The anti-vaccine community is tireless. As I wrote yesterday, they happily shift around their multiple goalposts as long as they have some working hypothesis about how vaccines are to blame for autism or some human suffering. They have moved from MMR to thimerosal to aluminum to “toxins” to squalene and now the HepB vaccine. They just spin the wheel and choose their next target – although they never really abandon their prior targets, they just back burner them a bit.

They also have their small dedicated group of researchers, like the father and son team of Geier and Geier, to produce crappy studies to support their anti-vaccine claims. Andrew Wakefield, who has been rightly vilified for starting the MMR scare with his now discredited Lancet study, has also apparently decided to make a career out of feeding bad studies to the anti-vaccinationists.

I acknowledge there is a certain symmetry to the situation now. The scientific community presents studies that show a lack of correlation between some aspect of vaccines and autism or other neurological disorders. They generally accept these studies as supporting vaccine safety, even while being open about their limitations. They also sharply criticize those studies that suggest there may be a connection between vaccines and autism as fatally flawed.

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Two recent studies concerning the prevalence of autism in the US have been getting a lot of attention, because they indicate that autism prevalence may be higher than previously estimated. This, of course, fuels the debate over whether or not there are environmental triggers of autism.

One study was conducted by the CDC but has yet to be published. The results were announced ahead of publication by the US Health and Human Services Secretary Kathleen Sebelius to the autism community. She reports that the new prevalence of autism spectrum disorder (ASD) is now estimated at 1% or 100 in 10,000 children. This is an increase over the last few years. In 2002 the prevalence was estimated to be 66 per 10,000.

The second study was published in the journal Pediatrics and is a phone survey of 78,037 parents. They asked if they had any children who had ever been diagnosed with an ASD. Here are the results:

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Orac thinks Jake Crosby is just a “crazy mixed up kid.” I am not inclined to be so generous. I have no personal knowledge of Crosby, so all I have to go by is his blogging over at Age of Autism. He recently wrote a two part blog that is nothing more than a malicious conspiracy-mongering grab-bag of logical fallacies, sloppy reasoning, and sloppy journalism – all in the name of anti-vaccine pseudoscience. Maybe he is just an innocent tool, but it really doesn’t matter – he’s responsible for the absurd vitriol he had dumped onto the blogosphere.

Orac has nicely deconstructed the nonsense in Part I of Crosby’s rant. But there is a Part II, and Crosby threw into his follow up a regurgitation of the personal attacks that J.B. Handley had previously made against me.

In the words of the immortal Bugs Bunny, “Of course you know this means war.”

Weaving a Conspiracy

The entire two-part blog is based upon the naive premise that finding tenuous connections among science bloggers, skeptics, and skeptical outlets means that they are all involved in a deep dark conspiracy. Further, that any connection, no matter how tenuous, to any other organization or corporation means that the science blogger is in fact a shill for such organizations. This is conspiracy-mongering at its most childish and uninformed.

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Mark and David Geier are a father and son team that have been pushing the claim that autism results from mercury poisoning from vaccines. They have produced a string of junk science, denounced by mainstream scientists for terrible methodology, reasoning, and statistics. They portray themselves as mavericks, but in my opinion they are just terrible and dangerous scientists.

Their latest atrocity raises their medical mischief to new levels.  For several years now they have been pushing their testosterone hypothesis of autism. They claim, in short, that autism is caused by mercury poisoning, primarily from vaccines. Children with autism, especially boys, have high testosterone, which is partly the cause of their symptoms. But also the testosterone binds to mercury, preventing it from being removed from the body by chelating agents.

They have therefore conducted a study with the drug Lupron in addition to chelation. Lupron is a powerful drug that lowers testosterone levels. It is used for rare disorders associated with premature or high testosterone, or to treat prostate cancer in some men. It is also used as a form of chemical castration for sex offenders.

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A new genome-wide analysis of families with autism has found significant gene associations, adding to the growing evidence for strong genetic contribution to autism.  While this is still a long way away from explaining autism, it represents a significant advance in a very fruitful area of research.

But to put this into context, we need some background. Autism spectrum disorder (ASD) is not a single discrete pathophysiological disease. In fact, the term “disease” is probably not appropriate at all, which is why it is termed a “disorder.” Like many neurological conditions with primarily cognitive and behavior effects, ASD likely correlates with the organization and function of neurons in the brain – not a pathological disease process.

What this means is that there is likely to be a complex set of many factors that contribute to ASD – not one single cause. ASD is defined by the clinical symptoms that are evident – decreased social and verbal skills with a tendency to display repetitive behaviors or a narrow focus of interest. Brain function itself is highly complex, and these higher-order behaviors may just be the final common pathway of many potential underlying changes.

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A new study looks at the effectiveness of hyperbaric oxygen therapy in autism. The study is the first double-blind placebo controlled study of such therapy in autism and found a significant improvement in those children in the treatment group.

However, the treatment is very controversial and remains so, even after this study.

Hyperbaric oxygen therapy involves placing patients in a chamber with pressure increased above atmospheric pressure with an enriched oxygen content.  It has many legitimate medical applications, such as treating certain kinds of infection, but also has become popular among some as an unscientific treatment. It is offered by practitioners and chambers are even sometimes purchased by private individuals for their own family’s use.

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The much awaited decision on the first test case of the Autism Omnibus was just announced – and it’s good news. They have found that the petitioners failed to make their case that vaccines caused their children’s autism, and that therefore compensation was not appropriate.

The Autism Omnibus hearings were set up to evaluate for thousands of petitions for compensation under the vaccine injury compensation program. This is a program set up in the US to compensate those who suffer adverse effects from vaccines, and it is paid for by a tax on all vaccines. This is a sensible system because it allows manufacturers to produce much needed vaccines without risking bankruptcy over fad pseudoscientific accusations – like those that took down Dow Chemical. It also more quickly and fairly compensated families, which is fair given that vaccines are somewhat compulsory in the US (although in most states it is all too easy to get an exemption).

These cases arise out of the now scientifically discredited notion that certain vaccines or something in vaccines (like thimerosal) is linked to autism. I have written extensively about this controversy, and what we can say at this time is that the scientific evidence is solidly against any link.

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A new study published yesterday (Monday) in the journal Pediatrics provides more evidence against any link between thimerosal (a mercury-based preservative in some vaccines) and autism or other neurological disorders. This study adds to the large and growing body of scientific evidence for the safety of vaccines, and contradicting the claims of the anti-vaccine movement that vaccines cause autism.

The study is a bit fortuitous in that it was not originally designed to probe this question. Rather, this was a safety and efficacy study of the acellular pertussis vaccine conducted in Italy between 1992 and 1993. But it created a cohort of children who were carefully screened and monitored, and randomized to different exposures to thimerosal. This allowed the researchers to go back 10 years later to survey and examine the children for neurological disorders.

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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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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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