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New MMR study makes the NAA angry

4 Sep

Oh dear.

As I posted yesterday, MMR still doesn’t cause autism – as reported by yet another group of researchers.

And yet there was something special about this group of researchers. The lead author is Dr Mady Hornig who it seems is trying to turn over a new leaf and recapture her place as a good scientist.

As the link I supplied shows, it was not always thus and for a long time Dr Hornig was a card carrying member of the mercury militia. In fact, she was a regular speaker at conferences organised by SafeMinds and the NAA.

Which makes the press release about this new MMR study by the NAA all the more painful to read.

A Centers for Disease Control and Prevention (CDC) study released today claims there is no link between the MMR vaccine and autism

Thats how the NAA refers the Hornig study all the way through its press release. ‘The CDC study’. Its a little like reading the decree nisi in the lead up to a divorce you just know is going to be long and bitter.

Anyway, lets have a look at the rest of the points the NAA try to make.

…In a 2002 paper where the majority of autistic children were found to have measles in their intestines, the children examined showed a clear temporal link between MMR exposure and regression. The CDC’s attempt to replicate the 2002 study fell far short of proving the safety of the MMR vaccine.

No reference is supplied for this ‘2002 paper’ so I have no idea what to talk about here. Thats not very smart NAA. Also, as discussed yesterday in the press conference, the intent was to replicate Wakefield’s original study. In 1998. Not 2002.

The CDC study was designed to detect persistent measles virus in autistic children with GI problems. The assumption being if there is no measles virus at the long delayed time of biopsy, there is no link between autism and MMR. But NAA says this underlying assumption is wrong. The questions should have been: Do normally developing children meeting all milestones have an MMR shot, develop GI problems and then regress into autism? Do they have evidence of measles and disease in their colons compared to non-vaccinated age and sex matched controls?

Ahhh, I _see_ – so when you don’t like the answer, change the question? Nice one. The NAA are obviously South Park fans, seeing as they just introduced the Chewbacca defense.

In the current CDC study, only a small subgroup of children was the correct phenotype to study……Only 5 of 25 subjects (20%) had received MMR before the onset of GI complaints and had also had onset of GI episodes before the onset of AUT (P=0.03).” The other 20 autistic children in the study had GI problems but the pathology developed before the MMR vaccine.

This really does take the piss in an extreme way. The NAA love the 1998 study by Wakefield which had a group of 12 participants. Now they suddenly don’t like small numbers?

And really, that is besides the point. The authors took some autistic kids with GI issues and then looked to match them to a hypothesis. The fact that the only found a very, very small number who actually fit the description that the NAA would _like_ them to fit is extremely telling. The vast majority of the kids had GI issues _before administration of MMR_ . Now, what does that tell you? Its not difficult to work out.

Inflammatory bowel disease in the absence of MMR RNA does not mean that MMR shot didn’t precipitate the GI disease and didn’t precipitate autism…

Oho…is that the rumble of some goalpost shifting I can hear? I think it is.

Lets be clear. For literally a decade now, the NAA and the groups like it have been claiming that their kids had the MMR, developed gastric issues, then developed autism all as a result of the measles vaccine RNA contained in the measles component of the MMR. This is the hypothesis that the Autism Omnibus plaintiffs are arguing for right now. This study has thrown yet another large, cold bucket of reality over that nonsense. So now, thats _not_ the hypothesis?

Public confidence in the safety of vaccines is at risk until safety studies are performed that are required by law, ethics, and science….blah blah blah

Is it? If that _was_ the case then the only people who have put the public confidence of vaccines at risk are groups like the NAA. There is no way to keep saying the same thing without appearing repetitive: what you believe is wrong. The MMR vaccine does not cause autism. Shut up. Start working _for_ autism.

And is it really the case that public confidence is slipping? I recently wrote about a phone survey that had found that:

….66 percent had heard that “some parents and researchers say vaccines have side effects that may lead to autism, asthma, diabetes, attention deficit disorder and other medical problems.” About 33 percent had not heard of these concerns, and 1 percent was uncertain.

Seventy-one percent of the adults said “the benefits of immunizations outweigh the risks,” while 19 percent “have questions about the risks of immunization,” and 10 percent were uncertain or gave other responses such as “it depends upon the kind of immunization.”

So, its clear that people (in the US at least) are beginning to get some confidence back in vaccines and see the need for them. That is backed up by an article by the American Academy of Family Physicians who report:

Although the alleged link between childhood autism and the vaccine preservative thimerosal still sparks occasional controversy, the good news is that by and large, parents don’t seem to be buying into the hype. According to the latest reports available from the CDC, overall childhood immunization rates in the United States continue to steadily increase.

This is good news. Partly anyway. It is good news for herd immunity and the general level of the health of the US.

However, this is never going to be good news for autism and for autistic people whilst we have the various conspiracy theory addled groups who claim to represent the autism community continually burying their collective heads in the sand whenever yet another study comes out to show them how silly they’re being. I urge two things to happen.

1) Doctors and scientists – please don’t stop talking about this issue once vaccinations reach safe levels. Your job is only part done at that stage. You *must* continue to talk to reach new parents and the parents who can be reached from the autism community. Don’t let these kooks get the control back.

2) So-called autism advocacy groups in the US and UK. You know who you are. You’re doing nothing to help autistic people. Change your ways or shut up.

MMR still doesn't cause autism

3 Sep

In shocking news, yet another study shows that the MMR doesn’t cause autism. The study (which is here for your edification Dear Reader).

attempted to replicate 1998 research by a team led by Dr. Andrew Wakefield, then of Britain’s Royal Free Hospital, in the Lancet medical journal that suggested the vaccine was linked to autism and gastrointestinal problems.

And how did that work out for them?

….they could not find any link and hope their study will encourage parents to vaccinate their children to combat a rash of measles outbreaks.

The ‘official’ study conclusion is:

This study provides strong evidence against association of autism with persistent MV RNA in the GI tract or MMR exposure. Autism with GI disturbances is associated with elevated rates of regression in language or other skills and may represent an endophenotype distinct from other ASD.

Interestingly, the lead author is one Mady Hornig whom you might remember from the infamous Rain Mouse debacle. Seems like she’s turned over a new leaf. Gone are the lurid descriptions of skull chewing and in instead are pleas to vaccinate children from a killer disease. Credit where its due Ms Hornig, well done.

“We found no relationship between the timing of MMR vaccine and the onset of either GI complaints or autism,” Dr. Mady Hornig, also of Columbia, said in a statement.

Another interesting aspect is that the methodology the team used means they utilised three different labs. One of which was the O’Leary lab. This time, they did a good job. Shame they screwed up so bad the first time. Maybe if they hadn’t, things would’ve been over a long time ago. Is it just me or does this paper feel like a few people trying to claw back some scientific credibility?

Anyway, the study also found:

But the study did find evidence that children with autism have persistent bowel troubles that should be addressed.

They still didn’t say whether these bowel troubles (which they found weren’t associated with the MMR) were occurring at a higher rate in autistic kids. Maybe someone will address that one day.

Oh and Rick Rollens was there too, teeth and buttocks clenched no doubt as he congratulated the scientists. He said:

No longer can mainstream medicine ignore parents’ claims of clinically significant GI distress.

Had they ever? I’ve never seen a study that shows that. He also said:

“This study by itself does not exonerate the role of all vaccines”

What a genius. He spotted the phrase ‘Measles Virus Vaccine’ in the study title and worked out the rest all by himself! Nothing gets past our Rick!

So, MMR doesn’t cause autism. No news and of course won’t convince the flat earthers but still – another welcome addition to the ever growing canon of evidence against MMR causation.

Further Reading Elsewhere
Mike at Action For Autism
Kristina at AutismVox
Anthony at Black Triangle
Orac at Respectful Insolence
Steve at One Dad’s Opinion
Phil at Bad Astronomy

Conflicts, then and now

3 Sep

There is a lot of talk about conflicts of interest in autism.  This is especially true with Dr. Paul Offit’s book, Autism’s False Prophets: Bad Science, Risky Medicine, and the Search for a Cure out now.

Consider his letter to the New England Journal of Medicine in May, 2008.

Dr. Offit reports being a co-inventor and co-holder of a patent on the rotavirus vaccine RotaTeq, from which he and his institution receive royalties, as well as serving on a scientific advisory board for Merck. No other potential conflict of interest relevant to this article was reported.

In August Dr. Poling responded to that May Letter, and Dr. Offit was able to comment as well. Below is Dr. Offit’s conflict of interest statement.

…

Yep, that’s right. No statement. In a few short months, the royalties for the RotaTeq vaccine have been settled and Dr. Offit’s tenure as a consultant to Merck has ended. Basically, it’s as we’ve discussed before: Dr. Offit no longer has any financial conflicts of interest in discussing vaccines.

Note this statement about the book from the publisher’s site: He [Offit] will donate all royalties from sales of this book to autism research. I.e. he also doesn’t even have a conflict of interest in promoting his newest book.

I don’t expect all the people who dislike what Dr. Offit has to say to report these facts accurately. I will say that Sharyl Attkisson didn’t repeat the “Offit works for Merck” line, and good for her. I think it is a good assumption that the people who helped her with that story probably did push the “He’s a Merck consultant” idea.

Many people people (and Orac, and Kev, and AutismNewsBeat, to name a few) have gotten it right already, so I shouldn’t be too worried about it. But, as I await the book showing up in my mailbox, I keep thinking about the issue of conflicts of interest and Dr. Offit.

[note: I made a few minor edits after this post went live. They were for clarity and did not change the substance of the post]

"I don't believe that"

29 Aug

To promote his new book ‘Autism’s False Prophets. Bad science, risky medicine and the search for a cure’ (Amazon UK, Amazon US, Amazon Canada) – and look for a review here very, very soon – Dr Paul Offit went on the US radio show Talk of the nation ‘Science Friday’ earlier today.

It turned into a microcosm of exactly the sort of scenario that those of us who have blogged about this for some time have come to expect. A question, a reasoned response and then a flat statement of denial.

The show began with the show host (who’s name I didn’t catch) asking why people weren’t vaccinating. Offit gave the answers we all know.

Then the show took a turn into what could’ve been a blog argument on any one of a number of blogs – including this one. A caller called Chantelle/Chantal came on the line and essentially asked Dr Offit how it could possibly be safe for a newborn to receive up to 1250micrograms of Aluminium and that there hadn’t been any studies on how Aluminium could affect a child. She said –

that is why I will not follow the CDC’s guidelines….my child will be vaccinated on my own schedule.

(Her emphasis)

Dr Offit answered with a brief overview of Aluminium’s role in a vaccine is and then told Chantal the simple truth – one that I blogged about fairly recently – there’s more Aluminium in between 50 days to a years worth of breast milk than in the entire vaccine schedule:

We live on the planet Earth. If we choose to live on the planet Earth that means we’re going to be exposed to light metals like Aluminium and heavy metals like mercury.

Chantal then seemed (I wasn’t entirely clear) to want to compare kids with kidney issues (who clearly need to be careful with Aluminium) with _all_ kids. As Dr Offit stated – that’s hardly a valid or real-world comparison.

Then the host asked a great question:

Chantal, is there anything Dr Offit could tell you that would change your mind

.

The answer: “Absolutely not”.

And there we have it. That is the rock bottom of every single argument the autism/antivax brigade peddle. Screw the science, screw the facts. I just don’t want to hear it and I will put my fingers in my ears and make ‘la-la’ noises until you go away.

Chantal then goes on to justify this ridiculous stance by saying (a la Jenny McCarthy) that there is no independent science supporting vaccine safety. This is tosh. A study this is submitted for peer review to a science journal is peer reviewed by independent experts from the relevant field all over the world. And then, the ultimate test of impartiality takes place – the science is either replicated or it isn’t. Replicated science _has to be_ by definition be independent of its author. How could it not be? If we want to see the opposite of reproducible science, then that can be arranged.

Chantal goes on to say that Dr Offit ‘makes millions’ from speaking about the safety of vaccines. A bizarre claim that I’m pretty sure is not true. He then goes on to describe the ‘high bar’ that vaccine studies must pass. Studies with tens of thousands of participants.

Next, Chantal tries the ‘too many too soon’ dogma that we’ve become recently familiar with. She claims ‘six at one time is absurd’. Dr Offit gives Chantal some facts to play with on that score too:

…the bacteria that live on their nose [a newborn], or the surface of their throat are literally in the trillions. Those bacteria have between 2,000 and 6,000 immunological components and consequently our body makes grams of antibody to combat these bacteria….The number of immunological challenges contained in vaccines is not figuratively, it is literally a drop in the ocean of what you encounter every day.

(Emphasis his, slight paraphrasing)

Chantal then got a bit snappy.

So tell me…how many studies have been done on vaccine loading, which means five or six vaccines at one time. How many?

Dr Offit’s answer:

Somewhere in the vicinity of the high hundreds to low thousands.

Chantal:

I don’t believe that.

Boom! There it is again – she simply doesn’t believe it. Screw the facts, screw the evidence, my fingers are going right back in my ears…la-la-la-la…I can’t hear you…

Dr Offit explains further that any vaccine in the US has to undergo something called a ‘concomitant use study’. These are to establish that vaccines work OK together.

You have to show that vaccine does not interfere with the immune response or the safety of existing vaccines and similarly that existing vaccines don’t interfere with the immune response or the safety of the new vaccine

Dr Offit said ‘high hundreds to low thousands’ of studies (Chantal didn’t believe that remember). A simple Google search reveals over 1,800 results for that phrase. Searching PubMed for ‘concomitant vaccine’ returns over 700.

Dr Offit closes the interview by saying he doesn’t believe all parents are as close minded as Chantal. He uses a nicer phrase than that as he’s a gentleman but that’s how I see it. Close minded to the point of obstinate stupidity.

For some people, it truly doesn’t matter what the facts are, or what the science is. They just stick their fingers in their ears.

La-la-la.

John McCain starting to back away from vaccines?

28 Aug

I’m a bit hesitant to blog about political figures from other countries. I don’t know an awful lot about John McCain other than he was a Vietnam (I think) veteran and was a POW for awhile. I know the Bush team sledged him pretty badly in the run up to Bush’s current term and I know he tries hard to cultivate a old-fashioned-take-no-shit-youngster attitude. I neither like him nor dislike him.

However, back in February he did irritate me quite a lot when he said:

[Autism]….is on the rise amongst children, the question is what’s causing it. And we go back and forth and there’s strong evidence that indicates that it’s got to do with a preservative in vaccines.

It irritated me because firstly, there’s no evidence its ‘on the rise’ in the sense I think he meant it. There’s no way of scientifically telling from current studies if it is or not. In fact, the best science done so far on the issue (Shattuck, 2006) states:

The mean administrative prevalence of autism in US special education among children ages 6 to 11 in 1994 was only 0.6 per 1000, less than one-fifth of the lowest CDC estimate from Atlanta (based on surveillance data from 1996). Therefore, special education counts of children with autism in the early 1990s were dramatic underestimates of population prevalence and really had nowhere to go but up. This finding highlights the inappropriateness of using special education trends to make declarations about an epidemic of autism, as has been common in recent media and advocacy reports.

In other words, because autism has not been tracked well up until now, there is no way we can say with any degree of confidence that is increasing. It may be, but most scientists think that instead of an _increase in autism_ , we are seeing an increase in _accurate diagnosis_ of autism.

Secondly, McCain’s statement irritated me because, of course, there is _no_ evidence, strong or otherwise, that indicates autism is caused by preservatives in vaccines. And certainly McCain totally failed to provide any kind of evidence for this silly statement.

However, as election time draws nearer, it seems McCain’s statements are growing a bit more (he said with no trace of irony) conservative. Maybe someone explained the facts of life to him: after having someone of less than stellar brain power in office for the last eight years, it might be a good idea to evaluate things properly, rather than just sound off and come across as Dubya Part II.

Here’s what he said recently:

We don’t know what causes [autism]. There’s a huge debate going on now about vaccinations. And I’ve read and studied and gotten briefings, and I don’t know all the answers.

Thats quite a lot more circumspect than ‘there’s strong evidence that indicates that it’s got to do with a preservative in vaccines’. A simple statement of facts. After all, its true – we _don’t_ know what causes autism. And there _is_ a debate going on about vaccinations. And guess what? John McCain _doesn’t_ know all the answers.

I’m guessing McCain’s team have suggested to him that if he doesn’t want to be known as the also-ran who hyped up unfounded fears of vaccinations in the middle of a measles epidemic sweeping through the country he’s attempting to lead then it would be a good idea to engage his brain before opening his mouth.

Sharyl Attkisson's 3rd autism/vaccine concession

26 Aug

A few days ago, I posted an entry about Sharyl Attkisson’s breathless parroting of ‘facts’ regarding a case from 1991 based on a child born in 1974. This case was settled in favour of the child. It transpired (of course) that the Special Master had in fact said nothing about autism whatsoever.

However, an interesting comment was left by ‘M’ who said:

Dravet syndrome? It is a genetic disorder, de novo mutations of the sodium-channel gene SCN1A. Children with these mutations are seemingly normal until they have the first high fever episode (it could be post-vaccination fever as well) – then the syndrome manifests with epileptic syndrome and subsequent developmental delay (encephalopathy). The genetic diagnosis was not possible until recently – the mutation was first identified in 2001.

An intriguing possibility that I read and then with my usual stunning foresight, totally forgot about.

However, I got an email yesterday that raised the issue once more. I cannot share with you who its from, a fact that is rather annoying (but understandable, this person doesn’t want to expose themselves to the loving care of the mercury militia) but I assure you, you would recognise this name.

The writer assumes that this is a vaccine injury because the special master determined that this was a compensable case. However, this event occurred in 1974 and the hearing in 1990-91. Now, in 2008, it is obvious that the epilepsy and resultant developmental impairment and “autism” are not caused by DTP but, rather, are due to Dravet syndrome (or severe myoclonic epilepsy of infancy), which is a genetic epilepsy with a mutation or change in the SCN1A gene. The evolution is typical of this disorder. It is a very temperature sensitive epilepsy (a 1 degree Celcius elevation is sufficient to trigger a seizure) and is not caused or aggravated by any immunization. Berkovic et al described this entity as a cause of vaccine encephalopathy in their Lancet Neurology 2006 paper.

I am concerned about the superficial investigatory actions of this writer (actually no real investigation was done – she assumes everything to be true). I thought I would share this information with you and let you use the information as you wish.

I can’t find a copy of the entire transcript, but from the parts Attkisson transcribed and quoted and comparing the evolution to the Dravert Syndrome home page, it certainly does look like a good match.

So what does that imply? Well, if its _not_ Dravert Syndrome then, nothings changed – still not autism though. If it _is_ Dravert Syndrome then it goes to show how little we know about genetic disorders and how careful we should be about rushing to judgements.

Leaky gut aka intestinal permeability

18 Aug

Leaky Gut syndrome is a hypothesis associated with autism by people who believe that toxins (particularly those caused by vaccines – notably the MMR) weakens the lining of the bowel letting various rubbish thorough (undigested food, toxins, whatever) and triggering an immune response and/or leading to Wakefield’s much-hyped but never backed up Autistic Enterocolitis.

This unverified condition has (of course) been found by any number of Wakefield supporters and yet, curiously, no researchers external to Wakefield’s peers have found any evidence for it and the phrase exists as a diagnosis within that AltMed community.

In fact, its not curious at all as the only groups that _did_ find evidence for ‘Autistic Enterocolitis’ used the now discredited Unigentics lab run by John O’Leary.

Anyway, in Feb of this year a team from the University of Calgary published a Pilot study into the ‘leaky gut’ (posh name: ‘intestinal permeability’) issue.

They enrolled 14 autistic kids (all of whom had parents who reported gastric issues), 7 NT siblings of these kids, and 8 NT non-related controls.

In the ‘leaky gut’ opioid-excess theory, it is proposed that increased intestinal permeability in children allows for increased absorption of dietary peptides, which ultimately leads to disruption of neuroregulatory mechanisms and normal brain development.

The reason for choosing autistic kids who were reported by parents to have gastric issues is that the researchers reasoned that these kids would be more likely to have ‘abnormal gastrointestinal tests’.

In this population, the researchers found:

we neither demonstrate abnormal small intestinal permeability, nor abnormal postprandial responses of the enteroendocrine peptide GLP-2.

…..

It has been suggested that increased permeability may be causally related to the onset of the inflammatory bowel disease and not just a consequence of inflammation. Our data does not support a similar hypothesis in autism.

…..

Our study did not detect differences in the functional gastrointestinal parameters measured in a group of children with autism. Although there may be a subset of children with autism with a specific gastrointestinal abnormality there is no firm evidence yet of a role for gastrointestinal dysfunction in
the etiology of autism.

One of the things the authors reported that struck me was:

The subtle endoscopic and histological findings of lymphonodular hyperplasia in the colon and ileum previously described in ‘‘autistic enterocolitis’’ (Wakefield et al. 1998, 2005) are also seen in normally developing children with similar gastrointestinal symptoms (Furlano et al. 2001).

This is only a pilot study of course so not too much can be read into the results but if the study is expanded upon and replicated then the results would be interesting to see. Its certainly a smallish spanner in the works of the ‘autistic enterocolitis’ believers.

Tags:

Politics of Mitochondrial-PDD

15 Aug

For most people reading this blog, the story of Hannah Poling is very familiar. She was diagnosed with a condition called “Mitochondrial-PDD” by Richard Kelley of the Kennedy Kreiger Institute (*according to the document David Kirby blogged)

That, of course, is not what makes her well known. A year ago, I doubt many if any readers here would have heard of Mitochondrial-PDD. What makes her well known is that her case before the Federal Court of Claims (the “vaccine court”) was conceded by the U.S. Department of Health and Human Services (HHS).

What did they say? According to David Kirby’s post:

In sum, DVIC has concluded that the facts of this case meet the statutory criteria for demonstrating that the vaccinations [Hannah Poling] received on July 19, 2000, significantly aggravated an underlying mitochondrial disorder, which predisposed her to deficits in cellular energy metabolism, and manifested as a regressive encephalopathy with features of autism spectrum disorder. Therefore, respondent recommends that compensation be awarded to petitioners in accordance with 42 U.S.C. § 300aa-11(c)(1)(C)(ii).

The HHS conceded that vaccines caused an injury. In specific, the injury was an “aggravation of an underlying mitochondrial disorder”

It’s worth asking a series of questions at this point, I think

Q) Do all mitochondrial disorders result in autistic features or autism?
A) No.

Q) Do all the children in the 30-child study have vaccine injury?
A) No. It appears that Hannah Poling is unique in that group.

Q) Is mitochondrial medicine a highly specialized field?
A) Absolutely.

Q) Are autism doctors/researchers experienced with mitochondrial disorders?
A) Only a few, and not likely to the depth that the mitochondrial doctors/researchers are

Q) Is anyone going to look at the potential role of vaccines with mitochondrial disorders?
A) Yes.

And that is a key point that deserves some extra attention. Dr. Poling in his letter to the NEJM noted that

Also commendable is the new 5-year research plan of the National Vaccine Advisory Committee, which will entail the study of minority subpopulations, including patients with mitochondrial disorders.

In doing so, he cites the Centers for Disease Control and Prevention’s Immunization Safety Office Scientific Agenda: Draft Recommendations.

Which states:

CISA has formed a working group to identify key research questions and consider study methods related to mitochondrial disorders and immunization, in collaboration with partners.

CISA being the “Clinical Immunization Safety Assessment (CISA) Network”

The document further states as the first lines of the first two bullet points under this proposed study:

Mitochondrial disorders are a heterogeneous group of disorders characterized by impaired energy production.

and

Children with mitochondrial disorders commonly present with a range central nervous system findings.

*Again, note that autism/autistic-features are not the only outcome of mitochondrial disorders.

*I think this proposed study is a good idea. The government has conceded a case, mitochondrial doctors state that the question is open as to whether vaccines could be a stressor that causes a metabolic crisis.

People are pushing for this to be a part of the IACC’s Strategic Plan.

Why?

A group of people, experts in vaccine safety studies, are already going to look at the whole question of the potential role vaccines and mitochondrial disorders. Why carve out the even smaller subset with autism? Or, to put it more directly, why call for a second study, and, at the same time, leave out people who don’t have autism?

The answer is simple: politics. People want the idea of vaccine induced autism in the Strategic Plan. To do so, they are willing to ignore the fact that the study is already being planned and, worse, they are willing to sacrifice a large segment of the potential target population.

It’s just not right. Let the correct groups do the correct study. It’s in the planning stage. If people really care about the question of vaccines potentially causing crises in people with metabolic disorders, support the CISA study.

Why do I have a feeling this isn’t going to happen?

* added on edit.

GFCF Double Blind Study

9 Aug

Washington, Aug 8 : In one of the first double-blind, clinical studies, scientists at The University of Texas Health Science Center at Houston will be seeking to determine if gluten and dairy products have a role to play in autistic behaviour, as has long been claimed by parents.

Source

This should be interesting.

Personally, I don’t have much of an issue with the GFCF diet, aside from the lack of evidence supporting it. Regulating someone’s diet is nowhere near as dangerous as chelation or Lupron injections or industrial cleaner being marketed as chelators. But maybe a nutritionist will correct me on that.

I am a little bit worried about a statement attributed to one of the study authors:

A lot of children with autism have gastrointestinal problems such as constipation and diarrhea.

Do they? Is there any actual evidence beyond the anecdotal that backs that statement up? I can’t recall seeing any myself. Not that I’m omniscient on the subject you understand.

We tried our autistic child on the diet shortly after xyr diagnosis and it did absolutely nothing. But then I think we misunderstood it. Xe didn’t have any diet or gastro issues to begin with. We were still in that rather naive ‘must cure at all costs’ phase and there was only a small handful of websites dedicated to autism or autism treatments. Indeed, one of the things that amazes me is how autism has become something of an industry over the five years or so.

Anyway, I’ll be interested to see how this one pans out. How ’bout you?

Jon Poling on Paul Offit

7 Aug

Jon Poling writes a letter in the NEJM that says:

Offit’s remarks about Hannah’s case are not evidence-based. He has no access to my daughter’s personal medical records, legal documents, or affidavits. In contrast, physicians from the Department of Health and Human Services (DHHS) who studied this information recommended that the government concede Hannah’s case. The clinical history Offit presents contains significant inaccuracies, and the resulting conclusions are consequently flawed.

This paragraph lies at the very heart of the mystery surrounding Hannah Poling’s diagnosis, concession and the subsequent media-frenzy.

There are two documents regarding Hannah Poling from which all medical information has been forthcoming.

1) Concession Report (This document has been removed due to the possibility of it being illegally obtained). If people really wish to read the document for themselves it can be founf here, at the Huffington post

2) Zimmerman Case Study

These two documents – and only these two documents – have informed *everyone’s* opinion. Aside from these two documents, there is nothing else (aside from Hannah Poling’s medical records). If anyone believes that not to be the case, I challenge them to either link to them or have the Poling’s release them. The Special Masters have made it very very clear that all that needs to happen for *all* records to be released is for the Poling’s solicitor to write and ask.

….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.

Until the Polings elect to do this very simple action, they have to assume that people will write about what is available. They will also have to put up with the fact that people like me find it very, very suspicious that they repeatedly claim what they simply cannot back up and then refuse to release information that could clear these issues up straight away.

The Case Report contains _all_ the information necessary to make a judgement on whether:

a) Hannah Poling was diagnosed with autism (she was)
b) Hannah Poling was injured by vaccines (she was)
c) Hannah Poling’s autism was caused by vaccines (it was not)

How do I claim point c) as true? Easily. One takes the symptoms listed in the Case Study as being those caused by vaccines and compares them to the DSM (IV) criteria for autism.

fever to 38.9°C
inconsolable crying
irritability
lethargy
refused to walk
waking up multiple times in the night
having episodes of opisthotonus
no longer normally climb stairs
Low-grade intermittent fever
generalized erythematous macular rash
spinning
gaze avoidance
disrupted sleep/wake cycle
perseveration
expressive language was lost
chronic yellow watery diarrhea
appetite remained poor for 6 months
body weight did not increase
decline on a standard growth chart
atopic dermatitis
slow hair growth
generalized mild hypotonia
toe walking
normal tendon reflexes.

I have emboldened the items which match the DSM (IV). I’ve italicised the items which are repeated.

Hannah Poling’s Case Study was authored by four people. One was, of course, Jon Poling. The other authors are:

John Shoffner. In an interview in Scientific American, Shoffer agreed that the scientific evidence presented in the case did not make enough of a case to warrant compensation. He went on to say:

Shoffner notes that parents and advocates looking to impugn vaccines as triggers for autism—or mitochondrial disease—need direct, not just circumstantial, evidence. “If you were sitting in a waiting room full of people and one person suddenly fell ill or died or something,” he says, “would you arrest the person sitting right next to them?”

….

Jon Poling, says Shoffner, has been “muddying the waters” with some of his comments. “There is no precedent for that type of thinking and no data for that type of thinking,” Shoffner says.

Its worth noting that John Shoffner – unlike Jon Poling – is a mitochondrial specialist.

Andrew Zimmerman: When I attempted to get Zimmerman’s comments about the case, I received the following reply:

Dr. Zimmerman…….is not able to publicly discuss this patient. As a participant in this case, the family provided consent for Dr. Zimmerman to share information with the court, but we do not have parental consent to discuss the patient publicly – as we are bound by HIPAA privacy regulations, as in any healthcare setting in the U.S.

Why? If the Poling’s are so very keen to make an _accurate_ case then surely, giving permission to the doctors involved is the first step? What is it they don’t want Zimmerman to say?

Richard E Frye, as far as I know has not made any public statements on this case.

The report from Dr Offit was not inaccurate. It was accurate to the information we have. If there is more information then I ask the Poling’s once more to _release_ it. They are legally able to and if they really believe in what they claim then they should be doing it right now. Why aren’t they?

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