evidence. Autistic people, parents of autistic people and interested professionals are smart enough to know and understand a certain level of science these days.

Don’t be shy about providing people with science. You have some truly excellent science on ‘your side’ as I and others have attempted to blog about in the last five years to no small effect. For example, Googling mmr autism displays, amongst others, the blog of a friend of mine – also the parent of an autistic child and also convinced of the need to blog about the bad science surrounding the various vaccine/autism hypotheses. Googling thiomersal autism brings up _this_ blog. We’re doing your job for you!

You’re being left behind in this debate. Its time you caught up.

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