Recent Vaccine-Autism Award Not the First
According to two people with intimate knowledge of the vaccine court, the compensation that will be paid to Hannah Poling is not the first paid by the court to a child with symptoms of autism. On Thursday I noted that the award, which has gotten huge media play, was quite unusual and does not mean that the government is acknowledging that vaccines cause most cases of autism--or even this one, which isn't exactly autism. Dr. Edwin Trevathan, director of the CDC's National Center on Birth Defects and Developmental Disabilities, told reporters that infections are usually what trigger mitochondrial disorders, a condition involving the failure of the energy-generating part of cells. Stress can trigger a failure in various parts of the brain in these kids, including areas involved in autism-like symptoms. Trevathan said he'd never heard of a vaccine triggering mito disease symptoms, but he didn't rule it out. Hannah got very sick a day or two after receiving five shots in a "catch-up" immunization visit with her pediatrician.
I have since learned that the 934 families paid out more than $800 million since 1990 by the vaccine court included several with injuries that resulted in "autism-like symptoms." At least a few of these cases involved tuberous sclerosis complex, a rare genetic condition in which tumors pop up in the brain and other organs, sometimes causing severe mental disability. Like mitochondrial disease, tuberous sclerosis can occur in the form of a regression in a normal-seeming child--and has been known to follow a shot. A senior court official tells me that a handful of TSC kids awarded by the court were, for all intents and purposes, autistic--though no one called it autism.
"We just were not in tune to autism issues in those days," the official said. Indeed, much of the "epidemic" in autism today has resulted from shifting diagnostic criteria, better awareness among doctors and educators, and the availability of funds to pay for therapy and special ed for autism-spectrum kids.
Comments:
Posted 03/09/2008 11:38am with
It seems like this is an artifact of the ambiguity in whether something should be called autism if its cause is identifiable, like in fragile X syndrome or, apparently, mitochondrial disease or tuberous sclerosis complex. I would guess that these conditions would be considered part of the autism spectrum for therapeutic purposes but separated out for purposes of studies on etiology. Not a distinction that most people are prepared to appreciate, unfortunately.
Posted 03/09/2008 01:02pm with
You are correct Irandall. Because various genetic causes can lead to similar symptoms—I use deafness as the model, with about 4 dozen known causative genes all having a similar end result—catch-all diagnoses, like Autism Spectrum Disorder (ASD) will eventually become clarified. In cancer genetics this phenomenon has become commonplace. Often, more than one gene in a biochemical pathway can cause a specific cancer. Sometimes genes in completely different pathways can have very similar phenotypic effects. About half of all genes are expressed in the brain, so I think that there’s a good chance that soon, several dozen genetic mutation will be identified as causes of ASD. Among other genes already associated with ASD, are MECP2 (Rett syndrome), PRKCB1, DHCR7 (Smith-Lemli-Opitz syndrome), CSMD3, NLGN4 (Tourette syndrome), and NRXN1. Genomewide association studies are beginning to identify several other candidate genes. Until we begin to sort out whether some of these can impart a susceptibility to brain damage when triggered by vaccines, we have no way of determining if the children referred to in the 934 compensated families would have developed the symptoms of ASD with or without vaccines. So, to assume vaccines as the causative triggers in the cited cases should still be regarded as speculative.