Send letter to journal:
Re: What does this study test, and why?

Dear Editor,

Of the original 1770 Special Educational Needs (SEN)cases in this study [1] 255 were Autistic Spectrum Disorder (ASD). Of the 1770 735 dropped out, then a further 780 were excluded for reasons which are not transparent. 255 were left (a different 255 from before): some ASD, some just SEN but we do not know in what proportion. Then, exactly 100 were excluded because of inadequate blood tests. Of the remainder 101 had ASD (less the 40 per cent of the original 255 autistic cases). None is reported to have bowel disease (the sub-group of Wakefield's study) or adverse reaction to MMR.

It is not clear what the scientific purpose of this study is. The study states "We did not obtain gut mucosal samples for ethical reasons". It would, of course, be unethical to obtain gut biopsies from cases without gut symptoms, and since none of the cases in the study had gut symptoms there would be no grounds for subjecting them to such invasive treatment. This, of course, makes this a distinct group from the children referred to Andrew Wakefield and his colleagues at the Paediatric Gastroenterology department of the Royal Free Hospital in the 1990s and slighlty beyond.

In this regard it is worth noting the recent warning of the National Autistic Society (NAS):

"The National Autistic Society is keenly aware of the concerns of parents surrounding suggested links between autism and the MMR vaccine. The charity is concerned that the GMC hearing, and surrounding media coverage, will create further confusion and make it even more difficult for parents to access appropriate medical advice for their children.

"It is particularly important that this case is not allowed to increase the lack of sympathy that some parents of children with autism have encountered from health professionals, particularly on suspected gut and bowel problems. Parents have reported to the NAS that in some cases their concerns have been dismissed as hysteria following previous publicity around the MMR vaccine. It is crucial that health professionals listen to parents' concerns and respect their views as the experts on their individual children.

"There is an urgent need for further, authoritative research into the causes of autism, to improve our understanding of the condition, to respond to parents' concerns and to enable us to ensure that there are appropriate services and support in place to meet people's needs."

"There is an urgent need for further, authoritative research into the causes of autism, to improve our understanding of the condition, to respond to parents' concerns and to enable us to ensure that there are appropriate services and support in place to meet people's needs." [2]

There is presently not enough consensus about the etiology of ASD to assume there is any single origin, nor anything to rule out ASD subjects having gut symptoms which justify on occasion invasive procedures. The NAS apparently consider that there is a sub-group which is being denied sympathy, investigation or treatment, and this is in itself troubling. It also suggests that this study is not representative since no such cases are included, and it does not address their problems.

The NAS warning relates to the GMC hearing involving doctors Wakefield, Walker-Smith and Murch which is set to resume on 25 March approaching. I do not think it is being unduly cynical to query the publication of this study at the present time as a media event, bearing in mind that it seems to have been carried out five or six years ago. Moreover, the study has once again been promoted as refuting the Wakefield hypothesis when it in fact tests for a possibility that had not been proposed. Meanwhile, the plight of autistic children with gastro- intestinal symptoms is excluded both from the study and public attention, as if they did not exist. The NAS statement warned of "creating further confusion" and this is precisely what this study and its media exposure has done.

John Stone

References:

[1] Gillian Baird, Andrew Pickles, Emily Simonoff, Tony Charman, Peter Sullivan, Susie Chandler, Tom Loucas, David Meldrum, Muhammed Afzal, Brenda Thomas, Li Jin, and David Brown, Measles vaccination and antibody response in autism spectrum disorders Arch Dis Child 2008; 0: adc.2007.122937v1

[2] General Medical Council hearing against Dr Andrew Wakefield,

Send letter to journal:
Re: Re: What does this study test, and why?

This study doesn't clearly say if there were blood tests done on normal subjects and subjects with autism measuring whether the subjects with autism had elevated measles antibodies.(1)

Or if they tested to see whether subjects with autism tested positive for myelin basic protein antibodies.(2)

Vijendra Singh did both these types of blood tests and the subjects with autism had elevated measles antibodies and tested positive for myelin basic protein antibodies. The normal subjects did not have these indicators.

So what did this study actually do???

References:

1. http://content.karger.com/ProdukteDB/produkte.asp?Aktion=ShowFulltext&ProduktNr=224259&ArtikelNr=65007

Send letter to journal:
Re: Autism is a non-fatal variant of SSPE (Subacute Sclerosing Panencephalitis)

The article "Measles vaccination and antibody response in autism spectrum disorders" published in the Feb. 5, 2008 online edition of Archives of Diseases in Childhood is yet another example of the incestuous relationship between the medical profession and the vaccine manufacturers, and their collusion to avoid admitting that inoculations are causing the biggest epidemic the world has ever known; vaccine induced diseases, which include all autoimmune diseases and cancer, not just autism. The mechanism whereby this occurs is explained in my documents on www.drcarley.com.

First of all, the authors admit their conflicts of interest, most importantly that they give advice to lawyers in MMR litigation; one of them has even acted as an expert witness in said litigation. Would such prejudiced individuals ever publish an article that did not support the party line that the MMR vaccine is not the cause of autism? The research was funded by agencies who have a vested interest in NOT finding a causal relationship between vaccination and autism, including the Department of Health. Such conflictsof interest are self evident proof that this paper is bogus, and the equivalent of asking the foxes to do research on why the chickens are disappearing.

It is obvious that children with "special education needs" are also neurologically vaccine damaged; if truth be told, ADD, ADHD and learning disabilities are just the lowest level of the autism spectrum disorders; visual impairments, cerebral palsy and deafness are also consequences of vaccine damage (the symptoms of the damaged child being merely a consequence of where the damage occurs in the nervous system). Shockingly, the authors admit that of the 98 autistic children and 52 children with "special education needs" (for a grand total of 155 neurologically damaged children), 100 children from this group "did not have satisfactory blood samples for a variety of reasons". THIS LEAVES A TOTAL OF 55 ACTUAL NEUROLOGICALLY DAMAGED TEST SUBJECTS. To base a conclusion that the MMR vaccine does not cause autism on such a small sample is self evident FRAUD.

And then there is the GLARING omission of any testing for measles antibody in the cerebrospinal fluid of the autistic children, which is the telltale finding (in addition to serum mealses antibody) in children with subacute sclerosing panencephalitis; which differs from autism only in the fact that autism is not fatal. In fact, it is obvious that the word autism was invented for non fatal subacute sclerosing panencephalitis and made a psychiatric disorder to hide the measles vaccine etiology in autism. The fact that anti-myelin and anti-neuronal filament antibodies were not tested for in this study makes the predetermined conclusions even more self evident.

As for the 90 "typically developing" controls who also received the MMR vaccine, there is no mention anywhere in the article as to whether these children have any other autoimmune disorders, such as food allergies, asthma, insulin dependent diabetes, etc. This is critical information, as it is also self evident that the only place genetics comes into play in vaccine induced diseases is where that individual's weak link is. If these children were not inoculated and their immune systems not corrupted, their weak link would not manifest in disease (and Big Pharma would not make billions of dollars to treat, but NEVER cure, those diseases).

OBSERVATION is one of the most important aspects in utilization of the scientific method. Millions of parents all over the world have watched their normally developing children descend into the hellish state of autism after they are inoculated with the MMR vaccine (which has never had mercury); and it is beyond immoral and unethical for the medical profession to continue their collusion with Big Pharma to obfuscate the obvious relationship of MMR vaccination with autism, as well as the relationahip of vaccines with all other autoimmune disease and cancer. In fact, this unholy alliance will eventually cause the death of medicine, and expose how those who took an oath to "first do no harm" have sold their souls for cash.

In Service to the TRUTH, I AM, Rebecca Carley, MD Court Qualified Expert in VIDS (Vaccine Induced Diseases) cc: gillian.baird@gstt.nhs.uk

Send letter to journal:
Re: Getting it wrong

In a case-control study of 10 to 12-year-old children with either autism, special-educational needs, or normal development, the authors examined measles-antibody responses (plaque reduction neutralization assay) and the presence of measles virus in peripheral blood mononuclear cells (reverse transcriptase polymerase chain reaction). The study apparently sought to identify autistic children relevant to the original MMR/autism hypothesis, i.e., those who regressed and those with bowel symptoms.

The study is severely limited by case definition in the context of the crucial ‘possible enterocolitis’ group. For inclusion in this group they required the presence of two or more of the following five current gastrointestinal symptoms: • current persistent diarrhea (defined as watery/loose stools three or more times per day >14 days), • current persistent vomiting (occurring at least once per day, or more than five times per week), • current weight loss, • current persistent abdominal pain (3 or more episodes [frequency not specified by authors] severe enough to interfere with activity); • current blood in stool; plus: • past persistent diarrhea >14 days’ duration, and excluding current constipation.

Over the last 10 years we have evaluated several thousand children on the autistic spectrum who have significant gastrointestinal symptoms. Upper and lower endoscopy and surgical histology have identified mucosal inflammation in excess of 80% of these children. Almost none of these children with biopsy-proven enterocolitis would fit the criteria set out above. Firstly, these children rarely have vomiting, current weight loss (as opposed to failure to gain weight in an age-appropriate manner), or passage of blood per rectum. The requirement is thus narrowed to a child having two of two relevant symptoms – current persistent diarrhea and current abdominal pain according to their criteria, plus a past history of persistent diarrhea excluding current constipation.

The requirement for the current presence of these symptoms, for 14 or more days continuously, shows a singular lack of understanding of the episodic, fluctuating, and alternating (e.g. diarrhea/constipation) symptom profile experienced by these children. In our experience, ASD children with histologic enterocolitis typically have 1 to 2 unformed stools per day that are very malodorous and usually contain a variety of undigested foodstuffs. This pattern alternates with that of “constipation” in which the unformed stool is passed after many days of no bowel movements at all, and with excessive straining. This group is entirely overlooked by the arbitrary criteria set forth in their paper. With respect to diarrhea and constipation, a detailed discussion of stool pattern in these children is available1 which further highlights the shortcomings of the above criteria. Moreover, the interpretation of pain as a symptom in non-verbal children, as it often manifests as self injury, aggressive outbursts, sleep disturbances, and abnormal posturing, is notoriously difficult. This interpretation requires an insight based upon the correlation of symptoms, histological findings, and response of symptoms to anti-inflammatory treatment. There is no evidence in the Baird et al. paper that these crucial factors were taken into account. This study’s inappropriate symptom criteria would explain the discordance with other reports that have revealed a high prevalence of significant gastrointestinal symptoms in general autism populations2,3.

It is surprising that Dr Peter Sullivan, a co-author on the paper, who presumably provided the above gastroenterological criteria, was not aware of the aforementioned limitations. In his role as a Defendant’s expert in the UK MMR litigation, he will have had access to the clinical records of autistic children with the relevant intestinal symptoms and biopsy-proven intestinal inflammation.

We suggest that the authors might wish to reflect on the ethical implications of setting the bar too high for the investigation of such children by ileo-colonoscopy, with the attendant risk of missing symptomatic, treatable inflammation.

Since the relevant MMR/autism children are considered to be those with regression and significant gastrointestinal symptoms, the appropriate stratification for between-group analyses of measles virus antibody levels has not been conducted; therefore the paper is difficult to interpret, adding little if anything to the issue of causation. Moreover, it is a major error to have presumed that peripheral blood mononuclear cells are a valid ‘proxy’ for gut mucosal lymphoid tissues when searching for persistent viral genetic material.

A further major problem in this study is the number of children who dropped out or who were unable to provide adequate blood samples. We know nothing about either the 735 children who were lost at stage two, or the 100 children for whom blood samples were not available. At the very least, we should be told whether the children who dropped out were likely to be representative of those who stayed in, with regard to the key issues of interest.

For reasons that will emerge in the near future, it would be of interest to know whether siblings of autistic children were included in either of the two control groups. This information is not provided.

As a general observation, this paper contributes nothing to the issue of causation, one way or another. Case definition alone is likely to have obscured the relevant group of autistic children. The study tells us nothing about what actually happened to the children at the time of exposure. We are increasingly persuaded that measuring things in blood many years down the line tells us very little about the initiating events in what is, in effect, a static (non-progressive) encephalopathy unlike, for example, subacute sclerosing panencephalitis, which is a progressive measles encephalopathy. The gut is a different matter, and analysis of mucosal tissues has been very informative, since here, in the relevant children, active ongoing, possibly progressive4, inflammation has been identified.

References.

1. Wakefield AJ. Autistic enterocolitis: is it a histopathological entity? Histopathology 2006;50:380-384. 2. Valicenti-McDermott M, et al. Frequency of Gastrointestinal Symptoms in Children with Autistic Spectrum Disorders and Association with Family History of Autoimmune Disease. Developmental and Behavioral Pediatrics. 2006;27:128-136. 3. Horvath K, and Perman JA. Autistic disorder and gastrointestinal disease. Current Opinion in Pediatrics. 2002;14:583–587. 4. Balzola F et al. Autistic Enterocolitis in childhood: the early evidence of the later Crohn’s disease in autistic adulthood? Gastroenterology 2007;132:suppl 2, A 660.

Send letter to journal:
Re: MMR and Autism

Send letter to journal:
Re: Re: Re: What does this study test, and why?

Both John Stone and Raymond Gallup would find the answers to their questions if they actually read the study they are so quick to criticise. The authors were testing a specific hypothesis which is clearly explained. I suggest Raymond Gallup reads the detailed section concerning measles antibody tests and their results, if he does not know whether these were measured in this study. If John Stone is unclear about selection of cases, he should, as the authors suggest, refer to their 2006 SNAP paper in the Lancet.

Of course this study is "not representative" of those with bowel problems - being a population-based study entirely free of selection bias (Wakefield, anyone?) it is merely representative of those with autism. There is precious little evidence for enterocolitis in this group - so of course it would be unethical to do invasive gastrointestinal biopsies. There is no conspiracy surrounding the timing of publication of this study. This SNAP work was started several years ago - and as John Stone should know it takes time for papers to come to press. From his perspective, any paper that dismisses a vaccine link to autism is inconveniently timed, whenever it is published.

Send letter to journal:
Re: Response to article by Baird et Al

Analysis of “Measles vaccination and antibody response in autism spectrum disorders”, Baird et Al, Arch Dis Child doi:10.1136/adc.2007.122937. Published 5th February 2008

The report was examined and the following conclusions have been drawn from the evidence presented:

1. The choice of participants in the study appears to have been chosen on the basis of established diagnostic criteria. However, and more importantly, the authors have taken no evidence of the etiology of the children's ASD. Furthermore, given that all MMR vaccine manufacturers advise in their fact sheets that in rare cases encephalitic fevers may result from administration of the vaccine none of the children were identified as having had an adverse reaction to the vaccine.

2. There is a growing body of evidence to suggest that ASD presentations may be a result of genetic mutations occurring in utero, triggered by ingested exogenous agents which cross the placenta to insult the developing fetus. The resultant damage to the developing central nervous system of the fetus in the first trimester of pregnancy inevitably results in a miscarriage, or at later stages, around 7-8 months gestation, a premature delivery. Damage to the central nervous system of a fetus gives rise to traumatic birth procedures and in many cases the need for assisted birth or c-section delivery. The resulting unnatural birth further exacerbates an already compromised central nervous system.(1)

3. The study is clearly compromised when comparisons are made with the work undertaken by Dr Wakefield and the Royal Free team. It is misleading to draw such conclusions given the limited study of blood samples many years after the initiating events. Likewise to undertake a study to test a hypothesis that measles vaccination was/was not involved in the pathogenesis of autism spectrum disorder is invalid if the study cohort of ASD individuals only contains children already neurologically dysfunctional at birth, immediately after birth and before vaccination.

4. Whilst the study is valid the report's conclusions have been presented to show “no association between measles vaccination and ASD” by its authors. This of course will be sold by many health professionals as being further proof of the safety of MMR vaccine. However, it will be construed by many as an attempt by the Department of Health to sway public opinion on the 'benefits' of MMR vaccination without accepting any downsides.

5. The final point being that in all the study group - ASD with SEN, ASD but no SEN and no ASD but SEN can be considered neurological dysfunctional by brain injury resulting from similar etiology.

References 1. Articles published in website www.theautismcentre.co.uk