And with good reason.

I am a bit late to the latest round of this party, but as I have previously pointed out, The Huffington Post has been since its inception a bastion of pseudoscience, especially in the medical field. Like distressingly many news outlets, it has decided to abandon all pretense of being “fair and balanced” in its actual content when it comes to its ideological stance.

Arianna Huffington clearly is enamored of anti-scientific pseudomedical nonsense. Earlier in her career she wrote for and frequently appeared on Politically Incorrect with Bill Maher – another quack-friendly media personality.

So it is no surprise that the HuffPo has been a haven for unscientific dangerous medical misinformation. Specifically, writers for the HuffPo, including David Kirby, have consistently taken an anti-vaccine stance.

The science blogging community just can’t keep up with the steady stream of medical stupid coming from the HuffPo, but occasionally an article or group of articles reaches a critical mass of stupid and triggers a response. Such is the case recently.

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I have been critical of the Huffington Post’s anti-scientific editorial stance. Since the beginning of this online news source it has been a home to the anti-vaccination movement, featuring articles and blogs by David Kirby, Jenny McCarthy, Jim Carey, and RFK Jr. The health section of the the HuffPo is largely composed of credulous promotion of unscientific health claims and gross misinformation. In fact, this has led me to criticize the HuffPo’s de facto  “war on science.”

Recently Dr. Rahul K. Parikh has written an excellent criticism of the Huffington Post for Salon.com. The full article is worth a read, but here are his main points.

He convincingly demonstrates that the anti-scientific editorial stance of the HuffPo comes directly from its founder, Arianna Huffington. She is hostile toward scientific medicine and enamored of so-called “alternative medicine.” Further, she has recruited health bloggers and editors in a scattered fashion, mostly on her personal whim, and has not taken care to provide even a balanced approach to health reporting, let alone a scientific or responsible one.

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It is without controversy that the number of autism diagnoses being made is on the rise. In 1991 there were about 6 cases per 10,000 births, and in 2001 there were about 42. This number continues to rise at about the same rate.

The cause of this rise, however, is very controversial. There are basically two schools of thought: 1 – that true autism rates are on the rise, and 2 – that the measured rise is an artifact of increased surveillance and a broadening of the definition. A new study published today in the journal Epidemiology lends support to the school claiming that autism rates are truly rising – or at least that is how proponents are interpreting it. After a closer look, I am not so sure.

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There is a dedicated fringe anti-vaccine movement. They are dedicated to some permutation of the collection of beliefs that vaccines are: 1) not effective; 2) have not reduced or eliminated any infectious disease; 3) are not safe; and 4) are a conspiracy of Big Pharma, the government, and paid-off doctors. Specific claims have wandered over the years, but they have as a central theme that vaccines are bad. When one specific claim collapses, they will move on to the next anti-vaccine claim.

While anti-vaccine cranks have been around as long as vaccines, it is only recently that they have captured the attention of the mainstream media and the skeptical movement and the battle has really been engaged.

Anti-vaccinationists have focused much of their recent efforts on the claim that vaccines cause autism. At first the MMR vaccine was blamed, sparked by a now-discredited study performed by Andrew Wakefield. This led to declining vaccination rates in the UK and a resurgence of measles.

As the MMR claim was in decline (although by no means abandoned), attention shifted to thimerosal – a mercury-based preservative in some vaccines. There are many flaws with the thimerosal hypothesis, and numerous studies have shown no link between thimerosal and autism or any neurological disorder. But the fatal blow to the thimerosal hypothesis was struck when thimerosal was removed from the routine childhood vaccine schedule (thimerosal, incidentally, was never in the MMR vaccine) in the US by 2002. In the subsequent 6 years the rate of autism diagnoses kept increasing at their previous rate, without even a blip. Only the most rabid (or scientifically illiterate)  anti-vaccine fanatics still cling to the thimerosal claim.

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Recently there has come to attention a potential cluster of autism cases among Somali immigrant in Minnesota and Sweden. If true, this could potentially be an important clue as to the pathophysiology of some types of autism.

Autism is unknown in Somalia, but the children of Somali immigrants in two communities in Minnesota and Sweden have reported higher numbers of cases than the general population. This suggests that there is an environment trigger – something they are getting or not getting in their new communities that is different than Somalia. This report indicates:

In Minneapolis, Somalis account for 6 percent of the city’s public school population, but make up 17 percent of early childhood special education students who have been labeled autistic, according to data aggregated by the Minneapolis Public Schools.

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This week Michael Savage questioned the legitimacy of most diagnoses of autism because they are based only on symptoms – not on any objective tests. I have also been engaged in a blog discussion with Dr. Jon Poling about the exact nature of his daughter’s diagnosis – does it represent autism or something else. Both questions are ultimately about the very nature of a neurological diagnosis (or medical diagnosis in general). So I thought I would dig deeper on this question for background.

As a clinician I often discuss with patients what I think about their diagnosis. In my experience most people begin with many misconceptions about how diagnoses are typically made. I also train student doctors and they too typically come to me needing a far more complete and complex understanding of how diagnoses are made and what they mean. So even outside of the context of autism controversies this is a very useful topic to cover.

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I have bemoaned in the past the celebrity culture in which we grant more weight to the opinions of celebrities than they deserve. It seems to be part of human nature to idolize and hero-worship. It can be benign, even healthy. Young athletes idolizing the talent and hard work of sports stars may be spurred on to greater achievement themselves. I also think that intellectual heroes, like Carl Sagan and Stephen J. Gould, can have an enormously positive influence on culture and society.

TV and movie stars, however, are famous because their profession involves public performance in a medium that potentially reaches millions. This is fine as far as it goes – I have no problem admiring stars for their entertainment value, their charisma, and their artistic talent and skills. It is reasonable to admire artists for their art.

The problem comes, in my opinion, when actors and actresses feel that their political opinions or ideology are somehow more valuable than anyone else’s because of their fame. I don’t necessarily blame them – they have a right to express their opinions and their fame gives them an outlet. I do think that if they are going to trade on their fame then they have a responsibility for what they promote, but I am not questioning their right to promote whatever they choose. Rather I maintain that the public should largely not care what celebrities think about issues that have nothing to do with their art and profession.

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Kathleen Seidel runs the neurodiversity blog – a science blog dedicated to autism and related issues. She is an outspoken critic of the “mercury militia” – those who claim that autism spectrum disorder is caused by mercury and/or vaccines. Recently she has been the subject of a subpoena to present all of her financial records and communication related to her website. The subpeona was issued by Clifford Shoemaker who is the attorney for plaintiffs Rev. Lisa Sykes and Seth Sykes against Bayer and other companies based upon the claim that vaccines caused their child’s autism. The subpeona was issued within hours of Kathleen writing a blog entry critical of Shoemaker.

Read the subpeona. I can tell you as a blogger, this is meant to be intimidating and to have a chilling effect on anyone who would dare express a controversial opinion inconvenient to this attorney and the misguided cause he represents. The consensus of the legal blogosphere is that it is without merit and represents an abuse of the subpoena privilege. Kathleen has written her own motion to quash the subpoena, and her motion will likely succeed.

This incident is a disturbing milestone in the shrillness of the autism/vaccine controversy. Those arguing for a connection are evolving more and more into an almost religious cult. Last week on Larry King Live actress Jenny McCarthy, who believes her son’s autism was caused by vaccines, shouted down the scientists who were calmly trying to discuss the scientific facts. Her husband, actor Jim Carrey, chimed in to support the notion that there is a conspiracy to hide the truth from the public.

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It must be tough being a presidential candidate. You have to field so many questions, and there are hidden landmines everywhere. Well, John McCain recently stepped on a doozy. When asked about vaccines an autism he is quoted by ABC News’ Bret Hovell as saying:

“It’s indisputable that (autism) is on the rise amongst children, the question is what’s causing it. And we go back and forth and there’s strong evidence that indicates that it’s got to do with a preservative in vaccines.”

Yikes. This is yet another example of why, in today’s science and technology dominated world, we need leaders with a modicum of scientific literacy. I don’t expect every politician to be completely up to date on every complex scientific question, not even every one that has political implications. The big ones, sure. Politicians need to have an opinion about global warming, the utility of biofuels, the importance of science education, and why intelligent design is not science.

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No. But David Kirby and other anti-vaccinationist ideologues and members of the so-called mercury militia would like you to think so. For background, the Autism Omnibus refers to a set of hearings before the Vaccine Injury Compensation Program regarding claims by about 5000 parents that their childrens’ autism was caused by vaccines. These claims are primarily based upon the various hypotheses that the MMR vaccine, or thimerosal in some vaccines (but not MMR), or the combination of both, is a cause of autism.

So far there have been hearings, but only one final decision. In November the US government settled one case in favor of the petitioner. This is the case those who have supported the failed hypothesis that vaccines cause autism now point to as admission that they were right all along (or at least as a means of stoking the flames of fear about vaccines.) But the US government did not admit vaccines cause autism – they conceded one case that is highly complex and not necessarily representative of any other case and cannot be reasonably used to support the vaccine/autism connection.

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