AUTISM ONE RADIO IS EXPANDING
www.autismone.org/radio
There
is so much information available that is helpful to getting our children better
and improving their lives - information that they need NOW. Autism One Radio is
pleased to welcome new hosts who will share information important to our
children's health and welfare.
In February, Nicola McFadzean, ND will
begin helping parents with preconception health tips to break the cycle of
autism. Dennis Debbaudt will inform us how to keep our children safe and educate
first responders and others in the Autism Risk and Safety Show. Beth Clay's
Capitol Weather Report focuses on national legislation and policies affecting
the autism and disability communities with complementary discussions regarding
innovative treatments on the horizon. The show will bring interviews with
recognized experts and legislators and provide insights on effective advocacy.
Dr. Timothy Ray debuts with his experienced perspectives on detoxification.
Chantal Sicile-Kira is adding a program to reach listeners in France and other
French-speaking countries. And Emily Iland and her expert guests, alternating
programs in English and Spanish, will help you know what to expect at different
ages and stages and share ideas to meet the challenges. Learn about strategies,
programs and options for older elementary-aged children, teens and adults.
Create an informed plan for the future and feel ready for what lies ahead.
In March, look for the debut of faith-centered programming on Autism One
Radio with Jack & Rebecca Sytsema; Sound Effects with Dorrine Davis; Rhonda
Brunett's Unlocking the Door to Autism; Jane Casey addressing autism with diet -
including practical tips such as how to handle birthday parties - and
detoxification methods, such as infra-red saunas and HBOT; and Larry Kaplan, PhD
who will interview guests from across America on a wide variety of topics
relevant to autism, including biomedical and educational interventions, research
studies, and current events. Other upcoming programs will focus on: explanations
of scientific concepts and terminology from Dr. Lauren Underwood; neurofeedback,
with Dr. Betty Jarusiewicz and Bob Patterson; siblings' perspectives, with
Ashley and Dillan Bono; and nutritional intervention, with consultant Karen
Hubert of Total Health Coach. Also planned are: a new news program, Autism
Global Week in Review, and a multi-part series on the history of autism.
Thank you for tuning in to Autism One Radio.
February 11, 2006
Autism One Radio is Expanding
From Autism One:
David Kirby Visits Canada
From David Kirby:
When Autism Today asked me if I would be interested in touring Canadian cities to speak about my book, “Evidence of Harm – Mercury in Vaccines and the Autism Epidemic,” I jumped at the chance. This simmering controversy affects Canada every much as it does the United States, and I am honored to be able to discuss the debate with our northern neighbors.
It will be the first time I take the “Evidence of Harm” message outside the United States.
Why should Canadians be concerned about mercury and their children? There are many reasons. To begin with, many Canadian kids received significant amounts of thimerosal in their vaccines until at least 1994, and some children may have received mercury after that time. In fact, many children born in three Canadian provinces and three territories received mercury in their Hepatitis B vaccines until at least 2002, and perhaps beyond. These exposures were in addition to possible exposure through the influenza vaccine, which is often given to pregnant women and children in Canada.
Mercury Exposures Today
Canadian children who received the flu and hepatitis B vaccine series were exposed to as much as 63 micrograms of ethylmercury in the first seven months of life, nearly equal to the amount of exposure in the UK, until very recently. And prenatal exposure to thimerosal in Canada continues, in the form of the flu shot (25 mcgs). Also, some women may have received injections of thimerosal-containing immune globulin products while pregnant. Prenatal exposure to mercury is thought to be extremely hazardous for the developing fetus.
Meanwhile, a number of other thimerosal-containing vaccines for children are still used in Canada, including some single antigen acellular pertussis and conjugate H. influenzae vaccines, diphtheria-tetanus (DT), and diphtheria-tetanus-acellular pertussis (DTaP) vaccines, all of which contain 25 micrograms of ethylmercury.
All of this comes on top of environmental exposures in Canada, including fish consumption, dental amalgams and air pollution. Some Canadians are exposed to increased levels of mercury from coal-fired plants in Canada and the US. Meanwhile, mining activities are also a significant source of environmental mercury contamination.
Autism in Canada
It is much more difficult to assess mercury exposures and autism statistics in Canada than in the US. To begin with, there are no reliable nationwide autism prevalence statistics in Canada, and it is impossible to say what are the current trends in the number of cases in the country. The rate of Pervasive Development Disorders in Canada is said to be 1-166, roughly the same at the US. However, these numbers include children up to 19 years of age, and many of them would have received mercury in vaccines. The prevalence of full blown autism in Canada, as opposed to PDD, has not been reported publicly.
These are just some of the many topics I will address on my tour. I will also give an update on all new science that has been generated recently and recent action in the US Senate. In addition, information on controversial new treatments for autism – such as chelation and methyl B12 therapy – will be discussed.
Thanks are due to Autism Today for making these important engagements a reality.
Also check in at http://www.autismevents.com/
Tomatos For Autism
Keith Mueller at the Online Tomoato Vine has created a few new breeds of tomatos that he is selling to raise money for Thoughtful House and the National Autism Association. He named two of his new tomatos for Liz Birt and Dr. Haley.
Blurb: Bookify Your Blog
Blurb books your blogs
February 7, 2006 7:53 AM PST
PHOENIX--They say everybody has a book in them and these days, it appears everybody has a blog. Blurb is showing its BookSmart product, which makes it easy to convert a blog to a book. Sounds like a recipe for a terrible book, although maybe a good photo album (if your blog is primarily pictures). And to be fair, BookSmart doesn't only bookify blogs. It's really a tool to create a pleasing, bound document from whatever input you want--blogs, text files, photos, etc. It costs about $30 and it's like Apple Computer's iPhoto albums, but far more flexible: You can make novels, albums, coffee-table-like books, cookbooks and so on. The books look great, and the product looks like a winner.
February 7, 2006 7:53 AM PST
PHOENIX--They say everybody has a book in them and these days, it appears everybody has a blog. Blurb is showing its BookSmart product, which makes it easy to convert a blog to a book. Sounds like a recipe for a terrible book, although maybe a good photo album (if your blog is primarily pictures). And to be fair, BookSmart doesn't only bookify blogs. It's really a tool to create a pleasing, bound document from whatever input you want--blogs, text files, photos, etc. It costs about $30 and it's like Apple Computer's iPhoto albums, but far more flexible: You can make novels, albums, coffee-table-like books, cookbooks and so on. The books look great, and the product looks like a winner.
The Age of Autism: Doctors for mercury
The Age of Autism: Doctors for mercury
By DAN OLMSTED
UPI Senior Editor
WASHINGTON, Feb. 9 (UPI) -- As doctors and health authorities fight state bans on mercury in vaccines and keep giving it to kids and pregnant women, one fact stands out: their certainty.
The image of pediatricians and public officials as valiant defenders of mercury takes a bit of getting used to, given their longstanding efforts to keep the toxic element out of our food, our bodies and the environment.
No reasonable person -- let alone health professional -- would advocate keeping mercury in childhood vaccines unless they were absolutely certain it was an exception to this lethal legacy.
That's especially so because vaccines can be made without the mercury preservative, called thimerosal. You can take it out and still protect the health of American children through vaccination, and if you had a shred of doubt about its safety, surely you would.
If you keep it in, you had better be right.
But what is the real degree of certainty that thimerosal is safe? Is it absolute? Beyond a reasonable doubt? A preponderance of the evidence -- the lesser standard that applies in civil cases but not when someone's freedom (or life) is at stake?
Here's the kind of thing that makes doctors -- most of whom have no more ability than you or I to investigate the safety of vaccines for themselves -- feel so certain. It's a paper titled "Vaccine Safety Controversies and the Future of Vaccination Programs," and it appears in the November 2005 issue of The Pediatric Infectious Disease Journal.
The authors are from the U.S. Centers for Disease Control and Prevention, which recommends the childhood immunization schedule; the United Nations World Health Organization, which oversees the vaccination of tens of millions of people worldwide every year, and several big universities. The report was supported by "unrestricted grants from GlaxoSmithKline Biologicals, Sanofi Pasteur MSD, several universities and other institutions."
"Thimerosal has been used for (more than) 60 years in infant vaccines and in other applications and has not been associated with adverse health effects in the general population, except when persons have been exposed to amounts many orders of magnitude greater than found in vaccines or pharmaceuticals," the authors write.
That's a ringing endorsement of safety (whether it's supported by the data is an issue I'll address in upcoming columns). But keep reading: "It should also be borne in mind that the risks of thimerosal-containing vaccines to the fetus, premature infant and low-weight infant have insufficiently been studied."
Whoa. "Insufficiently studied" -- after more than 60 years of giving thimerosal to pregnant women and babies of every size and shape? Nonetheless, the CDC recommends flu shots for pregnant women and 6-to-23-months-olds and won't recommend thimerosal-free versions. As a result, most flu shots still contain mercury.
Another new study is condescendingly titled, "When science is not enough -- a risk/benefit profile of thimerosal-containing vaccines," by Australians C. John Clements and Peter B. McIntyre in the journal Expert Opinion on Drug Safety:
"Thimerosal is safe as a vaccine preservative, and should continue to be used in settings where accessibility and cost require that multi-dose vials of vaccine are available."
Clements advises the WHO on vaccine policy; McIntyre is director of Australia's National Center for Immunization Research and Surveillance of Vaccine-Preventable Diseases.
"The overwhelming weight of scientific opinion rejects the hypothesis that neurodevelopmental abnormalities are causally related to the use of thimerosal in vaccines," they point out.
This is the kind of ammunition public health officials and the American Academy of Pediatrics are firing back at proponents of mercury bans --"overwhelming" evidence that thimerosal is safe. In Illinois, the state AAP vigorously opposed the ban.
"Though well intended, these bills do not advance public health and could inadvertently diminish our state's efforts at fighting influenza," the AAP said. "Though it is a mercury-containing compound, thimerosal does not pass from the bloodstream into the brain to any significant degree."
The state legislators listened politely to that dubious assertion -- and voted to limit thimerosal in childhood vaccines anyway. But that was not the last word.
As reported by R. L. Nave in the Illinois Times last month: "Citing cost concerns and a potential shortfall for the upcoming flu season, the Illinois Department of Public Health filed for a 12-month exemption to the Mercury-Free Vaccine Act, passed last summer to limit the use of vaccines containing mercury. However, child-health-care advocates who lobbied for the bill's passage are upset by what they believe was a premeditated attempt by IDPH to circumvent state law."
This is what you call chutzpah -- public health authorities thwarting the express will of the people, certain that flu shots will save humanity and mercury never hurt anybody. Does the governor never fire anyone?
Almost lost in this crossfire is the simple fact that in 1999, these selfsame health authorities -- the CDC, the Public Health Service, the pediatricians, the family physicians -- urged drug companies to remove thimerosal from childhood immunizations in the United States as soon as possible.
Most childhood vaccines -- in the United States, not overseas -- are now thimerosal-free. But that's hardly a blanket reassurance, because most flu shots do contain thimerosal.
Yet the CDC is still studying whether thimerosal causes autism.
"We do agree the preponderance of evidence to date suggests there is no association between thimerosal and autism," CDC spokesman Glen Nowak told us last month. But he said CDC Director Dr. Julie Gerberding is committed to exploring all possibilities until the cause or causes of the disorder are identified.
"Dr. Gerberding has made it clear the CDC has not ruled out anything as possible causes of autism, including thimerosal," Nowak said. "Science is a dynamic process. We have continued to fund studies to look at the role, if any, of thimerosal."
Given these caveats, what would you do? Well, there are two maxims of medicine that might apply. "First, do no harm," is the obvious one.
The second, related concept is the precautionary principle which, according to wikipedia.org, "is the idea that if the consequences of an action are unknown, but are judged to have some potential for major or irreversible negative consequences, then it is better to avoid that action."
So: Vaccines don't need mercury. Even government experts acknowledge some possible risks -- to the fetus, for example -- are insufficiently studied 60 years on. A link to autism has not been ruled out. They're continuing to investigate, as they should.
But the doctors and their public and private allies are battling state by state to stop mercury bans, and the CDC won't recommend a thimerosal-free flu shot for kids and pregnant woman. There's a phrase for this approach:
Bombs away.
By DAN OLMSTED
UPI Senior Editor
WASHINGTON, Feb. 9 (UPI) -- As doctors and health authorities fight state bans on mercury in vaccines and keep giving it to kids and pregnant women, one fact stands out: their certainty.
The image of pediatricians and public officials as valiant defenders of mercury takes a bit of getting used to, given their longstanding efforts to keep the toxic element out of our food, our bodies and the environment.
No reasonable person -- let alone health professional -- would advocate keeping mercury in childhood vaccines unless they were absolutely certain it was an exception to this lethal legacy.
That's especially so because vaccines can be made without the mercury preservative, called thimerosal. You can take it out and still protect the health of American children through vaccination, and if you had a shred of doubt about its safety, surely you would.
If you keep it in, you had better be right.
But what is the real degree of certainty that thimerosal is safe? Is it absolute? Beyond a reasonable doubt? A preponderance of the evidence -- the lesser standard that applies in civil cases but not when someone's freedom (or life) is at stake?
Here's the kind of thing that makes doctors -- most of whom have no more ability than you or I to investigate the safety of vaccines for themselves -- feel so certain. It's a paper titled "Vaccine Safety Controversies and the Future of Vaccination Programs," and it appears in the November 2005 issue of The Pediatric Infectious Disease Journal.
The authors are from the U.S. Centers for Disease Control and Prevention, which recommends the childhood immunization schedule; the United Nations World Health Organization, which oversees the vaccination of tens of millions of people worldwide every year, and several big universities. The report was supported by "unrestricted grants from GlaxoSmithKline Biologicals, Sanofi Pasteur MSD, several universities and other institutions."
"Thimerosal has been used for (more than) 60 years in infant vaccines and in other applications and has not been associated with adverse health effects in the general population, except when persons have been exposed to amounts many orders of magnitude greater than found in vaccines or pharmaceuticals," the authors write.
That's a ringing endorsement of safety (whether it's supported by the data is an issue I'll address in upcoming columns). But keep reading: "It should also be borne in mind that the risks of thimerosal-containing vaccines to the fetus, premature infant and low-weight infant have insufficiently been studied."
Whoa. "Insufficiently studied" -- after more than 60 years of giving thimerosal to pregnant women and babies of every size and shape? Nonetheless, the CDC recommends flu shots for pregnant women and 6-to-23-months-olds and won't recommend thimerosal-free versions. As a result, most flu shots still contain mercury.
Another new study is condescendingly titled, "When science is not enough -- a risk/benefit profile of thimerosal-containing vaccines," by Australians C. John Clements and Peter B. McIntyre in the journal Expert Opinion on Drug Safety:
"Thimerosal is safe as a vaccine preservative, and should continue to be used in settings where accessibility and cost require that multi-dose vials of vaccine are available."
Clements advises the WHO on vaccine policy; McIntyre is director of Australia's National Center for Immunization Research and Surveillance of Vaccine-Preventable Diseases.
"The overwhelming weight of scientific opinion rejects the hypothesis that neurodevelopmental abnormalities are causally related to the use of thimerosal in vaccines," they point out.
This is the kind of ammunition public health officials and the American Academy of Pediatrics are firing back at proponents of mercury bans --"overwhelming" evidence that thimerosal is safe. In Illinois, the state AAP vigorously opposed the ban.
"Though well intended, these bills do not advance public health and could inadvertently diminish our state's efforts at fighting influenza," the AAP said. "Though it is a mercury-containing compound, thimerosal does not pass from the bloodstream into the brain to any significant degree."
The state legislators listened politely to that dubious assertion -- and voted to limit thimerosal in childhood vaccines anyway. But that was not the last word.
As reported by R. L. Nave in the Illinois Times last month: "Citing cost concerns and a potential shortfall for the upcoming flu season, the Illinois Department of Public Health filed for a 12-month exemption to the Mercury-Free Vaccine Act, passed last summer to limit the use of vaccines containing mercury. However, child-health-care advocates who lobbied for the bill's passage are upset by what they believe was a premeditated attempt by IDPH to circumvent state law."
This is what you call chutzpah -- public health authorities thwarting the express will of the people, certain that flu shots will save humanity and mercury never hurt anybody. Does the governor never fire anyone?
Almost lost in this crossfire is the simple fact that in 1999, these selfsame health authorities -- the CDC, the Public Health Service, the pediatricians, the family physicians -- urged drug companies to remove thimerosal from childhood immunizations in the United States as soon as possible.
Most childhood vaccines -- in the United States, not overseas -- are now thimerosal-free. But that's hardly a blanket reassurance, because most flu shots do contain thimerosal.
Yet the CDC is still studying whether thimerosal causes autism.
"We do agree the preponderance of evidence to date suggests there is no association between thimerosal and autism," CDC spokesman Glen Nowak told us last month. But he said CDC Director Dr. Julie Gerberding is committed to exploring all possibilities until the cause or causes of the disorder are identified.
"Dr. Gerberding has made it clear the CDC has not ruled out anything as possible causes of autism, including thimerosal," Nowak said. "Science is a dynamic process. We have continued to fund studies to look at the role, if any, of thimerosal."
Given these caveats, what would you do? Well, there are two maxims of medicine that might apply. "First, do no harm," is the obvious one.
The second, related concept is the precautionary principle which, according to wikipedia.org, "is the idea that if the consequences of an action are unknown, but are judged to have some potential for major or irreversible negative consequences, then it is better to avoid that action."
So: Vaccines don't need mercury. Even government experts acknowledge some possible risks -- to the fetus, for example -- are insufficiently studied 60 years on. A link to autism has not been ruled out. They're continuing to investigate, as they should.
But the doctors and their public and private allies are battling state by state to stop mercury bans, and the CDC won't recommend a thimerosal-free flu shot for kids and pregnant woman. There's a phrase for this approach:
Bombs away.
February 8, 2006
February 6, 2006
The Legal Rights of Children With Autism
Interview
The Legal Rights of Children With Autism: An Expert Interview With Jill G. Escher, BA, MA, JD
Medscape Psychiatry & Mental Health. 2005;10(2) ©2005 Medscape Posted 07/28/2005
Editor's Note:
On behalf of Medscape, Randall White, MD, interviewed Jill G. Escher, BA, MA, JD, a California attorney in the field of autism law, whose son has autism.
Like many parents, she met resistance from the school district when she attempted to have her child evaluated for special educational services. To assist other parents who face this situation, she discusses pertinent laws, policies, and procedures intended to protect children with autism.
Medscape: How is autism defined by federal law?
Ms. Escher: Unfortunately, autism is defined in very vague terms. For a definition by federal law, I refer to the Individuals With Disabilities Education Act (IDEA).[1] This act confers the right to a free and appropriate public education to children with disabilities. The first step is to determine whether the particular child is eligible. There are several eligibility categories; some have to do with well-understood problems like blindness, deafness, and speech and language disorders. One of the categories is autism.
There are other pertinent [federal] laws, including section 504 of the Rehabilitation Act,[2] that can help parents obtain specialized services for autistic children. But when it comes to education, IDEA is the primary statute that creates a structure for providing special services. The Rehabilitation Act requires the district to accommodate children with disabilities so that they can be included in ordinary schooling. A typical example of a request via 504 is a child in a wheelchair who cannot go on field trips. On behalf of the child, a parent or guardian would request a 504 plan with the school district to ensure that he or she has equal access for field trips. Usually, because children with autism are deemed eligible for special services under IDEA, they tend not to rely on section 504.
Medscape: When was IDEA passed?
Ms. Escher: Initially, in 1974. It was substantially revised in 1997, and then it was reauthorized with some amendments in 2005. The 1970s was when it was first recognized that there were hundreds of thousands of disabled children who weren't getting any education. At that time, there was no requirement to force the school district to educate these children; so many of them languished at home or in baby-sitting situations.
Medscape: What does the parent of a child with autism need to do to initiate appropriate educational services?
Ms. Escher: First and foremost, if parents believe that their child has some form of autism, it is critical to obtain at least 1 independent expert evaluation for that child. Under IDEA, the school district must provide an evaluation of its own. But, in my experience, the school district evaluations are seldom trustworthy or sufficiently comprehensive. They tend to underdiagnose children, and their opinions tend to be preformed. In addition, the evaluations are performed by school psychologists who generally have little knowledge about both autism and the range of educational interventions available for such children, including which of
these interventions is best for a given child. It is extremely important that parents find the time and, if possible, the money to locate well-qualified experts in autism who can complete a comprehensive evaluation of the child, including recommendations for educational interventions. Universities often serve as an excellent resource for such experts. In California, for example, the University of California at San Francisco, at Davis, or at Los Angeles all have excellent programs with highly regarded experts who routinely do this work. The cost of these
evaluations can run from $700 to $3000. Insurance will probably cover some of the cost, but to get the most appropriate, [unbiased] services, parents usually have to make the investment.
Medscape: What happens once the parent has the evaluation in hand?
Ms. Escher: The parent should give a copy to the special education contact at the school district. The district is obligated to review all independent evaluations submitted by the parents, including from the [primary care] physician, a neurologist, a psychiatrist, or a psychologist. This type of an evaluation usually comes from a psychologist or a psychiatrist. The district has the obligation to review those, but not to agree with them. Well before the individualized education plan (IEP) meeting, everybody on the child's IEP team should review the parents' independent evaluation(s). Here is a likely scenario: The school district evaluates a child and finds that the child is autistic. However, they only recommend a half hour of speech therapy each week and 20 hours in a mixed-disabilities special education classroom. In contrast, an evaluation by an expert who really understands autism and what is best for the particular autistic child recommends several hours each week of one-on-one speech therapy and 25 hours or more in an intensive, autism-specific program at home or at school. So, the IEP team can be faced with divergent recommendations, and it's very important for the parents to have all the evidence there supporting their view of what their child needs.
Medscape: In this type of circumstance, what is the school district required to do?
Ms. Escher: The school district is required to hold an IEP meeting before the child commences services through the district. States vary in the details of the timeline, but on the day children turn 3 years old, they are supposed to start a program with the district. The IEP should happen well in advance of the child's third birthday. I also want to emphasize that the school district is obligated to provide evaluations in all areas of the child's disabilities, so that would include not only the psychological evaluations, but also a speech evaluation and an occupational therapy evaluation, and, in some cases, a physical therapy evaluation. There could be others; it depends on the particular child's situation. Therefore,
parents may want to obtain independent evaluations in these areas as well. Evaluations should not only describe the scope of the disability, but also set forth recommendations for programming. These should be done before the IEP.
Medscape: Parents are permitted to participate in the IEP meeting, correct?
Ms. Escher: Not only are they permitted to; the district is required to make all reasonable efforts to ensure their participation. Parents are considered full and equal participants at an IEP meeting. But, while that sounds very good on paper, parents are not usually treated as full and equal participants because the school district regularly withholds vital information about their programming and their policies. In certain cases, the district has even withheld information about the child, and that has affected what services were offered.
Medscape: How commonly do parents meet resistance to implementing the experts' recommendations?
Ms. Escher: Almost always. In autism, I don't think I've ever heard of a case when a child with autism was routinely given the set of services that the independent experts had suggested. It's all about money. There was a recent federal report showing that a child with autism costs a district something like $19,000 per year, and in California, the number is substantially higher, especially for younger children with autism -- about $25,000-$90,000 annually. It's extremely expensive because the autistic child, especially when young, will often require one-on-one intervention.
Medscape: What is the procedure to resolve the difference between parents and the district?
Ms. Escher: The procedure is very complicated. If at the IEP meeting (or as often happens, series of IEP meetings), the parents are still unhappy with what the district is wiling to provide, the parents have a couple of choices. The particular procedures vary a little bit from state to state, but the parents generally have the option to file a complaint with the state, which is not the preferred choice. They can ask for mediation, which is sometimes successful. But usually, if this is an irresolvable conflict with the district, the parents will file for a due process hearing -- in other words, an administrative appeal in front of an administrative law judge who works through the state department of education. I would say that in excess of 80% of the time, after parents file for a due process hearing, the dispute is settled. Parents who hire an attorney have a much higher
success rate than those who choose to go it alone. Going for due process, while it is the dispute service authorized by law, can be very time-consuming and expensive for parents.
Medscape: And what if parents can't hire an attorney?
Ms. Escher: Well, that happens a lot. Parents can hire an advocate, who is a layperson schooled in IDEA and knowledgeable about education services. In most states, there are many advocates willing to do this sort of work. Often, the parents just go it alone and look for resources that can help them on the Web. One really good source for parents is www.wrightslaw.com (http://www.wrightslaw.com/) .[3] It's an excellent site; I highly recommend that parents visit it. (Note: Ms. Escher[4] also has established a valuable Web site for parents, _http://www.autism-law.com_ (http://www.autism-law.com/) .) Unfortunately, this is a system like many in the world where it helps to have money to hire a lawyer. If you prevail, you are entitled to at least a portion of your attorney's fees.
Medscape: How equipped are most school districts to meet the needs of autistic and developmentally disabled children?
Ms. Escher: The answer is that except for a few areas, the quality and quantity of services are very lacking. There's a dramatic shortage of teachers who are trained and experienced to work with autistic kids. But I think there's also something else a bit more sinister at work -- school districts have a very strong disincentive to provide quality autism programs because the last thing they want is to gain a reputation for excellence in autism. They don't want more autistic kids to move into the district. More autistic children means more cost. In addition, there are no
standards for providing autism education. Federal law is entirely procedural; IDEA has not 1 word that specifies anything about the substance of what needs to happen in the classroom. The idea that Congress had is that these kids have individualized needs. In addition, there are no standards for providing autism education. Federal law is entirely procedural; IDEA has not 1 word that specifies anything about the substance of what needs to happen in the classroom. The idea that Congress had is that these kids have individualized needs: We [Congress] can't possibly prescribe appropriate programming for every child; so, let's set out a series of procedures for districts and parents to engage in, and hopefully, in this tussle over each and every aspect, the process will yield an appropriate program for a child Medscape: Has there been an effort for professionals, such as teachers and psychologists, to create a consensus on the best approach for autistic children in school?
Ms. Escher: The most important one to date is the National Academy of Sciences book called Educating Children With Autism, in which a group of about 14 autism specialists tried to synthesize best practices.[5]
Medscape: Have any school districts adopted them?
Ms. Escher: The book didn't get into a lot of specifics. It recommended a minimum of 25 hours/week of intensive intervention 12 months a year. The book really relates to children age 8 and younger. There's an important effort that just got under way called the Autism Treatment Network, which has a Web site.[6] It is a collaboration among 6 universities to come up with some treatment standards, which are going to focus on treatment by physicians. But, my understanding is that they are looking at educational interventions as well. Naturally, no one set of standards is going to provide guidance for every single autistic child. However, I think that there should be some joint understanding of minimum practices. Right now,
there is so much debate and controversy, it is hard to put standards together. Every time a parent walks into an IEP meeting, they have to reinvent the wheel because there's not a single word in any law about what a school district should do for an autistic child.
Medscape: I wanted to ask if you have any advice for people in rural areas with autism, because I'm sure it is even more difficult.
Ms. Escher: It is extremely difficult. People in rural areas often have to devise a program on their own. Frequently, where there really aren't any autism programs, the parents pay out of pocket to get a therapist trained in applied behavioral analysis or similar techniques, and that therapist will then train others. The parents can then ask the school district for reimbursement.
Medscape: Is reimbursement usually available?
Ms. Escher: Yes, reimbursement is available, but parents have to go through certain procedures to get that. They have to make the request for services and be denied; then after they provide written notice to the district of their intent, they can go ahead and seek reimbursement through a due process hearing.
Medscape: Is there anything more you think people should know?
Ms. Escher: Unfortunately, when parents have a child with autism, they have to learn not only how to adjust their lives and how to care for a child with a catastrophic disability; they have to learn how to be quasi-attorneys. We have a system based entirely on procedure, and parents should make all efforts to learn about the procedures and use them to their advantage.
References
1. US Department of Education. Individuals with Disabilities Education
Improvement Act (IDEA). 2004. Available at:
_http://www.ed.gov/policy/speced/leg/edpicks.jhtml_
(http://www.ed.gov/policy/speced/leg/edpicks.jhtml)
Accessed June 30, 2005.
2. US Department of Education. The Rehabilitation Act. Available at:
_http://www.ed.gov/policy/speced/leg/edpicks.jhtml_
(http://www.ed.gov/policy/speced/leg/edpicks.jhtml) Accessed June 30,
2005.
3. Wright PWD, Wright PD. Wrightslaw. Available at:
_http://www.wrightslaw.com/_ (http://www.wrightslaw.com/) Accessed May 5,
2005.
4. Escher J. Autism Law: A Parent's Guide to Federal and California
Special Education Law. Available at: _http://www.autism-law.com/_
(http://www.autism-law.com/) Accessed June 30, 2005.
5. National Research Council, Committee on Educational Interventions
for Children with Autism. In: Lord C, McGee JP, eds. Educating Children
With
Autism. Washington, DC: National Academy Press; 2001. Available at:
_http://books.nap.edu/openbook/0309072697/html/index.html_
(http://books.nap.edu/openbook/0309072697/html/index.html) Accessed May 5,
2005.
6. Autism Treatment Network. Available at:
_http://autismtreatmentnetwork.org/about.htm_
(http://autismtreatmentnetwork.org/about.htm) Accessed May
5, 2005.
Funding Information
Supported by an educational grant from Janssen.
Jill G. Escher, BA, MA, JD, Attorney-at-Law, San Jose, California
Disclosure: Randall White, MD, has disclosed that he owns stock, stock options, or bonds in Novartis AG ADR, Millipore Corporation, Novo Nordisk, and Sanofi-Aventis.
Disclosure: Jill G. Escher, BA, MA, JD, has disclosed no relevant financial
relationships.
The Legal Rights of Children With Autism: An Expert Interview With Jill G. Escher, BA, MA, JD
Medscape Psychiatry & Mental Health. 2005;10(2) ©2005 Medscape Posted 07/28/2005
Editor's Note:
On behalf of Medscape, Randall White, MD, interviewed Jill G. Escher, BA, MA, JD, a California attorney in the field of autism law, whose son has autism.
Like many parents, she met resistance from the school district when she attempted to have her child evaluated for special educational services. To assist other parents who face this situation, she discusses pertinent laws, policies, and procedures intended to protect children with autism.
Medscape: How is autism defined by federal law?
Ms. Escher: Unfortunately, autism is defined in very vague terms. For a definition by federal law, I refer to the Individuals With Disabilities Education Act (IDEA).[1] This act confers the right to a free and appropriate public education to children with disabilities. The first step is to determine whether the particular child is eligible. There are several eligibility categories; some have to do with well-understood problems like blindness, deafness, and speech and language disorders. One of the categories is autism.
There are other pertinent [federal] laws, including section 504 of the Rehabilitation Act,[2] that can help parents obtain specialized services for autistic children. But when it comes to education, IDEA is the primary statute that creates a structure for providing special services. The Rehabilitation Act requires the district to accommodate children with disabilities so that they can be included in ordinary schooling. A typical example of a request via 504 is a child in a wheelchair who cannot go on field trips. On behalf of the child, a parent or guardian would request a 504 plan with the school district to ensure that he or she has equal access for field trips. Usually, because children with autism are deemed eligible for special services under IDEA, they tend not to rely on section 504.
Medscape: When was IDEA passed?
Ms. Escher: Initially, in 1974. It was substantially revised in 1997, and then it was reauthorized with some amendments in 2005. The 1970s was when it was first recognized that there were hundreds of thousands of disabled children who weren't getting any education. At that time, there was no requirement to force the school district to educate these children; so many of them languished at home or in baby-sitting situations.
Medscape: What does the parent of a child with autism need to do to initiate appropriate educational services?
Ms. Escher: First and foremost, if parents believe that their child has some form of autism, it is critical to obtain at least 1 independent expert evaluation for that child. Under IDEA, the school district must provide an evaluation of its own. But, in my experience, the school district evaluations are seldom trustworthy or sufficiently comprehensive. They tend to underdiagnose children, and their opinions tend to be preformed. In addition, the evaluations are performed by school psychologists who generally have little knowledge about both autism and the range of educational interventions available for such children, including which of
these interventions is best for a given child. It is extremely important that parents find the time and, if possible, the money to locate well-qualified experts in autism who can complete a comprehensive evaluation of the child, including recommendations for educational interventions. Universities often serve as an excellent resource for such experts. In California, for example, the University of California at San Francisco, at Davis, or at Los Angeles all have excellent programs with highly regarded experts who routinely do this work. The cost of these
evaluations can run from $700 to $3000. Insurance will probably cover some of the cost, but to get the most appropriate, [unbiased] services, parents usually have to make the investment.
Medscape: What happens once the parent has the evaluation in hand?
Ms. Escher: The parent should give a copy to the special education contact at the school district. The district is obligated to review all independent evaluations submitted by the parents, including from the [primary care] physician, a neurologist, a psychiatrist, or a psychologist. This type of an evaluation usually comes from a psychologist or a psychiatrist. The district has the obligation to review those, but not to agree with them. Well before the individualized education plan (IEP) meeting, everybody on the child's IEP team should review the parents' independent evaluation(s). Here is a likely scenario: The school district evaluates a child and finds that the child is autistic. However, they only recommend a half hour of speech therapy each week and 20 hours in a mixed-disabilities special education classroom. In contrast, an evaluation by an expert who really understands autism and what is best for the particular autistic child recommends several hours each week of one-on-one speech therapy and 25 hours or more in an intensive, autism-specific program at home or at school. So, the IEP team can be faced with divergent recommendations, and it's very important for the parents to have all the evidence there supporting their view of what their child needs.
Medscape: In this type of circumstance, what is the school district required to do?
Ms. Escher: The school district is required to hold an IEP meeting before the child commences services through the district. States vary in the details of the timeline, but on the day children turn 3 years old, they are supposed to start a program with the district. The IEP should happen well in advance of the child's third birthday. I also want to emphasize that the school district is obligated to provide evaluations in all areas of the child's disabilities, so that would include not only the psychological evaluations, but also a speech evaluation and an occupational therapy evaluation, and, in some cases, a physical therapy evaluation. There could be others; it depends on the particular child's situation. Therefore,
parents may want to obtain independent evaluations in these areas as well. Evaluations should not only describe the scope of the disability, but also set forth recommendations for programming. These should be done before the IEP.
Medscape: Parents are permitted to participate in the IEP meeting, correct?
Ms. Escher: Not only are they permitted to; the district is required to make all reasonable efforts to ensure their participation. Parents are considered full and equal participants at an IEP meeting. But, while that sounds very good on paper, parents are not usually treated as full and equal participants because the school district regularly withholds vital information about their programming and their policies. In certain cases, the district has even withheld information about the child, and that has affected what services were offered.
Medscape: How commonly do parents meet resistance to implementing the experts' recommendations?
Ms. Escher: Almost always. In autism, I don't think I've ever heard of a case when a child with autism was routinely given the set of services that the independent experts had suggested. It's all about money. There was a recent federal report showing that a child with autism costs a district something like $19,000 per year, and in California, the number is substantially higher, especially for younger children with autism -- about $25,000-$90,000 annually. It's extremely expensive because the autistic child, especially when young, will often require one-on-one intervention.
Medscape: What is the procedure to resolve the difference between parents and the district?
Ms. Escher: The procedure is very complicated. If at the IEP meeting (or as often happens, series of IEP meetings), the parents are still unhappy with what the district is wiling to provide, the parents have a couple of choices. The particular procedures vary a little bit from state to state, but the parents generally have the option to file a complaint with the state, which is not the preferred choice. They can ask for mediation, which is sometimes successful. But usually, if this is an irresolvable conflict with the district, the parents will file for a due process hearing -- in other words, an administrative appeal in front of an administrative law judge who works through the state department of education. I would say that in excess of 80% of the time, after parents file for a due process hearing, the dispute is settled. Parents who hire an attorney have a much higher
success rate than those who choose to go it alone. Going for due process, while it is the dispute service authorized by law, can be very time-consuming and expensive for parents.
Medscape: And what if parents can't hire an attorney?
Ms. Escher: Well, that happens a lot. Parents can hire an advocate, who is a layperson schooled in IDEA and knowledgeable about education services. In most states, there are many advocates willing to do this sort of work. Often, the parents just go it alone and look for resources that can help them on the Web. One really good source for parents is www.wrightslaw.com (http://www.wrightslaw.com/) .[3] It's an excellent site; I highly recommend that parents visit it. (Note: Ms. Escher[4] also has established a valuable Web site for parents, _http://www.autism-law.com_ (http://www.autism-law.com/) .) Unfortunately, this is a system like many in the world where it helps to have money to hire a lawyer. If you prevail, you are entitled to at least a portion of your attorney's fees.
Medscape: How equipped are most school districts to meet the needs of autistic and developmentally disabled children?
Ms. Escher: The answer is that except for a few areas, the quality and quantity of services are very lacking. There's a dramatic shortage of teachers who are trained and experienced to work with autistic kids. But I think there's also something else a bit more sinister at work -- school districts have a very strong disincentive to provide quality autism programs because the last thing they want is to gain a reputation for excellence in autism. They don't want more autistic kids to move into the district. More autistic children means more cost. In addition, there are no
standards for providing autism education. Federal law is entirely procedural; IDEA has not 1 word that specifies anything about the substance of what needs to happen in the classroom. The idea that Congress had is that these kids have individualized needs. In addition, there are no standards for providing autism education. Federal law is entirely procedural; IDEA has not 1 word that specifies anything about the substance of what needs to happen in the classroom. The idea that Congress had is that these kids have individualized needs: We [Congress] can't possibly prescribe appropriate programming for every child; so, let's set out a series of procedures for districts and parents to engage in, and hopefully, in this tussle over each and every aspect, the process will yield an appropriate program for a child Medscape: Has there been an effort for professionals, such as teachers and psychologists, to create a consensus on the best approach for autistic children in school?
Ms. Escher: The most important one to date is the National Academy of Sciences book called Educating Children With Autism, in which a group of about 14 autism specialists tried to synthesize best practices.[5]
Medscape: Have any school districts adopted them?
Ms. Escher: The book didn't get into a lot of specifics. It recommended a minimum of 25 hours/week of intensive intervention 12 months a year. The book really relates to children age 8 and younger. There's an important effort that just got under way called the Autism Treatment Network, which has a Web site.[6] It is a collaboration among 6 universities to come up with some treatment standards, which are going to focus on treatment by physicians. But, my understanding is that they are looking at educational interventions as well. Naturally, no one set of standards is going to provide guidance for every single autistic child. However, I think that there should be some joint understanding of minimum practices. Right now,
there is so much debate and controversy, it is hard to put standards together. Every time a parent walks into an IEP meeting, they have to reinvent the wheel because there's not a single word in any law about what a school district should do for an autistic child.
Medscape: I wanted to ask if you have any advice for people in rural areas with autism, because I'm sure it is even more difficult.
Ms. Escher: It is extremely difficult. People in rural areas often have to devise a program on their own. Frequently, where there really aren't any autism programs, the parents pay out of pocket to get a therapist trained in applied behavioral analysis or similar techniques, and that therapist will then train others. The parents can then ask the school district for reimbursement.
Medscape: Is reimbursement usually available?
Ms. Escher: Yes, reimbursement is available, but parents have to go through certain procedures to get that. They have to make the request for services and be denied; then after they provide written notice to the district of their intent, they can go ahead and seek reimbursement through a due process hearing.
Medscape: Is there anything more you think people should know?
Ms. Escher: Unfortunately, when parents have a child with autism, they have to learn not only how to adjust their lives and how to care for a child with a catastrophic disability; they have to learn how to be quasi-attorneys. We have a system based entirely on procedure, and parents should make all efforts to learn about the procedures and use them to their advantage.
References
1. US Department of Education. Individuals with Disabilities Education
Improvement Act (IDEA). 2004. Available at:
_http://www.ed.gov/policy/speced/leg/edpicks.jhtml_
(http://www.ed.gov/policy/speced/leg/edpicks.jhtml)
Accessed June 30, 2005.
2. US Department of Education. The Rehabilitation Act. Available at:
_http://www.ed.gov/policy/speced/leg/edpicks.jhtml_
(http://www.ed.gov/policy/speced/leg/edpicks.jhtml) Accessed June 30,
2005.
3. Wright PWD, Wright PD. Wrightslaw. Available at:
_http://www.wrightslaw.com/_ (http://www.wrightslaw.com/) Accessed May 5,
2005.
4. Escher J. Autism Law: A Parent's Guide to Federal and California
Special Education Law. Available at: _http://www.autism-law.com/_
(http://www.autism-law.com/) Accessed June 30, 2005.
5. National Research Council, Committee on Educational Interventions
for Children with Autism. In: Lord C, McGee JP, eds. Educating Children
With
Autism. Washington, DC: National Academy Press; 2001. Available at:
_http://books.nap.edu/openbook/0309072697/html/index.html_
(http://books.nap.edu/openbook/0309072697/html/index.html) Accessed May 5,
2005.
6. Autism Treatment Network. Available at:
_http://autismtreatmentnetwork.org/about.htm_
(http://autismtreatmentnetwork.org/about.htm) Accessed May
5, 2005.
Funding Information
Supported by an educational grant from Janssen.
Jill G. Escher, BA, MA, JD, Attorney-at-Law, San Jose, California
Disclosure: Randall White, MD, has disclosed that he owns stock, stock options, or bonds in Novartis AG ADR, Millipore Corporation, Novo Nordisk, and Sanofi-Aventis.
Disclosure: Jill G. Escher, BA, MA, JD, has disclosed no relevant financial
relationships.
January 30, 2006
So Cal Families Wanted
From Jennifer McNulty:
Hi Friends,
Wanted: Families in the Southern California area who would be interested in being featured in a brochure being designed to benefit Autism Research Institute and DAN! Defeat Autism Now!
The purpose is to raise awareness that many children are significantly improving and even recovering as a result of biomedical interventions.
Why are we doing this? My husband Dan and I have a eight year old son, Kyle, with a diagnosis of autism who has benefitted greatly from DAN! Defeat Autism Now, and we want to give back our time to this wonderful organization, and the doctors who are such brave individuals. We own a graphic design firm, and in behalf of ARI, won a grant from a paper company to print this brochure.
The photography will be done by an award-winning photographer, Marcelo Coehlo, and the families stories will be outlined in the brochure by a very talented writer, Richard Huvard. We are hoping to initiate photography the week of February 6 -10th. We are working in close collaboration and approval from Dr. Bernie Rimland and ARI, and the piece will also feature several of the doctors, and researchers who have played key roles in furthering treatment for our kids.
If you feel your child has greatly improved, or has even recovered from autism due to biomedical interventions pioneered by DAN!, and you would be willing to share your story, and have your child featured, PLEASE email me at the address below.
As, well, we are also looking to feature a few children of families with newly diagnosed children, who are just starting their journey into searching for answers for their kids. Please also contact me if you would be interested in having your child photographed, and sharing your experiences.
I know how very busy everyone is, we would try to only take a couple hours of your time. If you know of a family who may be interested, please forward this email to them.
Email: jennim@mcnultyco.com
Please leave your contact phone numbers, and let me know the best time to reach you.
Jennifer McNulty
Aspie Mood Phone
"Mood Phone" for Aspies Wins Student Award, Car and Job
Earlier this week, Motorola crowned the winner of its MOTOFWRD contest, which is devoted to finding the best new technology created by students all over the country. The winner (picking up a $10,000 scholarship, new Bluetooth-enabled car and apprenticeship with Motorola's Chief Technology Office) was John Finan, a Duke University graduate student, who came up with a "Mood Phone" that would be able to help "improve social interactions," especially for those suffering from Asperger's Syndrome, a mild form of autism. The technology would allow for a cellphone to light up in a bunch of different colors depending on what's being said. The warm red to cool blues would then let the user figure out the mood and inflection coming from whomever is speaking, depending on the words and phrases.
January 19, 2006
Discover: Mercury
So I know I am doing a lot of Mercury blogging these days, but there is just so much out there on in these days. Long article on Mercury from Discover. If you want a broad view of mercury in your world, take some time and read the whole thing.
Our Preferred Poison
A little mercury is all that humans need to do away with themselves quietly, slowly, and surely
By Karen Wright
Illustration by Don Foley
DISCOVER Vol. 26 No. 03 March 2005 Biology & Medicine
Let’s start with a straightforward fact:
Mercury is unimaginably toxic and dangerous.
A single drop on a human hand can be irreversibly fatal.
A single drop in a large lake can make all
the fish in it unsafe to eat.
Often referred to as quicksilver, mercury is the only common metal that is liquid at room temperature. Alchemists, including the young Sir Isaac Newton, believed it was the source of gold. In the modern era, it became a common ingredient of paints, diuretics, pesticides, batteries, fluorescent lightbulbs, skin creams, antifungal agents, vaccines for children, and of course, thermometers. There is probably some in your mouth right now: So-called silver dental fillings are half mercury.
Mercury is also a by-product of many industrial processes. In the United States coal-fired power plants alone pump about 50 tons of it into the air each year. That mercury rains out of the sky into oceans, lakes, rivers, and streams, where it becomes concentrated in the flesh of fish, shellfish, seals, and whales. Last year the Food and Drug Administration determined there is so much mercury in the sea that women of childbearing age should severely limit their consumption of larger ocean fish. The warning comes too late for many mothers. A nationwide survey by the Centers for Disease Control shows that one in 12 women of childbearing age already have unsafe blood levels of mercury and that as many as 600,000 babies in the United States could be at risk. But that begs a critical question: At risk for what?
Infants born to mothers contaminated by mercury in Japan’s Minamata Bay in 1956 had profound neurological disabilities including deafness, blindness, mental retardation, and cerebral palsy. In adults, mercury poisoning can cause numbness, stumbling, dementia, and death. “It’s no secret that mercury exposure is highly toxic,” says toxicologist Alan Stern, a contributor to a 2000 National Research Council report on mercury toxicity. But high-level exposures like those at Minamata cannot help scientists determine whether six silver fillings and a weekly tuna-salad sandwich will poison you or an unborn child. “The question is, what are the effects at low levels of exposure?” he says.
Data now suggest effects might occur at levels lower than anyone suspected. Some studies show that children who were exposed to tiny amounts of mercury in utero have slower reflexes, language deficits, and shortened attention spans. In adults, recent studies show a possible link between heart disease and mercury ingested from eating fish. Other groups claim mercury exposure is responsible for Parkinson’s disease, multiple sclerosis, Alzheimer’s, and the escalating rate of autism.
How—and in what form—mercury inflicts damage is still unclear. Yet scientists and policymakers agree that more regulation is imperative. The Environmental Protection Agency plans to finalize its controversial first rule on reducing mercury emissions from power plants this month, and delegates from the United Nations Environment Programme met in late February to discuss an international convention limiting mercury use and emissions.
A decade ago researchers and lawmakers agreed that lead, another heavy metal, was harmful to children at levels one-sixth as high as previously recognized. But it took scientists decades to establish the scope and subtlety of lead poisoning. Mercury is now a ubiquitous contaminant. The average American may have several micrograms of it in each liter of blood, and the atmospheric burden of mercury has perhaps tripled since the industrial age. Whatever needs to be done to protect humanity from its love affair with quicksilver, it had better happen soon.
In August 1996 Karen Wetterhahn, a chemistry professor at Dartmouth College in Hanover, New Hampshire, spilled a few drops of a laboratory compound called dimethyl mercury onto one of her hands. She was wearing latex lab gloves, so she didn’t think much of it. A colleague saw her at a conference the following November. “She said she thought she was coming down with the flu,” says toxicologist Vas Aposhian of the University of Arizona. By the time Wetterhahn was diagnosed with mercury poisoning, in January, it was too late. Despite subsequent treatment that helped clear the metal from her body, she lapsed into a vegetative state in February and died the following June.
Scientists are at a loss to explain why mercury often takes months to exert its effects. “If we knew that, we’d know a lot more about how mercury poisons the brain,” says Tom Clarkson, a toxicologist at the University of Rochester Medical Center.
The degree of mercury’s toxicity depends on the form and route of exposure. You can swallow the liquid form of elemental mercury without much fear because it doesn’t easily penetrate the lining of the stomach and intestines. On the other hand, liquid mercury vaporizes at room temperature, and when you inhale the vapor it moves right from the lungs to the bloodstream to the brain. A broken thermometer can release enough mercury vapor to poison the air in a room—one reason why some cities and several states discourage the sale of mercury fever thermometers.
Mercury also binds with other elements in salts and organic compounds of varying toxicity. Dimethyl mercury, the substance that poisoned the Dartmouth chemist, is a synthetic form of organic mercury rarely found outside a lab. A simpler organic compound called methylmercury is of greater concern because methyl- mercury is the form found in the flesh of fish.
Seafood is one of the two most common sources of mercury exposure in adults. Although concentrations of mercury in air and water are increasing, they are still too small for alarm. But bacteria process the mercury in lakes and oceans into a form that accumulates in living tissue. Plankton take in the bacteria and are in turn eaten by small fish. With each meal, the mercury concentration rises. Then larger fish eat the small fish, increasing tissue concentrations still more. Fish at the top of the food chain accumulate the most mercury. The species singled out by the recent FDA advisory—big predators such as albacore tuna, shark, and swordfish—can have 100 times more mercury in their tissues than smaller fish do.
The methylmercury in fish passes readily from the human gut to the bloodstream and on into all organs and tissues. It seems to act most powerfully on the brain because the compound is strongly attracted to fatty molecules called lipids, and the brain has the highest lipid content of any organ. Methylmercury crosses the protective blood-brain barrier by binding with an essential amino acid that has dedicated carrier proteins for shunting it into brain cells. Once inside brain cells, some of it gets converted to an inorganic form that sticks to and disables many structural proteins and enzymes essential to cell function. “It can destroy the biological function of any protein it binds to,” says Boyd Haley, a biochemist at the University of Kentucky.
Researchers learned how much mercury the body can tolerate from studies of victims of catastrophic poisoning, such as the Japanese sickened by eating fish from Minamata Bay and the Iraqis who ate grain treated with a methylmercury-based preservative in the early 1970s. But those studies do not reveal how little mercury it takes to cause harm. At the time of her diagnosis, the Dartmouth chemist had 4,000 micrograms of mercury per liter in her blood. A diet consistently high in fish can create a blood-mercury level of about 25 micrograms per liter. That’s far below a lethal dose, but it still may not be safe.
Concerns about low-level toxicity haunt discussions of another ubiquitous source of mercury exposure: silver dental fillings. Elemental mercury, which makes up half of silver fillings, releases mercury vapor, just as liquid mercury does. The vapor from dental amalgams is the primary source of the one to eight micrograms of mercury per liter of blood, that is, according to some sources, in the average American adult. That amount uncomfortably overlaps the Environmental Protection Agency’s current safe level of 5.8 micrograms per liter. But the EPA’s safety level is based on methylmercury exposure, about which more is known. No human studies have assessed prolonged exposure to low levels of mercury vapor. One study hints at subtle neural and behavioral anomalies in dentists, who collectively use 300 metric tons of mercury in amalgams each year and who often have two to five times the typical concentration of mercury in their urine.
“I think the methylmercury in fish is probably our least toxic exposure,” says Haley, who broadcasts the hazards of dental fillings.
Silver-mercury fillings have never been tested for safety. “The amalgam question will never be solved until we do a clinical trial like those we do with other medical devices,” says Aposhian.
“It’s really unclear what’s going on with dental amalgams,” says Stern, who notes that the issue is complicated by the potential for panic and lawsuits. “It’s a snake pit.”
One of the lessons of Minamata is that mercury, like lead, is harder on fetuses than on the women carrying them, or adults in general. In the Japanese event, women with no overt symptoms of poisoning gave birth to severely disabled children. “It was evident there was a major difference in susceptibility between the developing brain and the mature brain,” says Philippe Grandjean, an epidemiologist at the Harvard University School of Public Health. “When we saw serious poisonings in Minamata, that made us wonder whether mercury could be like lead.”
Studies of lead have shown that IQ decreases approximately two or three points for every doubling of prenatal and early postnatal exposure. To see if mercury has comparable effects, Grandjean, along with Pál Weihe at the University of Southern Denmark, is conducting the largest study to date of children’s cognition and behavior in a population routinely exposed to low levels of mercury. His work in the Faeroe Islands of Denmark includes 1,000 mother-child pairs and spans almost 20 years. In a typical year, Faeroe islanders consume 1,000 pilot whales, or one whale for every 50 islanders. “They belong to one of the most fish-eating populations in the world,” says Grandjean.
Whale meat is one of the most highly contaminated seafoods because whales are at the top of the food chain. Even so, the mercury content of whale meat is considerably lower than that of the hypertoxic Minamata fish. An earlier study of shark eaters in New Zealand suggested that relatively high levels of mercury in a mother’s hair during pregnancy correlated with a loss of three IQ points in her child. High levels, in that study, were identified as six parts per million and above in the hair shaft.
Grandjean gave a battery of sophisticated cognitive and developmental tests to the Faeroese children when they were 7 and 14. His results indicate that IQ drops 1.5 points for every doubling in prenatal exposure to mercury. The 2000 National Research Council report concluded that the risk documented by Grandjean “is likely to be sufficient to result in an increase in the number of children who have to struggle to keep up in school.”
“We learned there is a response at low levels,” says Grandjean. “It’s not a huge loss, but it’s certainly not negligible.”
Yet in another large, long-term epidemiological study conducted on the Seychelles Islands in the Indian Ocean, Clarkson has so far found no effect on neurological development from prenatal exposure to low levels of mercury in seafood. “We can’t exclude effects from 20 parts per million or even 12 parts per million,” he notes. But he concludes there is no graded risk that extends to the lowest exposure levels.
The 2000 research council report evaluated the Faeroe, Seychelles, and New Zealand studies and recommended that the EPA set safety standards based on Grandjean’s more sobering findings. The agency did. Then, for good measure, it added a 10-fold uncertainty factor—a safety margin to protect against scientific unknowns and individual differences in response to a toxin. The uncertainty factor lowers the threshold to a figure of 5.8 micrograms per liter of blood and 1.2 parts per million in hair.
The problem with safety factors is that they create a toxicological limbo between demonstrably harmful doses and levels that have been declared safe. Thus, when Centers for Disease Control surveys find that one in 12 American women of childbearing age—8 percent—have blood mercury levels above the safety threshold, the implications aren’t clear, either for them or for the children they bear. Epidemiologist Tom Sinks says, “It doesn’t tell us there’s a hazard.”
“The whole idea of a safety factor is to protect people,” Clarkson says. “You can’t turn it around to use as an indication of who’s at risk. If you’re just above it, you aren’t necessarily in trouble.”
That kind of hedging, along with disagreement among population studies, leaves regulators with plenty of wiggle room. The FDA, for example, uses a more relaxed safety standard for mercury based on studies from the 1970s and 1980s. Where the EPA safety level for daily exposure is 0.1 microgram per kilogram (about 2.2 pounds) of body weight, the FDA’s standard is about 0.4 microgram per kilogram per day. The difference is four times as much mercury.
Concern about early exposure to mercury doesn’t end at birth. Until recently, many infants received regular injections of mercury on a state-mandated, medically sanctioned schedule. The mercury came from a compound called thimerosal that has been used as a preservative in vaccines and other medicines since the 1930s. In 1999 the FDA recommended that thimerosal no longer be used in pediatric vaccines, and manufacturers have removed it from all but the influenza vaccine. But some scientists and many more aggrieved parents are convinced that thimerosal in childhood vaccines has already caused, or at least catalyzed, the U.S. epidemic of autism.
An estimated 400,000 Americans today have autism, a once rare neurological disorder characterized by social withdrawal, difficulty communicating, and involuntary, repetitive movements. Although the exact numbers are in dispute, the rate of diagnosis seems to have climbed sharply in the last decade. In California the incidence of autism was six times higher in 2002 than in 1987.
During that period, federal health officials added four new kinds of vaccines to the childhood immunization schedule, and the amount of mercury routinely administered to infants in the first six months of life more than doubled. Throughout the 1990s, a 3-month-old baby might receive as much as 63 micrograms of mercury in a single visit to a doctor—roughly 100 times the daily EPA safety level. By the age of 6 months, properly immunized children were exposed to at least 188 micrograms of mercury in a series of at least nine injections. Although the 1999 FDA action minimized such exposure, some infant flu vaccines still contain 12.5 micrograms of mercury per dose—more than 10 times the daily EPA safety level for a 20-pound baby.
Circumstantial evidence also implicates mercury in autism. Some of the symptoms of autism and mercury poisoning are similar, and Haley has garnered evidence from hair samples that autistic children do not clear mercury from their bodies as efficiently as most kids do. They may have a genetic susceptibility that allows more mercury to accumulate in their tissues, he says. That could make them more vulnerable to mercury-laced vaccines and the continuous low-level exposure from their mothers’ dental fillings. “It is amazing to me that no one has taken the tissue of autistic children to see if there is excess mercury there,” Aposhian told a committee at the Institute of Medicine in Washington, D.C., last year. “That’s one thing that really has to be done.”
There are other sources of uncertainty. The form of mercury in thimerosal—an organic compound called ethyl mercury—is the least studied of all mercury’s incarnations. When scientists argue about its toxicity, they typically rely on data from methylmercury, which may not be an equivalent form of exposure. Experts even disagree about whether ethyl mercury can cross the blood-brain barrier. (It probably does.) “There are no good ways to measure ethyl mercury in tissue,” toxicologist Polly Sager of the National Institute of Allergy and Infectious Diseases told the Institute of Medicine committee.
The Institute of Medicine concluded last May that no claim could be made for a causal link between mercury-laced vaccines and autism, but several independent researchers had complained that their access to federal vaccine databases, which could provide evidence of a link, had been repeatedly blocked. A few scientists, including Haley and neuropharmacologist Richard Deth of Northeastern University in Boston, continue to study possible mechanisms for the connection. Deth reported last year, for example, that in human nerve cells thimerosal blocks a chemical reaction called methylation that is critical to gene activity and that is also disabled by exposure to lead.
The report that first triggered worries about a connection between vaccines and autism was published in the British medical journal The Lancet in 1998. It described eight children whose behavioral problems surfaced within two weeks of receiving the measles-mumps-rubella vaccine. The Lancet and most of the article’s coauthors ultimately disowned the study because its lead author had not divulged that he was also being paid to conduct research for parents seeking to sue vaccine manufacturers. Nonetheless, the number of parents in the United Kingdom willing to immunize their babies with the vaccine dropped from 90 percent in 1998 to less than 80 percent in 2004.
Health officials in the United States addressed suspicions about immunization by recommending that thimerosal be removed from pediatric vaccines. Thimerosal might yet prove harmless, they reasoned, but the threat to public health posed by a drop in immunization rates was not worth risking. The same balance of risks exists regarding the issue of mercury in fish. The current Federal Dietary Guidelines Advisory Committee Report recommends at least two fish meals a week. Fish are high in omega-3 fatty acids, which have proven benefits in preventing heart disease, the number one killer in the United States. “We know mercury is a hazardous substance,” says the CDC’s Sinks. “We know that less is better than more. We know that fish and shellfish are the principal source of methylmercury. But we also know that fish and shellfish are pretty nutritious food: high in protein, high in vitamins. They contain healthy fats.”
But troubling evidence suggests that methylmercury in fish might cause heart disease. A seven-year study of more than 1,800 men in Finland showed that those who ate the most fish doubled their risk of heart attack compared with those whose diets had less fish. The same men showed the same increase in risk for death from coronary and cardiovascular disease. And Grandjean’s Faeroe Islands study found that prenatal exposure to mercury caused significant increases in blood pressure among 7-year-olds.
The most troubling aspect of this controversial heart-disease data is that deleterious effects occur at mercury-exposure levels equal to or lower than for any other toxicological outcome, including the subtle neurological symptoms in the Faeroe Islands study. In Grandjean’s most recent examination of 14-year-olds, he has found a doubling of certain neurotoxic effects at five parts per million in hair samples. In the Finnish study, the men with the doubled risk of heart attack had hair samples with only two parts per million of mercury. They were eating little more than an ounce of fish a day. Stern speculates that 10 percent of American men may already eat enough fish to raise their risk of heart attack.
“There’s this interaction between mercury and fish oils that makes it very complicated because they both come from the same place,” he says.
The National Research Council report noted that low levels of mercury contamination might also harm the immune and reproductive systems. And mercury is being investigated in relation to Alzheimer’s, Parkinson’s, attention deficit disorder, and multiple sclerosis. But many low-level developmental effects will be difficult to identify, Stern says, because the compromised organ or function still falls within the range of normal. The intelligence scores of the Faeroese children, for example, were not pathologically low; it took rigorous statistical analyses to prove they were simply lower than they would have been otherwise. Likewise heart disease, as the nation’s leading killer, has plenty of confounding variables. “You’re looking to pull a signal out of a lot of noise,” Stern says.
That signal might soon get a lot stronger. While mercury contamination is no longer a threat in most childhood vaccines, it is likely to get worse in fish. “Because of the beneficial effects of fish consumption, the long-term goal needs to be a reduction in the concentrations of [methylmercury] in fish rather than a replacement of fish in the diet by other foods,” said the council’s report.
That goal is nothing less than unrealistic.
Mercury was a naturally occurring element in Earth’s atmosphere long before coal-fired generators, medical-waste incinerators, and chlor-alkali plants put more there. Some mercury escapes into the air when volcanoes erupt and mountains erode. It stands to reason that mercury has been accumulating in the flesh of fish, shellfish, and marine mammals since humankind began eating them—which is most likely why humans have a protein called metallothione to help detoxify mercury and other heavy metals.
But human activities have caused the mercury content of the atmosphere to rise by 1.5 percent a year, according to the U.S. Geological Survey, and the problem is global. Roughly half of the mercury deposited on U.S. soils and streams comes across the Pacific from Asia. Last year a United Nations report found that the toxin can travel thousands of miles in the atmosphere to contaminate pristine and uninhabited areas, such as the Arctic. Still, the United States has so far balked at attempts by the United Nations Environment Programme to draw up a binding protocol to reduce mercury pollution worldwide.
In the 1990s the United States made considerable progress in curbing emissions from incinerators for medical and municipal waste. Yet the number of states issuing local fishing advisories went from 27 to 48 in the last decade. Due to heightened concern, advisories for mercury are increasing faster than for any other pollutant.
The EPA is in the final stages of formalizing a rule that would limit emissions from coal-fired utilities, which produce 42 percent of the nation’s domestic mercury pollution. The agency’s standing proposal has been for a 70 percent reduction in mercury emissions by 2018. But environmentalists argue that the Clean Air Act calls for a 90 percent reduction by 2008. In 1992 the Natural Resources Defense Council sued the EPA for not maintaining the act’s standards, and in 1994 the parties reached a settlement. Under the terms of the agreement, the agency is required to issue a cleanup rule this month.
History
Mercury was known to the ancient Chinese and Hindus; the element has been found in Egyptian tombs from 1500 B.C.
Source
Mercury rarely occurs free in nature but can be found in ores, principally cinnabar. The element, which exists in its natural form as a mix of seven stable isotopes, is most often found near volcanoes or geothermal springs. The metal is obtained by heating cinnabar in an air current and condensing the vapor.
Uses
Mercury easily forms alloys, called amalgams, with other metals like gold, silver, and tin. The element has many uses in the chemical industry, such as in the manufacture of sodium hydroxide and chlorine by the electrolysis of brine, as well as in making advertising signs, mercury switches, and other electrical apparatuses. It is also used to make sensitive measuring devices for laboratories. Other uses are in dental work, batteries, and catalysts. Because of mercury’s toxicity, many of these uses are under review.
Favored Fish
An inspector at a California cannery in 1953 spot-checks canned tuna. In the United States, canned tuna is the third most commonly purchased food item, after sugar and coffee, based on dollar sales per amount of shelf space devoted to the product. An EPA study reported the median amount of mercury, measured in parts per million, in the following varieties of canned tuna: chunk light: .08 parts per million; canned albacore tuna: .34 ppm; fresh or frozen tuna: .30 ppm. A 2004 EPA advisory mentions five types of fish and shellfish that are low in mercury: shrimp, canned light tuna, salmon, pollack, and catfish. The advisory also warns consumers not to eat shark, swordfish, king mackerel, and tilefish because they all contain high levels of mercury.Mercury Fillings
Dental amalgams, known as silver fillings, are composed of roughly 50 percent mercury. Studies of people with mercury-containing dental fillings show a correlation between the number and size of the fillings and the amount of mercury excreted in their urine. The relationship suggests that the mercury is derived from mercury vapor released from the fillings. Some evidence shows that the level of mercury in the brain tissue of fetuses, newborns, and young children is also directly proportional to the number of surfaces of amalgam fillings the mother has.
January 18, 2006
Drug Error, Not Chelation Therapy, Killed Boy, Expert Says
I have been preparing a post on the frustration that I have over the fact that the coroners report on Tariq's death gave us no answers to the questions that chelating parents have been asking for the last several months. Was this an allergic reaction? Was the wrong chelating agent used? Then today from the CDC comes word that the wrong chemical compound was used, making Tariq's death a medical accident (or malpractice) due to a drug mix up.
I have to ask why was this information not made public a week ago. Why did the CDC have to request the coronor's report and then issue their own statement to answer the question.
Props to Dr. Brown for settling the question for us.
Update: Wade has a good post on this.
I have to ask why was this information not made public a week ago. Why did the CDC have to request the coronor's report and then issue their own statement to answer the question.
Props to Dr. Brown for settling the question for us.
Drug error, not chelation therapy, killed boy, expert says
Wednesday, January 18, 2006
By Karen Kane, Pittsburgh Post-Gazette
One of the nation's foremost experts in chelation therapy said she has determined "without a doubt" that it was medical error, and not the therapy itself, that led to the death of a 5-year-old boy who was receiving it as a treatment for autism.
Dr. Mary Jean Brown, chief of the Lead Poisoning Prevention Branch of the Atlanta-based Centers for Disease Control and Prevention, said yesterday that Abubakar Tariq Nadama died Aug. 23 in his Butler County doctor's office because he was given the wrong chelation agent.
"It's a case of look-alike/sound-alike medications," she said yesterday. "The child was given Disodium EDTA instead of Calcium Disodium EDTA. The generic names are Versinate and Endrate. They sound alike. They're clear and colorless and odorless. They were mixed up."
Both types of EDTA are synthetic amino acids that latch onto heavy metals in the bloodstream.
Dr. Brown said she obtained the child's autopsy report on behalf of the CDC after reading an article about the death in the Pittsburgh Post-Gazette. She said it didn't take long to figure out what had happened.
Essentially, Tariq died from low blood calcium. Without enough calcium -- a metal -- in the blood, the heart stops beating. Dr. Brown said the Disodium EDTA the child was given as a chelation agent "acted as a claw that pulled too much calcium" from his blood.
"The blood calcium level was below 5 . That's an emergency event," she said.
Officials from the state police, the district attorney's office and the coroner's office will meet soon to decide whether to hold an inquest into the child's death and whether it should remain listed as accidental.
Dr. Brown said the same mix-up happened in two other recent cases: a 2-year-old girl in Texas who died in May during chelation for lead poisoning and a woman from Oregon who died three years ago while receiving chelation for clogged arteries.
Dr. Brown said that in each case, the blood calcium level was below 5 milligrams. Normal is between 7 and 9.
The correct chelation agent -- Calcium Disodium EDTA -- would not have pulled the calcium from the bloodstream, she said.
The Butler County coroner's office confirmed last week that Tariq had died as a result of his chelation treatment, but the findings that were released didn't indicate whether the treatment had been improperly administered.
Dr. Brown said chelation was once a common and necessary therapy that was used on children and adults alike for lead poisoning. Chelation means administering an agent into the bloodstream that causes heavy metals in the body to cling to it and then be excreted in urine.
Though its only approved use, according to the U.S. Food and Drug Administration, is for lead poisoning, Dr. Brown said she is aware that it is used by some people for other medical problems, ranging from clogged arteries to autism.
She said there have been no reputable medical trials demonstrating the effectiveness of chelation as a therapy for anything but lead poisoning. But if it were administered accurately, the procedure would be harmless.
She said it is well known within the medical community that Disodium EDTA should never be used as a chelation agent. She quoted from a 1985 CDC statement: "Only Calcium Disodium EDTA should be used. Disodium EDTA should never be used .. because it may induce fatal hypocalcemia, low calcium and tetany."
"There is no doubt that this was an unintended use of Disodium EDTA. No medical professional would ever have intended to give the child Disodium EDTA," Dr. Brown said.
Tariq was brought to the United States from England last spring by his mother, Marwa, for the chelation therapy. He was in the Portersville, Butler County, office of Dr. Roy Eugene Kerry when he went into cardiac arrest.
In recent months, chelation treatments of a wide variety ranging from IV to oral to topical have been gaining popularity for autistic children due to anecdotal information from parents indicating a reduction in symptoms. The underlying belief is that autism is caused by a sensitivity to heavy metals in the bloodstream.
Howard Carpenter, executive director of the Advisory Board on Autism and Related Disorders said the determination by Dr. Brown clears up the mystery surrounding Tariq's death but not the uncertainty over chelation itself.
"Since this child died, there have been parents who are pro-chelation who have been very angry that there's talk against it. On the other side, they say the death was a natural consequence of a dangerous activity. Maybe what happened to is explained, but we still don't have a conclusion about whether chelation is an effective treatment for autism," he said.
Tariq's father is a medical doctor who practices in England.
Dr. Kerry could not be reached for comment. A board-certified physician and surgeon, he advertises himself as an ear, nose and throat doctor who also specializes in allergies and environmental medicine.
Update: Wade has a good post on this.
January 14, 2006
Thimerosal Safety: Point - Counterpoint
The Illinois AAP thinks that thimerosal in vaccines is safe:
Dr. David Ayoub does not:
Thimerosal and Vaccine Safety: What Providers Should Know
Dr. David Ayoub does not:
RESPONSE TO: Thimerosal and Vaccine Safety: What Providers Should Know By Ed Pont, MD FAAP, President Elect and Chair, ICAAP Committee on Government Affairs, and Julie Morita, MD, Medical Director, Immunization Program, Chicago Department of Public Health
1)”A law recently passed in Illinois may inadvertently support parents’ fears that vaccines are unsafe”
If this were true then why wasn’t there widespread panic when in 1999 mercury was suddenly removed from three childhood vaccines- Neonatal Hepatitis B, HiB and DTaP? Why not add all the mercury back into vaccines? This will “boost parents’ confidence” in the vaccine program! What an absurd statement. Reports from one
Springfield hospital indicate, as predicted, influenza vaccine acceptance rates increased this year once they secured only thimerosal-free shots. Safer vaccines will restore much of the lost confidence in the vaccine industry.
2) Since the 1930s, thimerosal has been widely used as a preservative in biological and drug products, including vaccines, to help prevent bacterial contamination.
The observation of thimerosal’s historic widespread use does not alone prove safety. There have been no safety studies conducted. I have read all of the published safety studies (Smithburn 1930, Powell and Jameson 193) from the 1930’s, and they showed that: 1) thimerosal-exposed animals died of mercury poisoning and 2) all humans who received intravenous thimerosal died. I fail to see how these studies assure safety.
Thimerosal is such an ineffective preservative that Chiron lost over half of the US flu vaccine supply because it became contaminated with bacteria in spite of the preservation by thimerosal. The ineffectiveness of thimerosal as an anti-microbial agent has been reported by numerous researchers as far back as the 1940’s. Through the use of single-dose vials, the FDA does not require vaccines to contain any preservatives. I would suggest that this statement is designed to distract from the fact that NO SAFETY STUDIES EXIST.
3) “No guidelines exist for ethylmercury [thimerosal]”.
This fact alone should be sufficient reason for the AAP to support the elimination of mercury. Drs. Pont and Morita chose to leap to the conclusion that the amount of mercury in current vaccines is safe yet admits to inadequate safety guidelines. What ever happened to “first do no harm”? Common sense would dictate that if no guidelines have been established for its use, it should not be used.
4) “Thimerosal has been the subject of several studies. There has been no scientific evidence of harm caused by the small amounts of thimerosal in vaccines, except for minor effects like swelling and redness at the injection site.”
It has been said that a lie told over and over again will eventually be believed as fact. First, thimerosal, at the levels found in today’s thimerosal-containing vaccines, has been documented to cause severe adverse reactions, including, but not limited to, anaphylactic shock and death in “sensitive” individuals. Apparently Drs. Pont and Morita overlooked these major reactions. This is even acknowledged by thimerosal manufacturers. Secondly, the volume of research published in peer-review journals that confirms thimerosal is a neurotoxin and is associated with autism and other neurodevelopmental disorders is extensive and their unwillingness to acknowledge this data will not make it go away. (see appendix)
5) “The committee [2004 Institute of Medicine Immunization Safety Review Committee] also concluded that there is no scientific evidence of a causal relationship between thimerosal-containing vaccines and autism and that potential biological mechanisms for vaccine-induced autism that have been generated to date are only theoretical.”
First, The IOM report has been widely criticized by the scientific as well as the legislative community. (see attached speech, Congressman Weldon, Dr Ed Yazbak). The IOM conclusions are only as good as the science that supports them. And in a word, the science was garbage (extensive discussion available upon request). The cited research was uniformly funded by pharmaceutical companies. The IOM executive committee is comprised of a small number of individuals who are tied to the drug industry, including Gail Cassell, the VP of Eli Lily, the very organization that is being charged with $100’s of billions in liability, and two former employees of the CDC, the very organization being charged with oversight failure with regards to vaccine safety and mercury content. Finally, the AAP would unlikely acknowledge that documents obtained through FOIA showed that the IOM committee had decided NOT to find a link between vaccines and autism before reviewing a single paper on the subject. The IOM process was conflicted, biased and wrong.
6)” ICAAP fought for language in the law that authorizes the Illinois Department of Public Health (IDPH) to exempt a vaccine from the Act in case of an actual or potential bio-terrorist incident or public health emergency such as an epidemic or vaccine shortage.”
In fact, the bill’s sponsors introduced the exemption when they crafted the language from several other states’ legislation. The AAP should not take credit for this. Furthermore, considering 1 of 6 Americans suffer from learning disabilities and 1 in 80 males from autism; it is hard to imagine a more successful bioterrorism agent than mercury.
7) “However, some preparations of the inactivated influenza vaccine, now routinely recommended for healthy infants aged six to 23 months and other high-risk children, contain thimerosal as a preservative. Thimerosal-free preparations are of the inactivated influenza vaccine are available in limited supplies”
The majority of children will get a flu vaccine that contains 12.5 micrograms of mercury. Based upon EPA limits, these infants will receive 11-16 times what is considered safe. There is a LIMITED amount of just about everything tangible on earth, but there were 6 million doses of pediatric flu vaccines available for the current season, easily enough for all children in Illinois of this age group, which is the first state to activate the mercury-free flu vaccine legislation. Yet, the AAP chose not to advice clinicians to order these available vaccines for this season or next season, but rather chose to support an exemption.
8) “Vaccine opponents have inappropriately referenced the 1999 AAP statement when arguing that thimerosal-containing vaccines are unsafe and should be banned... Providing children with influenza and other vaccines is safe and consistent with the 1999 joint AAP/PHS recommendation.”
What is crystal clear, the Illinois AAP has chosen to ignore the main point of the 1999 warning.
The “9 July 1999” joint statement said: (with bolding added for emphasis)
“Nevertheless, because any potential risk is of concern, the Public Health Service (PHS), the American Academy of Pediatrics (AAP), and vaccine manufacturers agree that thimerosal-containing vaccines should be removed as soon as possible. Similar conclusions were reached this year in a meeting attended by European regulatory agencies, European vaccine manufacturers, and FDA, which examined the use of thimerosal-containing vaccines produced or sold in European countries.PHS and AAP are working collaboratively to assure that the replacement of thimerosal-containing vaccines takes place as expeditiously as possible while at the same time ensuring that our high vaccination coverage levels and their associated low disease levels throughout our entire childhood population are maintained.”
The AAP has an adequate flu vaccine supply for infants for 2005-06 and yet has not advised any pediatrician to order thimerosal-free vaccine preferentially. The supply next flu season will almost certainly be expand. The concern about “potential risk” was very clearly stated. The AAP and IDPH may choose to spin this announcement in defense of their own actions, but their actions speak volumes….they have chosen to inject more mercury into childhood vaccines and shots for pregnant women in spite of the will of the governor, legislators, parents, advocates and a growing number of physicians.
David Ayoub, MD
9th Jan 2006
January 13, 2006
While We Are On The Subject Of Flu Shots
It is nice to see that this Doc is taking seriously the possibility that her condition is a flu shot side effect. I have a friend that three years ago contracted Gulliam Barre (an autoimmune disorder where the immune system attacks the nervious system) and was paralized from head to toe. It took her more than a year to become mobile again. Only this year did it occur to me to ask her if she had gotten the flu shot before the onset. She had, 5 weeks before, and was told by her doctors that it was likely the cause. (I was the first to tell her about the Vaccine Injury Compensation Fund)
We know not everyone can be vaccinated, just like we know not everyone can take antibiotics or even eat peanuts. So my question is this. Why are we not figuring out a way to screen for those who may have life threatening or crippling illnesses as a result of vaccinating? Seems to me we should be able to evaluate the individual's immune system to look for warning signs as to when a horrible autoimmune disorder is a greater threat to someone than the flu.
I am sure it all comes down to money.
Officials may document possibility of rare flu-shot reaction
Friday, January 13, 2006
rparker@kalamazoogazette.com 388-2734
A 10-year-old Plainwell girl is fighting her way back from a coma while an anxious community prays for her recovery.
No one knows what caused Claudia Klein to develop a rare bleeding disorder about a month after she received a routine influenza vaccine Nov. 9.
Despite the uncertainty about the cause of her illness, Kalamazoo county's health officer is considering including Claudia's case in the national tracking of adverse reactions to vaccines.
"I think that's a public-health responsibility," said Dr. Richard Tooker, medical officer of Allegan and Kalamazoo counties' health departments.
Claudia fell ill Dec. 8. with symptoms that mirrored those of leukemia, her father, Dan, said. "We were thrilled to hear it was ITP" -- idiopathic thrombocytopenic purpura -- a rare condition thought to be a misguided immune response that depletes the body's blood platelets. That illness, they were told, usually subsides with no lasting ill effects. ITP is extremely rare, and it is rarer still for the disease to reach the level of severity experienced by Claudia.
She failed to respond to aggressive treatment. Instead, her condition worsened, and on Dec. 16 she developed bleeding in her brain. Claudia underwent surgery and has been in the pediatric intensive-care unit at Bronson Methodist Hospital ever since. She is currently listed in good condition and is beginning to breathe without reliance on a ventilator.
The rare link between ITP and vaccines makes it important to consider documenting what happened to Claudia, Tooker said.
Because of the one-month interval between the vaccination and the onset of the ITP, Tooker said, he was not surprised "the pediatrician never even considered the connection until we brought it to his attention."
Tooker said he will discuss the case with colleagues, the Centers for Disease Control and Prevention and perhaps the vaccine manufacturer.
"If there have been other reports filed with a similar time frame, we will file one," Tooker said. "We may file one anyway just to be prudent."
"Insomuch as we know that pediatric ITP can be affiliated with viral infections, and the notion is, there's interplay between components of the viral infection and the immune system, it follows it is within the realm of possibility that a vaccine may have played a role in her condition."
"This in no way suggests the influenza vaccine is dangerous to anybody. If there were dozens or hundreds of reports of this happening, we would certainly revise our opinion of that, and that's exactly why we do surveillance as we do."
The Vaccine Adverse Event Reporting System is a voluntary tracking of reactions reported by physicians and does not suggest a cause-and-effect relationship, he said. An Internet search of the system's Web site showed that in 2004, there were nine cases of ITP following vaccinations (only one associated with influenza vaccine), and nine more in 2005, through Nov. 30. No cases were reported in Michigan.
Only by carefully documenting adverse reactions to a medication can scientists determine whether there are risks to certain populations.
"If there is a risk, we want to identify that as soon as possible and eliminate the risk," Tooker said.
"On the other hand, and more likely, if this is a coincidence, we want to dispel any inappropriate fear around a very safe vaccine.
"I think it's important in the early stages of this story being told and retold through word of mouth ... to make sure people are putting this in perspective and getting accurate information," he said.
Word of Claudia's condition has spread throughout her school and community.
"This has brought thousands of people together who have no connection other than Claudia," Dan said.
Tim Grinwis, Claudia's fifth-grade teacher at Gilkey Elementary School, has visited almost daily to read aloud to her and bring her news from school, since she is not up to classmate visits yet, and her mother e-mails news of Claudia's recovery.
In Plainwell, a sign on a local restaurant implores: "Pray for Claudia ."
On Christmas Eve a group of friends from Plainwell gathered on the hospital's heliport in a candlelight vigil, singing carols outside Claudia's room.
"People walking or driving by noticed the candles, and many joined them who didn't even know Claudia or the Kleins but felt so moved they joined right in," Grinwis said. In the end, more than 100 people were assembled.
"It's mind-boggling -- mind-boggling and absolutely humbling," Dan said. "You find out in a hurry the capacity of people, and what community means. And the Bronson Pediatric Intensive Care Unit staff has been compassionate and amazing. They've been our family for a month up there.
"A very rare thing happened to my beautiful daughter. In no way does the family feel the flu shot was the definitive cause here, and it would be irresponsible to say so," given that the vaccinations help so many people.
The important message, Tooker said, is that, statistically, the overwhelming majority of ITP cases in children are triggered by actual viral illnesses.
"They flat out don't know" what prompted Claudia's illness, Dan Klein said. But he is adamant that what happened to his daughter should not prevent anyone from getting a flu shot.
"The reality is, my daughter ... won all the wrong lottos on this one," he said.
We know not everyone can be vaccinated, just like we know not everyone can take antibiotics or even eat peanuts. So my question is this. Why are we not figuring out a way to screen for those who may have life threatening or crippling illnesses as a result of vaccinating? Seems to me we should be able to evaluate the individual's immune system to look for warning signs as to when a horrible autoimmune disorder is a greater threat to someone than the flu.
I am sure it all comes down to money.
Officials may document possibility of rare flu-shot reaction
Friday, January 13, 2006
rparker@kalamazoogazette.com 388-2734
A 10-year-old Plainwell girl is fighting her way back from a coma while an anxious community prays for her recovery.
No one knows what caused Claudia Klein to develop a rare bleeding disorder about a month after she received a routine influenza vaccine Nov. 9.
Despite the uncertainty about the cause of her illness, Kalamazoo county's health officer is considering including Claudia's case in the national tracking of adverse reactions to vaccines.
"I think that's a public-health responsibility," said Dr. Richard Tooker, medical officer of Allegan and Kalamazoo counties' health departments.
Claudia fell ill Dec. 8. with symptoms that mirrored those of leukemia, her father, Dan, said. "We were thrilled to hear it was ITP" -- idiopathic thrombocytopenic purpura -- a rare condition thought to be a misguided immune response that depletes the body's blood platelets. That illness, they were told, usually subsides with no lasting ill effects. ITP is extremely rare, and it is rarer still for the disease to reach the level of severity experienced by Claudia.
She failed to respond to aggressive treatment. Instead, her condition worsened, and on Dec. 16 she developed bleeding in her brain. Claudia underwent surgery and has been in the pediatric intensive-care unit at Bronson Methodist Hospital ever since. She is currently listed in good condition and is beginning to breathe without reliance on a ventilator.
The rare link between ITP and vaccines makes it important to consider documenting what happened to Claudia, Tooker said.
Because of the one-month interval between the vaccination and the onset of the ITP, Tooker said, he was not surprised "the pediatrician never even considered the connection until we brought it to his attention."
Tooker said he will discuss the case with colleagues, the Centers for Disease Control and Prevention and perhaps the vaccine manufacturer.
"If there have been other reports filed with a similar time frame, we will file one," Tooker said. "We may file one anyway just to be prudent."
"Insomuch as we know that pediatric ITP can be affiliated with viral infections, and the notion is, there's interplay between components of the viral infection and the immune system, it follows it is within the realm of possibility that a vaccine may have played a role in her condition."
"This in no way suggests the influenza vaccine is dangerous to anybody. If there were dozens or hundreds of reports of this happening, we would certainly revise our opinion of that, and that's exactly why we do surveillance as we do."
The Vaccine Adverse Event Reporting System is a voluntary tracking of reactions reported by physicians and does not suggest a cause-and-effect relationship, he said. An Internet search of the system's Web site showed that in 2004, there were nine cases of ITP following vaccinations (only one associated with influenza vaccine), and nine more in 2005, through Nov. 30. No cases were reported in Michigan.
Only by carefully documenting adverse reactions to a medication can scientists determine whether there are risks to certain populations.
"If there is a risk, we want to identify that as soon as possible and eliminate the risk," Tooker said.
"On the other hand, and more likely, if this is a coincidence, we want to dispel any inappropriate fear around a very safe vaccine.
"I think it's important in the early stages of this story being told and retold through word of mouth ... to make sure people are putting this in perspective and getting accurate information," he said.
Word of Claudia's condition has spread throughout her school and community.
"This has brought thousands of people together who have no connection other than Claudia," Dan said.
Tim Grinwis, Claudia's fifth-grade teacher at Gilkey Elementary School, has visited almost daily to read aloud to her and bring her news from school, since she is not up to classmate visits yet, and her mother e-mails news of Claudia's recovery.
In Plainwell, a sign on a local restaurant implores: "Pray for Claudia ."
On Christmas Eve a group of friends from Plainwell gathered on the hospital's heliport in a candlelight vigil, singing carols outside Claudia's room.
"People walking or driving by noticed the candles, and many joined them who didn't even know Claudia or the Kleins but felt so moved they joined right in," Grinwis said. In the end, more than 100 people were assembled.
"It's mind-boggling -- mind-boggling and absolutely humbling," Dan said. "You find out in a hurry the capacity of people, and what community means. And the Bronson Pediatric Intensive Care Unit staff has been compassionate and amazing. They've been our family for a month up there.
"A very rare thing happened to my beautiful daughter. In no way does the family feel the flu shot was the definitive cause here, and it would be irresponsible to say so," given that the vaccinations help so many people.
The important message, Tooker said, is that, statistically, the overwhelming majority of ITP cases in children are triggered by actual viral illnesses.
"They flat out don't know" what prompted Claudia's illness, Dan Klein said. But he is adamant that what happened to his daughter should not prevent anyone from getting a flu shot.
"The reality is, my daughter ... won all the wrong lottos on this one," he said.
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