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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).

Dr. Rust testifies in the Autism Omnibus Hearing

22 May

Today Dr. Robert Rust testified in the thimerosal-only causation portion of the Autism Omnibus Proceedings. Dr. Rust also testified in the Hazlehurst case regarding the combined MMR-thimerosal causation hypothesis. You can find Dr. Rust’s testimony in the Hazlehurst case in the Day 3 transcript from that case. Today is “Day 8” of the thimerosal portion so you can look for the “Day 8” mp3 files on the US Federal Court website.

Dr. Rust has some impressive credentials. He is the Thomas E. Worrall, Jr. Professor in Epileptology and Neurology, and Professor of Pediatrics at the University of Virginia. He had a residency in Pediatrics at Yale University and in Child Neurology and neurochemistry at Washington University in St. Louis. He also had a fellowship in Neurochemistry, Neonatal Neurology, and Brain Metabolism, at Washington University. A University of Virginia website says that he has clinical interests in epilepsy, headache, neonatal neurology and degenerative disorders.

Dr. Rust had a lot of material to cover in his testimony. It seemed to me that he was trying to cover a semester or two’s worth of neurodevelopment and neurophysiology in a couple of hours, trying to keep it simple enough for the needs of the court, and yet detailed enough to make some critical points about how neurons, microglia and astroglia work and discussing what is known about regression in autism and what might cause it. He also discussed some of the particulars of the medical records of William Mead and Jordan King. Their main DAN! doctor is Dr. John Green III of Oregon. Dr. Green is a favorite DAN! doctor as was made clear in the testimony by Jordan King’s mother. She said something like seeing Dr. Green was “invitation only.” No doubt. Many of the lab tests discussed were ordered by Dr. Green, and many of the therapies the boys had were ordered or administered by Dr. Green, including one very traumatic IVIG infusion Mr. Mead described his son enduring.

Bogus lab tests are a huge problem in autism “biomedical” therapies. Not that all of the lab tests used by all DAN! (Defeat Autism Now!) doctors are bogus, but it sure seems like many of those that parents share with the public are highly questionable lab tests such as hair analysis for heavy metals, and urine heavy metals lab tests from one particular lab that was mentioned several times in the testimony. For instance, an image of one of these very lab tests was used as an illustration at the top of a blog entry on a certain autism hysteria promoting group blog recently.

When Dr. Mumper testified she commented about how one of the boy’s lab results had this extremely high level of tin while the other metals were in a normal range. (Keeping in mind that the “normal ranges” on these tests are nearly arbitrary and don’t have much to do with real world levels of anything in healthy or sick autistic children.) Dr Mumper acted as if this was not that weird and she said a couple of times, at least, that when they see such a high level of tin in a child she will ask the parents if the kids are eating a lot of toothpaste or drinking a lot of juice from “juice boxes”. She didn’t offer a specific therapy for “tin intoxication”, whereas if mercury had been that high they no doubt would have all been sobbing over the horror of it all. At any rate, Dr. Rust made an interesting point that high levels of tin are almost unheard of and to get a high enough level of tin to affect health, it basically takes a decade or two of working with tin every day where the tin is exposed to heat and is creating tin vapor and a worker is inhaling it. This didn’t reflect well on the quality of that lab’s tests, or on Dr. Mumper’s ability to think critically about such things as lab test results, in my opinion.

The following is a very rough transcript of one portion of Dr. Rust’s testimony that I found very interesting. I don’t know if the Dept. of Justice lawyer was Ms. Renzi, but I think it was, so I’m using her name for the time being. [Edit: The DoJ lawyer was Ms. Esposito, not Ms. Renzi. This portion of the audio transcript is found in the 2nd file on day 9 the following part is found around a 30 minutes into that recording). The words I added in parentheses are not direct quotes but gives the meaning of what was said. I can’t type that fast and so as I was taking notes I didn’t transcribe portions of it word for word, but got the gist.

Ms. Renz Esposito: I’d like to discuss some of the treatments given to these children.

Esposito:: (Can you tell us if) IVIG therapy (is helpful in autism?)

Rust: t’s been tried along with it’s cousin corticosteroids, but no improvement has been seen bahaviorally, functionally or with EEG.

Esposito:: (Can you tell us about the) supplements (given to William Mead and Jordan King?)

Rust: We don’t hear about most of them probably, to the extent that there is data (these supplements don’t help), to the extent that parents tell us what they are using.

Esposito:: Secretin?

Rust: Secretin was found not to be effective

Esposito:: Chelation?

Rust: I’ve seen no evidence that chelation is helpful in this setting…. (recalls when kids with lead poisoning were chelated in a clinic/hospital where he work) considerable pain it caused. Children would be screaming on the way into chelation.

Esposito: Saunas?

Rust: Saunas can help with headaches and stress and tensions but in autism there is nothing to sweat out except some of the notions about treatments that have been offered to the child.

Esposito:: Dr. Green’s therapies…. (for William Mead or Jordan King) included an implantation enema, ideally with a colonic delivery system, using maternal fetal [fecal?] supernate…

Rust: So far as I know that the approach has been around since Roman times, …. used to be a regular feature of childbirth.

Esposito:: Feeding a child fermented vegetables?

Rust: …(doesn’t change autism)…

Esposito: Earthworm eggs?

Rust: No known benefit that I’m aware of. (The discussion changed to something about herbal treatments.) I had a patient with seizures, the parents gave a Chinese herbal (medicine). The Chinese botanical was interesting. We were astonished (the child had a striking improvement in seizures) , we sent a sample of it to a lab and found out it was phenobarbital.

Esposito: Charcoal?

Rust: (No reason to think it would help)

Esposito: Oral baygam (oral immune globulin)?

Rust: I have no information about that.

Esposito: Valtrex?

Rust: I don’t know any reason to think it would work. (a little later he added that Valtrex is a drug used to treat herpes infections.)

Esposito:: Are you familiar with Eskimo oil?

Rust: (slightly amused) No I haven’t heard of that.

Esposito: Actos?

Rust: (I don’t know of any benefit for autism.)

Esposito: If there were a report of improvement would you extrapolate that there was a cause of autism.

…

Esposito: Is it standard practice to prescribe something to patients and then sell it to them?

Russ: (A doctor’s obligation to the patient) is to listen without repeating their problems… (not to sell the patient treatments) … to keep an office of Amway products. It trades on the prestige we have and the reliance that the patients have on us. It is one of the most grave violations of our code of ethics.

Esposito: Do you prescribe these things?

Russ: No …

Esposito: Do other neurologists prescribe these things?

Russ: No …

The “implantation enema” as I understood it, that was recommended by Dr. Green for one of the boys
was a “fecal enema“.

Specifically, again as I understood it, what was recommended was to take some of the boy’s mother’s feces and mix it with water and infuse that into the boy’s colon or something. From Dr. Rust’s response I got the feeling that he didn’t understand that this particular enema wasn’t just a water enema, but that the idea was to put the germs from the mom’s feces into the boy’s intestines.

Now I thought Dr. Rashid Buttar’s urine injections were bizarre. This one ranks right up there, though, for sheer gross-out factor. And how about those “earthworm eggs”? It’s possible that what Ms. Renzi asked about was “whipworm eggs.” Perhaps I heard what she said wrong, but it sounded like “earthworm eggs” [edit: She said “earthworm eggs”]. Taking pig whipworm eggs orally is an alternative therapy for Crohn’s disease, apparently. I remember reading somewhere that a mom asked Dr. Andrew Wakefield what he thought of giving autistic kids worms to treat their gut problems. He was quoted by that mom as saying that he didn’t think it would work for autistic children’s guts.

I encourage everyone to listen to the recordings of the autism omnibus and to read the transcripts, they are very educational. One can learn a lot about the ‘therapies’ being offered to parents of autistic children as well as some of the best of the best of the science that is known about autism. I don’t agree with everything the experts are saying, such as when Dr. Rust called autism a “disease”, but it’s still very interesting listening if you are at all interested in autism.

Autism Omnibus – Liz Mumper

21 May

Elizabeth Mumper is an expert witness for the Petitioners (for the families). She is the medical director for DAN/ARI and founder of the Rimland Centre.

She firmly believes vaccines cause autism.

On Days four and five last week, Mumper testified. Again, there’s little point me going through the Petitioners exam – you can easily guess the content. Where things got interesting was on cross exam.

Again, this is me making notes on the audio so there may be minor errors. I also didn’t get the name of the young man doing the cross exam for the Dept of Justice.

In the expert reports that Mumper prepared for the thiomersal hearings, she stated:

1 in 6 children born today is predicted to have blood levels of mercury high enough to impair neurological development.

And she referenced Stern, 2005 to support that statement.

The DoJ immediately asked her where in the Stern paper that figure was quoted. After 2mins, 01 seconds of which only the noise of someone rifling through a paper could be heard, Mumper stated:

I do not see the 1 in 6 statistic there.

To which the DoJ lawyer asked:

Q: So the Stern paper does not state ‘1 in 6 children born today is predicted to have blood levels of mercury high enough to impair neurological development.’

A: You are correct.

Ouch.

The next question that came Mumpers way was – in fact I’ll do the whole exchange:

Q: Have you ever treated a child for mercury poisoning?

A: No.

Q: What formal training have you received in toxicology?

A: None.

Now wait just a minute – Liz Mumper, medical director of DAN! is stating that _she has never treated a child for acute mercury poisoning???_ Did I miss something here?

There was a lengthy to and fro after this during which ‘autism: a novel form of mercury poisoning‘ was discussed. Mumper squirmed a bit but admitted that it was published by three non-scientists, in a non-peer reviewed journal and that as she put it ‘the science had progressed’ since its publication (which was her way of saying it was dead wrong I think).

The DoJ moved on to a discussion of some of the papers that Mumper used to support her beliefs. Key amongst them were Mady Hornig’s Rain Mouse study and the Nataf Porphyrin study.

Mumpers take on the Hornig paper was fascinating. According to her, the:

…mice got OCD behaviours and they clawed through each others skull…

Now firstly – OCD behaviours? According to every member of the mercury militia worth their salt, Mady’s mice got _autistic_ behaviours. Now, obviously, they didn’t. Everyone from the IOM down (including certain tiara wearing bloggers) pointed out that the behaviours reported by Hornig bore no resemblance to autism. Now here was Mumper confirming that.

Secondly – this skull clawing – why was that raised in court? This behaviour was certainly not part of Hornig’s paper. It smacks of second hand sensationalism.

The DoJ lawyer asked Mumper what her opinion was of the Berman paper that entirely refuted Hornig (‘the present results do not indicate pervasive developmental neurotoxicity following vaccine-level thimerosal injections in SJL mice, and provide little if any support for the hypothesis that thimerosal exposure contributes to the etiology of neurodevelopmental disorders’).

Amazingly, Mumper’s response was that she hadn’t read it! I must admit that when she said that (and yes, you could clearly hear the embarrassment in her voice when she admitted that) I laughed out loud. Aren’t medical directors supposed to keep up to date with science relevant to their ‘areas of expertise’?

The next section concerned the role of the ‘new kid on the black’ – Porphyrins. I’ll quote the initial exchange as near to verbatim as I can.

Q: You order this Porphyrin test in your own practice?

A: Yes.

Q: And do you find them to be a reliable measure of mercury toxicity in autistic patients?

A: *I’m split on that now* because I think that they’re good at showing differential toxicities but the thing that is worrying us now is that we’ve not looked at a lot of control children and we’re starting to do that and *finding that some normal children have abnormal Porphyrins too* .

Again, to those of us who’ve been following these stories, this is not news. However, what _is_ news is to hear the medical director of DAN/ARI confirm that Porphyrins aren’t as useful as touted. Note that although she knows she’s getting false positives she’s still ordering the tests.

There was some back and forth at that point as to why Mumper thought that the Porphyrin test wasn’t very accurate. She says she thinks it is because the control in the Nataf paper were French and Swiss and that US kids are ‘environmentally and genetically different’.

Could be. But, as Prometheus pointed out when we talked about this via email:

Now, if Swiss and French kids are “…too genetically different…” from US (and presumably UK) children for something as simple (and reportedly reliable) as the “porphyrin profile” to work, then what about the Amish?

Which is an excellent point. Its an established fact that the Amish _are_ genetically different. They’re also certainly environmentally different. I guess that doesn’t matter though.

DoJ wrapped up day four by asking:

Q: Porphyrins do not provide any evidence that mercury is in the brain, is that correct?

A: That’s correct.

On day five, DoJ played a little dirty. Bearing in mind that Mumper had said on day four that she was ‘split’ on the efficacy of the Porphyrin test, DoJ asked her to read out sworn testimony she had given in a separate case in Jan/Aug 2007:

Probably the most helpful test to me now is the Porphyrin test….

Which direct contradiction of yesterdays testimony was embarrassing enough, but she then went on to say (in 2007) that:

….it actually looked at the impact of ethyl mercury….

When on day four she had testified that it did no such thing.

All in all, DoJ made Mumper look very unsure. They tripped her up factually any number of times and led her into making statements (never treated mercury poisoning!) that I’m pretty sure she would not really have wanted to make.

New blog worth following

20 May

I don’t usually make recommendations about new blogs. Not because I’m above all that – course I’m not – but mostly because so many people have their set ideas about what makes a good blog and they don’t need me pushing my opinions on them.

But this is a little different. Its the first blog I’ve seen that concentrates on epidemiology and is written by someone who:

…has a Ph.D. in epidemiology from an Ivy League university. Before that I got a bachelor’s degree from a different Ivy League college, a master’s degree in developmental psychology, and a master’s degree in medical sociology from another Ivy League University. I worked for more than 30 years as an epidemiology professor in medical academia and schools of public health, and in the senior biomedical research service at the Centers for Disease for Disease Control and Prevention (CDC). During my career I have been the editor of two epidemiology journals and one more general biomedical journal.

Thats some pretty impressive credentials.

I wouldn’t (and I doubt Epi would either) claim that the blog is about autism or vaccines, or autism related science but the two posts I’ve read that have discussed autism have been clear, concise and easy for non-experts to parse.

So, I hope that Epi will continue to blog tangentially about autism from time to time as there are big issues surrounding autism epidemiology that we could all learn about. But more than that I plan on reading Epi’s blog on a regular basis in order to learn.

That’s not to say I expect to become an epidemiology expert simply by reading a blog! Of course not. But that doesn’t preclude me from being able to hopefully discern from an expert what is important in epidemiological studies and what is not.

I would _love_ to see Epi turn her attention to some of the Geier’s epidemiological studies for example. I think we all might learn a lot from a detailed critique of that particular body of work!

I’d also like to see Epi’s opinion on some of the epidemiological studies being utilised in the Autism Omnibus hearings. As we’ve all seen, the epidemiological basis on the autism/vaccine hypothesis seems to have undergone a substantive revision of late. I’d like to see a professionals take on it.

Best of all though? The name Epi Wonk. It reminds me of Wonko The Sane from ‘So Long and Thanks For All The Fish”. Anyone that sounds that much like a man who believes he’s living in a perpetual lunatic asylum can’t be all bad 😉

So – visit Epi Wonk, see what you think.

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.

No such thing as a genetic epidemic

15 May

Since the Autism Omnibus started up again, I’ve been talking about how the Petitioners have pulled the tablecloth out from under the feet of the mercury militia. Its been a mainstay of the militia that there has been an epidemic of autism since the early 1990’s, caused by vaccines, most notably thiomersal and MMR (hence the strapline of mercury militia bible Evidence of Harm – Mercury in Vaccines and the Autism Epidemic and the ‘M’ in SafeMinds (Sensible Action For Ending Mercury -Induced Neurological Disorders).

In fact, lets be clear, SafeMinds believe in an Autism Epidemic, Generation Rescue believe in an Autism Epidemic, the NAA believe in an Autism Epidemic, Jenny McCarthy believes in an Autism Epidemic.

And yet this week, we had petitioners expert witness (i.e. _for the families_) in the autism omnibus destroying the idea of an epidemic. According to him, the number of children throughout the 1990’s/early noughties was in the hundreds.

That’s ‘hundreds’ from a population of 40 million.

He went on to say:

Q: So if the risk is confined to that group, clearly regressive autism, are you assuming then that there is no elevated risk to any other group – any other cases of autism?

A: In the calculations I made, yes.

This is a deliberate strategy on behalf on Petitioners. They want to destroy the idea that all the epidemiological evidence regarding autism and vaccines has shown thus far – that there is no association between autism and any vaccine. They cannot challenge the quality of the science itself so they have moved the goal posts. They are now saying _not_ that vaccines cause autism, but that _some_ vaccines _may_ cause autism in a population of children so tiny it cannot be detected by epidemiology.

That is in direct opposition to the very idea of an autism epidemic which, by definition, must be large and ‘unmissable’ – a tsunami of autism.

Amusingly, the beloved science editor of the Age of Autism blog decided the best way to deal with _his own sides_ expert testimony was to pretend it had never happened.

‘You cannot have a genetic epidemic’ – that’s another mainstay of the mercury militia. The idea that there has been an epidemic is used to support the idea that genes play a small, negligible role in autism (if they play a role at all) because ‘you cannot have a genetic epidemic’ and as we all know there has been au autism epidemic right? Therefore, genees can’t have played any role _in_ that epidemic.

Except that the families in the Autism Omnibus are now relying almost totally on the idea that there never _was_ an autism epidemic.

The genetic role in autism science came to the fore again yesterday when Yale announced a new study that found Genetic links to impaired social behavior in autism:

With the help of Yale’s Autism Center of Excellence, led by Drs. Ami Klin and Fred Volkmar, and many families of individuals with ASD, we have registered a possible association between some of the genes identified in animal studies as controlling affiliative behaviors in ASD.” The strongest statistical findings of the study implicate the prolactin gene, the prolactin receptor gene, and the oxytocin receptor gene in these affiliative behavior deficits.

I haven’t read the paper yet (and I’ll probably need help to understand all the highly technical gene talk) but I’ll probably have nore to say once I have. For now, its interesting that in the week that expert witness for the families in the Autism Omnibus gutted the epidemic hypothesis, yet another study was released linking genes to autism.

Autism Omnibus – Petitioners suggest new prevalence

14 May

As noted by Ms Clark yesterday, petitioners in the current Autism Omnibus hearing are redefining the terms of the so called ‘epidemic’ to proportions that would’ve been unthinkable to any card-carrying mercury militia member at the start of this year.

And as I noted yesterday, not only is the ‘epidemic’ (so long a standard of the vaccine hypotheses) being seriously watered down, so is the very definition of who can claim status as a member of the vaccine-induced-autism club.

And this is not as a result of any utterance by anybody on respondents (HHS) side – this is all direct from the mouths of the Petitioners legal team and their experts. Truly amazing.

The audio files were posted yesterday (please note that despite everything being linked, as of right now, only Day 1 audio files are actually present for download) so I could finally hear some of what was being said for myself. I haven’t listened to the whole thing yet but I wanted to hear more about what I posted yesterday – the fact that Petitioners are now claiming that thiomersal induced autism (assuming it exists at all) accounts for such a small proportion of autism that it is not detectable using epidemiology.

Dr Greenland says (and this is all on Day 1 File 1 – I ain’t going to transcribe it exactly!) that the figures Petitioners are talking about represent a sub-group of regressive autism he terms ‘clearly regressive autism’ (this is also mentioned in his report which I linked to in the post I made yesterday). And of course regressive autism itself is a sub group of autism. According to Greenland, the figures are:

Regressive autism: 28% of autism1.
Clearly regressive autism: 20% of regressive autism
Therefore, clearly regressive autism: (approx) 6% of autism

Now, when we translate this to what the vaccine hypothesis believers like to call ‘proper’ autism (by which I assume they mean classic/low functioning) we get this:

Classical/LF autism: 33% of ASD (based on Fombonne data again).
So, ‘clearly regressive autism’ is 6% of 33% of ASD.

Or in other words, Petitioners ‘clearly regressive autism’ accounts for approx 2% of all ASD.

I can’t say it often enough. This is the expert report of an expert testifying for petitioners. Amazing.

And lets also bear in mind that Greenland is not claiming that *all* ‘clearly regressive autism’ cases are caused by thiomersal. He’s saying that this is the numerical size of the group Petitioners claim *contain* those injured by vaccines, resulting in autism.

So, when we translate that to actual numbers what do we get?

According to CDC, we can estimate that 560,000 children (0 – 21) have an ASD. Using Greenland’s data we can see that:

2% of 560000 = 11,200 people aged between 0 and 21 have ‘clearly regressive autism’.

Based on the data on the front page of census.gov, there are 304,079,911 American citizens as of right now. The child population of which is 25% or 76,019,961.5.

Therefore, according to Petitioners expert witness, the ‘clearly regressive autism’ (aka autism-caused-by-thiomersal) population percentage of the US is *0.015%*.

Tsunami? Hardly.

1] interesting point to note – this is based on Fombonne’s work. Who would’ve thought we’d ever see Fombonne’s data being used to support Petitioners?

PS – maths is not my strong point. Feel free to double check and point out errors/fixes.

Presto Chango

12 May

Now, there’s nothing wrong with making a mistake. Nothing at all. People make mistakes all the time – as I saw on the back of a window cleaners van the other day – ‘guano happens’.

For a trivial mistake (spelling etc) its easy to change things on a blog. I can simply edit and re-save the post. I don’t need to tell anyone my Bluto sized fingers have typed ‘teh’ instead of ‘the’ again. I can just change it and republish.

However, sometimes, you make a mistake that is rather more important. A mistake that changes the factual interpretation _and_ the tone of a post. These should be altered _and_ a little note be made close to the alteration to point out the error and the fact its fixed. Trying to get away with making such large scale errors and hoping no one notices is bad form.

If one is a journalist – a professional writer – you would expect the notification as a matter of course. Don’t journalists pride themselves on their accuracy and attention to detail?

So it was something of a surprise to see that the article Sullivan discussed written by David Kirby had undergone a mysterious and totally unremarked upon alteration.

This (click for larger image and then use your browsers ‘back’ button to return here after viewing) is the original post David made on the Huffington Post. The page was recovered from Google Cache. As you can see, this contains the erroneous ‘34,000’ figure and all that flows from it. The maths error that Sullivan noted.

However, visiting the Huffington Post post today reveals the following:

.

(Again, click for bigger).

As we can see, the post has undergone very significant change of a key part of important factual information. With no (that I can see) notification that the data has been altered. I took a screen shot of the entire page as of 09:43 on Mon 12th May 2008 and couldn’t see such a notification. Maybe someone else can see one?

Tut tut.

However, even more curiously, the same article David posted at the Age of Autism blog still contains the error.

(Again, click for bigger).

Why? Are AoA readers less interested in facts? Is David too busy packing for his trip over here in June (which I am _very_ much looking forward to by the way)?

Enforced Vaccination

11 May

I don’t like this, I really don’t.

I know I advocate for the undoubted and scientifically established benefits of vaccination and will continue to do so, but the news that the influential Fabian Society have recommended a policy of enforced vaccination is not good.

In an article for the Fabian Society, leading public health expert Sir Sandy Macara called for child benefit to be linked with vaccination uptake.

And Labour MP Mary Creagh said children should have to prove they are vaccinated before they start school to improve uptake of MMR.

Call for vaccine opt-out penalty

I’m all up for improving the uptake of MMR, I think that is a worthy and vital goal. But is this – educationally and financially punishing children – the right way to do it? Because make no mistake, the parents won’t particularly care that their kids are home schooled. And the type of parent who doesn’t vaccinate (wealthy, white middle class) won’t miss the child benefit. But the child at the heart of these penalties may well miss scholastic education. As a home schoolers ourselves (less through choice than lack of any other option) one of the things we are keenly aware our child misses is the company of her peers in an educational setting.

For those who don’t know, the Fabian Society is a ‘middle-left’ think tank that recommends policy to Labour Party members, particularly influential whilst we have a Labour government (as we do now). They reached this recommendation apparently after:

A poll by YouGov for the Fabian Society suggested that the public would back government action on MMR to address large rises in mumps and measles’ cases. It found that 63% of the public felt that immunisation only worked if everyone was covered, and only 31%felt if was purely up to families to make the choice.

MMR press release

YouGov are a well thought-of (in terms of results accuracy) market research agency. I’ve little doubt the figures they collected are correct. I still don’t like it though. I think that something needs to be done, but this? The penalties seem targeted to ‘hit’ the kids. It also seems tantamount to admitting that attempts to utilise the excellent, freely available science that has killed the MMR hypothesis is pointless.

I’m also frankly disturbed by this quote from Fabian review author Sir Sandy Macara:

One ought to recognise that mothers have a responsibility for ensuring their children are protected.

Mothers? Not parents?

This seems ill thought out, knee-jerk-ish and guaranteed to play into the hands of the conspiracy theorists. We need to do better – much better – than this.

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