Correction: 6 year old girl DEAD

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Experts to Discuss a Puzzling Autism Case, as a Second Case Looms

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By _GARDINER HARRIS_

(http://topics.nytimes.com/top/reference/timestopics/people/h/gardiner_harris/in\

dex.html?inline=nyt-per)

Published: June 28, 2008

Federal health officials on Sunday will call together some of the world’s

leading experts on an obscure disease to discuss the controversial case of a

9-year-old girl from Athens, Ga., who became _autistic_

(http://health.nytimes.com/health/guides/disease/autism/overview.html?inline=nyt\

-classifier) after

receiving numerous _vaccinations_

(http://health.nytimes.com/health/guides/specialtopic/immunizations-general-over\

view/overview.html?inline=nyt-classifier) .

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Related

_Times Health Guide: Autism_

(http://health.nytimes.com/health/guides/disease/autism/overview.html)

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* _Get Health News From The New York Times »_

(http://www.nytimes.com/services/xml/rss/nyt/Health.xml)

But the government has so far kept quiet a second case that some say is more

disturbing and more relevant to the meeting.

On Jan. 11, a 6-year-old girl from Colorado received FluMist, a _flu vaccine_

(http://health.nytimes.com/health/guides/specialtopic/influenza-vaccine/overvi

ew.html?inline=nyt-classifier) , and about a week later “became weak with

multiple episodes of falling to ground†and “difficulty walking,â€

according to

a case report filed with federal health officials and obtained by The New

York Times.

The girl grew increasingly weak and feverish and “became more limp, appears

sleepy, acts as if drunk,†the report said. She was hospitalized and underwent

surgery and was finally withdrawn from life support. She died on April 5,

according to the report.

Both the 9- and 6-year-olds had mitochondrial disorders, a spectrum of

genetic diseases that have received almost no attention from federal health

officials. The 9-year-old, _Hannah Poling_

(http://topics.nytimes.com/top/reference/timestopics/people/p/hannah_poling/inde\

x.html?inline=nyt-per) , was 19 months

old and developing normally in 2000 when she received five shots against nine

_infectious diseases_

(http://health.nytimes.com/health/guides/specialtopic/travelers-guide-to-avoidin\

g-infectious-diseases/overview.html?inline=nyt-classif

ier) . Two days later, she developed a _fever_

(http://health.nytimes.com/health/guides/symptoms/fever/overview.html?inline=nyt\

-classifier) , cried

inconsolably and refused to walk. In the next seven months, she spiraled

downward,

and in 2001 doctors diagnosed autism.

No one knows whether vaccinations had anything to do with the girls’ health

problems, and the scientific significance of individual cases is always

difficult to assess. But suggestions that mitochondrial disorders could be set

off

or worsened by vaccinations, and that the disorders might be linked to

autism, prompted the meeting on Sunday and has brought the disorders sudden

national attention.

Those scheduled to present at the meeting who were contacted by The Times

said they knew nothing of the Colorado case.

“I haven’t heard about this case,†said Dr. R. Insel, director of

the

National Institute of Mental Health and the day’s first speaker.

Dr. Iskander, acting director of the immunization safety office at the

_Centers for Disease Control and Prevention_

(http://topics.nytimes.com/top/reference/timestopics/organizations/c/centers_for\

_disease_control_and_prevention/

index.html?inline=nyt-org) , said his group had studied the Colorado case

closely but did not discuss it with those presenting at the meeting and had no

plans to present the case to the conference, although he and members of his

group will attend.

“Part of the consideration is, what was the best use of that time?†Dr.

Iskander said in an interview. “To a large extent, the judgment of the meeting

organizers was to have the experts in these conditions — which are not vaccine

safety experts — to have most of the agenda.â€

Dr. Iskander said the Clinical Immunization Safety Assessment Network of the

disease agency reviewed the medical records related to the Colorado and

Georgia cases, searched for similar reports and asked vaccine manufacturers if

they knew of similar cases. A spokeswoman for MedImmune, the maker of FluMist,

declined to comment.

The team noted that the Colorado child had not experienced any problems with

her previous vaccinations and was relatively old at the time of her

diagnosis. Dr. Iskander said the group had concluded “that this is another

case that

points to the need of better data on the risks and benefits of vaccinations in

children with these rare disorders.â€

Study after study has failed to show any link between vaccines and autism,

but many parents of autistic children are convinced that vaccines — usually

given around the time autism becomes apparent — are to blame.

Parents and a small group of doctors have offered a variety of scientific

explanations in recent years to try to explain why they think vaccines may cause

or contribute to autism. Among the first was that the _measles vaccine_

(http://health.nytimes.com/health/guides/specialtopic/mmr-vaccine/overview.html?\

inl

ine=nyt-classifier) caused a low-level _measles_

(http://health.nytimes.com/health/guides/disease/measles/overview.html?inline=ny\

t-classifier) infection

that affected children’s brains. The science underlying that theory has since

been discredited.

The next theory was that a mercury-containing vaccine preservative,

thimerosal, poisoned their brains, causing autism. Multiple studies have failed

to

find any relationship between thimerosal exposure and autism, and nearly seven

years after the preservative was removed from childhood vaccines, autism

rates seem unaffected.

The Poling case, however, offered advocates a new theory: that vaccines may

cause or contribute to an underlying mitochondrial disorder, which in turn

causes autism. Although autism is common among children with mitochondrial

disorders, several experts in the disorders dismissed the notion that vaccines

may cause the disease, which is widely understood to have a genetic origin.

“After caring for hundreds of children with mitochondrial disease, I can’t

recall a single one that had a complication from vaccination,†said Dr. Darryl

De Vivo, a professor of neurology and _pediatrics_

(http://topics.nytimes.com/top/news/health/diseasesconditionsandhealthtopics/ped\

iatrics/index.html?inlin

e=nyt-classifier) at _Columbia University_

(http://topics.nytimes.com/top/reference/timestopics/organizations/c/columbia_un\

iversity/index.html?inline=nyt-o

rg) who will present at the meeting on Sunday and is one of the premier

experts in the field.

Mitochondria, which serve as the energy factories of cells, have their own

genetic material that is passed directly from mother to child. Flaws in this

material are relatively common. As those flaws multiply, they interfere with

mitochondrial function.

Dr. De Vivo said as many as 700,000 people in the United States had flawed

mitochondria, and in roughly 30,000 of them the genetic flaws were expansive

enough to cause disease.

" Ms. Michele "

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