Severe Influenza Among Children and Young Adults with Neurologic and Neurodevelopmental Conditions — Ohio, 2011

17 Feb

Children with neurologic and neurodevelopmental conditions are at increased risk for severe outcomes from influenza, including death. Those aren’t my words. They are the first sentence in a new report by the CDC: Severe Influenza Among Children and Young Adults with Neurologic and Neurodevelopmental Conditions — Ohio, 2011.

Individuals with developmental disabilities are at a higher risk of harm or death from infectious diseases. They are also often more difficult to diagnose due to many factors including difficulties with communication.

The residents included a high percentage of individuals with great challenges. For example, of those with severe infections, nine had “do not resuscitate” orders (the reasons for this is not given).

All 13 residents with severe influenza had severe to profound neurologic and neurodevelopmental disabilities, including physical limitations (e.g., scoliosis, hemiplegia or quadriplegia, or cerebral palsy) (Table 1), and nine had “do not resuscitate” orders.

The story from this Ohio facility is bad on many fronts. An outbreak of influenza swept through the facility. 130 residents total. 76 residents had acute onset of respiratory illness. 13 were severely ill. 10 were hospitalized, and seven died.

All of those severely ill had the influenza vaccine. However, during the investigation it was found that the refrigerator that stored the vaccines was 27 degrees F. If the same temperature was in effect while the vaccines were stored, the low temperature could have inactivated the vaccine.

In other words, these individuals were given vaccines but they could have been rendered useless by the storage conditions.

Here is the abstract:

Children with neurologic and neurodevelopmental conditions are at increased risk for severe outcomes from influenza, including death. In April 2011, the Ohio Department of Health and CDC investigated an influenza outbreak that began in February 2011 in a residential facility for 130 children and young adults with neurologic and neurodevelopmental conditions. This report summarizes the characteristics and clinical courses of 13 severely ill residents with suspected or confirmed influenza; 10 were hospitalized, and seven died. Diagnosis is challenging in this population, and clinicians should consider influenza in patients with neurologic and neurodevelopmental conditions who have respiratory illness or a decline in baseline medical status when influenza is circulating in the community. Prompt testing, early and aggressive antiviral treatment, and antiviral chemoprophylaxis are important for these patients. When influenza is suspected, antiviral treatment should be given as soon as possible after symptom onset, ideally within 48 hours. Treatment should not wait for laboratory confirmation of influenza. During outbreaks, antiviral chemoprophylaxis should be provided to all residents of institutional facilities (e.g., nursing homes and long-term- care facilities), regardless of vaccination status. Residential facilities for patients with neurologic and neurodevelopmental conditions are encouraged to vaccinate all eligible residents and staff members against influenza.

The story notes the relatively low efficacy of the influenza vaccine (about 60%). If the vaccines were compromised by low temperature storage, 60% efficacy could have saved 4 of the seven people. So called “vaccine safety” groups should be calling for more effective vaccines, not downplaying the need for vaccines using the 60% figure.

What are the take-away messages from this? For one, influenza *is* a serious disease. Especially to many in the disability community.

Eugene Hoskins Is His Name

16 Feb

Slate.com has a very interesting story up: Eugene Hoskins Is His Name, The long-forgotten story of a black autistic man in Oxford, Miss., who crossed paths with William Faulkner. The story describes a man from the early 20th century with calendar (and other) savant skills,

“Eugene Hoskins is his name. He lives at Oxford, Miss., a University place of about three thousand people. He is well known about town for his eccentricities.” Thus begins the 1920 account of a 24-year-old black man whose constellation of neuropsychological symptoms—that is to say, his “eccentricities”—are now immediately recognizable as those of an autistic savant. Remarking on his “uncanny knowledge of dates,” the case report relates how “a bystander said to him: ‘I was married on the 8th of June, 1901.’ Without a moment’s hesitation Eugene said: ‘Dat was a Satu’day.’ Given the month, day and year, he will give the day of the week. He never fails, never hesitates. Vary if you will by giving the year and month and asking what day of the month was the second Tuesday, or the fourth Friday—he answers just the same.”

The paper they reference is from 1920. Here is the abstract:

The case of a feeble-minded negro is described. He is chronologically 24 years and mentally between 8 and 9. He has a rather short auditory memory span failing on five digits. He has committed to memory a large array of facts about dates, places and locomotive engine numbers. Given a date—month, year, and day of month—he will give day of week. He cannot go back of 1901 nor forward beyond 1924. Between these limits he never fails. From Psych Bulletin 18:01:00034. (PsycINFO Database Record (c) 2010 APA, all rights reserved)

Not all savants are autsitic. Certainly, not all autistics are savants. But the story is interesting nonetheless.

Follow up on Redwood City special ed teacher story

16 Feb

Last week I wrote about a news story: Redwood City teacher accused of slapping, kicking special needs students. If you are reading this, I would urge you to read two posts by Shannon Des Roches Rosa. On BlogHer: Alleged Special Ed Abuse and the Court of Public Opinion and on Squidalicious: Fair Witness. Ms. Rosa knows the teacher in question quite well.

A Comparison of Urinary Mercury between Children with Autism Spectrum Disorders and Control Children

16 Feb

Researchers are still looking at the question of whether autism is caused by mercury intoxication. One of the measures used in the past is to check the mercury content in the urine of autistic and non autistic children. Claims have been made that autistic children are “poor excretors” of mercury. This is defined as “more mercury in the urine than other children” or “less mercury in the urine of other children”.

A group of researchers from the UK and US have tested a group of autistic children, special needs non autistic children, siblings and regular school children. What did they find? No difference.

Background

Urinary mercury concentrations are used in research exploring mercury exposure. Some theorists have proposed that autism is caused by mercury toxicity. We set out to test whether mercury concentrations in the urine of children with autism were significantly increased or decreased compared to controls or siblings.

Methods

Blinded cohort analyses were carried out on the urine of 56 children with autism spectrum disorders (ASD) compared to their siblings (n = 42) and a control sample of children without ASD in mainstream (n = 121) and special schools (n = 34).
Results

There were no statistically significant differences in creatinine levels, in uncorrected urinary mercury levels or in levels of mercury corrected for creatinine, whether or not the analysis is controlled for age, gender and amalgam fillings.

Conclusions

This study lends no support for the hypothesis of differences in urinary mercury excretion in children with autism compared to other groups. Some of the results, however, do suggest further research in the area may be warranted to replicate this in a larger group and with clear measurement of potential confounding factors.

There were outliers of high mercury content in the special needs children (both autistic and non autistic). Expect those promoting the autism/mercury connection to focus on those children and to build connections between the funding agencies and pharmaceutical companies.

Attorney for Prof. Walker-Smith: alleged link between MMR and autism utterly disproved

14 Feb

Prof. John Walker-Smith was a colleague of Andrew Wakefield, a co-author on the no-retracted 1998 Lancet paper and shared the same fate as Mr. Wakefield after the General Medical Council Hearings: he was struck off the medical register. Prof. Walker-Smith has appealed (Mr. Wakefield did not). A few news stories have come up about this appeal. In Doctor struck off over MMR controversy appeals against ruling, the Guardian notes:

Prof John Walker-Smith tells high court he was denied a fair hearing before he was struck off by the General Medical Council

Many are looking to this appeal for vindication of Mr. Wakefield and his theories on MMR being linked to and causal in autism. Prof. Walker-Smith’s attorney appears to have made a rather clear statement to the contrary:

Miller said it had been important that the disciplinary panel “separate out research from the clinical medicine – but that was a task that appeared to be beyond them”.

The judge asked Miller whether the alleged link between MMR and the vaccine “has now been utterly disproved” in the opinion of “respectable medical opinion”.

Miller said that was “exactly” the position.

edit to add:

I took the statement “The judge asked Miller whether the alleged link between MMR and the vaccine “has now been utterly disproved” ” to be a mistaken report by the Guardian because, as written, it does not make sense. My own interpretation was that the actual question was whether the MMR and *autism* was the point. However, I should have made that assumption very clear in the above piece and I apologize for that. I have written the paper as well as some other people who might be able to clarify the statement.

CBS Pulls Attkisson From CPAC Award Event

10 Feb

Sharyl Attkisson, CBS journalist best known here for her bias towards those promoting autism as a vaccine injury, was slated to accept an award Thursday from Accuracy In Media (AIM). This was discussed on Left Brain/Right Brain recently.

Media Matters is reporting CBS Pulls Attkisson From CPAC Award Event.

CBS still accepted the award, though:

CBS Correspondent Sharyl Attkisson did not appear at the Conservative Political Action Conference today to receive her journalism award from fringe group Accuracy In Media (AIM), despite previous reports that she would speak at the event. Instead, CBS Vice President and Washington Bureau Chief Christopher Isham accepted the award on her behalf.

As one commenter on MediaMatters wrote, this just looks like Ms. Attkisson had better things to do. It would have been good, in my opinion, for CBS to decline the award.

The Panic Virus: now in paperback

9 Feb

The Panic Virus came out just over a year ago. We discussed it on Left Brain/Right Brain (here and here). As one who has spent a great deal of time reading and writing about the autism/vaccine discussion, I found the book to be extremely well researched and very well written.

The author, Seth Mnookin, now teaches science writing at the Massachusetts Institute of Technology (MIT) and writes for the PLoS blogs.

Here is a blurb on the book:

WHO DECIDES WHICH FACTS ARE TRUE?

In 1998 Andrew Wakefield, a British gastroenterologist with a history of self-promotion, published a paper with a shocking allegation: the measles-mumps-rubella vaccine might cause autism. The media seized hold of the story and, in the process, helped to launch one of the most devastating health scares ever. In the years to come Wakefield would be revealed as a profiteer in league with class-action lawyers, and he would eventually lose his medical license. Meanwhile one study after another failed to find any link between childhood vaccines and autism.

Yet the myth that vaccines somehow cause developmental disorders lives on. Despite the lack of corroborating evidence, it has been popularized by media personalities such as Oprah Winfrey and Jenny McCarthy and legitimized by journalists who claim that they are just being fair to “both sides” of an issue about which there is little debate. Meanwhile millions of dollars have been diverted from potential breakthroughs in autism research, families have spent their savings on ineffective “miracle cures,” and declining vaccination rates have led to outbreaks of deadly illnesses like Hib, measles, and whooping cough. Most tragic of all is the increasing number of children dying from vaccine-preventable diseases.

In The Panic Virus Seth Mnookin draws on interviews with parents, public-health advocates, scientists, and anti-vaccine activists to tackle a fundamental question: How do we decide what the truth is? The fascinating answer helps explain everything from the persistence of conspiracy theories about 9/11 to the appeal of talk-show hosts who demand that President Obama “prove” he was born in America.

The Panic Virus is a riveting and sometimes heart-breaking medical detective story that explores the limits of rational thought. It is the ultimate cautionary tale for our time.

If you were waiting for paperback to save some money, here’s the Amazon.com link. Other booksellers will have it too.

Autism SA battles for funds

9 Feb

For most within the autism communities, I suspect that charities are chosen with great care. Whether under- or un-employed autistic or a parent concerned about providing for a child, each dollar counts to many of us. But if you will allow me to suggest a charity to consider: Autism South Africa

I was reminded of Autism SA while reading another blog. The Simons Foundation SFARI blog has a discussion of a recent study on Autism in Africa. The study they focus on is Excess of non-verbal cases of autism spectrum disorders presenting to orthodox clinical practice in Africa – a trend possibly resulting from late diagnosis and intervention. On many levels this study is important to me. But, what I’m writing about now is based on a comment:

Things are not improving fast enough. South Africa’s main autism charity, Autism SA, has only two months left if it doesn’t get funds to continue. http://www.sowetanlive.co.za/news/2012/02/08/autism-sa-battles-for-funds The majority of doctors, psychologists and other healthcare practitioners in South Africa and the rest of Africa are not trained to diagnose autism.

Autism South Africa’s website includes a link to how to donate. I just sent a few Rand their way, it’s pretty easy.

Sharyl Attkisson to receive media award

8 Feb

Sharyl Attkisson has been one of the less reliable members of the media when it comes to the autism/vaccine discussion. She promotes the purported link, defended Andrew Wakefield and gave David Kirby (of Evidence of Harm fame) a platform to promote his views.

For example. Recall a few years back when the Hornig study (Lack of Association between Measles Virus Vaccine and Autism with Enteropathy: A Case-Control Study) came out definitively putting to rest the idea that MMR causes autistic regression/GI disease with persistent measles measles infection. Ms. Attkisson wrote a piece, New Study Disproves Vaccine/MMR/Autism Link.

But she didn’t write about the new study or how it disproves the MMR/autism link.

There’s a new study in the Public Library of Science regarding vaccine measles and autism which purports to disprove a vaccine/MMR/autism link.

Also, researchers at ThoughtfulHouse wrote an opposing analysis:

She didn’t discuss the study at all. Instead she linked to printed a press release by (then) Andrew Wakefield’s Thoughtful House.

Readers won’t be surprised that I was dismayed to read that she’s now getting an award. From “Accuracy in Media“, to be given out at the Conservative Political Action Conference.

Dismayed that is until I saw what “Accuracy” in Media has as a track record.

Here’s a particularly egregious example of an article from an “Accuracy in Media” “report“:

Repealing the ban on open homosexuals serving in the U.S. military would be a mistake of historic proportions but the mainstream media are turning a blind eye.

The intro is bad enough. The discussion worse. Why? Well, the author of that hate piece is

Dr. Scott Lively, a Massachusetts attorney and pastor, is co-author, along with Kevin E. Abrams, of The Pink Swastika: Homosexuality in the Nazi Party.

Yes. The Nazis were gay. How does the saying go, you can’t parody a farce? Read more examples of AIM’s “accuracy”in CBS To Receive Award From Fringe Group At CPAC. With links to AIM’s support of the Birthers and other outlandish claims against President Obama.

Well, this farcical organization is going to “honor” Sharyl Attkisson. I guess there is something worse than getting a “Gallileo” award from the Age of Autism.

Redwood City teacher accused of slapping, kicking special needs students

7 Feb

This by way of the Sam Jose Mercury News: Redwood City teacher accused of slapping, kicking special needs students

If the title of the news story isn’t enough, here are some details:

A Redwood City special needs teacher faces nine misdemeanor charges for allegedly slapping, kicking and refusing food and drink to two developmentally disabled boys at Roosevelt Elementary School, a prosecutor said.
The boys were part of a special education pre-school class taught by Alexia Aliki Bogdis, 43, of Millbrae and had been abused between December and January, said San Mateo County Chief Deputy District Attorney Karen Guidotti. One of the boys was slapped in face and kicked in the stomach, while the other had bumped into a table after the teacher kicked his chair, had his wrist twisted and was deprived of food and drink, she added.

You can read the whole story at the mercury news. Frankly I have a hard time expressing the outrage I feel at these stories.

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