The Age of Autism: Ground Zero
By DAN OLMSTED
This column has long made the controversial case that autism had a beginning, a "big bang" if you will. That moment was 1930 -- no U.S. cases before then fully match the classic description of the disorder. Now let's take the next logical step: Not only did autism have a big bang, it also had a ground zero -- a place where many of the first cases concentrated before the disorder exploded nationwide. Ground zero was the nation's capital, in particular the Maryland suburbs where cutting-edge government research in the 1930s and 1940s exposed families to the chemical that first triggered the baffling disorder.
The foundation of this argument was laid out in the most recent Age of Autism column, "Mercury link to Case 2." Case 2 was known only as Frederick W., but we identified him as the son of a prominent plant pathologist named Frederick L. Wellman. At the time "Frederick W." was born, we showed, the senior Wellman was doing advanced work at the U.S. Agriculture Department's Beltsville research center in suburban Maryland, just outside the nation ' s capital. Wellman was experimenting with plant fungi and ways to kill them, and his extensive archive makes clear one compound he studied was ethyl mercury fungicide -- the exact kind also used in the controversial vaccine preservative thimerosal, which many parents blame for the recent rise in reported cases (mainstream experts say it has been ruled out as a cause).
Ethyl mercury in both vaccines and fungicides was pioneered and patented in the 1920s through the work of Morris S. Kharasch. When Kharasch filed the first relevant patents, he was a chemistry professor at the University of Maryland in College Park, which actually adjoins the Beltsville research center.
More links to Washington are evident in other early cases described in 1943 by Johns Hopkins University child psychiatrist Leo Kanner, who first diagnosed the disorder in Frederick W. and 10 other children born in the 1930s. Reading between the lines of his landmark 1943 paper, the very first autistic child seen at Hopkins (in 1935) was "Alfred L.," whose father was a lawyer and chemist at the U.S. Patent Office. Also a clear connection to newly patented chemicals, the federal government and the nation ' s capital. A child later profiled by Kanner was named Gary T. "Gary originally lived in Philadelphia," Kanner wrote in 1951. "The family then moved to Greenbelt, to Chicago, and back to Greenbelt." Take a look at Greenbelt, Md.: It also abuts the Beltsville agricultural center in the Washington suburbs.
Recently, a mutual friend in Washington introduced me to a 58-year-old man with Asperger's disorder, the milder version of autism. We got together for lunch, and when I asked where in the Washington area he lived, I was both startled and somehow not surprised: Riverdale, Md. That's another Washington suburb that clusters with the College Park-Beltsville-Greenbelt dots I was already plotting. What's more, he was born there in 1948 in the same house he lives in now.
I asked what his father did. He told me he was an engineer. That fits a stereotype of Asperger's affecting kids of scientists and engineers -- the so-called "geek syndrome," nerdy brainiacs hooking up to somehow spawn a generation of kids with "autism lite." I asked him what kind of engineer his father was. The answer: a mechanical engineer who tested guns for the Navy at the time he was born. And where was that? At what is now the Naval Surface Warfare Center in White Oak, Md. -- just a hop and a skip across I-95 from the Beltsville agriculture center.
I already had come across his father's line of work. In a 1972 paper, Kanner talked about a child named "Walter P.," born in June 1944. His father, too, was "an ordnance engineer for the federal government." Kanner didn't say where Walter P. was from, but the similarity makes me wonder. Mercury fulminate was widely used as a detonator for explosives and armaments. Could those two fathers, like Frederick W., be linked to cutting-edge research involving mercury? (My Riverdale acquaintance said his father sometimes brought containers of mercury home from the weapons center for the kids to play with.)
And is that kind of research a reason Leo Kanner, at Johns Hopkins in nearby Baltimore, started seeing cases of this "markedly and uniquely" different disorder in the 1930s and 1940s? Just last week I got an e-mail from the mother of a child with autism who lives on the other side of the country; her son was born nowhere near what I'm calling ground zero. But as I outlined this idea to her, she had a shock of recognition:
"I lived on a farm in Burtonsville, Md., while young and it is near Beltsville. The farm was surrounded by forest and abutted the Patuxent River." Of course, not all the early cases cluster this way. But of the two other original "Kanner kids" from his 1943 paper that I ' ve been able to identify along with Frederick W., one grew up in a town called Forest, Miss., a center of timber farming and planting; the other was the son of a forestry professor at North Carolina State University. Ethyl mercury fungicides were used to treat seeds, saplings and lumber in the 1930s, and in both places (as well as in Beltsville) the newly launched Civilian Conservation Corps was hard at work planting trees, cutting timber and building things with it. To sum up: The first cases of autism seem to radiate outward from a central point -- as big bangs tend to do. As those exposures expanded, so did autism.
This suggests a new and deeply disturbing truth about the Age of Autism: our fate is not in our genes, Dear Brutus, but in the chemicals that increasingly pollute our world and our children.
Showing posts with label Olmsted. Show all posts
Showing posts with label Olmsted. Show all posts
April 27, 2007
The Age of Autism: Ground Zero
January 1, 2007
The Age of Autism: The AOA Awards '06
The Age of Autism: The AOA Awards '06
By DAN OLMSTED
UPI Senior Editor
WASHINGTON, Dec. 27 (UPI) -- As this column heads into its third year, the time is right to cite those who made 2006 a memorable year in the history of autism -- and set the stage for even more remarkable ones to come.
And the winners are:
Person of the Year: Anne Dachel. This Chippewa Falls, Wis., mom and member of the National Autism Association keeps chipping away at the mainstream media's wall of indolence and incuriosity.
She sent e-mails to just about every reporter who wrote about the subject this past year along with letters-to-the-editor of their publications, as well as penning articles of her own.
She praises, she pushes, she relentlessly raises the questions at the heart of the matter: Why have the number of cases risen so dramatically? Why aren't journalists asking tougher questions of Important People?
A recent example: "We need the press to continue to investigate and report on the generation of affected children in the U.S. We're being overwhelmed by a disorder that was unheard of a few years ago, yet the press isn't calling for answers. If one in every 166 children were suddenly developing blindness, I'm sure it would be a front page story."
Some no doubt find this a bit much. But what Dachel represents is persistence. Private citizens have every right to question elected officials and keep the media on their toes, whether the pooh-bahs like it or not. It's an old-fashioned thing called citizenship.
Person of the Century: Bernard Rimland, who died this year, is all that. What's more, you can pick the century -- in the one just past, he made a massive contribution by demolishing the idea that parents' behavior can make their children autistic.
In his landmark 1964 book, "Infantile Autism: The Syndrome and Its Implications for a Neural Theory of Behavior," he laid out the case against the then-conventional wisdom. What's more, he laid the foundation for all serious research on the subject when he wrote that "conviction (must be) subordinated to evidence. The history of science proves this to be the first step toward progress."
Using that same approach, Rimland concluded that medical treatment could help many autistic kids. That's his contribution to the century just begun and the promise it holds for both prevention and treatment.
He thus exiled himself from most of mainstream medicine, but he may have helped thousands of children. Which would you rather have as your legacy?
Because of his guts, grit -- and perseverance -- he'll be remembered for leading not one, but two, medical revolutions.
Not So Hot National Magazine Story of the Year: Newsweek, which did a cover story on the looming caregiving crisis as thousands of autistic children "age out" of mandated care into an uncertain adulthood.
So far, so good. But the magazine failed to come to grips with the obvious: Why are there so many kids with autism?
Fishy Factoid of the Year Award: ABC News, which did a story much like Newsweek's and simply asserted that "up to 1 million" adults are living with autism.
Where are they?
Quote of the Year: From Irva Hertz-Picciotto, chair of an expert panel convened by the National Institute of Environmental Health Sciences at the request of Congress. The panel poked some gaping holes in the kind of data the Centers for Disease Control and Prevention uses to assure Americans that there's no link between autism and the mercury preservative in vaccines called thimerosal.
"I think there's more work to be done," said Hertz-Picciotto, a professor in the Department of Public Health at the University of California-Davis School of Medicine.
"We know there's a major genetic component to autism, but genes cannot explain a rise over a short time period of a few decades," she said, sounding a lot more like Anne Dachel and Bernie Rimland than Newsweek, ABC and the CDC.
"It's an 'open question' whether anything about vaccines -- timing, dose, preservative -- is related to the rise in diagnoses," she said.
That's right -- an open question, one that requires an urgent and definitive answer.
Not So Hot Magazine Story of the Year, Local Division: The Washingtonian, which ran an article in its November issue titled, "Something Happened and We Don't Know Why," about twins with autism.
Although the twins' mom thinks vaccine mercury did trigger their autism, she is brushed off with the author's comment that "many large-scale studies have disproved a link between thimerosal and autism."
Yeah, large-scale studies like the one the NIH expert panel just dumped a bucket of cold water on.
Prediction for '07: The pace of change is accelerating in ways that are not entirely in the control of the government and its often defensive bureaucracies.
I believe 2007 will be a very good year for the truth -- for the subordination of conviction to evidence, as Bernard Rimland so elegantly put it. And that would be a very good year, indeed.
December 4, 2006
The Age of Autism: What Newsweek Missed
The Age of Autism: What Newsweek missed
By DAN OLMSTED
UPI Senior Editor
WASHINGTON, Nov. 20 (UPI) -- Newsweek's cover story this week is about what happens to autistic kids when they grow up. The magazine does a good job of pointing to funding gaps and the plight of parents who can only imagine what will happen to their kids after they're gone.
But Newsweek fails to confront a key issue, one that bedevils mainstream publications every time they write about autism: Is it really increasing? Or are we just doing a better job of diagnosing the disorder?
Newsweek, without exactly saying it, comes down on the side of better diagnosis. " ... (M)ore sophisticated epidemiology has revealed the true magnitude of the problem," the magazine says. It also suggests the increase coincided with parents banding together "to raise awareness of a once rarely diagnosed, often overlooked disease."
Yet in a sidebar, Thomas Insel, director of the National Institute of Mental Health, says that as a psychiatrist in the 1970s he never saw a single person with autism. "In 1985, curiosity sent him searching; it took several phone calls to find a single patient," the article says.
Does today's "more sophisticated epidemiology" really square with Insel's experience? I don't believe it does; 1985 was hardly the dark ages of medical diagnosis. And autism was described as a distinct disorder more than 40 years before that -- concern already had arisen that it was becoming a trendy diagnosis, handed out too freely.
Yet Insel, obviously well-connected to the medical and psychiatric community, had to mount a virtual search party to find a single one?
The article goes on to say that NIMH is "newly interested in environmental factors that might set off the disorder in patients who are already genetically prone to it."
What does it mean to be "already genetically prone" to autism, yet have it triggered only after exposure to some outside factor? I'm not sure that makes sense. What does make sense is that some children might have a genetic inability to cope with that factor, triggering the "environmental insult" that leads to autism.
If such an exposure increased, it could certainly account for an increase in the autism rate. NIH officials are increasingly blunt about this, even if the media are not. At a recent meeting with a group of parents, according to several participants, the head of one NIH institute said: "There are no epidemic deniers here."
I'm told a second institute director said at another recent meeting that autism is primarily an "environmental" disease. An audience member's suggestion that genes alone explain the current rate was flatly dismissed by this official.
Because it doesn't connect the dots, Newsweek misses the point: We're in an epidemic, which is why the future of this generation is a crisis. The article's whole premise, however, inadvertently suggests the truth: There are now so many kids with autism -- "as many as 500,000 Americans under 21," the magazine says -- that caring for them as adults must be urgently addressed.
If there were already a comparable million-plus adults with the disorder, the issue would have been recognized years ago. To be sure, some autistic adults of all ages have been misdiagnosed over the years as retarded or mentally ill.
But if autism has held steady over the years, it shouldn't be hard to find thousands and thousands of clearly autistic people in their 30s, 40s, 50s -- even their 80s and 90s. The first child in the landmark 1943 study identifying autism, who was known as Donald T., is still alive at age 73. It was the striking uniqueness and novelty of such cases that prompted the study in the first place.
When NIMH's Insel went looking for cases in the 1980s, it seems autism was still pretty rare. It's not anymore -- as Newsweek points out, disorders on the autism "spectrum" now afflict as many as 1 in 166 children. Note: children. Where are the 1 in 166 autistic adults?
Until we stop ignoring the obvious, we're never going to stop this epidemic -- and find new and better treatments for people already afflicted.
And that's the most urgent issue of all.
April 4, 2006
The Age of Autism: Hot potato on the Hill
The Age of Autism: Hot potato on the Hill
By DAN OLMSTED
The newly proposed legislation to study the autism rate in never-vaccinated American kids could settle the debate over vaccines and autism once and for all. Does that mean it will never happen?
This week U.S. Rep. Carolyn Maloney, D-N.Y., stepped out front on the issue. She announced at a briefing at the National Press Club that she is drafting legislation to mandate that the federal government find the answer to that question.
Notice the word "mandate" -- as in "direct," which is the language the bill uses. As in, quit making excuses and just do it.
Bureaucrats and lobbyists and "experts" sometimes forget that the power in this country resides with the people, who express their will through their elected representatives. This may sound rather grand, but the point is that legislators are not some "special interest" who must be humored while the permanent ruling class goes on its merry way.
That's why putting a bill before the Congress -- which Maloney says she will do by the end of April after getting as much public comment as possible -- could be a bigger threat than people realize.
After all, as Maloney said this week, "Maybe someone in the medical establishment will show me why this study is a bad idea, but they haven't done it yet."
Maloney, who credits this column with the idea to look at the never-vaccinated, also critiqued the studies that supposedly have ruled out any link between vaccines -- particularly the mercury-based preservative thimerosal -- and autism.
"The one major government study to date, the Institute of Medicine's 2004 review, has been met with skepticism from a lot of people," she said. "There are serious questions about the data set and methodology.
"Meanwhile, there is new biological evidence published in top journals, and from major U.S. universities, to support the mercury-autism hypothesis. Just last week we saw the study out of UC Davis, which found that thimerosal disrupts normal biological signals within cells, causes inflammation and even cell death.
"In short," the congresswoman concluded, "I believe that there are still more questions than answers. But answers are what we desperately need."
Surely everyone's in favor of answers, aren't they? Well, no, they're not. Already, doubts are being raised about whether there are enough never-vaccinated kids to do such a study (there are); whether it's worth doing (it is); and what the results would really show (well, let's find out).
In fact, if the feds hadn't been contentedly dozing for the last decade as the autism rate inexplicably soared, we'd already have our answer.
Back in 2002 a woman named Sandy Gottstein, who does not even have an affected child, came all the way from Anchorage, Alaska, to raise this issue at a congressional hearing.
"My question is, is the National Institutes of Health ever planning on doing a study using the only proper control group, that is, never-vaccinated children?" Gottstein asked.
Dr. Steve Foote of NIH responded: "I am not aware of a proposed study to use a suitably constructed group of never-vaccinated children. ... Now CDC would be more likely perhaps to be aware of such an opportunity."
Responded Dr. Melinda Wharton of the CDC: "The difficulty with doing such a study in the United States, of course, is that a very small portion of children have never received any vaccines, and these children probably differ in other ways from vaccinated children. So performing such a study would, in fact, be quite difficult."
Another futile effort is recounted in David Kirby's book, "Evidence of Harm," which recounts parents' compelling stories that their children's regressive autism was triggered by vaccine reactions.
The book -- just out in paperback and winner of this year's prize from the prestigious Investigative Reporters and Editors -- describes how in 2004 Lyn Redwood of the advocacy group SafeMinds sent a list of proposed studies to Rep. Dave Weldon, R-Fla.
Weldon, a strong advocate of banning thimerosal, sent the list on to Dr. Julie Gerberding, director of the Centers for Disease Control and Prevention. Redwood's proposal No. 1: "An investigation into the rates of neurodevelopmental disorders including autism in vaccinated and unvaccinated populations (e.g., Amish, Christian Scientists.)"
Last year this column set out to test that theory among the Amish, in an unvaccinated subset of homeschooled kids and in a large medical practice in Chicago with thousands of never-vaccinated children. In this admittedly unscientific and anecdotal reporting, we didn't find very many kids with autism.
That's certainly not conclusive, but we did conclude there are plenty of never-vaccinated kids in this country, and not all of them are riding around in buggies and reading by candlelight. The total number of appropriate "controls" -- reasonably typical never-vaccinated kids -- is well into the tens of thousands, at least.
Nor is the issue pro-vaccines vs. no vaccines, as some who oppose such a study are subtly suggesting. It's safety vs. complacency.
After all, the CDC switched to an inactivated polio vaccine in 2000 when it became clear that the live polio virus was causing a handful of polio cases each year. And kids today are still protected from polio -- only now with zero chance of actually contracting it from the vaccine.
Switching to a safer vaccine did not cause a collapse in public confidence in childhood immunizations -- probably quite the contrary.
Expect to hear all kinds of excuses, including that one, from the powers that be as to why such a conclusive study couldn't, shouldn't and really mustn't be done. Then ask yourself, Why?
E-mail: dolmsted@upi.com
By DAN OLMSTED
The newly proposed legislation to study the autism rate in never-vaccinated American kids could settle the debate over vaccines and autism once and for all. Does that mean it will never happen?
This week U.S. Rep. Carolyn Maloney, D-N.Y., stepped out front on the issue. She announced at a briefing at the National Press Club that she is drafting legislation to mandate that the federal government find the answer to that question.
Notice the word "mandate" -- as in "direct," which is the language the bill uses. As in, quit making excuses and just do it.
Bureaucrats and lobbyists and "experts" sometimes forget that the power in this country resides with the people, who express their will through their elected representatives. This may sound rather grand, but the point is that legislators are not some "special interest" who must be humored while the permanent ruling class goes on its merry way.
That's why putting a bill before the Congress -- which Maloney says she will do by the end of April after getting as much public comment as possible -- could be a bigger threat than people realize.
After all, as Maloney said this week, "Maybe someone in the medical establishment will show me why this study is a bad idea, but they haven't done it yet."
Maloney, who credits this column with the idea to look at the never-vaccinated, also critiqued the studies that supposedly have ruled out any link between vaccines -- particularly the mercury-based preservative thimerosal -- and autism.
"The one major government study to date, the Institute of Medicine's 2004 review, has been met with skepticism from a lot of people," she said. "There are serious questions about the data set and methodology.
"Meanwhile, there is new biological evidence published in top journals, and from major U.S. universities, to support the mercury-autism hypothesis. Just last week we saw the study out of UC Davis, which found that thimerosal disrupts normal biological signals within cells, causes inflammation and even cell death.
"In short," the congresswoman concluded, "I believe that there are still more questions than answers. But answers are what we desperately need."
Surely everyone's in favor of answers, aren't they? Well, no, they're not. Already, doubts are being raised about whether there are enough never-vaccinated kids to do such a study (there are); whether it's worth doing (it is); and what the results would really show (well, let's find out).
In fact, if the feds hadn't been contentedly dozing for the last decade as the autism rate inexplicably soared, we'd already have our answer.
Back in 2002 a woman named Sandy Gottstein, who does not even have an affected child, came all the way from Anchorage, Alaska, to raise this issue at a congressional hearing.
"My question is, is the National Institutes of Health ever planning on doing a study using the only proper control group, that is, never-vaccinated children?" Gottstein asked.
Dr. Steve Foote of NIH responded: "I am not aware of a proposed study to use a suitably constructed group of never-vaccinated children. ... Now CDC would be more likely perhaps to be aware of such an opportunity."
Responded Dr. Melinda Wharton of the CDC: "The difficulty with doing such a study in the United States, of course, is that a very small portion of children have never received any vaccines, and these children probably differ in other ways from vaccinated children. So performing such a study would, in fact, be quite difficult."
Another futile effort is recounted in David Kirby's book, "Evidence of Harm," which recounts parents' compelling stories that their children's regressive autism was triggered by vaccine reactions.
The book -- just out in paperback and winner of this year's prize from the prestigious Investigative Reporters and Editors -- describes how in 2004 Lyn Redwood of the advocacy group SafeMinds sent a list of proposed studies to Rep. Dave Weldon, R-Fla.
Weldon, a strong advocate of banning thimerosal, sent the list on to Dr. Julie Gerberding, director of the Centers for Disease Control and Prevention. Redwood's proposal No. 1: "An investigation into the rates of neurodevelopmental disorders including autism in vaccinated and unvaccinated populations (e.g., Amish, Christian Scientists.)"
Last year this column set out to test that theory among the Amish, in an unvaccinated subset of homeschooled kids and in a large medical practice in Chicago with thousands of never-vaccinated children. In this admittedly unscientific and anecdotal reporting, we didn't find very many kids with autism.
That's certainly not conclusive, but we did conclude there are plenty of never-vaccinated kids in this country, and not all of them are riding around in buggies and reading by candlelight. The total number of appropriate "controls" -- reasonably typical never-vaccinated kids -- is well into the tens of thousands, at least.
Nor is the issue pro-vaccines vs. no vaccines, as some who oppose such a study are subtly suggesting. It's safety vs. complacency.
After all, the CDC switched to an inactivated polio vaccine in 2000 when it became clear that the live polio virus was causing a handful of polio cases each year. And kids today are still protected from polio -- only now with zero chance of actually contracting it from the vaccine.
Switching to a safer vaccine did not cause a collapse in public confidence in childhood immunizations -- probably quite the contrary.
Expect to hear all kinds of excuses, including that one, from the powers that be as to why such a conclusive study couldn't, shouldn't and really mustn't be done. Then ask yourself, Why?
E-mail: dolmsted@upi.com
February 11, 2006
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.
December 22, 2005
Dan Olmsted - Autism's Dick Tracy
Dan Olmsted - Autism's Dick Tracy
by Evelyn Pringle
According to officials in the nation's regulatory agencies, the main obstacle to proving or disproving a link between the autism epidemic and the mercury-based preservative, thimerosal, that was contained in childhood vaccines until a few years ago, and is still in flu vaccines, has been the inability to find a large enough group of people who have never been vaccinated to compare with people who have.
In fact, a few months ago, CDC officials claimed that such a study would be nearly impossible. On July 19, 2005, the CDC held a Media Briefing on the topic of vaccines and child health. On the issue of government research on autism, a reporter asked CDC Director, Dr Julie Gerberding: "are you putting any money into clinical studies rather than epidemiological studies, to verify or disprove the parents' claim about a particular channel, a particular mechanism by which a minority of genetically suspectable kids are supposed damaged?"
Gerberding replied: To do the study that you're suggesting, looking for an association between thimerosal and autism in a prospective sense is just about impossible to do right now because we don't have those vaccines in use in this country so we're not in a position where we can compare the children who have received them directly to the children who don't.
Dr Duane Alexander, of the National Institute of Health, agreed and said: It's really not possible ... in this country to do a prospective study now of thimerosal and vaccines in relationship to autism. Only a retrospective study which would be very difficult to do under the circumstances could be mounted with regard to the thimerosal question.
However, Dan Olmsted, investigative reporter for United Press International, and author of the Age of Autism series of reports, appears to have solved this problem when he came up with the idea of checking out the nation's Amish population where parents do not ordinarily vaccinate children.
First he looked to the Amish community in Pennsylvania and found a family doctor in Lancaster who had treated thousands of Amish patients over a quarter-century who said he has never seen an Amish person with autism, according to Age of Autism: A glimpse of the Amish on June 2, 2005.
Olmsted also interviewed Dick Warner, who has a water purification and natural health business and has been in Amish households all over the country. "I've been working with Amish people since 1980," Warner said.
"I have never seen an autistic Amish child -- not one," he told Olmsted. "I would know it. I have a strong medical background. I know what autistic people are like. I have friends who have autistic children," he added.
Olmsted did find one Amish woman in Lancaster County with an autistic child but as it turns out, the child was adopted from China and had been vaccinated. The woman knew of two other autistic children but here again, one of those had been vaccinated.
Next Olmsted visited a medical practice in Middleburg, Indiana, the heart of the Amish community, and asked whether the clinic treated Amish people with autism.
A staff member told Olmsted that she had never thought about it before, but in the five years that she had worked at the clinic she had never seen one autistic Amish.
On June 8, 2005, Olmsted reported on the autism rate in the Amish community around Middlefield, Ohio, which was 1 in 15,000, according to Dr Heng Wang, the medical director, at the DDC Clinic for Special Needs Children.
"So far," according to Age of Autism, "there is evidence of fewer than 10 Amish with autism; there should be several hundred if the disorder occurs among them at the same 166-1 prevalence as children born in the rest of the population."
In addition to the Amish, Olmsted recently discovered another large unvaccinated group. On December 7, 2005, Age of Autism reported that thousands of children cared for by Homefirst Health Services in metropolitan Chicago have at least two things in common with Amish children, they have never been vaccinated and they don't have autism.
Homefirst has five offices in the Chicago area and a total of six doctors. "We have about 30,000 or 35,000 children that we've taken care of over the years, and I don't think we have a single case of autism in children delivered by us who never received vaccines," said Dr Mayer Eisenstein, Homefirst's medical director who founded the practice in 1973.
Olmsted reports that the autism rate in Illinois public schools is 38 per 10,000, according to state Education Department data. In treating a population of 30,000 to 35,000 children, this would logically mean that Homefirst should have seen at least 120 autistic children over the years but the clinic has seen none.
It looks like the problem is finally solved. Thanks to autism's Dick Tracy, the government now has thousands of unvaccinated people to compare to people who were vaccinated.
evelyn.pringle@sbcglobal.net
by Evelyn Pringle
According to officials in the nation's regulatory agencies, the main obstacle to proving or disproving a link between the autism epidemic and the mercury-based preservative, thimerosal, that was contained in childhood vaccines until a few years ago, and is still in flu vaccines, has been the inability to find a large enough group of people who have never been vaccinated to compare with people who have.
In fact, a few months ago, CDC officials claimed that such a study would be nearly impossible. On July 19, 2005, the CDC held a Media Briefing on the topic of vaccines and child health. On the issue of government research on autism, a reporter asked CDC Director, Dr Julie Gerberding: "are you putting any money into clinical studies rather than epidemiological studies, to verify or disprove the parents' claim about a particular channel, a particular mechanism by which a minority of genetically suspectable kids are supposed damaged?"
Gerberding replied: To do the study that you're suggesting, looking for an association between thimerosal and autism in a prospective sense is just about impossible to do right now because we don't have those vaccines in use in this country so we're not in a position where we can compare the children who have received them directly to the children who don't.
Dr Duane Alexander, of the National Institute of Health, agreed and said: It's really not possible ... in this country to do a prospective study now of thimerosal and vaccines in relationship to autism. Only a retrospective study which would be very difficult to do under the circumstances could be mounted with regard to the thimerosal question.
However, Dan Olmsted, investigative reporter for United Press International, and author of the Age of Autism series of reports, appears to have solved this problem when he came up with the idea of checking out the nation's Amish population where parents do not ordinarily vaccinate children.
First he looked to the Amish community in Pennsylvania and found a family doctor in Lancaster who had treated thousands of Amish patients over a quarter-century who said he has never seen an Amish person with autism, according to Age of Autism: A glimpse of the Amish on June 2, 2005.
Olmsted also interviewed Dick Warner, who has a water purification and natural health business and has been in Amish households all over the country. "I've been working with Amish people since 1980," Warner said.
"I have never seen an autistic Amish child -- not one," he told Olmsted. "I would know it. I have a strong medical background. I know what autistic people are like. I have friends who have autistic children," he added.
Olmsted did find one Amish woman in Lancaster County with an autistic child but as it turns out, the child was adopted from China and had been vaccinated. The woman knew of two other autistic children but here again, one of those had been vaccinated.
Next Olmsted visited a medical practice in Middleburg, Indiana, the heart of the Amish community, and asked whether the clinic treated Amish people with autism.
A staff member told Olmsted that she had never thought about it before, but in the five years that she had worked at the clinic she had never seen one autistic Amish.
On June 8, 2005, Olmsted reported on the autism rate in the Amish community around Middlefield, Ohio, which was 1 in 15,000, according to Dr Heng Wang, the medical director, at the DDC Clinic for Special Needs Children.
"So far," according to Age of Autism, "there is evidence of fewer than 10 Amish with autism; there should be several hundred if the disorder occurs among them at the same 166-1 prevalence as children born in the rest of the population."
In addition to the Amish, Olmsted recently discovered another large unvaccinated group. On December 7, 2005, Age of Autism reported that thousands of children cared for by Homefirst Health Services in metropolitan Chicago have at least two things in common with Amish children, they have never been vaccinated and they don't have autism.
Homefirst has five offices in the Chicago area and a total of six doctors. "We have about 30,000 or 35,000 children that we've taken care of over the years, and I don't think we have a single case of autism in children delivered by us who never received vaccines," said Dr Mayer Eisenstein, Homefirst's medical director who founded the practice in 1973.
Olmsted reports that the autism rate in Illinois public schools is 38 per 10,000, according to state Education Department data. In treating a population of 30,000 to 35,000 children, this would logically mean that Homefirst should have seen at least 120 autistic children over the years but the clinic has seen none.
It looks like the problem is finally solved. Thanks to autism's Dick Tracy, the government now has thousands of unvaccinated people to compare to people who were vaccinated.
evelyn.pringle@sbcglobal.net
December 7, 2005
The Age of Autism: 'A pretty big secret'
The Age of Autism: 'A pretty big secret'
By Dan Olmsted
UPI Senior Editor
It's a far piece from the horse-and-buggies of Lancaster County, Pa., to the cars and freeways of Cook County, Ill.
But thousands of children cared for by Homefirst Health Services in metropolitan Chicago have at least two things in common with thousands of Amish children in rural Lancaster: They have never been vaccinated. And they don't have autism.
"We have a fairly large practice. We have about 30,000 or 35,000 children that we've taken care of over the years, and I don't think we have a single case of autism in children delivered by us who never received vaccines," said Dr. Mayer Eisenstein, Homefirst's medical director who founded the practice in 1973. Homefirst doctors have delivered more than 15,000 babies at home, and thousands of them have never been vaccinated.
The few autistic children Homefirst sees were vaccinated before their families became patients, Eisenstein said. "I can think of two or three autistic children who we've delivered their mother's next baby, and we aren't really totally taking care of that child -- they have special care needs. But they bring the younger children to us. I don't have a single case that I can think of that wasn't vaccinated."
The autism rate in Illinois public schools is 38 per 10,000, according to state Education Department data; the Centers for Disease Control and Prevention puts the national rate of autism spectrum disorders at 1 in 166 -- 60 per 10,000.
"We do have enough of a sample," Eisenstein said. "The numbers are too large to not see it. We would absolutely know. We're all family doctors. If I have a child with autism come in, there's no communication. It's frightening. You can't touch them. It's not something that anyone would miss."
No one knows what causes autism, but federal health authorities say it isn't childhood immunizations. Some parents and a small minority of doctors and scientists, however, assert vaccines are responsible.
This column has been looking for autism in never-vaccinated U.S. children in an effort to shed light on the issue. We went to Chicago to meet with Eisenstein at the suggestion of a reader, and we also visited Homefirst's office in northwest suburban Rolling Meadows. Homefirst has four other offices in the Chicago area and a total of six doctors.
Eisenstein stresses his observations are not scientific. "The trouble is this is just anecdotal in a sense, because what if every autistic child goes somewhere else and (their family) never calls us or they moved out of state?"
In practice, that's unlikely to account for the pronounced absence of autism, says Eisenstein, who also has a bachelor's degree in statistics, a master's degree in public health and a law degree.
Homefirst follows state immunization mandates, but Illinois allows religious exemptions if parents object based either on tenets of their faith or specific personal religious views. Homefirst does not exclude or discourage such families. Eisenstein, in fact, is author of the book "Don't Vaccinate Before You Educate!" and is critical of the CDC's vaccination policy in the 1990s, when several new immunizations were added to the schedule, including Hepatitis B as early as the day of birth. Several of the vaccines -- HepB included -- contained a mercury-based preservative that has since been phased out of most childhood vaccines in the United States.
Medical practices with Homefirst's approach to immunizations are rare. "Because of that, we tend to attract families that have questions about that issue," said Dr. Paul Schattauer, who has been with Homefirst for 20 years and treats "at least" 100 children a week.
Schattauer seconded Eisenstein's observations. "All I know is in my practice I don't see autism. There is no striking 1-in-166," he said.
Earlier this year we reported the same phenomenon in the mostly unvaccinated Amish. CDC Director Dr. Julie Gerberding told us the Amish "have genetic connectivity that would make them different from populations that are in other sectors of the United States." Gerberding said, however, studies "could and should be done" in more representative unvaccinated groups -- if they could be found and their autism rate documented.
Chicago is America's prototypical "City of Big Shoulders," to quote Carl Sandburg, and Homefirst's mostly middle-class families seem fairly representative. A substantial number are conservative Christians who home-school their children. They are mostly white, but the Homefirst practice also includes black and Hispanic families and non-home-schooling Jews, Catholics and Muslims.
They tend to be better educated, follow healthier diets and breast-feed their children much longer than the norm -- half of Homefirst's mothers are still breast-feeding at two years. Also, because Homefirst relies less on prescription drugs including antibiotics as a first line of treatment, these children have less exposure to other medicines, not just vaccines.
Schattauer, interviewed at the Rolling Meadows office, said his caseload is too limited to draw conclusions about a possible link between vaccines and autism. "With these numbers you'd have a hard time proving or disproving anything," he said. "You can only get a feeling about it.
"In no way would I be an advocate to stand up and say we need to look at vaccines, because I don't have the science to say that," Schattauer said. "But I don't think the science is there to say that it's not."
Schattauer said Homefirst's patients also have significantly less childhood asthma and juvenile diabetes compared to national rates. An office manager who has been with Homefirst for 17 years said she is aware of only one case of severe asthma in an unvaccinated child.
"Sometimes you feel frustrated because you feel like you've got a pretty big secret," Schattauer said. He argues for more research on all those disorders, independent of political or business pressures.
The asthma rate among Homefirst patients is so low it was noticed by the Blue Cross group with which Homefirst is affiliated, according to Eisenstein.
"In the alternative-medicine network which Homefirst is part of, there are virtually no cases of childhood asthma, in contrast to the overall Blue Cross rate of childhood asthma which is approximately 10 percent," he said. "At first I thought it was because they (Homefirst's children) were breast-fed, but even among the breast-fed we've had asthma. We have virtually no asthma if you're breast-fed and not vaccinated."
Because the diagnosis of asthma is based on emergency-room visits and hospital admissions, Eisenstein said, Homefirst's low rate is hard to dispute. "It's quantifiable -- the definition is not reliant on the doctor's perception of asthma."
Several studies have found a risk of asthma from vaccination; others have not. Studies that include never-vaccinated children generally find little or no asthma in that group.
Earlier this year Florida pediatrician Dr. Jeff Bradstreet said there is virtually no autism in home-schooling families who decline to vaccinate for religious reasons -- lending credence to Eisenstein's observations.
"It's largely non-existent," said Bradstreet, who treats children with autism from around the country. "It's an extremely rare event."
Bradstreet has a son whose autism he attributes to a vaccine reaction at 15 months. His daughter has been home-schooled, he describes himself as a "Christian family physician," and he knows many of the leaders in the home-school movement.
"There was this whole subculture of folks who went into home-schooling so they would never have to vaccinate their kids," he said. "There's this whole cadre who were never vaccinated for religious reasons."
In that subset, he said, "unless they were massively exposed to mercury through lots of amalgams (mercury dental fillings in the mother) and/or big-time fish eating, I've not had a single case."
Federal health authorities and mainstream medical groups emphatically dismiss any link between autism and vaccines, including the mercury-based preservative thimerosal. Last year a panel of the Institute of Medicine, part of the National Academies, said there is no evidence of such a link, and funding should henceforth go to "promising" research.
Thimerosal, which is 49.6 percent ethyl mercury by weight, was phased out of most U.S. childhood immunizations beginning in 1999, but the CDC recommends flu shots for pregnant women and last year began recommending them for children 6 to 23 months old. Most of those shots contain thimerosal.
Thimerosal-preserved vaccines are currently being injected into millions of children in developing countries around the world. "My mandate ... is to make sure at the end of the day that 100,000,000 are immunized ... this year, next year and for many years to come ... and that will have to be with thimerosal-containing vaccines," said John Clements of the World Health Organization at a June 2000 meeting called by the CDC.
That meeting was held to review data that thimerosal might be linked with autism and other neurological problems. But in 2004 the Institute of Medicine panel said evidence against a link is so strong that health authorities, "whether in the United States or other countries, should not include autism as a potential risk" when formulating immunization policies.
But where is the simple, straightforward study of autism in never-vaccinated U.S. children? Based on our admittedly anecdotal and limited reporting among the Amish, the home-schooled and now Chicago's Homefirst, that may prove to be a significant omission.
--
This ongoing series on the roots and rise of autism welcomes comment. E-mail: dolmsted@upi.com
By Dan Olmsted
UPI Senior Editor
It's a far piece from the horse-and-buggies of Lancaster County, Pa., to the cars and freeways of Cook County, Ill.
But thousands of children cared for by Homefirst Health Services in metropolitan Chicago have at least two things in common with thousands of Amish children in rural Lancaster: They have never been vaccinated. And they don't have autism.
"We have a fairly large practice. We have about 30,000 or 35,000 children that we've taken care of over the years, and I don't think we have a single case of autism in children delivered by us who never received vaccines," said Dr. Mayer Eisenstein, Homefirst's medical director who founded the practice in 1973. Homefirst doctors have delivered more than 15,000 babies at home, and thousands of them have never been vaccinated.
The few autistic children Homefirst sees were vaccinated before their families became patients, Eisenstein said. "I can think of two or three autistic children who we've delivered their mother's next baby, and we aren't really totally taking care of that child -- they have special care needs. But they bring the younger children to us. I don't have a single case that I can think of that wasn't vaccinated."
The autism rate in Illinois public schools is 38 per 10,000, according to state Education Department data; the Centers for Disease Control and Prevention puts the national rate of autism spectrum disorders at 1 in 166 -- 60 per 10,000.
"We do have enough of a sample," Eisenstein said. "The numbers are too large to not see it. We would absolutely know. We're all family doctors. If I have a child with autism come in, there's no communication. It's frightening. You can't touch them. It's not something that anyone would miss."
No one knows what causes autism, but federal health authorities say it isn't childhood immunizations. Some parents and a small minority of doctors and scientists, however, assert vaccines are responsible.
This column has been looking for autism in never-vaccinated U.S. children in an effort to shed light on the issue. We went to Chicago to meet with Eisenstein at the suggestion of a reader, and we also visited Homefirst's office in northwest suburban Rolling Meadows. Homefirst has four other offices in the Chicago area and a total of six doctors.
Eisenstein stresses his observations are not scientific. "The trouble is this is just anecdotal in a sense, because what if every autistic child goes somewhere else and (their family) never calls us or they moved out of state?"
In practice, that's unlikely to account for the pronounced absence of autism, says Eisenstein, who also has a bachelor's degree in statistics, a master's degree in public health and a law degree.
Homefirst follows state immunization mandates, but Illinois allows religious exemptions if parents object based either on tenets of their faith or specific personal religious views. Homefirst does not exclude or discourage such families. Eisenstein, in fact, is author of the book "Don't Vaccinate Before You Educate!" and is critical of the CDC's vaccination policy in the 1990s, when several new immunizations were added to the schedule, including Hepatitis B as early as the day of birth. Several of the vaccines -- HepB included -- contained a mercury-based preservative that has since been phased out of most childhood vaccines in the United States.
Medical practices with Homefirst's approach to immunizations are rare. "Because of that, we tend to attract families that have questions about that issue," said Dr. Paul Schattauer, who has been with Homefirst for 20 years and treats "at least" 100 children a week.
Schattauer seconded Eisenstein's observations. "All I know is in my practice I don't see autism. There is no striking 1-in-166," he said.
Earlier this year we reported the same phenomenon in the mostly unvaccinated Amish. CDC Director Dr. Julie Gerberding told us the Amish "have genetic connectivity that would make them different from populations that are in other sectors of the United States." Gerberding said, however, studies "could and should be done" in more representative unvaccinated groups -- if they could be found and their autism rate documented.
Chicago is America's prototypical "City of Big Shoulders," to quote Carl Sandburg, and Homefirst's mostly middle-class families seem fairly representative. A substantial number are conservative Christians who home-school their children. They are mostly white, but the Homefirst practice also includes black and Hispanic families and non-home-schooling Jews, Catholics and Muslims.
They tend to be better educated, follow healthier diets and breast-feed their children much longer than the norm -- half of Homefirst's mothers are still breast-feeding at two years. Also, because Homefirst relies less on prescription drugs including antibiotics as a first line of treatment, these children have less exposure to other medicines, not just vaccines.
Schattauer, interviewed at the Rolling Meadows office, said his caseload is too limited to draw conclusions about a possible link between vaccines and autism. "With these numbers you'd have a hard time proving or disproving anything," he said. "You can only get a feeling about it.
"In no way would I be an advocate to stand up and say we need to look at vaccines, because I don't have the science to say that," Schattauer said. "But I don't think the science is there to say that it's not."
Schattauer said Homefirst's patients also have significantly less childhood asthma and juvenile diabetes compared to national rates. An office manager who has been with Homefirst for 17 years said she is aware of only one case of severe asthma in an unvaccinated child.
"Sometimes you feel frustrated because you feel like you've got a pretty big secret," Schattauer said. He argues for more research on all those disorders, independent of political or business pressures.
The asthma rate among Homefirst patients is so low it was noticed by the Blue Cross group with which Homefirst is affiliated, according to Eisenstein.
"In the alternative-medicine network which Homefirst is part of, there are virtually no cases of childhood asthma, in contrast to the overall Blue Cross rate of childhood asthma which is approximately 10 percent," he said. "At first I thought it was because they (Homefirst's children) were breast-fed, but even among the breast-fed we've had asthma. We have virtually no asthma if you're breast-fed and not vaccinated."
Because the diagnosis of asthma is based on emergency-room visits and hospital admissions, Eisenstein said, Homefirst's low rate is hard to dispute. "It's quantifiable -- the definition is not reliant on the doctor's perception of asthma."
Several studies have found a risk of asthma from vaccination; others have not. Studies that include never-vaccinated children generally find little or no asthma in that group.
Earlier this year Florida pediatrician Dr. Jeff Bradstreet said there is virtually no autism in home-schooling families who decline to vaccinate for religious reasons -- lending credence to Eisenstein's observations.
"It's largely non-existent," said Bradstreet, who treats children with autism from around the country. "It's an extremely rare event."
Bradstreet has a son whose autism he attributes to a vaccine reaction at 15 months. His daughter has been home-schooled, he describes himself as a "Christian family physician," and he knows many of the leaders in the home-school movement.
"There was this whole subculture of folks who went into home-schooling so they would never have to vaccinate their kids," he said. "There's this whole cadre who were never vaccinated for religious reasons."
In that subset, he said, "unless they were massively exposed to mercury through lots of amalgams (mercury dental fillings in the mother) and/or big-time fish eating, I've not had a single case."
Federal health authorities and mainstream medical groups emphatically dismiss any link between autism and vaccines, including the mercury-based preservative thimerosal. Last year a panel of the Institute of Medicine, part of the National Academies, said there is no evidence of such a link, and funding should henceforth go to "promising" research.
Thimerosal, which is 49.6 percent ethyl mercury by weight, was phased out of most U.S. childhood immunizations beginning in 1999, but the CDC recommends flu shots for pregnant women and last year began recommending them for children 6 to 23 months old. Most of those shots contain thimerosal.
Thimerosal-preserved vaccines are currently being injected into millions of children in developing countries around the world. "My mandate ... is to make sure at the end of the day that 100,000,000 are immunized ... this year, next year and for many years to come ... and that will have to be with thimerosal-containing vaccines," said John Clements of the World Health Organization at a June 2000 meeting called by the CDC.
That meeting was held to review data that thimerosal might be linked with autism and other neurological problems. But in 2004 the Institute of Medicine panel said evidence against a link is so strong that health authorities, "whether in the United States or other countries, should not include autism as a potential risk" when formulating immunization policies.
But where is the simple, straightforward study of autism in never-vaccinated U.S. children? Based on our admittedly anecdotal and limited reporting among the Amish, the home-schooled and now Chicago's Homefirst, that may prove to be a significant omission.
--
This ongoing series on the roots and rise of autism welcomes comment. E-mail: dolmsted@upi.com
November 1, 2005
The Age of Autism: The Amish Elephant
The Age of Autism: The Amish Elephant
By Dan Olmsted
UPI Senior Editor
Oct. 29, 2005 at 2:34PM
A specter is haunting the medical and journalism establishments of the United States: Where are the unvaccinated people with autism?
That is just about the only way to explain what now appears to be a collective resistance to considering that question. And like all unanswered questions, this raises another one: Why?
What is the problem with quickly and firmly establishing that the autism rate is about the same everywhere and for everybody in the United States, vaccinated or unvaccinated? Wouldn't that stop all the scientifically illiterate chatter by parents who believe vaccinations made their children autistic? Wouldn't it put to rest concerns that -- despite the removal of a mercury-containing preservative in most U.S. vaccines -- hundreds of millions of children in the developing world are possibly at risk if that preservative is in fact linked to autism?
Calling this issue The Amish Elephant reflects reporting earlier this year in Age of Autism that the largely unvaccinated Amish may have a relatively low rate of autism. That apparent dissimilarity is, in effect, a proverbial elephant in the living room -- studiously ignored by people who don't want to deal with it and don't believe they will have to.
Here are a few cases in point.
Earlier this month the National Consumers League conference in Washington held a session on communicating issues around vaccine safety. I was on the panel and talked about the Amish and autism. In the Q&A session that followed, the first question was for me.
"Is this a proper role for a journalist, or is this just a straw dog set up there with a preliminary answer? It not only showed up where you wrote it. It was all over the place. You did very, very well for UPI (at which point I said, 'Thank you -- please tell my bosses that!') but the question is, did you do very, very well for America?
"Is it appropriate for a journalist -- you weren't reporting, you were investigating. And I just wonder if you think it's an appropriate role for you to play."
My answer: "There's different roles for the press. That's certainly a reasonable question. That is investigative reporting. This idea is something that's already been discarded -- that there's any reason why you would want to look in an unvaccinated population.
"One of my favorite comments about journalism is that it's the wild card of American democracy. The First Amendment says we can do (in the sense of reporting about) whatever we want. So one of our privileges is to get an idea in our head and go look at it."
My questioner was not finished. "I wasn't questioning whether you have a First Amendment right to do it. I think this is more of a question of the ethics, of what value we are bringing to the debate."
My response: "That's probably not a good one for me to answer. Obviously I thought it was ethical."
At that point a fellow panelist, Dr. Louis Cooper, former president of the American Academy of Pediatrics and a staunch vaccine defender, spoke up. "I would jump in and say I thought it was ethical and I think it was useful," said Cooper, a courtly and unfailingly courteous Manhattan pediatrician.
"As you've learned, it was annoying to many people. I wasn't annoyed by it because I thought you kept the process and the debate and the discussion going forward. And we have to do that for one another."
That did not end the discussion. A few minutes later a public-health professor from -- where else? Harvard -- did her own version of Jeopardy!, offering the correct "answer" in the form of a question.
"This question is for Dan. Did you mention the outbreak of polio that happened in the Amish community in the Netherlands that caused widespread problems there, and also the fact that there'd been some context with respect to history in our country in trying to reach out to the Amish to actually encourage them to try to benefit from some of the vaccine technology to the extent that we could?
"So there's been a long history in this country of the CDC trying to reach out to them to the extent that they could. Also with respect to polio, I think what's really amazing is it's such a great story, this is such an exciting time, in the sense that we are very close to global eradication. What that means is we've gone from 1988 when we had 350,000 estimated paralytic polio cases in the world every year to roughly a thousand. It's very exciting that in fact we don't have the terror or the hysteria and all of the fear that surrounded disease.
"I just want to remind everyone that one thing that's very important in the context of reporting these stories is making sure that people do remember and also realize with infectious disease is these things can come back, and until they are eradicated they can come back and devastate us just as much as they did before, except now there are a lot more people.
"There's some related news that people might find interesting. A headline in the Washington Post today, 'Polio outbreak occurs among Amish families.' So I thought people might be interested in that."
At that point the moderator, Dr. Roger Bernier of the Centers for Disease Control, said time was getting short -- why was I not surprised? -- and asked for the next "question."
One thing I've noticed is the more that people want to lecture instead of learn, the more they speak in breathless run-on sentences that are hard to stop, slow down or even diagram. They leave one with the unspoken idea that dialogue -- opening the door to new information -- is somehow dangerous.
These exchanges reminded me of the response I got from Dr. Julie Gerberding, the CDC director, when I asked her this summer, verbatim: "Has the government ever looked at the autism rate in an unvaccinated U.S. population, and if not, why not?"
Her answer, verbatim:
--
In this country, we have very high levels of vaccination as you probably know, and I think this year we have record immunization levels among all of our children, so to (select an unvaccinated group) that on a population basis would be representative to look at incidence in that population compared to the other population would be something that could be done.
But as we're learning, just trying to look at autism in a community the size of Atlanta, it's very, very difficult to get an effective numerator and denominator to get a reliable diagnosis.
I think those kind of studies could be done and should be done. You'd have to adjust for the strong genetic component that also distinguishes, for example, people in Amish communities who may elect not to be immunized (and) also have genetic connectivity that would make them different from populations that are in other sectors of the United States. So drawing some conclusions from them would be very difficult.
I think with reference to the timing of all of this, good science does take time, and it's part of one of the messages I feel like I've learned from the feedback that we've gotten from parents groups this summer (in) struggling with developing a more robust and a faster research agenda, is let's speed this up. Let's look for the early studies that could give us at least some hypotheses to test and evaluate and get information flowing through the research pipeline as quickly as we can.
So we are committed to doing that, and as I mentioned, in terms of just measuring the frequency of autism in the population some pretty big steps have been taken. We're careful not to jump ahead of our data, but we think we will be able to provide more accurate information in the next year or so than we've been able to do up to this point. And I know that is our responsibility.
We've also benefited from some increased investments in these areas that have allowed us to do this, and so we thank Congress and we thank the administration for supporting those investments, not just at CDC but also at NIH and FDA.
--
The latest response to my pesky persistence comes not from academia or government but from my own profession. Last week the prestigious Columbia Journalism Review published an article whose main thrust -- with which I concur -- was that a vigorous debate over a possible link between vaccines and autism was being thwarted by the self-induced timidity of the press.
Some reporters told the author, Daniel Schulman, that they have basically given up on the story because the criticism -- some of it from their own editors -- was so fierce, and the story was so complicated.
Schulman described Age of Autism's efforts to come at the issue "sideways," looking for possible clues to the cause of the disorder in the natural history of autism. And he mentioned our reporting on the Amish:
"Privately, two reporters told me that, while intriguing, Olmsted's reporting on the Amish is misguided, since it may simply reflect genetic differences among an isolated gene pool. ... Both reporters believed that Olmsted has made up his mind on the question and is reporting the facts that support his conclusions."
Ouch. Being slammed by one's peers is never enjoyable, although reporters need to have thick skins and realize they dish this kind of thing out every day. (And those anonymous sources really are annoying, especially when I am happy to be quoted by name about everything.)
What's interesting about the reporters' "private" remarks is the degree of presumed expertise they suggest -- that looking at the Amish is misguided "since it may simply reflect genetic differences among an isolated gene pool." Really? Where did these guys get their doctorate in genetics, Harvard?
This assertion -- that the Amish gene pool could explain everything, based on no data that I'm aware of -- is the kind of self-interested speculation masquerading as expertise that has beset the autism-vaccines discussion for far too long. The term I learned for it long ago is "convenient reasoning," and it does not always have to be conscious.
The Amish have all kinds of standard genetic mental and developmental disorders -- from bipolar to retardation -- and a lot more genetic issues to boot from this supposedly protective "isolated gene pool." The doctors who actually know something about the Amish have never suggested to me that genes have anything to do with a low rate of autism. They seem perplexed.
In upcoming columns, we'll put that question to the right people -- geneticists -- and tell you what we find. It's called reporting.
By Dan Olmsted
UPI Senior Editor
Oct. 29, 2005 at 2:34PM
A specter is haunting the medical and journalism establishments of the United States: Where are the unvaccinated people with autism?
That is just about the only way to explain what now appears to be a collective resistance to considering that question. And like all unanswered questions, this raises another one: Why?
What is the problem with quickly and firmly establishing that the autism rate is about the same everywhere and for everybody in the United States, vaccinated or unvaccinated? Wouldn't that stop all the scientifically illiterate chatter by parents who believe vaccinations made their children autistic? Wouldn't it put to rest concerns that -- despite the removal of a mercury-containing preservative in most U.S. vaccines -- hundreds of millions of children in the developing world are possibly at risk if that preservative is in fact linked to autism?
Calling this issue The Amish Elephant reflects reporting earlier this year in Age of Autism that the largely unvaccinated Amish may have a relatively low rate of autism. That apparent dissimilarity is, in effect, a proverbial elephant in the living room -- studiously ignored by people who don't want to deal with it and don't believe they will have to.
Here are a few cases in point.
Earlier this month the National Consumers League conference in Washington held a session on communicating issues around vaccine safety. I was on the panel and talked about the Amish and autism. In the Q&A session that followed, the first question was for me.
"Is this a proper role for a journalist, or is this just a straw dog set up there with a preliminary answer? It not only showed up where you wrote it. It was all over the place. You did very, very well for UPI (at which point I said, 'Thank you -- please tell my bosses that!') but the question is, did you do very, very well for America?
"Is it appropriate for a journalist -- you weren't reporting, you were investigating. And I just wonder if you think it's an appropriate role for you to play."
My answer: "There's different roles for the press. That's certainly a reasonable question. That is investigative reporting. This idea is something that's already been discarded -- that there's any reason why you would want to look in an unvaccinated population.
"One of my favorite comments about journalism is that it's the wild card of American democracy. The First Amendment says we can do (in the sense of reporting about) whatever we want. So one of our privileges is to get an idea in our head and go look at it."
My questioner was not finished. "I wasn't questioning whether you have a First Amendment right to do it. I think this is more of a question of the ethics, of what value we are bringing to the debate."
My response: "That's probably not a good one for me to answer. Obviously I thought it was ethical."
At that point a fellow panelist, Dr. Louis Cooper, former president of the American Academy of Pediatrics and a staunch vaccine defender, spoke up. "I would jump in and say I thought it was ethical and I think it was useful," said Cooper, a courtly and unfailingly courteous Manhattan pediatrician.
"As you've learned, it was annoying to many people. I wasn't annoyed by it because I thought you kept the process and the debate and the discussion going forward. And we have to do that for one another."
That did not end the discussion. A few minutes later a public-health professor from -- where else? Harvard -- did her own version of Jeopardy!, offering the correct "answer" in the form of a question.
"This question is for Dan. Did you mention the outbreak of polio that happened in the Amish community in the Netherlands that caused widespread problems there, and also the fact that there'd been some context with respect to history in our country in trying to reach out to the Amish to actually encourage them to try to benefit from some of the vaccine technology to the extent that we could?
"So there's been a long history in this country of the CDC trying to reach out to them to the extent that they could. Also with respect to polio, I think what's really amazing is it's such a great story, this is such an exciting time, in the sense that we are very close to global eradication. What that means is we've gone from 1988 when we had 350,000 estimated paralytic polio cases in the world every year to roughly a thousand. It's very exciting that in fact we don't have the terror or the hysteria and all of the fear that surrounded disease.
"I just want to remind everyone that one thing that's very important in the context of reporting these stories is making sure that people do remember and also realize with infectious disease is these things can come back, and until they are eradicated they can come back and devastate us just as much as they did before, except now there are a lot more people.
"There's some related news that people might find interesting. A headline in the Washington Post today, 'Polio outbreak occurs among Amish families.' So I thought people might be interested in that."
At that point the moderator, Dr. Roger Bernier of the Centers for Disease Control, said time was getting short -- why was I not surprised? -- and asked for the next "question."
One thing I've noticed is the more that people want to lecture instead of learn, the more they speak in breathless run-on sentences that are hard to stop, slow down or even diagram. They leave one with the unspoken idea that dialogue -- opening the door to new information -- is somehow dangerous.
These exchanges reminded me of the response I got from Dr. Julie Gerberding, the CDC director, when I asked her this summer, verbatim: "Has the government ever looked at the autism rate in an unvaccinated U.S. population, and if not, why not?"
Her answer, verbatim:
--
In this country, we have very high levels of vaccination as you probably know, and I think this year we have record immunization levels among all of our children, so to (select an unvaccinated group) that on a population basis would be representative to look at incidence in that population compared to the other population would be something that could be done.
But as we're learning, just trying to look at autism in a community the size of Atlanta, it's very, very difficult to get an effective numerator and denominator to get a reliable diagnosis.
I think those kind of studies could be done and should be done. You'd have to adjust for the strong genetic component that also distinguishes, for example, people in Amish communities who may elect not to be immunized (and) also have genetic connectivity that would make them different from populations that are in other sectors of the United States. So drawing some conclusions from them would be very difficult.
I think with reference to the timing of all of this, good science does take time, and it's part of one of the messages I feel like I've learned from the feedback that we've gotten from parents groups this summer (in) struggling with developing a more robust and a faster research agenda, is let's speed this up. Let's look for the early studies that could give us at least some hypotheses to test and evaluate and get information flowing through the research pipeline as quickly as we can.
So we are committed to doing that, and as I mentioned, in terms of just measuring the frequency of autism in the population some pretty big steps have been taken. We're careful not to jump ahead of our data, but we think we will be able to provide more accurate information in the next year or so than we've been able to do up to this point. And I know that is our responsibility.
We've also benefited from some increased investments in these areas that have allowed us to do this, and so we thank Congress and we thank the administration for supporting those investments, not just at CDC but also at NIH and FDA.
--
The latest response to my pesky persistence comes not from academia or government but from my own profession. Last week the prestigious Columbia Journalism Review published an article whose main thrust -- with which I concur -- was that a vigorous debate over a possible link between vaccines and autism was being thwarted by the self-induced timidity of the press.
Some reporters told the author, Daniel Schulman, that they have basically given up on the story because the criticism -- some of it from their own editors -- was so fierce, and the story was so complicated.
Schulman described Age of Autism's efforts to come at the issue "sideways," looking for possible clues to the cause of the disorder in the natural history of autism. And he mentioned our reporting on the Amish:
"Privately, two reporters told me that, while intriguing, Olmsted's reporting on the Amish is misguided, since it may simply reflect genetic differences among an isolated gene pool. ... Both reporters believed that Olmsted has made up his mind on the question and is reporting the facts that support his conclusions."
Ouch. Being slammed by one's peers is never enjoyable, although reporters need to have thick skins and realize they dish this kind of thing out every day. (And those anonymous sources really are annoying, especially when I am happy to be quoted by name about everything.)
What's interesting about the reporters' "private" remarks is the degree of presumed expertise they suggest -- that looking at the Amish is misguided "since it may simply reflect genetic differences among an isolated gene pool." Really? Where did these guys get their doctorate in genetics, Harvard?
This assertion -- that the Amish gene pool could explain everything, based on no data that I'm aware of -- is the kind of self-interested speculation masquerading as expertise that has beset the autism-vaccines discussion for far too long. The term I learned for it long ago is "convenient reasoning," and it does not always have to be conscious.
The Amish have all kinds of standard genetic mental and developmental disorders -- from bipolar to retardation -- and a lot more genetic issues to boot from this supposedly protective "isolated gene pool." The doctors who actually know something about the Amish have never suggested to me that genes have anything to do with a low rate of autism. They seem perplexed.
In upcoming columns, we'll put that question to the right people -- geneticists -- and tell you what we find. It's called reporting.
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