MMR fraud needs parliamentary inquiry, says BMJ, as new information puts spotlight on Wakefield’s co-authors

9 Nov

The British Medical Journal (BMJ) has published another set of articles on Andrew Wakefield’s research. In this case, the discussion focuses on the original histopathology report/scoring sheets from Prof. Dhillon (co-author on the original Lancet article). Four articles are presented. A special report by investigative journalist Brian Deer (Pathology reports solve new bowel disease riddle), an editorial by BMJ editor Fiona Godlee (Failings over the MMR scare may need parliamentary inquiry), a commentary by Ingvar Bjarnason, professor of digestive diseases, consultant physician and gastroenterologist, King’s College Hospital, London (Commentary: We came to an overwhelming and uniform opinion that these reports do not show colitis) and another commentary by Karel Geboes, professor of Pathology KU Leuven (I see no convincing evidence of enterocolitis, colitis, or a unique disease process).

The first sentence of Mr. Wakefield’s now retracted 1998 Lancet article was “Background We investigated a consecutive series of children with chronic enterocolitis and regressive developmental disorder. ” Based on review of these newly released reports, there is “not convincing evidence of enterocolitis” or colitis at all.

Below is the press release for this set of articles in BMJ:

MMR fraud needs parliamentary inquiry, says BMJ, as new information puts spotlight on Wakefield’s co-authors

Editorial: Failings over the MMR scare may need parliamentary inquiry
Special report: Pathology reports solve new bowel disease riddle
Commentary: We came to an overwhelming and uniform opinion that these reports do not show colitis
Commentary: I see no convincing evidence of enterocolitis, colitis, or a unique disease process

Britain s leading medical journal, the BMJ, is calling on MPs to launch a parliamentary inquiry into research which claimed that the MMR vaccine causes autism and bowel disease, following extraordinary new disclosures about what it calls the elaborate fraud behind the work of Andrew Wakefield.

In an editorial in the journal, BMJ editor-in-chief Dr Fiona Godlee says that at least six further research papers by Wakefield require independent investigation and that at least six former senior figures at the London medical school where the work was carried out may have a case to answer over their involvement.

In a letter sent to Andrew Miller MP, chair of the House of Commons committee on science and technology, Dr Godlee says that if University College London, where Wakefield worked, does not immediately convene an independent inquiry into the Wakefield affair, then parliament must intervene.

“Institutional misconduct is too important to be left to the institutions themselves,” she says.

In May 2010, Wakefield, formerly a researcher at the Royal Free medical school in Hampstead, north London, was struck off the medical register over a raft of charges, including dishonesty in research published in the Lancet in 1998. And last January, the BMJ concluded that his claims linking MMR vaccine with autism and bowel disease were an elaborate fraud.

Now, the journal publishes further revelations about the research, removing any remaining credibility to the claim that Wakefield and his co-authors had discovered a new inflammatory bowel disease associated with MMR. Experts studying unpublished raw data submitted to the BMJ with a view to exonerating Wakefield say it provides no evidence of such disease and that almost entirely normal findings were misreported in the Lancet paper.

Published in February 1998, the paper claimed that 8 of 12 children with brain problems seen at the Royal Free hospital developed autism within days of MMR, and that 11 of the 12 had colitis. The paper triggered a decade-long storm of public anxiety, plummeting levels of vaccination, and the re-emergence of measles as an endemic disease in Britain and elsewhere.

This new information does nothing to exonerate Wakefield of fraud but nor does it reflect well on his 12 authors, says Godlee. “It is impossible to reconcile [the new data] with what was published in the Lancet. The paper talks of enterocolitis and a new bowel disease involving a putative unique disease process. How could two consultant histopathologists have reported healthy biopsies and then put their names to such a text?”

The BMJ has been at the forefront of investigating the MMR scare, and earlier this year Dr Godlee wrote to University College London reporting six more papers involving Wakefield which have aroused concerns. She believes that a continuing failure to get to the bottom of the vaccine scandal raises serious questions about the prevailing culture of our academic institutions and attitudes to the integrity of their output. Given the extent of involvement of senior personnel at the highest level, only an independent inquiry will be credible, she says.

“This is not a call to debate whether MMR causes autism,” says Godlee. “Science has asked that question and answered it. We need to know what happened in this inglorious chapter in medicine. Who did what, and why?”

In an accompanying feature article published on bmj.com today, investigative journalist Brian Deer explains what the latest revelations add to our knowledge of the Wakefield saga. He also reveals that UCL included Wakefield s claims – not once but twice – in its submission to the UK s research assessment exercise as part of a bid for money.

“If UCL does not immediately initiate an externally-led review of its role in the vaccine scare, we believe that parliament should do it,” concludes Godlee. “After the effort and time it has taken to crack the secrets of the MMR scare, and the enormous harm it has caused to public health, it would compound the scandal not to heed the warnings from this catastrophic example of wrongdoing.”

Contacts:
Fiona Godlee, Editor-in-Chief, BMJ, London, UK

A reader request that won’t be honored

8 Nov

The idea that the anthrax vaccine should be tested on children in case it is needed in the future following a bioterrorism attack is controversial.

I was waiting to see how the age of autism blog would cover this. I knew it would be tricky for them given one fact (discussed below). They dodged it. Ignored it. And, yet, a bit of unkown irony showed up in the comments:

It is to be noted that mainstream medicine never seems to search for any method for stopping an infectious organism – other than a vaccine. Now, why is that, I wonder. After all, infections are caused by living, reproducing organisms, so there should be a variety of possible ways to decrease spread, stop reproduction, or inhibit life processes. For example, if I get a boil (carbuncle), I dont think of a vaccine or a medication. I simply apply hot water compresses for a few days and the boil fails to develope- no doubt because the heat does not agree with the organism.
Apparently, the anthrax organism responds very readily to certain antibiotics, therefore, it would seem that what we really need is simply a quick diagnostic test and the appropriate antibiotics readily available .
But as we all know, its more about drug company profits from vaccines, than about maintaining health.
My request is that AOA publish the photos of those individuals who have spoken against the vaccine trials- and put a blue ribbon under each photo.

Let’s leave aside the fact that the above comment isn’t even self consistent (the author claims medicine doesn’t look for methods other than vaccines to prevent illness and then with no sense of irony talks about antibiotics)

my request is that AOA publish the photos of those individuals who have spoken against the vaccine trials- and put a blue ribbon under each photo.

Who is amongst those who spoke put against the vaccine trial?

Paul Offit

“I don’t see how you can ethically do a study on a child where there is no chance the child benefits from that study,” says Paul Offit, an infectious disease specialist at the Children’s Hospital of Philadelphia in Pennsylvania, who often speaks out in favor of childhood vaccination. Offit attended one of the meetings of the working group and spoke out against a study. “I didn’t prevail,” he says.

I’ll check back to AoA in a couple of days for his picture with a blue ribbon. 😉

Judge denies request for new trial from woman convicted of killing her autistic daughter

8 Nov

Karen McCarron will likey not be getting a new trial on appeal. This from an associated press story:

Pekin, Ill. — A judge in central Illinois has denied a request for a new trial from a woman convicted in the suffocation death of her autistic 3-year-old daughter.

Tazewell County Judge Stuart Borden wasn’t swayed by lawyers for Karen McCarron, who argued that her trial attorney wasn’t effective. They contend the attorney should have let McCarron explain that she killed the girl because she suffered from a “religious delusion” that the child would rise from the dead without autism.

The Pekin Daily Times (http://bit.ly/vI1eUP) reports Borden ruled last week that there’s no evidence the attorney was ineffective. He also dismissed claims that the trial attorney was impaired by alcohol, calling that “completely spurious.”

McCarron is serving a 36-year prison term. She suffocated Katie McCarron with a plastic bag in May 2006.

and this story from PekinTimes.com 9with apologies for copying it in total):

With precision aim, a Tazewell County judge this week shot down every argument Karen McCarron raised in her latest effort to win a new trial for her killing of her young autistic daughter.

Unless an appellate court disagrees with him, McCarron, 42, formerly of Morton, will continue serving her 36-year prison term for suffocating 3-year-old Katie McCarron with a plastic bag in May 2006.

McCarron, through attorney Karla Fischer of Champaign, hoped to convince Circuit Judge Stuart Borden that her constitutional rights were breached by the ineptitude of her trial attorney because he never enabled her to explain that she killed Katie with the supposed “religious delusion” that the girl would rise from the dead without autism.

There is no evidence of that, Borden said in his ruling Wednesday that granted prosecutors’ motion to dismiss McCarron’s request for post-conviction relief.

The work of Chicago-area attorney Marc Wolfe in her defense “did not fall below an objective standard of reasonableness,” Borden said. Even if it did, “it certainly did not result in actual prejudice” against McCarron.

McCarron, a forensic pathologist, said after killing her daughter that she hated autism, blamed herself for causing it in Katie and believed Katie would not suffer from it in heaven.

An insanity defense raised in trial made no mention of religious delusions that Jesus would reawaken Katie without autism. Her jury found her guilty of first-degree murder in January 2008.

Borden also dismissed Fischer’s claim that Wolfe was impaired by alcohol during the case as “completely spurious and unsupported by the record.”

(note: this was edited shortly after first being published)

Want a lollypop with free chickenpox virus?

7 Nov

No, there isn’t some company which has some manufacturing contamination infecting kids. Instead, this is a response by people who want to set up “chickenpox parties” but can’t. The vaccine has been rather successful, you see, and one can’t find neighborhood kids sick with chickenpox. So, via the magic of the internet, parents are striking the deal and sending lollypops (and other items) which are only slightly “used” by their chickenpox infected children.

Yes, sick kids are slobbering on candy and their parents are sending them to other parents.

I’m a little late to this pox-party, so here’s some full discussions:

Emily at The Biology files as The antivax women who mail pox: Who are they?

Mike the Mad Biologist in ‘Pox Parties’ and Bioterrorism

Aitiology and Chickenpox parties–just a Facebook friend away

ToddW (Hapocrates Speaks) in Pox by Post.

Besides being strange, and a bad idea, it’s also illegal to ship infectious material through the mail. The same people who complain that vaccines are “biological wastes” if disposed of have no problems sending infectious agents in the post.

It doesn’t stop with chicken pox. Measles, mumps, rubella.

Remember the “why do we vaccinate children against hepatitis B? Kids are sexually active or using needles.” Well, how about sharing lollipops with an infected kid? HepB is blood borne. Unlike HIV, HepB can live outside the body for a considerable time. But, hey, so what if a kid gets an extra infection or two from a stranger’s lollipop? It’s natural immunity, right?

Another question: when do the parents who have subjected their kids to “pox parties” or the slobber of random strangers through the mail, when do these people quarantine their children?

There’s a lot of uncertainty as to when a child will be contagious after exposure.

When Is a Person Contagious?
A person with chickenpox is contagious 1-2 days before the rash appears and until all blisters have formed scabs.

It takes between 10 and 21 days after contact with an infected person for someone to develop chickenpox.

So, somewhere between 8 and 20 days after exposure, the child will be contagious. And a danger to other children and people with compromised immune systems.

Unless these parents quarantine their children starting from 8 days after exposure, they are “inviting” everyone they meet to a special “pox party”. Nice, huh?

The Prevalence of Autism Spectrum Disorders in Toddlers: A Population Study of 2-Year-Old Swedish Children.

6 Nov

A recent study, The Prevalence of Autism Spectrum Disorders in Toddlers: A Population Study of 2-Year-Old Swedish Children, considers changes in prevalence in very young children and the effect of early screening:

Autism Spectrum Disorder (ASD) is more common than previously believed. ASD is increasingly diagnosed at very young ages. We report estimated ASD prevalence rates from a population study of 2-year-old children conducted in 2010 in Gothenburg, Sweden. Screening for ASD had been introduced at all child health centers at child age 21/2 years. All children with suspected ASD were referred for evaluation to one center, serving the whole city of Gothenburg. The prevalence for all 2-year-olds referred in 2010 and diagnosed with ASD was 0.80%. Corresponding rates for 2-year-olds referred to the center in 2000 and 2005 (when no population screening occurred) were 0.18 and 0.04%. Results suggest that early screening contributes to a large increase in diagnosed ASD cases.

The prevalence for this young age group in Gothenburg Sweden showed a dramatic rise: from 0.04% in the year 2000, to 0.18% in 2005 and a big jump to 0.80% in 2010.

I’m sure many things have changed in Gothenburg in the past 10 years. However, the implementation of an early screening program is cited as having the major impact, as this was in place in 2010, but not for 2005 or 2000.

For those who will undoubtedly ask: the vaccine schedule for Sweden did not change remarkably in that time period.

2007: A revised schedule is implemented from 2007, including a diphtheria-tetanus-pertussis booster at school entry (DTaP) and at school leaving (dTap), and also a lower age for the second MMR (6-8 years). The new schedule starts with children born from 2002. Children born 1995-2001 receive a single dose pertussis catch-up in form of DTaP instead of DT at 10 years.

2009: PCV7 was introduced into the national childhood vaccination programme and recommended at 3, 5 and 12 months of age to all children born from October 2008 onwards.

2010: HPV introduced into the national childhood vaccination programme on 1st January 2010.

The 2007 change doesn’t affect children 2 1/2 and under. The 2009 addition of PCV7 doesn’t affect the children in 2005, where the prevalence was over 4 times higher than in 2000. HPV doesn’t affect children aged 2 1/2. Thimerosal was removed from vaccines in Sweden in the early 1990’s, so that exposure was unchanged over the entire period. My guess is this won’t stop people from pointing to the PCV7 vaccine as the “toxic tipping point” for Swedish kids.

Call me biased. I’m going with the authors on this one and giving credit to the hard work of the screening program implemented.

Nature: Special issue on neuroscience: The autism enigma

5 Nov

The journal Nature has a special focus issue this week on autism. They introduce the issue in: Special issue on neuroscience: The autism enigma with the subtitle “Diagnoses and research funding are rising, but much about autism remains a puzzle. Nature seeks some truths.”

Articles in the issue include:

The mind’s tangled web (“Efforts to elucidate how genes and the environment shape the development of autism, although making progress, still fall far short of their goal.”)

The prevalence puzzle: Autism counts (“Shifting diagnoses and heightened awareness explain only part of the apparent rise in autism. Scientists are struggling to explain the rest.”)

Scientists and autism: When geeks meet (“Psychologist Simon Baron-Cohen thinks scientists and engineers could be more likely to have a child with autism. Some researchers say the proof isn’t there.”)

Changing perceptions: The power of autism (“Recent data — and personal experience — suggest that autism can be an advantage in some spheres, including science, says Laurent Mottron.”)

and:

Autism’s fight for facts: A voice for science (“Convinced by the evidence that vaccines do not cause autism, Alison Singer started a research foundation that pledges to put science first.”)

With a link to Nature’s autism page: www.nature.com/autism.

AAP asks Delta Air Lines to reconsider NVIC ads

5 Nov

The National Vaccine Information Center (NVIC) is an organization which has been highly critical of vaccines. They have helped to keep the “vaccine induced autism epidemic” alive. They have not only supported, but awarded Andrew Wakefield, the doctor whose misconduct in his research lost him his license to practise medicine. With no sense of irony, NVIC presented Mr. Wakefield with the “Humanitarian Award” for “his compassion, brave spirit and uncompromising commitment to improving the health of children and the biological integrity of future generations.” One board member for NVIC wrote John Stossel with her opinion: “Vaccines are a holocaust of poison on our children’s brains and immune systems.”

Recently, NVIC has placed advertisements in the in-flight entertainment for Delta Air Lines for the holiday season. By NVIC standards, their ad is rather mild. The vaccine fear angle is not prominent, with the focus more on downplaying the need for the flu vaccine.

The American Academy of Pediatrics has sent a letter to the CEO of Delta asking them to reconsider the decision to accept the NVIC advertisement:

November 4, 2011

Richard Anderson
Chief Executive Officer
Delta Air Lines

Dear Mr. Anderson,

The American Academy of Pediatrics (AAP) objects to the paid advertisement/public service message from the National Vaccine Information Center (NVIC) being shown throughout the month of November on Delta’s in-flight programming. The ad urges viewers to become informed about influenza and how to stay well during the flu season without resorting to the influenza vaccine.

While hand washing and covering sneezes are parts of a larger strategy to prevent the spread of influenza, influenza vaccine continues to be the best way to protect against the disease. It is especially important in enclosed settings where disease droplets can easily spread to passengers sitting in close quarters, especially infants and children and those with special health care needs.

The AAP and many other child health organizations have worked hard to protect children and their families from unfounded and unscientific misinformation regarding vaccine safety. The influenza vaccine is safe and effective.

By providing advertising space to an organization like the NVIC, which opposes the nation’s recommended childhood immunization schedule and promotes the unscientific practice of delaying or skipping vaccines altogether, you are putting the lives of children at risk, leaving them unprotected from vaccine-preventable diseases. Diseases like influenza can have serious consequences. From September 2010 to August 2011, 115 children died from influenza disease, most of whom were unvaccinated.

The AAP’s 60,000 member pediatricians urge you to remove these harmful messages, which fail to inform the public about the safety and efficacy of influenza vaccine. Please do your part to help reassure parents that vaccinating their children is the best way to protect them from influenza disease, particularly during this busy travel season.

Autism parent’s listening day

1 Nov

Just as there shouldn’t be any one “Autistics Speaking day” (ASDay), there shouldn’t be any one “autism parent’s listening day”. That said, since this is “Autistics Speaking Day“, and I’m not autistic, I felt I would contribute by listening.

My guess is that Liz Ditz at I Speak of Dreams may compile a list of contributions from around the web in addition to those contributions on Autistics Speaking Day. As such, I’ll try to link to those sites. Julian Frost, over at AutismJungle, has the advantage of time zones and one of the first ASDay posts, Autistics’ Speaking Day: My Sense of Humour. I look forward to more ASDay posts.

Tomorrow: Autistics Speaking Day

31 Oct

In a great response to a bad event last year, Corina Becker sparked “Autistics Speaking Day”. From her post: “On November 1, there is an Autism awareness campaign called Communitcation Shutdown, whereas people are encouraged to stay off Twitter and Facebook for the day in order to promote an awareness of the communication difficulties that Autistics face. ”

Read the full post, and the many that followed it, for a discussion of why “Communication Shutdown” was such a bad idea. I’m glad that a year later “communication shutdown” is gone, but autistics speaking day is not.

From the website:

To raising Autism awareness and Acceptance, and battling negative stereotypes about Autism. To advocate for the inclusion of Autistic people in the community. To offer a forum to broadcast their voices, and to help the messages of Autistic people and non-Austistic allies reach the ears of as many people as possible.

From the FAQ:

Q. What do we do on ASDay?
A. The plan is that on November 1st social networking sites like Facebook, Tumblr, Twitter, as well as YouTube and blogging sites will see a huge increase in the posts of autistic people. We will post links to as many of these as we can to share the works of the autistic people. Our hope is that this will help promote autism awareness and autism acceptance. If you are a blogger or own a website, you can write a post on or around November 1st for Autistics Speaking Day and we will share the posts through this blog, Twitter, and Facebook. Everyone is free to participate in ASDay however they want. Some will just read through the posts, some will help to distribute the posts, and some will actively write them.

The Rituximab Story: not evidence for XMRV and NOT a potential autism therapy

31 Oct

The internet is rife with bad information, some of it dangerous. This is not news. Unfortunately autism is a hotbed of bad and sometimes dangerous information. Unfortunately, in an attempt to revive the XMRV/autism link, Kent Heckenlively of the Age of Autism blog is creating a new, dangerous conclusion: perhaps Rituximab (or a similar drug) could be an autism therapy.

In XMRV (HGRV) is Not Dead – The Rituximab Story Mr. Heckenlively writes once again about XMRV.

Promoting XMRV as causative in autism is nothing new for Mr. Heckenlively. Continuing this promotion, even in the light of serious negative results (here, here, here, here) is not new. The promotion of medical treatments which are based on a misunderstanding of autism is nothing new to the Age of Autism blog. So why write about this instance? Rituximab is really serious medicine.

Serious adverse events, which can cause death and disability, include:[22]

Severe infusion reactions
Cardiac arrest
Tumor lysis syndrome, causing acute renal failure
Infections
Hepatitis B reactivation
Other viral infections
Progressive multifocal leukoencephalopathy (PML)
Immune toxicity, with depletion of B cells in 70% to 80% of lymphoma patients
Pulmonary toxicity[23]

Here’s the “logic” behind Mr. Heckinlively’s article: XMRV has been linked to autism (he ignores the more recent data against this idea). XMRV has been linked to chronic fatigue syndrome (once again, he ignores the data which goes against they hypothesis). Therefore, autism and chronic fatigue syndrome must share some sort of link. In this case, a small study has been published which claims that Rituximab helped a number of patients with chronic fatigue syndrome.

One of the many glaring problems in this train of logic is the fact that the researchers in this particular study looked for XMRV in their subjects. And didn’t find it. So, the link between this group of CFS patients and autism, tenuous as it was from the start, is basically absent. This does not deter Mr. Heckenlively:

The question of why rituximab’s depletion of B cells helps those with chronic fatigue syndrome/ME remains unexplained. The researchers specifically noted they had searched for XMRV and not found evidence of its presence, but that touches on the greater issue of whether the currently validated test for XMRV is accurate.

Yes. Since there is no logical connection between this study and autism, we should question whether the test for XMRV is accurate. Are there inaccurate XMRV results? You bet. That’s what got a lot of the CFG (and autism) must be linked to XMRV story going.

Prometheus discusses this in Don’t use GMO’s to Treat Autism!! (at least not this one). Including a link to the study Benefit from B-Lymphocyte Depletion Using the Anti-CD20 Antibody Rituximab in Chronic Fatigue Syndrome. A Double-Blind and Placebo-Controlled Study which is at the heart of Mr. Heckenlively’s story.

Let’s remind ourselves of that story: XMRV (HGRV) is Not Dead – The Rituximab Story . Yes, he’s trying to use the Rituximab study to promote the link between XMRV and autism. Even though the patients in the Rituximab study didn’t have XMRV! Mr. Heckenlively takes a stance that is quite familiar: the “I’m just posing a question and promoting dialogue” idea:

I can’t say I’m a fan of rituximab. It’s a drug that comes with a black box warning, meaning it can cause death. But what has been revealed about the etiology of chronic fatigue syndrome/ME, and possibly autism, may be truly remarkable. Other, less toxic medications which supposedly do much of the same thing are on their way to market. I’m not suggesting any solutions in this article.

This is the same tactic used, over and over, by David Kirby (author of Evidence of Harm and formerly a frequent contributor to the Huffington Post) in promoting vaccines as causing autism, mercury as causing autism and chelation as a cure. He was “just promoting dialogue too”. Thankfully Rituximab isn’t available without prescription like many chelators.

In case you think Mr. Heckenlively’s disclaimer is enough to distance himself from promotion of this as a potential therapy, here are a couple of excerpts from the comments to that piece:

It makes sense that Rituximab would have dramatic results in autism. But there might be much less risky ways. Also, how about long term results? Maybe what is the root cause of the B cell dysfunction is still there after a Rituximab treatment and the whole cycle will start again as the B cell population builds up again.

and

Great article, thanks. I agree with your conclusion, and some of the comments below. While Rituximab is a very expensive and a very powerful drug with black box warning – in other words not something to be considered lightly (unless maybe the person is severely ill and all other options have been exhausted), it is GREAT to have some solid pointers at last, a mechanism to target with softer, safer means.

No. Seriously, no. It doesn’t make sense that Rituximab would have results in autism, dramatic or otherwise.