The Independent; 22/07/2003

The controversial MMR (measles, mumps, rubella) vaccine has not triggered an increase in the number of children being diagnosed with autism, according to experts.

Researchers at the Royal Free Hospital in London say figures actually show that the number of new cases has levelled off and may have peaked 11 years ago.

They also said that the rise in new cases throughout the 1980s and early 1990s could have been simply due to greater awareness of the condition.

Nevertheless, the study found that parents were now more likely to blame their children's autism on the MMR vaccine.

Professor Brent Taylor and colleagues at the Royal Free identified 567 children born between 1979 and 1998 who were diagnosed with autism in north-east London. They found that the number of children being diagnosed with autism peaked in 1992.
 
They reported that the number of new cases had levelled off between 1992 and 1996, with between 45 and 50 children being diagnosed with the condition. This was equivalent to 2.6 cases for every 1,000 live births. The researchers said that if autism were caused by the MMR vaccine, then figures would have jumped sharply throughout the early 1990s. The MMR vaccine was introduced in Britain in 1988.

Writing in the journal, Archives of Disease of Childhood, the researchers said: "The appearance of autism appears to have stabilised."

The researchers also dismissed claims that the vaccine can cause developmental or bowel problems in children. "The claims that MMR vaccine is involved in the initiation of autism, and/or with regression, and/or with bowel problems associated with autism are not supported by any credible scientific evidence, while there is compelling and increasing evidence showing no association."

SAN DIEGO, California, USA: Head circumference in infants with autism may indicate the disorder before their behaviour does. 

Children who are autistic appear to have accelerated brain growth well before any behavioural indicators appear, an American study has found.

Dr Eric Courchesne, professor of neurosciences at the University of California-San Diego and director of the Center for Autism Research at the Children's Hospital and Health Center in that city, has found that more than half of autistic children have an enlarged brain by the time they reach 14 months. This is the first time a potential early warning sign for autism has been identified.

Autism begins very early in life, but is not usually identified until a child shows behavioural signs and symptoms beginning at two or three years of age. These include delayed speech, unusual social and emotional reactions and poor attention to, and exploration of, the environment.

The study looked at the medical records of 48 children with autism spectrum disorder aged two to five years. The researchers compared head measurements of children with autistic disorder with those from two databases that describe normal growth patterns in infants.

They found that the children with autistic disorder had a rapid and excessive increase in head circumference measurements, beginning several months after birth. The findings appear in the July 16, 2003, issue of the Journal of the American Medical Association.

"In our study, head size increased from the 25th percentile - based on the Centres for Disease Control and Prevention averages of healthy infants - to the 84th percentile in six to 14 months," the researchers wrote in their paper. "This excessive increase occurred well before the typical onset of clinical behavioural symptoms."

The Western Mail, 24/06/2003

Parents of autistic children allegedly damaged by the triple MMR (measles, mumps, rubella) vaccine have welcomed new claims by researchers in the United States that they can prove that a significant number of children suffered an abnormal response to the measles component of the combined jab.

Their findings appeared to back up those published five years ago by the British gastroenterologist, Dr Andrew Wakefield, which started widespread concerns about a link between the triple vaccine, autism and bowel disease.

One Welsh mother, Julie Loch, who lives near Newport, believes her six-year-old son, Oliver, developed autism after the MMR jab. She told The Western Mail newspaper: "This study proves that our children have followed the same normal development pattern but have regressed after having MMR, and it seems as though the key is the children's immune systems. These findings reinforce what parents have been saying for so many years - something is happening to this group of children as they are reacting abnormally, with devastating effects. Our children cannot be ignored any longer."

The research, by Dr Vijendra Singh and Dr Ryan Jensen, of Utah State University, into samples from 52 autistic children who had been vaccinated with MMR, found that measles antibodies - a sign of an immune reaction to the measles virus - were significantly greater in this group than among the non-autistic children studied. More than 80 per cent of the autistic children had these antibodies compared with none of the 30 normal children and none of the 15 siblings involved in the research.

Drs Singh and Jensen believe the presence of antibodies show that many autistic children have suffered an abnormal response to the measles element of the MMR vaccine, causing them to develop these "inappropriate" antibodies.

The findings, which are published in the journal Pediatric Neurology, are the result of the pair's theory that, as viruses are common trigger agents for auto-immune diseases, where the human body attacks itself, autism could involve a virus-induced auto-immune response, which in turn leads to autism.

Crucially, none of the autistic children involved had any history of measles rash or wild-type natural measles infection, which implies that the source of the measles antibody is the strain of measles virus used in the MMR vaccine.

This new research comes 10 days after the High Court ruled that two British girls, aged four and 10, had to have the MMR jab, on their absent fathers' insistence, despite their mother's concerns about its safety.

Public confidence and take-up rates of MMR have plummeted since Dr Wakefield's controversial study in 1998 linking it to autism and bowel disease.

In Wales, the MMR take-up rate has fallen again over the last quarter to just 78.1 per cent, compared with a year ago when 82.5 per cent of children were vaccinated with MMR.

The Chief Medical Officer for Wales, Dr Ruth Hall, said: "I realise that parents are concerned about the MMR vaccine and the unproved allegation that the vaccine can harm some children, but it is the safest way to protect children from measles, mumps and rubella. The vaccine is used successfully in over 30 countries around the world and is the vaccine recommended by the World Health Organisation. "Measles is one of the world's biggest killers and the recent outbreaks in the Cardiff area demonstrate the importance of the MMR vaccine."

New Scientist; Glasgow Herald, 18 and 19/06/2003

Children who develop autism may do so because they have problems processing the toxic metal mercury, researchers have suggested.

Researchers in Louisiana looked at mercury levels in the baby hair of children who later developed autism. They were found to have far lower levels of mercury than children who did not have the condition, according to Britain's New Scientist magazine.

The researchers say this could be because autistic children's bodies cannot make use of metals such as mercury properly, or because they have trouble excreting the metal from their body.

A group of parents in the United States and Canada are suing health authorities because they believe thimerosal, a mercury-based preservative used in vaccines, could have caused their children's autism.

The triple MMR (measles, mumps, rubella) vaccine, which some parents fear is linked to autism, does not contain thimerosal.

Experts are divided over whether there could be a link between mercury and autism. Some say that more studies need to be carried out before a connection can be confirmed.

But others, such as Louisiana-based Dr Amy Holmes, who carried out this latest research, believe there is a causal link.

Dr Holmes obtained baby hair cuttings which had been taken when children were around 18 months old. She analysed mercury levels in cuttings from 94 autistic children and 45 other children The average level of mercury in baby hair of children later diagnosed as autistic was 0.47 parts per million, compared to 3.63 per million in the other children. The more severe the children's autism, the lower the mercury levels found.

Most of the mercury came from the children's mothers in the form of fillings, injections containing the thimerosal or through eating a lot of fish.

In the group of non-autistic children, mercury levels rose in line with their mother's exposure.  But levels in the baby hair of the autistic children were low even when their mother's exposure was high.

The researchers say that one explanation could be that autistic children's bodies are unable to make use of metals properly, so they could also be deficient in metals which are needed for brain development such as zinc, iron and copper. Alternatively, they suggest, some children might have problems excreting mercury. Most of the metal is excreted through urine and faeces.

NEW YORK STATE, USA: The University of Rochester Medical Center is about to test the theory that symptoms of autism can be reduced in children by eliminating the amount of gluten and dairy products they eat.

Thanks to a five-year, US$7.5 million grant from the National Institutes of Health, UR and seven other research centres are embarking on the nation’s most extensive study of how children respond to various treatments for autism.

With awareness of autism on the rise, the NIH is seeking a broad, scientific review of treatments to determine which ones are most effective. 

"Autism treatment is very expensive financially and emotionally - and no single approach works for all children," said Dr Patricia M. Rodier, UR professor of obstetrics and gynecology and the principal investigator on the university’s autism project. "If we could predict in advance which children would benefit from available treatments and which would not, children could be matched to the best treatments available." 

In addition to the diet test, UR will plot brain activity to discover why some children with autism exhibit little or no facial expression. Also, a behavioural study will collect data on IQ, social and language skills, repetitive movements and other characteristics of children with autism. 

But what may garner the most attention is the study on gluten, which is commonly found in wheat, rye and oats; and the protein casein, found in many dairy products. Some parents with autistic children believe that casein and proteinaceous gluten produce symptoms of autism by disrupting the biochemical processes in the brain. 

"I know parents who swear by it," said Bonnie Watson of Pittsford, whose 8-year-old daughter, Adrienne, has autism. "Most of them believe that eliminating these proteins increases their children’s eye contact and level of interaction with others. But give them one glass of milk and their behaviour worsens." 

A special diet - free of gluten and casein - is not something that Watson is willing to try for Adrienne right now. Adrienne’s behaviour is such that she won’t eat many foods, and getting her to eat a regimented diet is beyond her ability, Watson said. "Maybe when she gets older. By then, this study might be able to give us an idea of what’s really going on with these proteins," Watson said. 

Dr Rodier has been delving into the roots of autism since 1994. In 2000, she and a team of UR investigators announced the discovery of a gene that could increase a person’s susceptibility to autism. The gene, known as HOXA1, may play a crucial role in early brain development, doing much of its work during three or four days in the third week of pregnancy. 

At least 16 of every 10,000 babies are born with autism or a related disorder. This means that as many as 1.5 million Americans today are believed to have some form of autism.