The Age of Autism: Pox -- Part 7

By DAN OLMSTED, UPI Senior Editor  |  May 23, 2006 at 6:03 PM
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WASHINGTON, May 23 (UPI) -- When a mother in Washington state and a researcher in Washington, D.C., offer an identical observation about autistic kids, you can't help but notice.

That observation is simple but potentially significant: Children later diagnosed with regressive autism often got physically sick around the time of their live-virus vaccinations.

Here's how Denise Rohrbeck, the mom in Olympia, Wash., put it after collecting vaccine records and medical histories from fellow parents of local preschoolers diagnosed with full-syndrome autism.

"Most of the parents recall their child had a viral illness -- roseola, rotavirus or an unnamed flu -- less than four months before or after those live-virus shots."

Denise's three-year-old son, Grant, is a case in point. A couple of months before he got the live-virus chickenpox and measles-mumps-rubella shots at the same office visit at age 1, Grant had a stubborn and severe case of roseola, which like chickenpox is a herpesvirus.

Four days after the MMR and chickenpox injections he became ill with a fever and lay limp in his mother's arms for the first time in his life.

"He began having chronic diarrhea, and by his 15-month checkup he had regressed so drastically that his pediatrician suggested he could be autistic," Rohrbeck recalled in Part 1 of this series. The doctor agreed to the parents' request for an immediate neurodevelopmental evaluation, which eventually confirmed their fears. By age 2 Grant was diagnosed with full-syndrome autism.

An even more immediate example is Ryan Boe, an Olympia child profiled in the last installment. He got his MMR at 16 months and his chickenpox and three other vaccines two months later. During that visit, Ryan broke out in hives while still at the doctor's office, had a 105-degree fever by the end of the day that lasted a week, and displayed classic signs of regressive autism within the month.

The second source for the same observation about vaccines, illness and autism is British researcher Paul Shattock. In an interview in April while attending an autism conference in Washington, Shattock said he suspects that children who contract viral infections too close to their MMR shot may have an increased risk for autism.

He noticed that parents who believed the MMR vaccine triggered their child's autism tended to cite an "undisclosed viral illness" around the time of the shot.

Shattock decided to test that observation. Britain doesn't give kids chickenpox shots, meaning they still get chickenpox, so he looked for a diagnosis of that unmistakable childhood disease around the time of the MMR vaccination.

He studied the records of 100 children whose parents blame the MMR for the onset of autism, compared to 100 children whose parents do not, to see if there was more chickenpox in the three months on either side of the MMR immunization.

"Now, there was," Shattock said. "It wasn't statistically significant at the 95 percent level -- but enough to make you think that if it was a huge study, it might be."

The implication: Too many viruses too close together from whatever sources might overload the immune system, lead to persistent infection and, ultimately, cause brain damage resulting in autism. To Shattock, old-fashioned chickenpox interacting with measles, mumps and rubella vaccines looked like a red flag.

What resonates in Olympia is not just the pattern of illness but the families' problematic histories with chickenpox and other herpesviruses. The specter: Live-virus chickenpox vaccine and viral infections like roseola playing the same "overload" role in vulnerable children as real-live chickenpox in Shattock's suspected British cases.

Consider, for example, Jimmy Flinton. As outlined in Part 3, his father, Paul, had an unusual case of shingles, the reactivated form of the virus, at 15; his paternal grandmother, Mary Southon, had a case at 20 and a lifelong problem with cold sores -- a kind of herpesvirus -- that eventually infected her eyes and may require cornea transplants.

Jimmy is one of two Olympia children with autism who were in clinical trials of investigational, apparently high-dose chickenpox vaccines in conjunction with the MMR shot.

In 2002, Jimmy was given ProQuad, a four-in-one chickenpox-MMR vaccine that has about 10 times the typical dose of chickenpox virus. That is necessary to overcome a phenomenon known as immune interference when live viruses are combined, according to a spokesman for Merck & Co., which developed the vaccine.

During the 42-day "study window" following his vaccination, Jimmy may have had a slight, brief fever, his mother, Jennifer, recalls. But she said it was nothing notable, and she didn't record it on the adverse-event log she was asked to keep.

But less than four months later Jimmy had an acute illness with a fever around 102. After that, in retrospect, his development stalled, and he eventually was diagnosed with full-syndrome autism.

The other child, Timothy Baltzley, was in a clinical trial two years earlier. As described in Part 4, he got a Merck "process upgrade" chickenpox shot that his mother, Kimberly, was told had a much higher amount of live-virus vaccine.

Again, chickenpox history seems potentially relevant: After two mild cases as a child, Kimberly had an unusually severe and late case of chickenpox at 16, just three years before Timothy was born.

In his clinical trial, Timothy got the experimental chickenpox shot at the same office visit as the standard MMR. Kimberly says the pediatrician told her it was part of the development of the combined chickenpox-MMR vaccine; Merck, to the contrary, said the two trials were completely unrelated.

Midway through the 42-day "study window," Timothy had an acute illness -- a fever of 102, vomiting and listlessness. Again the pattern: Four live-but-weakened viruses including a big dose of chickenpox; family susceptibility; physical illness, and autism.

Both Kimberly Baltzley and Jennifer Flinton are emphatic that the pediatrician who performed the trials in Olympia, Dr. Carl Lindgren, is not the source of their concern. (Lindgren referred our questions to Merck.)

"Dr. Lindgren has been incredibly conscientious and proactive in his dealings with us regarding Jimmy's autism -- much more so than most pediatricians would be," Jennifer said.

"So, not only do we not think he did anything wrong with the clinical trial, but we actually think he went above and beyond the call of duty after the trial."

Other Olympia parents say similar things, concerned that broader issues of vaccine safety and a possible link to autism will get translated into criticism of individual doctors.

"I worry about pediatricians being vilified," said Denise Rohrbeck, the mom who collected the vaccination records. "We vaccinated our son because we shared their faith that vaccines were safe.

"If it turns out that some vaccines are not safe for all children and that these hazards could have been found with more rigorous testing -- or worse, that the dangers were already known -- that's the fault of the CDC, the FDA and the manufacturers," she said.

"I'll defend doctors to the end on this point. They are a convenient front line for those agencies to hide behind -- it's just shameful."

That puts the issue squarely in the lap of the drug companies and the public-health authorities. They say vaccines simply don't cause autism, period -- so the idea of susceptibility to a viral overload from live-virus vaccines, coincident viral infections or any other source is a non-starter.

"We don't see an association," Merck spokeswoman Christine Fanelle said, citing as confirmation a 2004 report by the widely respected Institute of Medicine, part of the National Academies. That report rejected a link between autism and either the MMR vaccine or the mercury-based preservative thimerosal. The report also urged that research dollars be spent on "more promising" autism research.

"There will always be some people who say vaccines cause autism despite the lack of scientific evidence," Fanelle said. She noted ProQuad subsequently was approved by the FDA and its safety profile is the same as the individual chickenpox and MMR shots. Merck acknowledged, however, that it did not report the two Olympia autism cases to the FDA until this March -- six months after ProQuad's approval -- which is when it says it became aware of them.

The FDA did not respond to requests for comment.

That is where the matter now rests. But several researchers who remain concerned about a link between vaccines and autism -- in particular from combined live-virus shots -- say the Olympia cases, grounded in the parents' concerned but careful observations, may prove hard to ignore indefinitely.

"It's actually heartbreaking, listening to these parents, for more than just the immediate reasons their child has met this fate," said British researcher Dr. Andrew Wakefield, whose controversial theories on the MMR vaccine and autism essentially drove him out of England. He is now doing research in the United States and met with several of the Olympia parents during an autism conference in Portland, Ore.

"It's that you're staring into an abyss," Wakefield said. "You're listening to stories which reflect the fundamental misconception of vaccine manufacturers of what viruses are and what they do."

And what now?

"The way forward is clearly to alert the regulatory authorities to the fact that these children exist," Wakefield said, "that their stories are consistent with a delayed adverse reaction to the vaccine and that this would not have been picked up in the (clinical) trials."

Meanwhile, in Washington state, a law takes effect July 1 requiring proof of chickenpox immunization before a child can enroll in school or daycare. The Centers for Disease Control and Prevention says ProQuad now is the preferred way to administer chickenpox and MMR vaccines, ideally on a child's first birthday or as soon thereafter as possible.

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Last in a series. This ongoing column on the roots and rise of autism welcomes reader comment. Earlier articles are available at theageofautism.com. E-mail: dolmsted@upi.com

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