Medscape article on autism

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Autism Continued to Increase Subsequent to Thimerosal Removal

Busko

Medscape Medical News 2008. © 2008 Medscape

January 11, 2008 — Analysis of data from a California database shows that

the number of autism cases continued to increase after the

ethylmercury-containing preservative thimerosal was eliminated from most

childhood vaccines,

according to a report in the January issue of the Archives of General

Psychiatry.

" These findings are inconsistent with the idea that exposure to thimerosal is

a major cause of autism, " study coauthor Schechter, MD, from the

California Department of Public Health, in Richmond, told Medscape Psychiatry.

Diagnosed cases of autism have continued to increase in the past decade, and

it has been suggested that this may be linked to increased exposure to

thimerosal in vaccines. Thimerosal has been used since the 1930s to prevent

microbial contamination in vaccines. Infants and toddlers in the United States

were

exposed to more thimerosal after recommendations in 1991 that influenza and

hepatitis B vaccines be added to childhood immunization. They have been

exposed to less thimerosal since its removal from childhood vaccines was

recommended in 1999. From 1999 to 2004, the average exposure to thimerosal

among

healthy infants and 2-year-olds dropped to minimal amounts.

If thimerosal exposure is a primary cause of autism, the prevalence would be

expected to decrease as children's exposure has dropped to the lowest levels

in decades. In the current study, researchers sought to determine whether

trends in the California Department of Developmental Services (DDS) autism

client database support the hypothesis that thimerosal is a primary cause of

autism.

They looked at prevalence of autism in children born from 1989 to 2003 who

received public services for autism from the DDS from mid-1995 to mid-2006.

They found that instead of decreasing, the prevalence of autism for children

at each year of age from 3 to 12 years increased consistently throughout the

study period, including when exposure to thimerosal was declining.

" Our findings are in concordance with the rigorous 2004 review of at least 12

previous published and unpublished studies by the [institute of Medicine]

IOM Immunization Safety committee, which concluded that the body of evidence

rejected a causal relationship between thimerosal-containing vaccines and

autism, " the authors write.

The hypothesis that thimerosal, a modifiable risk factor, is a major cause of

autism offered the hope for prevention through reduced exposure, they note.

Although their present findings do not support this hypothesis, the authors

encourage the continued quest for discovery of other potential modifiable risk

factors.

" Thimerosal Disappears but Autism Remains "

The study by Schechter and colleagues is just one of a long series of studies

that has accumulated over the past 6 or 7 years and provides additional

evidence of the lack of association between thimerosal exposure and risk of

autism in the US population, Fombonne, MD, from Montreal Children's

Hospital,

in Quebec, who wrote an editorial accompanying the paper, told Medscape

Psychiatry.

The main messages from the study are that parents who have a child with

autism should be reassured that their child's autism did not occur through

vaccination, and they should vaccinate the child's siblings, he said. The

practice

of chelation " treatment, " which consists of removing mercury from the body,

for children with autism is dangerous and is not warranted, he added.

Chelation therapy gives false hopes instead of doing what is needed, which is

education and behavioral stimulation, he noted.

" I think it is very important that family doctors, pediatricians, and

healthcare practitioners strongly say to parents, 'The research has been done.

There is absolutely no risk that thimerosal is bad. And if you don’t vaccinate

your child against measles or against the other recommended diseases, you put

him or her at risk.' "

Measles is a preventable infectious disease that can be lethal, so it is very

important that people maintain immunity by keeping vaccination at its

current high level, he noted.

No financial disclosures were reported by the study authors. In the United

Kingdom, Dr. Fombonne has provided advice on the epidemiology and clinical

aspects of autism, advising parents, measles-mumps-rubella vaccine

manufacturers, and several government committees between 1998 and 2001. In the

United

States, he has been a consultant to ad hoc committees from the Institute of

Medicine and the American Academy of Pediatrics and is an expert witness for

the

US Department of Health and Social Services and for vaccine manufacturers in

the US thimerosal litigation. None of his research has ever been funded by the

pharmaceutical industry.

Arch Gen Psychiatry. 2008; 65:19-24 _Abstract_

(http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve & db=PubMed & list_uids=\

18180424 & dopt=Abstract) ,

15-16. _Abstract_

(http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve & db=PubMed & list_uids=\

18180423 & dopt=Abstract)

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