Thursday, May 27, 2010

Wakefield Drops a Bomb

Well, not really, merely an execrable bit of ordure (redundant, I know, but apropos) meant to titillate his adoring fans and distract from the larger issue of why he was erased from the GMC register. Andrew Wakefield appeared on the Today Show, Wednesday, 24 May 2010 and made some statements regarding the replication of his research and his accusation that the U.S. government has been settling vaccine-induced autism cases, some in secret, since 1991. Here is the clip from the Today Show:

Visit msnbc.com for breaking news, world news, and news about the economy


Here is the transcript of the interview that Leftbrain/Rightbrain has kindly put together (the times the relevant quotes appear in the video are marked in red):
INTRO

MATT LAUER: [But]...in the years following his publication in The Lancet.no large scale study could reproduce exactly what Dr. Wakefield’s small study found. Dr. Wakefield is here for an exclusive interview. Doctor, good morning.

WAKEFIELD: Good morning Matt.

MATT LAUER: It may sound like a strange way to start the interview but…do I still refer to you as Doctor?

WAKEFIELD: Yes, they can’t take away the fact that I have a medical degree.

MATT LAUER: You were not surprised by this action … the stripping of your medical license. Why?

WAKEFIELD: Not at all. It was determined from the very beginning I believe, the pressure the government brought on the GMC.. to find this ruling.

MATT LAUER: You don’t think this was an impartial panel?

WAKEFIELD: I think that the panel .. whether they believe they were influenced or not .. were certainly of this opinion .. when I read their decision which came out in February .. this decision had been made from the outset.

MATT LAUER: Doctor is this the final blow to your credibility? Doctor, I mean if you look at the studies that have been conducted since your research wved[sic] your theories. The fact that The Lancet has since said, “If we knew then what we know now, we wouldn’t have published the study in the first place”. You lost your job down in Texas and now your medical license. Is that it?

WAKEFIELD: The findings we made originally have been replicated in five different countries of the world. So, the bowel disease in these children exists. This is a little bump on the road .. and .. that’s how it should be perceived. It’s a bump on a very bumpy road .. but .. it’s a bump. What it does not detract from is the fact there are millions of children out there suffering .. and .. the fact that vaccines can cause autism. That’s a fact that’s accepted by the American government … because they have been settling cases of vaccine induced autism since 1991. [4:15]

MATT LAUER: You say to me the findings have been replicated. I have seen studies, several major studies. Your study involved twelve children … I’ve seen studies that involved hundreds of thousands of children that do not replicate your findings. And, so, today .. will you sit across from me and tell me you still believe there is a possible link between tha particular vaccine .. the MMR vaccine .. and .. autism in children?

WAKEFIELD: Not only do I think it .. but .. the American government has conceded that it exists. A causal relationship between vaccines and autism exists .. and .. they have actually been secretly settling cases as early as 1991. Out of court as well. [4:40]

MATT LAUER: As you know, we have talked to people since we had a chance to meet .. when you were kind enough to sit down for that exclusive interview with us .. and .. people in our government have said “NO! NO! We no longer believe this. We went out and checked out the possibilities and we no longer believe this to be true.” And .. every doctor I’ve spoken to says “It’s dangerous … it’s dangerous to even keep talking about it because .. every time you talk about it .. parents stop vaccinating their children .. and .. some children are dying from preventable diseases”.

WAKEFIELD: Matt, you are missing the point. The point is .. despite denying it .. in the public relations campaign they waged against me and against the parents .. they are conceding these cases in vaccine court. [5:15]

MATT LAUER: What’s your next step .. real quickly?

WAKEFIELD: My next step is to continue this work till it’s natural conclusion. These parents are no going away, the children aren’t going away ..and .. I most certainly am not going away.

MATT LAUER: Dr. Andrew Wakefield, thank you for joining us. I appreciate your time….

I'll take this statement first since Catherina already demolished that claim in a previous post
WAKEFIELD: The findings we made originally have been replicated in five different countries of the world. So, the bowel disease in these children exists. [4:15]
I will include reference #4, Balzola et al. (2005) since that wasn't discussed:
Autistic enterocolitis: confirmation of a new inflammatory bowel disease in an Italian cohort of patients.
Federico Balzola, Clauser Daniela*, Alessandro Repici, Valeria Barbon, Anna Sapino***, Cristiana Barbera**, Pier Luigi Calvo**, Marina Gandione*, Roberto Rigardetto*, Mario Rizzetto.

Dept of Gastroenterology. University of Turin. Molinette Hospital Turin, Italy

*Dept of Neuropsychiatry for Children. University of Turin Regina Margherita Pediatric Hospital, Turin, Italy ** Dept of Pediatric Gastroenterology. University of Turin Regina Margherita Pediatric Hospital, Turin, Italy *** Dept of Biomedical Science and Human Oncology University of Turin

Although the causes of autism are largely unknown, this long-life developmental disorder is now recognised to affect as many as 1 to 500 children. An upper and lower intestinal disease has been recently described in these patients (pts) in spite of gastrointestinal symptoms have been reported by the parents back more many years. This disorder comprising ileo-colonic lymphoid nodular hyperplasia (LNH) and chronic inflammatory colonic disease was called autistic enterocolitis: an association between autism and bowel disease was then proposed.

Nine consecutive male pts (mean age 18 years, range 7-30 years) with a diagnosis of autism according to ICD-10 criteria that showed chronic intestinal symptoms (abdominal pain, bloating, constipation and/or diarrhoea) were enrolled. After routinely blood and stool tests, gastroscopy and colonoscopy with multiple biopsies were performed under sedation. A wireless enteroscopy capsule was also performed in 3 adult pts.

Anemia and fecal blood positive test were found in 2 pts and 3 pts, respectively. Gastroscopy revealed mucosal gastritis in 4 pts, esophagitis in 1 and duodenitis in 1 pts. Histological findings showed a chronic inflammation of the stomach and duodenum in 6 pts (66%) but inconsistent with celiac disease. Macroscopic mucosal abnormalities (aphtoid ulcerations and loss of vascular pattern) were found in 1 pts (11%) at colonoscopy and a LNH in the terminal ileum in 4 pts. (44%) Microscopic colitis with intraepithelial lymphocytes and eosinophils infiltrations, mucosal atrophy and follicular hyperplasia was histologically present in all the pts (100%) whereas a chronic inflammation with iperemia and villous shortening of the terminal ileum was shown in 6 (66%) pts. The wireless capsule revealed areas of bleeding or patchy erythema, mucosal erosions and ulcers in both jejunum and ileum in 1 patients whereas a particular chronic jejunum and ileal erosive pattern was evident in the other two.

These preliminary data are strongly consistent with previous descriptions of autistic enterocolitis and supported a not-coincidental occurrence. Moreover, they showed for the first time a small intestinal involvement, suggesting a panenteric localisation of this new IBD. The treatment to gain clinical remission has still to be tried and it will be extremely important to ameliorate the quality of life of such pts who are likely to be overlooked because of their long-life problems in the communication of symptoms.

These findings do not support a distinct pathology unique to autism. Additionally, Wakefield's original claim was essentially, 'MMR vaccination, then appearance of gastrointestinal symptoms, then regression into autism'. So not only was Wakefield's original claim roundly disproven, but Balzola et al.'s findings do not indicate anything remotely descriptive of Wakefield's original claim. This abstract also remains just that, i.e. an abstract presented at a meeting 5 years ago and has not gone through any peer-review, nor publication.

None of these studies or conference presentation present any evidence of a novel, gastrointestinal disorder unique to autism. In fact, it doesn't appear as though those with autism spectrum disorders have prevalence of any gastrointestinal pathology above that of the general population aside from constipation or diarrhoea. In short, Wakefield's own work isn't what he claims, nor has anyone replicated his work, anywhere, because it is hard to replicate a fabrication.

The other claims that de-licensed physician Andrew Wakefield makes are:
WAKEFIELD: .. the fact that vaccines can cause autism. That’s a fact that’s accepted by the American government … because they have been settling cases of vaccine induced autism since 1991. [4:15]

WAKEFIELD: Not only do I think it .. but .. the American government has conceded that it exists. A causal relationship between vaccines and autism exists .. and .. they have actually been secretly settling cases as early as 1991. Out of court as well. [4:40]

WAKEFIELD: Matt, you are missing the point. The point is .. despite denying it .. in the public relations campaign they waged against me and against the parents .. they are conceding these cases in vaccine court. [5:15]
These hidden-out-in-the-open, not-so-secret vaccine injury cases were blogged about by Kathleen Seidel on Neurodiversity, over 2 years ago. And here are some key quotes from that:
In each of the above-listed cases, the autism diagnosis followed the development or aggravation of profoundly disabling physical conditions.

As established in Lassiter v. HHS, an autism diagnosis does not prevent compensation for individuals who can demonstrate to the satisfaction of the special master that they have experienced a vaccine injury. However, in no instance has the VICP awarded compensation to cognitively disabled individuals who were not also physically disabled.
Emphasis mine. None of these compensated cases even remotely resembles the six test cases that were chosen to represent the over 5000 Omnibus Autism Proceedings' petitioners. None of these cases were 'secretly settled' as Wakefield claimed. It appears as though nothing that falls from Wakefield's mouth is truthful, even now when he has nothing more to lose.

Just to add insult to injury, the much touted "American Rally for Personal Rights" held in Grant Park, Chicago, IL to converge with Autism One, ended up being quite the damp squid. Wakefield was a keynote speaker at the rally, attended by a whopping 100 or so of his adoring fans, falling well-short of the thousands anticipated. That's okay though; Andy only cares about the children.


Photo courtesy of Age of Autism. American Rally for Personal Choice, 26 May 2010.

KWombles on Countering Age of Autism is having a caption contest for all of you snarkmeisters.

Wednesday, May 5, 2010

Andrew Wakefield has written a book

Oh joy - Andrew Wakefield has written a book. In a brilliant display of his 'special kind of humour' (haha, two children fainted and one threw up over his mother, haha), he has called it "Callous Disregard". This comes from the ruling of UK's General Medical Council, which attested Wakefield "callous disregard for the distress and pain children might suffer". Good one, Andy, wink wink, nudge nudge.

Fiction is Andrew Wakefield's field and has been for over a decade, readers will remember his wonderful work of fiction about children with an autism specific gut inflammation caused by measles containing vaccines published in the Lancet in 1998. Certainly, we can expect the same kind of imagination from his new publication - cannot wait!

(sarcasm off)