SAN FRANCISCO, Sept. 12 (UPI) -- (Note: In this multi-part installment, based on dozens of reports, conferences and interviews, Ped Med is keeping an eye on autism, taking a backward glance at its history and surrounding controversies, facing facts revealed by research and looking forward to treatment enhancements and expansions.)
In 1943 eminent psychiatrist Leo Kanner of Johns Hopkins University first described to the world eight boys and three girls with a curious condition that, in his expert opinion, "differs ... markedly and uniquely from anything reported so far."
In a way, he was more prescient than he may have realized.
His characterization of the baffling disorder he dubbed "early infantile autism" could just as readily apply to the peculiar developments occurring more than a half century later.
For one, the hunt for the source of the ailment that, in general, fetters a child with social, language and behavioral challenges has taken some unusual turns.
The search parties, traditionally limited to the closed ranks of medically trained specialists, have expanded to independent-minded, parent-propelled advocacy groups, many of which promote, provide for and/or produce scientific research.
Some of these have fanned out in such divergent directions, they find themselves on a collision course with established experts whose word once was undisputed law.
"You can look at the history of autism and know that a lot of the changes have been brought around by parents basically not willing to concede to the medical establishment," said Peter Bell, chief executive officer of Cure Autism Now, a parent-founded network that has become a leading funder of research into the disorder.
The parting of the ways has been paved by dismay and distrust -- residues of years of scientific miscalculation and inattention, a time of lost opportunities for a generation of autistic children.
Doubts and disillusionment have festered over mainstream medicine's failure to pinpoint the disorder's core and procure its cure as well as for its decades-long blame of cold-hearted "refrigerator moms" for what it now regards as a biologically based neurodevelopmental disturbance.
This "age of denial," as some have dubbed it, shackled parents with shame, guilt and remorse.
Its demise relieved them of the undeserved responsibility for their children's suffering, but to many it offered no release from despair at doctors' inability to alleviate it.
"It wasn't until the mid '60s that we were able to more or less convince everyone that there was a biological basis to autism, and, unfortunately, we then entered 'the age of defeat' -- established medicine offered little hope," said Bell, who has a son with autism.
Having borne the burden, a growing number of parents and their supporters are no longer unquestionably accepting of medical opinion, no matter the reputation of the source.
Arguably their most hotly contested stand concerns the role of vaccines in autism and certain other childhood developmental and even medical disorders.
The question of whether medical measures to prevent suffering are in fact causing it has morphed into one of the most fractious and divisive issues in pediatric medicine.
Dismissing adamant assurances to the contrary by those not long ago considered the ultimate authority on such matters, the renegade thinkers -- including some scientists and physicians -- insist on implicating immunization in the exploding U.S. rates of autism diagnoses.
During the 1990s these shot up more than ten-fold -- from an estimated four to as high as nearly 60 per 10,000 live births.
What has raised more than a few suspicious eyebrows is that the increase occurred alongside a concurrently rapid rise in the number of vaccines added to the ever-expanding mandatory infant inoculation schedule.
In 1980 babies were immunized against just four illnesses. Today a tyke receives up to 23 shots against 12 infectious diseases by the time he's 2, with as many as six injections during a single pediatric visit.
And the list keeps on growing, with immunization against rotavirus, a common cause of childhood diarrhea, tagged on earlier this year.
The shot replaces a vaccine pulled off pharmacy shelves in 1999 after being linked to a dangerous bowel obstruction in some infants.
Until the turn of the century, many of the vaccines contained thimerosal, once better known as the blood-orange first-aid antiseptic Merthiolate that left a stinging stain on skinned knees.
In 1998 the Food and Drug Administration deemed the sterilizing agent "not generally recognized as safe and effective" and ordered its discontinuation from over-the-counter drugs -- but not from childhood shots.
Thimerosal is nearly half a potent neurotoxin. It contains 49.6 percent ethylmercury by weight.
There are differing opinions whether this form of mercury is more or less hazardous than methylmercury, the kind found in fish and power-plant emissions -- and the type upon which vaccine safety standards are based.
More to the point, there is scant direct scientific showing of its effect on humans, particularly on vulnerable infants whose disease-fighting immune system is still under construction.
A 1931 study found no ill consequences from thimerosal. However, it was conducted on 22 adult meningitis patients, who died, precluding a follow-up to determine any long-term reactions, had a poor design -- seven of the subjects were observed for only a day -- and failed to definitively rule out the possibility of harm, the FDA acknowledges.
Developed by Eli Lilly and Co. in 1929, thimerosal had been commonly added to biologic drugs and vaccines since the 1930s to prevent microbial contamination and prolong shelf life.
Carefully skirting the fallacious reasoning of association as proof of causation, those who hold the mercury-based preservative responsible for the rise in autism make it a point to note that's about the time Kanner started seeing the first of the documented cases of what appeared to him to be a new disorder.
Thimerosal was never needed in the single-use, individually bottled, more expensive vaccines, only in those packaged in multiple-dose containers susceptible to bacterial infestation with each needle insertion.
As the number of required infant and toddler inoculations multiplied in the late 1980s and early 1990s, the multi-dose vials were particularly favored because they were cheaper to produce, easier to store and more convenient for parents, who would not have to make as many trips to the doctor's office.
Thimerosal was added to make them safer and longer-lasting.
Next: View of vaccine as agent of autism
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