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Big Rise In Autism Cases Prompts Debate Over Causes

May 25, 2003 | AP An alarming rise in the number of children with autism in Virginia drew researchers, physicians and parents to a conference here, including a British doctor who claims that widely administered childhood vaccines may be responsible for the increase.

According to the Autism Program of Virginia, the number of autism cases in the United States jumped 173 percent over the past decade. In Virginia, the number of cases has climbed by about 78 percent over the past three years, and now 2,702 children have autism in the state.

Among the speakers at Saturday's conference, sponsored by the Central Virginia Autism Group, was Dr. Andrew Wakefield, a British gastroenterologist whose studies have prompted heated debate and helped prompt a congressional investigation.

Wakefield told the approximately 100 people attending the conference that his first encounter with an autistic child led him to question the conventional wisdom about the causes of autism. His subsequent research linked a mercury-containing preservative in the Measles-Mumps-Rubella, or MMR, vaccine with autism.

Wakefield described how the child's mother said her son was developmentally normal until he had his MMR vaccine at 15 months old. Then the autism appeared, and with it severe bowel problems.

In the five years since he saw that first patient, Wakefield has extensively studied bowel disease in children with autism. He has identified an inflammatory condition that seems to be linked to the MMR vaccine. MMR contains the preservative Thimerosal, which has the toxic element mercury among its ingredients.

Wakefield says that some children with the inflammatory disorder in the bowel also have other developmental disorders. He said he believes the damaged membrane of the intestine can't act as an efficient barrier to harmful molecules, which can then enter the blood stream and cause problems throughout the body.

His team's first findings on 12 children were published in The Lancet, a British medical journal. Wakefield said he lost his job after refusing to back down from the findings and now continues research with several other teams. His latest findings implicate the measles virus used in the vaccine, he said.

Dr. Elizabeth Mumper, a Lynchburg pediatrician, said she plans to work on repeating Wakefield's research. She will work with Michael H. Hart, a Roanoke pediatric gastroenterologist who will do the evaluations needed.

Mumper first became interested in autism after hearing Wakefield speak previously about his research.

"I thought it was very compelling," she said. "And I thought it was something that made it clear that other investigators should try to look into this issue, and either say, 'We're seeing the same thing the Wakefield team did' or 'In our laboratory we can't reproduce these findings."'

In general, Mumper said, she sees indications of a link to the vaccine.

"There does seem to be a change in the pattern of autism," she said. "For many years, most kids seemed to be affected very early on. And in the last 15 years or so, the numbers have shifted a bit. And what people are reporting is more and more kids who seem normal (at first) and were noted to regress between 15 months and two years."

Wakefield's allegations have drawn widespread attention and prompted hearings by U.S. Rep. Dan Burton of Indiana, chairman of the House Government Reform Committee. Burton's committee staff recently released a report that found that "there's no question that mercury does not belong in vaccines" and that the federal Centers for Disease Control should have acted at least three years ago to encourage the use of vaccines that do not contain the additive.

Part of the problem, according to critics, is that although the amount of mercury in each vaccine was within federal guidelines for mercury exposure, many children got several vaccines at once. As a result, some were getting up to 125 times the level considered safe.

The CDC currently is working with pharmaceutical companies to develop vaccines that do not contain mercury. In the meantime, the pharmaceutical makers continue to deny that their vaccines are responsible for the rise in autism cases.

Controversy over the claimed link to mercury is likely to continue for some time, in part because autism is very complex, said Dr. Mary Megson, a Richmond pediatrician who has more than 2,000 patients who have autism and other disabilities.

"I think autism is caused by having a genetic predisposition and then an environmental event which disconnects major metabolic pathways in the body," she said.

Megson said she is having some success treating autism with vitamin A, which she said is best absorbed as an oil molecule but is most often found in other forms in today's diet. By switching patients to an oil-based form of the vitamin, she said, she has seen dramatic improvements.

"The first child I treated was a fifth-grader with no language," she said. "I put him on just the RDA, the recommended dietary requirement of vitamin A in the form of oil molecules and cod liver oil. Three weeks later, when I walked into the room, he was telling his mother, 'Leave me alone, I can get up on the table by myself."'

Although much of the conference was highly technical, even the laymen in the audience said it was important to air the issues thoroughly.

"It is complicated," said Willmer Price, parent of a 3 year-old autistic child. "Autism itself is complicated. So there is no one answer to any of the problems."

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