POST 00817E : THIMEROSAL AND AUTISM
Follow-up on Posts 00809E and 00812E
31 July 2005
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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?
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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
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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.
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