POST 00817E : THIMEROSAL AND AUTISM

POST 00817E : THIMEROSAL AND AUTISM Follow-up on Posts 00809E and 00812E 31 July 2005 _____________________________________ Julie Milstien (mailto:[email protected]) or (mailto:[email protected]) from the United States but living in France, answers the double-spelling question. Bob Davis (mailto:[email protected]) from UNICEF/ESARO has also sent a "TechUpdate" about autism. We cross-post here this interesting information. How can we explain this phenomenon that is happening in the United States (NY Times' article)? We must surely presume that parents of autistic children genuinely search for a cause, hence possibly a treatment for this disease. But we cannot exclude greed. In the USA lawsuits have become a way to becoming immensely rich, courts awarding scandalously large compensations. People are suing for whatever you can imagine. In my opinion however, the phenomenon goes beyond these consideration. We are probably witnessing a process of faith development, that is an irrational belief, by definition unsupported by any scientific evidence or despite even such evidence. Is there any difference between this American mother, or Indian or Nigerian mothers who believe that vaccination will make their children sterile? _____________________________________ Just as aluminum and aluminium are spelled differently depending on which side of the Atlantic you are on, so are thiomersal and thimerosal. I use the latter because that is how we say it. WHO is on this side therefore they tend to use British spellings. Who is right? Julie Dr Julie Milstien Montpellier, France --------------------------- Dear All, The use of thiomersal in vaccines remains a topic of discussion in both medical and nonmedical circles. The first item in this update abstracts an article on the proposed causal relationship between thiomersal (also known as thimerosal) and autistic spectrum disorder; the second, from a recent issue of The New York Times, shows the gap between public understanding of the issue and the views of health professionals. It is unfortunate that we have not succeeded in convincing some members of a skeptical public that there is no causal link between thiomersal and autism. Good reading, Bob Davis ----- Thimerosal-containing vaccines and autistic spectrum disorder: a critical review of published original data. Parker SK, Schwartz B, Todd J, Pickering LK. Department of Pediatrics, Children's Hospital and University of Colorado Health Sciences Center, Denver, Colorado 80262, USA. Full text at : www.pediatrics.org OBJECTIVE: The issue of thimerosal-containing vaccines as a possible cause of autistic spectrum disorders (ASD) and neurodevelopmental disorders (NDDs) has been a controversial topic since 1999. Although most practitioners are familiar with the controversy, many are not familiar with the type or quality of evidence in published articles that have addressed this issue. To assess the quality of evidence assessing a potential association between thimerosal-containing vaccines and autism and evaluate whether that evidence suggests accepting or rejecting the hypothesis, we systematically reviewed published articles that report original data pertinent to the potential association between thimerosal-containing vaccines and ASD/NDDs. METHODS: Articles for analysis were identified in the National Library of Medicine's Medline database using a PubMed search of the English-language literature for articles published between 1966 and 2004, using keywords thimerosal, thiomersal, mercury, methylmercury, or ethylmercury alone and combined with keywords autistic disorder, autistic spectrum disorder, and neurodevelopment. In addition, we used the "related links" option in PubMed and reviewed the reference sections in the identified articles. All original articles that evaluated an association between thimerosal-containing vaccines and ASD/NDDs or pharmacokinetics of ethylmercury in vaccines were included. RESULTS: Twelve publications that met the selection criteria were identified by the literature search: 10 epidemiologic studies and 2 pharmacokinetic studies of ethylmercury. The design and quality of the studies showed significant variation. The preponderance of epidemiologic evidence does not support an association between thimerosal-containing vaccines and ASD. Epidemiologic studies that support an association are of poor quality and cannot be interpreted. Pharmacokinetic studies suggest that the half-life of ethylmercury is significantly shorter when compared with methylmercury. CONCLUSIONS: Studies do not demonstrate a link between thimerosal-containing vaccines and ASD, and the pharmacokinetics of ethylmercury make such an association less likely. Epidemiologic studies that support a link demonstrated significant design flaws that invalidate their conclusions. Evidence does not support a change in the standard of practice with regard to administration of thimerosal-containing vaccines in areas of the world where they are used. ----- On Autism's Cause, It's Parents vs. Research By GARDINER HARRIS and ANAHAD O'CONNOR The New York Times ; Published: June 25, 2005 Kristen Ehresmann, a Minnesota Department of Health official, had just told a State Senate hearing that vaccines with microscopic amounts of mercury were safe. Libby Rupp, a mother of a 3-year-old girl with autism, was incredulous. Libby Rupp of St. Paul, whose 3-year-old daughter, Isabella, has autism, says she is not convinced by studies that say there is no link between autism and childhood vaccines that include mercury. "How did my daughter get so much mercury in her?" Ms. Rupp asked Ms. Ehresmann after her testimony. "Fish?" Ms. Ehresmann suggested. "She never eats it," Ms. Rupp answered. "Do you drink tap water?" "It's all filtered." "Well, do you breathe the air?" Ms. Ehresmann asked, with a resigned smile. Several parents looked angrily at Ms. Ehresmann, who left. Ms. Rupp remained, shaking with anger. That anyone could defend mercury in vaccines, she said, "makes my blood boil." Public health officials like Ms. Ehresmann, who herself has a son with autism, have been trying for years to convince parents like Ms. Rupp that there is no link between thimerosal - a mercury-containing preservative once used routinely in vaccines - and autism. They have failed. The Centers for Disease Control and Prevention, the Food and Drug Administration, the Institute of Medicine, the World Health Organization and the American Academy of Pediatrics have all largely dismissed the notion that thimerosal causes or contributes to autism. Five major studies have found no link. Yet despite all evidence to the contrary, the number of parents who blame thimerosal for their children's autism has only increased. And in recent months, these parents have used their numbers, their passion and their organizing skills to become a potent national force. The issue has become one of the most fractious and divisive in pediatric medicine. "This is like nothing I've ever seen before," Dr. Melinda Wharton, deputy director of the National Immunization Program, told a gathering of immunization officials in Washington in March. "It's an era where it appears that science isn't enough." Parents have filed more than 4,800 lawsuits - 200 from February to April alone - pushed for state and federal legislation banning thimerosal and taken out full-page advertisements in major newspapers. They have also gained the support of politicians, including Senator Joseph I. Lieberman, Democrat of Connecticut, and Representatives Dan Burton, Republican of Indiana, and Dave Weldon, Republican of Florida. And Robert F. Kennedy Jr. wrote an article in the June 16 issue of Rolling Stone magazine arguing that most studies of the issue are flawed and that public health officials are conspiring with drug makers to cover up the damage caused by thimerosal. "We're not looking like a fringe group anymore," said Becky Lourey, a Minnesota state senator and a sponsor of a proposed thimerosal ban. Such a ban passed the New York State Legislature this week. But scientists and public health officials say they are alarmed by the surge of attention to an idea without scientific merit. The anti-thimerosal campaign, they say, is causing some parents to stay away from vaccines, placing their children at risk for illnesses like measles and polio. "It's really terrifying, the scientific illiteracy that supports these suspicions," said Dr. Marie McCormick, chairwoman of an Institute of Medicine panel that examined the controversy in February 2004. Experts say they are also concerned about a raft of unproven, costly and potentially harmful treatments - including strict diets, supplements and a detoxifying technique called chelation - that are being sold for tens of thousands of dollars to desperate parents of autistic children as a cure for "mercury poisoning." In one case, a doctor forced children to sit in a 160-degree sauna, swallow 60 to 70 supplements a day and have so much blood drawn that one child passed out. Hundreds of doctors list their names on a Web site endorsing chelation to treat autism, even though experts say that no evidence supports its use with that disorder. The treatment carries risks of liver and kidney damage, skin rashes and nutritional deficiencies, they say. In recent months, the fight over thimerosal has become even more bitter. In response to a barrage of threatening letters and phone calls, the Centers for disease control has increased security and instructed employees on safety issues, including how to respond if pies are thrown in their faces. One vaccine expert at the centers wrote in an internal e-mail message that she felt safer working at a malaria field station in Kenya than she did at the agency's offices in Atlanta. ______________________________________________________________________________ Visit the TECHNET21 Website at http://www.technet21.org You will find instructions to subscribe, a direct access to archives, links to reference documents and other features. ______________________________________________________________________________ To UNSUBSCRIBE, send a message to : mailto:[email protected] Leave the subject area BLANK In the message body, write unsubscribe TECHNET21E ______________________________________________________________________________ The World Health Organization and UNICEF support TechNet21. The TechNet21 e-Forum is a communication/information tool for generation of ideas on how to improve immunization services. 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