Tetanus in an Unvaccinated Boy in NZ

It happens - unvaccinated children do contract tetanus (as we had reported before). It doesn't happen very often, but when it does, it is incredibly cruel. Alijah, a 7 year old Auckland (NZ) boy cut his foot (as children will do) and developed tetanus. The NZ Herald provides a harrowing description of what that means:

Within 36 hours, the 7-year-old Auckland boy was crippled by body spasms, unable to swallow and racked with pain.

"He was screaming in agony," mother Linda Williams said.

.../...

"It was hideous. He was spasming every three minutes. He was biting his tongue and bleeding. His arms were spasming and he was arching his back and his whole face and jaw was completely locked."

Alijah was admitted to a ward but 24 hours later he was moved to intensive care, put into an induced coma and paralysed by drugs to prevent the spasms and relieve the pain.

His breathing had to be monitored because the muscle contractions could close the airway, and later a tracheotomy tube was inserted in Alijah's throat to help him breathe.

Luckily, Alijah survived and could leave the hospital after 26 days, although he now faces a year of rehabilitation to relearn how to eat and walk. The parents are blaming themselves for their son's horrific ordeal and have since vaccinated their other children and asked other parents of unvaccinated children at their son's school to reconsider. Although both hold degrees in the science/health field, they had fallen for the anti-vaccine misinformation. Alijah's dad says:

Parents like us make the decision to not vaccinate on very little factual information about the actual consequences of the diseases - massive pain, disability and death - and a lot of non-factual, emotive information from the internet stating inflated figures on the frequency and severity of adverse reactions and conspiracy theories about 'evil' doctors, governments and drug companies.

.../...

Believing myths about vaccines is not the same as getting the facts. And that is the core problem.

We hear from more and more parents who are regretting their non-vaccine decision (e.g. against pertussis) and maybe it is about time more parents spoke about vaccinating. Currently, the discussion seems to be dominated by a very vocal minority, which, despite being on the very fringe manage to endanger children's lives.

ETA: a bit more info and renewed self awareness here.

When The Truth Calls....

Hollie from Motherhood: The Truth is a great mom - all natcheral - she used cannabis during pregnancy and birth and she is NOT poisoning her pweshous snow flakes with evil vaccines, instead, she was looking for pox and whooping cough parties. Unfortunately, Hollie seems to suffer from really low self-esteem, because, faced with a little criticism, she called one random pro-vaccine minded Facebooker at her workplace (a law school, cough) and since nobody answered, Hollie left her threats on her target's voicemail (which I guess does answer the question what cannabis does to your IQ).

Classy:

MMR-Encephalitis NVICP Decision

The United States Court of Federal Claims (USCFC) has recently compensated petitioners Saeid B. Mojabi, Parivash Vahabi and their minor son, Ryan B. Mojabi for a table injury of encephalitis as a result of MMR vaccination.  Naturally the usual suspect is exploiting this for his own validation.  Dr. Bob Sears states:

Vaccines don't cause autism . . . except when they do. Here is another case of MMR-induced encephalitis that resulted in autism.

While the child clearly suffers from neurological deficits there is no diagnosis of autism, only an allegation by the parents (petitioners).

Petitioners allege that the MMR vaccination that Ryan received on December 19, 2003 (the first MMR vaccination), resulted in a Vaccine Table Injury, specifically an encephalopathy that produced “a severe and debilitating injury to his brain, described as Autism Spectrum Disorder (‘ASD’).” Id. Alternatively, petitioners argue that “as a cumulative result of [Ryan’s] receipt of each and every vaccination between March 25, 2003, and February 22, 2005, Ryan has suffered, and continues to suffer, neuroimmunologically-mediated dysfunction[] in the form of asthma and ASD, [conditions] which were ‘caused-in-fact’ by the vaccinations.” Id. at 1-2.

The child did not have any ASD behaviours from two CHAT screenings:

On May 10, 2004, at Ryan’s sixteen month well-child visit, Dr. Armstrong completed a Checklist for Autism in Toddlers (CHAT) screen. Ps’ Ex. 4 At 25. That CHAT screen indicated that Ryan was interested in other children, pretend play, peek-a-boo, points with index finger, makes eye contact, and brings object for show. Id. On January 25, 2005, Dr. Armstrong examined Ryan for his twenty-four month well-baby check. Ps’ Ex. 4 at 31. During the visit, Dr. Armstrong conducted another CHAT screen, and again Ryan postively performed each of the listed behaviors.

Although, again the child exhibited neurological deficits affecting language and behaviour:

A month later, on October 27, 2005, Ryan was examined by the intake team at the Early Start Program. Id. at 55. The notes from this assessment reflect that Ryan’s parents “are concerned that Ryan’s development of speech and language appears to be delayed.” Id. The notes go on to state that “[Ryan] does not say very many words. Father relates that Ryan seems to have about 10 words that he will sometimes use. [Ryan] no longer uses words that he has previously learned. He is shy with other children and he is not able to adapt to new situations easily. He does not like to have other people come over to visit.” Id. On November 7, 2005, Dr. Armstrong examined Ryan again and observed that Ryan had “some aggressive interactions with vocalizations and hitting outbursts.” Ps’ Ex. 4 at 57.

Fewer than one child per million doses of MMR develops encephalitis but as many as 1,000 children will develop encephalitis per million cases of natural measles.  This is what we would observe in less than a generation if people like Dr. Bob get their way and stop vaccinating.  It's easy for people like him to criticise vaccines but do nothing to offer a viable alternative.  Single measles vaccines are no different in terms of serious reactions.

The Mojabi-Vahabi family has my utmost sympathy and I am glad that the NVICP system worked for them as it should.  But this decision, in no way, represents the thousands of OAP petitioners who claim some compilation of vaccines caused autism.  Dr. Bob would do well to report the facts instead of continuing to whip parents into a frenzy with histrionics but then again, if he did, he wouldn't be able to sell books, products and "services".

Organic Food Causes Autism (r=9971; p=0.0001)

not found by me, but by jasonp55 - it is impressive, it is unambiguous, it is clearer than the fact that storks deliver babies (p=0.008)

I think respondent Doorsofperceptron has a point when s/he says:

I think they're related.

Both diagnosing autism and buying organic food indicate movement to a society rich enough to concern itself with secondary health issues.

No one believes that autism or eating inorganic food will kill you, but diagnosing autism and developing coping strategies or eating organic food, are seen as good ways to improve people's lifestyle.

Not only have you found a real correlation in American history, but I think if you checked countries all around the world, the percentage of food sold labelled as organic should strongly correlation with the proportion of the population diagnosed as autistic.

Basically, autism testing and organic food are proxies that measure how rich people are.

In any case, this little graph shows impressively that correlation ≠ causation. An important thing to keep in mind when the usual anti-vaccine activists make vaccines responsible for autism and infant deaths.

sources: http://www.ota.com/pics/documents/2011OrganicIndustrySurvey.pdf
http://penndata.hbg.psu.edu/documents/ADR/Idea06.pdf

The proof that MMS is bleach

Scientists are a curious folk - best illustrated by xkcd:

Last year, a lot of bloggers had tackled the ludicrous recommendation to use MMS (= bleach) to "cure" your child's autism/your cancer/your HIV (see Orac, Just the Vax,  Emily Willingham at TPGA, also see Autismum's excellent posts, here and here). Both Emily and we got hit by a necromancer  a couple of days ago, leaving their typo- and error-riddled insight, first and foremost "MMS is not bleach".

Emily just posted the BEST ANSWER EVER to that claim. Better than any previous attempts by various colleagues to explain chemistry, she went out, prepared MMS according to the woosters' instructions and poured it on some dark cloth. She actually did the experiment (imagine my squees of delight).

before

one hour after application

MMS: Yes, it is bleach - QED - thank you Emily - you are my heroine!

Messenger's muddled message (updated)

or something along the lines of that. Stephanie Messenger wrote a little book about measles and how great they are - for kids aged 6 to 10. Stephanie's first son died of what she thinks was a vaccine reaction (heartbreaking picture warning), but her sister says was Alexander Disease. Losing a child is very very sad. It doesn't give anyone the right to spew dangerous nonsense and advertise vaccine refusal and taking carrot juice against measles instead. You say "what"? Here's blurb (you can also read Skepticat's summary - it is way cool):

Melanie has measles, so Tina and her mum go over to play and bring healthy food, including carrot juice, because of the vitamin A, which makes measles not so bad. Tina doesn't get measles, because she eats so healthily, which means that Melanie's mum must be a bad mum, because she didn't feed her Melanie enough carrot juice or something. Measles also makes you strong and is great to get, but when junk food guzzling vaccinated Jared gets the measles, it'll hopefully teach him to eat well. Not sure how something that is great to get teaches you a lesson.

Ridunculous! A lot of bloggers have been enraged (it is those details - that the teacher in Melanie's class is pregnant for example), see these insights and well-deserved insolence.

However, what made me (and Katie) really angry is the similarity of the rhythm of "Melanie's marvellous Measles" with "George's marvellous Medicine" a book by Roald Dahl. I cannot possibly know whether this intentional. I do know for sure, though, that while Stephanie thinks measles make kids "mature", and that kids "can feel hot for a day or so" with measles, Roald Dahl knows that they kill. They killed his daughter, Olivia (the smiling girl in the foreground).



Roald Dahl knows that measles are a dangerous illness - he writes:

Olivia, my eldest daughter, caught measles when she was seven years old. As the illness took its usual course I can remember reading to her often in bed and not feeling particularly alarmed about it. Then one morning, when she was well on the road to recovery, I was sitting on her bed showing her how to fashion little animals out of coloured pipe-cleaners, and when it came to her turn to make one herself, I noticed that her fingers and her mind were not working together and she couldn’t do anything. “Are you feeling all right?” I asked her. “I feel all sleepy, ” she said. In an hour, she was unconscious. In twelve hours she was dead. The measles had turned into a terrible thing called measles encephalitis and there was nothing the doctors could do to save her. That was twenty-four years ago in 1962, but even now, if a child with measles happens to develop the same deadly reaction from measles as Olivia did, there would still be nothing the doctors could do to help her. On the other hand, there is today something that parents can do to make sure that this sort of tragedy does not happen to a child of theirs. They can insist that their child is immunised against measles.

 (my bold - again, read the whole thing, this man has a way with words)

So, how does one limit the reach of a dangerous disease door-to-door saleswoman? After some initial resistance, one supplier, Booktopia, took Messenger's marvellous Megalomania off their shelves - here's the press report (worth listening to if just for the lovely accent):



For those who are so inclined, there is a petition asking Pearson Australia Group (Angus and Robertson, and Bookworld) to end sales of ‘Melanie's Marvellous Measles’ in any forum (form?). I am not sure that banning bad books is the way forward, although peddling deadly diseases to kids is pretty far out there. It appears Stephanie Messenger is not going to leave it at that anyway and is planning Messengers Marvellous Movie - making use of another media and providing blog fodder for many posts to come.

Sad really.

ETA (11/1/13) Bookworld have now announced that they will no longer sell Melanie's Marvellous Measles. Messenger says this "doesn't matter". I am afraid she is right...

Why Some Just Shouldn't Write About Science

We've taken a hiatus from blogging for too long and for mundane reasons after being so productive.  But leave it to Dr. Bob Sears to provide irresistible blog fodder.  This time he tries to critique a novel test for autism which results in the usual clumsy and error-riddled claim when he attempts to write about a subject he is clearly out of his depth on...science.

This is actually a novel and useful test with a premise that has tremendous diversity in terms of autism aetiology and treatment research.  But that doesn't stop Dr. Bob from not only getting it wrong out of the gate but proffering an inept criticism of it.  Dr. Bob states:

Researchers at the Children’s Hospital of Boston have developed a genetic test to detect the most common gene mutations that occur in children with autism (1.)

No they didn't and in fact stipulate quite clearly that they have developed a test based upon perturbed gene expression signatures in ASD children as compared to the control groups.  This is vastly different than genetic tests based upon mutational nucleotide sequences.  Dr. Bob's one and only "source" is a CNN report yet there is a very good, plain English press release from Boston Children's Hospital that explains very precisely what the test is and isn't.  There is also the primary research study open-accessed published in PLOS ONE which he obviously didn't bother to read before commenting.  Dr. Bob also states:

The small initial study only looked at 66 kids with autism, and compared their genetics to 33 neurotypical kids.

No they didn't.  The researchers started with a pool of 489 gene expression candidates, drew blood samples from their P1 group which was on a sample cohort of 66 male ASD cases and 33 age-matched male controls.  They examined perturbed expression (either up or down regulated) of those genes in the ASD group as compared to controls.  They then narrowed that pool of genes down to 391 based upon the strength of signature (you want a consistently detectable difference between groups) and applied the test to a subsequent group (P2) consisting of 104 male and female ASD cases and 82 age/sex-matched controls (although females were over-represented in the control group).  From the original study:

First, the training set (P1) was utilized to determine a classification signature (i.e. a combination of gene expression measurements) that was used to classify ASD patients in P1 (compared to controls). We ranked the 489 differentially expressed genes according to their area under the receiver operating characteristic (ROC) curve (AUC). Next we excluded those genes with low expression, requiring the minimum expression level across all samples to be at least 150. A total of 391 differentially expressed genes were then utilized in building the prediction models, which were subsequently tested against the samples in our independent validation cohort (P2).

The researchers then found that 55 gene expression signatures provided the the best prediction model while minimising the number of gene expression signatures needed and tested them again on the P2 group. The resulting accuracy of the test is both interesting and impressive.

Analyzing the blood samples, Kong and colleagues flagged 489 genes as having distinct expression patterns in the ASD group, then narrowed this to a group of 55 genes that correctly identified or ruled out autism in 76 percent of samples. They validated their findings in a second group of 104 male and female patients with ASDs and 82 controls, achieving an overall classification accuracy of 68 percent (73 percent for males and 64 percent for females).

This is an exciting find with positive ramifications that I will get to in a moment.  But since it's a genetic test, Dr. Bob doesn't like it and invokes an appeal to authority:

“They are measuring gene expression and then assuming it has something to do with mutations in the genetic code, which is not necessarily the case. In fact, there is a lot of information that suggests that differences in gene expression in autism are due to differences in gene methylation and gene regulation, which would not change the genetic code.”

I guess Dr. Frye didn't bother to read the study either where the authors explicitly state:

The classification performance in this study is encouraging, particularly as the two groups were heterogeneous and profiled using two different array-types. The classification of 73% of cases by expression profiling contrasts with the small percentage of ASD cases characterized by genetic mutations or structural variations to date. It also compares favorably to the performance of CMA, which, while high confidence, accounts for only 7–10% of cases of ASD. Together, these results suggest that gene expression signatures, which comprise multiple perturbed pathways, may serve as signals of genetic change suggestive of ASD in most patients. In this regard, this work parallels studies in neuropsychiatry where investigators have demonstrated that blood expression signatures are significantly different in schizophrenia [53], Alzheimer's disease [54], and bipolar disorder [55].

And

“It’s clear that no single mutation or even a single pathway is responsible for all cases,” says Kohane. “By looking at this 55-gene signature, which can capture disruptions in multiple pathways at once, we can say with about 70 percent accuracy, ‘this child does not have autism,’ or ‘this child could be at risk,’ putting him at the head of the queue for early intervention and evaluation. And we can do it relatively inexpensively and quickly.”

Emphasis added.  They aren't assuming any such thing as they are examining the actual expression of a set of genes and NOT the nucleotide sequences.  I would have expected better from Dr. Frye given he has an academic research appointment but there is no accounting for intellectual honesty and accuracy when one decides to associate themselves with a biomeddler anti-vaxx group like TACA.

The study authors identified two subsets of autism based upon gene expression signatures.

The biological pathways implicated by the differentially expressed genes identified in this study are of interest because some of the gene sets link to synaptic activity-dependent processes (i.e., long-term potentiation and neurotrophin signaling in Table 4), for which several ASD mutations have been found [40], [41]. Immune/inflammatory pathways were also identified in this analysis (e.g. chemokine signaling and Fc gamma R-mediated phagocytosis), which have been implicated in several studies of children with ASD compared to controls through CNS cytopathology [61], serum and CSF proteomics [59], as well as in cadaveric expression studies of the CNS [51].

This result improves upon what has already been elucidated with regards to differential gene expression in autism and other neurological disorders as well as identifying a substantial portion of children at risk for developing autism who could then be followed prospectively.  Familial histories, in utero environmental and neonatal exposures could be recorded to help identify potential inducers of perturbed gene expression and identify additional subsets of autism.  The more that is known, the more can be done to reduce the risk of autism and develop evidence-based treatment modalities.  This is a good thing but obviously eludes the likes of Dr.s Bob and Frye.

In my opinion the most important of all is to never take a “wait and see approach” if early signs develop. If we witness any regression or developmental delays we need to recommend and begin developmental and biomedical therapies as soon as possible to achieve the best possible outcomes. The decision to seek out these therapies will be based on an infant’s development, not on a genetic test which needs much more research and verification before we get excited.

Dr. Bob critiques this test based upon his own deficits in science but thinks he can ameliorate autistic behaviours with "biomedical therapies" which consist of throwing everything at the wall and see what sticks and of course, withholding vaccines.  Whereas identifying gene expression signatures before a child develops developmental delays is nothing to get excited about.  The only thing he manages to get right is that this test needs wider validation before becoming commercially-available.  This is acknowledged by the study authors:

The application of these predictors to a prospective cohort would allow us to further assess their validity as a diagnostic and prognostic tool. Finally, our groups with ASD were compared to developmentally normal controls and not to individuals with other neurodevelopmental disorders. Nevertheless, the accuracy we have obtained in this study is a necessary first step towards a trial validating a set of predictive biomarkers.

In conclusion, this study of children with ASD describes a gene expression signature that shows promising accuracy in classifying children with ASD from controls. The ability of the ASD55 predictor to correctly classify ASD samples compares favorably to the DNA-based tests currently proposed for ASD diagnosis. The results presented here raise further questions that bear investigation but are outside this study's scope: At what age does this ASD55 signature manifest? Is it present at birth? Finally, we expect that larger studies can be used to determine whether particular characteristics of ASD can be classified or predicted from a gene expression signature (e.g. seizures and language delay) and thereby improve individualized treatment in the near future.

One of Dr. Bob's faithful asks the question on his Facebook page: 

 Is this MTHFR or another mutation?

To which he responds:

I am not sure if this test includes MTHFR.

Read the damn study Bob; the answer is no, MTHFR expression is not included.

Another asks:

I'm interested. Would it detect asbergers [sic]

The answer (not from Dr. Bob) is yes, the test was able to distinguish autism, Asperger's and PDD-NOS.

All in all this is a test to get excited about, not just for its potential commercial use as an early detection method for autism risk but its current utility for research that appears to be an expedient avenue to elucidating autism aetiology, developing preventative and targeted treatment strategies.  If there is one thing I have learned being involved with vaccine discussions is that biomeddlers/anti-vaxxers hate genetics research because the evidence keeps mounting against vaccine causation and thus "recovery" via DAN! nonsense.  Of course this makes "biomed" pedallers like Dr. Bob even more obsolete as they are getting left in the dust by actual technology.