Orac is the nom de blog of a humble pseudonymous surgeon/scientist with an ego just big enough to delude himself that someone, somewhere might actually give a rodent's posterior about his miscellaneous verbal meanderings, but just barely small enough to admit to himself that few will. (Continued 
I have good news and bad news for you.
First, the good news. The devastating death crud that has kept me in its grip for nearly a week now appears to be receding. For the first time, "whining" or not, I start to see the light at the end of the tunnel. Whether it's due to PalMD's kind offer of Pranic Healing or not, I don't know, but things are on the mend.
And now the bad news. There will be no Friday Dose of Woo this week. The reason is simple. My mucus-laden head continues to pound, and my hacking cough continues to put me into an ill mood. This makes it very difficult to attain and maintain the appropriately light-hearted and jovial tone towards which I strive when I bring each week's dose of amazing woo, and no one wants YFDoW to turn vicious. When that happens, it ceases to be fun.
On the other hand, my current not-quite-recovered state puts me in the perfect frame of mind to apply some richly deserved not-so-Respectful Insolence™ to David Kirby's latest bit of antivaccination nonsense published the other day in that repository of antivaccination nonsense, The Huffington Post, entitled The Next Big Autism Bomb.
Suffice it to say that, as usual, the only "big bomb" here is the one that Kirby drops on science and logic. In fact, as per his usual M.O., Kirby carpet-bombs logic and science under a torrent of obfuscating verbiage designed to mask just how weak his arguments are. He probably thinks he's delivered a thermonuclear blast to scientists and skeptics who tell him he's full of crap, but in reality you'd be hard-pressed to hear a ladyfinger explosion there. In fact, I doubt it's the equivalent of a sparkler, even. A wet, sputtering sparkler just before it fizzles out. If anything, it's nothing more than part two of the incredibly shrinking causation claim and another desperate attempt to keep blaming autism on vaccines, despite all evidence failing to find a link.
Because Kirby, in his usual fashion, seeks to baffle with bullshit where he can't dazzle with brilliance, before addressing other points I'm going to zero in like the proverbial laser beam on one key admission that comes near the end of the article. It's an admission so buried in the mounds of Kirby's usual verbal prestidigitation that it's easy to let it slide by, even if you know that David Kirby is the author of Evidence of Harm: Mercury in Vaccines and the Autism Epidemic: A Medical Mystery, a book that three years ago contributed to massive fear-mongering about mercury in the thimerosal preservative in vaccines as a cause of autism. Since, then, as has been well documented by several studies, there has been no sign of a decrease in the incidence of autism now over six years since the last thimerosal-containing vaccines were taken off the shelf. Kirby's been trying to dodge and weave about that originally saying that if we didn't start to see a decline in autism rates by 2005 it would be a serious blow to the thimerosal hypothesis Of course, 2005 came and went without a decrease; so he shifted the goalpost back to 2007. Meanwhile, he started to strategically back away from blaming mercury in vaccines, going so far as to pull ridiculous excuses such as blaming mercury from the fillings of corpses cremated in California. 2007 came and went without a decrease. So most recently he shifted the goalposts back to 2011, declaring it a "tad premature" to vindicate thimerosal, while even still trying to speculate how he could revive the "thimerosal-causes-autism" gig that made him famous.
Now, here's his admission:
And it might help explain why autism rates are not plummeting now that thimerosal levels have been significantly reduced in most childhood vaccines.
Got that? David Kirby admits that autism rates are not decreasing six years after nearly all thimerosal has been removed from childhood vaccines. Even he knows that the evidence is against the mercury militia. I suspect also that even Kirby realized how ridiculous his hand-waving blaming mercury in pollution from China or mercury in the fillings of corpses being cremated in California as the reasons why autism rates were not falling sounded. He knew he needed a new story. Thanks to the Hannah Poling case, he (and the rest of the mercury militia) found one. I will come back to that later, but the Poling case was clearly manna from heaven to rescue Kirby from what must have looked like the rest of his career (whatever his career is) wandering through the desert of crankery, and like a starving man Kirby latched onto it and fed deeply. The only problem is that in doing so, he excreted the results as pseudoscientific claptrap, and this is what we see in his Huffington Post opuses. In the meantime, remember that all of Kirby's florid verbiage surrounding the above admission is nothing more than the desperate gasp of a man looking for a way to keep blaming vaccines for the autism "epidemic" in the face of increasingly incontrovertible science showing that they are not to blame.
Much of Kirby's article consists mainly of anonymous quotes from people who supposedly were part of or listening in to a teleconference held earlier this month by the CDC. Apparently, it was convened to discuss the Hannah Poling case and whether mitochondrial disorders are part of the pathogenesis of autism. (My take on the question can be found here; so I won't rehash it.) Kirby makes much hay of a number of sources who say lots of ominous things. Not surprisingly, these sources are all anonymous; not a single one is identified. Normally, I would not consider this that huge an issue, but this is David Kirby we're talking about. For me to trust a journalist's use of anonymous sources, I first have to trust that journalist. Kirby's history is so replete with spreading misinformation, goalpost-shifting, and dubious statements that I just plain don't trust him, and I think I'm quite justified in that mistrust. I have no way of knowing if this is the case, but it wouldn't surprise me in the least if his "sources" are true believers, advocates who were included in the teleconference in the same way that antivaccinationists have been included on a major federal panel on autism. The point is that I have learned from bitter experience not to trust Kirby's word alone on anything. If he told me it was raining outside, I'd be sure to look out my window to verify it before grabbing my umbrella.
The other part of Kirby's article includes his rehashing two studies that he mentioned before and then going--shall we say?--a bit wild with speculations based on them. The first of these was a recently published study out of Portugal by Guiomar Oliveira et al. This study surveyed autism prevalence in mainland Portugal and the Azores, and children with a diagnosis of autism or autism spectrum disorder (ASD) were screened for associated medical conditions. They found that 20% of autistic children had associated medical problems, with what was reportedly a higher than expected incidence of mitochondrial disorders at 4.2%. This report appears to be basically a rehash of data from a study from 2005 in a group of 120 children with autism. After children with identified associated medical disorders were excluded, out of the 102 children, only 56 underwent the full planned investigative protocol, and only 69 underwent any sort of screening for mitochondrial disorders (lactate levels), of which 14 were found to be abnormal. Eleven ultimately underwent muscle biopsy (the definitive test for mitochondrial disorders) of which five were reported to have definite mitochondrial respiratory chain disorders. None of the children had any of the deletions or mutations in mitochondrial DNA tested for. If this study is reproducible (and others have not as far as I know reported anywhere near as high a level of mitochondrial disorders, at least not in any reports in peer-reviewed literature), once again, as I pointed out before it still doesn't answer the question of whether such abnormalities are a cause of autism or an epiphenomenon. But that never stopped David Kirby from going off on wild speculations before.
Even worse is the second "study" that Kirby cites. Unlike the previous study, this study was not locatable on PubMed. In fact, the only link that I could find to it was here. It's nowhere else that I could find. That right away gave me little confidence. Perhaps it was an abstract presented at a meeting. Whatever the case, it clearly hasn't been published in the peer-reviewed medical literature indexed by PubMed, and its lead author doesn't list it on his webpage. Kirby makes a great deal of this study, which claims to show that as many as 20% of autistic children have mitochondrial disorders. Of course, even if the study had been confirmed and published in the peer-revieweed literature, one caveat that would have to be made would be that this is a skewed population. The population is that referred to the Kennedy-Krieger Institute, which is known for its expertise in mitochondrial disorders. It would not be surprising that investigators at the KKI would find a much higher rate of such disorders than in the general population. Not only do they have the expertise to find them, but children with suspected metabolic disorders would be more likely to be referred there. And, once again, even if such an observation were replicated in a more general population, it would not answer the question of whether we are observing an epiphenomenon or not. Also, don't forget that we don't know how good the study was because we have only an abstract to look at. There is no detailed methods section to evaluate and no way to determine if the study is sound or a piece of crap. Again, none of these sorts of concerns have ever stopped David Kirby from going off on wild speculations before.
But before his speculations, Kirby couldn't resist demonstrating his ignorance with this howler:
Another surprise came when one researcher announced an "inheritance pattern" that linked each case through the genetics of the father: In families where two cousins had autism, the genetic link was always through the father.This unexpected discovery would clearly implicate nuclear DNA inheritance, and not mitochondrial DNA, which is inherited only through the mother.
Kirby announces this as though it meant anything. Here's some news for Kirby: Not all mitochondrial proteins are coded for by mitochondrial DNA. Lots of them are coded by nuclear DNA, the same way every other non-mitochondrial protein in the body is. Finding a genetic mutation in the nuclear DNA involving a mitochondrial protein, defects in which can result in mitochondrial dysfunction, is entirely possible--even probable. Whether mutations implicated in individual types of mitochondrial disorders are in nuclear genes or mitochondrial genes says little about the mitochondrial dysfunction they cause, only about the mode of inheritance. Mentioning the possibility of paternal inheritance says nothing other than that whatever gene the KKI investigators claim to have implicated, it's not a mitochondrial gene, although it apparently somehow codes for a mitochondrial protein.
But, again, that doesn't stop Kirby from going off into the Twilight Zone of pure speculation gussied up with pretty prose to make it sound like something other than the B.S. that it is, starting thusly:
The mercury-containing vaccine preservative, thimerosal, for example, "can definitely kill cells in vitro through the mitochondria," one teleconference participant told me. "And some people are beginning to suspect that the dose of hepatitis B vaccine given at birth might be interfering with proper mitochondrial function in certain children."
It's irrelevant whether thimerosal can kill cells in cell culture at high doses through the mitochondria. Once again, the dose makes the poison, and there is no evidence that thimerosal in the dose given in vaccines kills neurons in vivo, through the mitochondria or otherwise. This is nothing more than another attempt by David Kirby to keep a dead hypothesis alive. Moreover, pretty much any process that induces apoptosis will result in death through the mitochondria; the mitochondria are intimately associated with programmed cell death. In other words, so what? Kirby then proposes a "three hit" idea:
STEP ONE: Child is conceived and born healthy, but with an underlying nuclear DNA genetic susceptibility to mitochondrial dysfunction, inherited from dad.TRIGGER ONE: An early environmental "adversity" occurs in the womb or during the neonatal period, perhaps caused by prenatal exposure to heavy metals, pollutants, pesticides and medicines. Or, it occurs in early infancy, through environmental toxins, thimerosal exposure, or even the Hepatitis B vaccine "birth dose."
Note the convenient inclusion of an unspecified mix of "toxins" and "heavy metals," plus the dreaded thimerosal prenatally. Anything to keep the mercury idea alive, you know! Also note his emphasis on paternal inheritance. There's really no basis for that, given that the actual abstract he cites noted autosomal dominant inheritance, which, unless a sex-linked gene, does not imply that any susceptibility gene has to be inherited from the father. True, the abstract did mention transmission through male relatives, but I'm guessing that there was nowhere enough data in the family tree to conclude that this was a sex-linked gene. In any case, according to Kirby:
This trigger results in:STEP TWO: Child develops mild, usually asymptomatic mitochondrial dysfunction (though I wonder if the ear infections and eczema so common in these cases might also be symptoms of mito problems).
TRIGGER TWO: Child, now with an underlying mitochondrial dysfunction, suffers over-stimulation of the immune system beyond the capacity of his or her metabolic reserves. This stress is either via a viral febrile infection, or from multiple vaccinations, as in the Poling case. This trigger results in:
STEP THREE: Acute illness, seizures, encephalopathy, developmental regression, autism.
Or, if someone with a rare genetic disorder gets a certain combination of vaccines when the moon is full, they might have a reaction that causes autism. Surely you can see the beauty of Kirby's new hypothesis. It's nowhere near as easy to falsify as the original mercury hypothesis. There are way more variables. Before, it was simply the mercury in vaccines, stupid. Or, as Generation Rescue used to put it, autism and ASD were all "misdiagnoses" for mercury poisoning. Very clear. Very concise. Of course, this concept had the inconvenient problem of making a clear cut and testable hypothesis: That autism rates should decline if thimerosal exposure is drastically decreased. Well, since late 2001, childhood exposure has been drastically decreased, and six-plus years later autism rates are not declining. That's why we're now treated to Kirby pulling calculations based on numbers from studies that have not been verified or replicated by other investigators, like this:
It remains to be seen how all this plays out. And many important questions still lie ahead.For example, if mitochondrial dysfunction turns out to be as common as 200-per-10,000, and autism is now at 66 per 10,000, did anything bad happen to any of the other 134-per-10,000 children, apart from autism (i.e., ADD, ADHD, speech delay, etc.)?
Note that it's hard to resist asking why Kirby assumes that children with autism are a subset of children with mitochondrial disorders. He seems to be assuming here that 100% of children with autism have mitochondrial disorders. But, wait, there's more stupid to consider:
Moreover, if 10-20% of autism cases can actually be traced to an underlying mitochondrial dysfunction, then what about the majority of autism cases where this did not come into play?And, if 20% of autism cases are mito related, and 6% of those cases regressed because of vaccines, that would mean that at least 1% of all autism cases were vaccine related. Some estimates of autism go as high as a million Americans - that would mean 10,000 people with vaccine-triggered autism, and billions of dollars in the cost of lifetime care.
This is just speculation on figures pulled out of Kirby's nether regions and so loosely based on reality that Kirby should think of a career in science fiction. The figures are custom-designed to be as inflated as Kirby can possibly make them. Even taking that into consideration, think about just what this represents. This is nothing more than what Kirby's been doing all along since the Hannah Poling case was announced. It's nothing more than a full retreat from the claim that mercury in vaccines is a major cause of autism. The fallback has been amazingly far, all the way to "maybe somehow vaccines aggravate some rare underlying mitochondrial disorder to cause autism in some children." Once again, Kirby's pretty rhetorical flourishes and speculation are about nothing more than finding a way to seem relevant when he is not. They're there to distract you from the utter failure of science to support the original claims of the mercury militia, namely that mercury in vaccines was the cause for most cases of autism. They're there to distract you from the existence of multiple large and well-designed epidemiological studies that have utterly failed to find a link between mercury in vaccines or vaccines in general and autism.
It's worth repeating one more time that Kirby's behavior is there to hide the fact that the idea that vaccines cause autism, an idea he once championed but has now clearly recognized as a loser, is the incredible shrinking hypothesis. It's gone from confident claims that mercury or vaccines cause nearly all cases of autism to a lot of handwaving based on one case conceded by the government in which the plaintiff had a rare mitochondrial disease which may have been aggravated by vaccines. Now Kirby's dug up small studies, one published and one unpublished (and thus unevaluable), that claim that mitochondrial disorders may be more common in autistic children than in the general population and used them to come up with a tortured "three step" idea of autism causation that allows him to admit that thimerosal doesn't cause autism while continuing to blame vaccines for at least some autism. It also allows him to cite wildly inflated estimates of how many children might be affected and to make up evidence-free recommendations about "numbers of antigens" that children should receive at one time.
Here's the thing that, in all his verbiage, David Kirby hopes that you won't notice: This strategy is in essence an admission of utter defeat of the mercury militia. Think about it. They've gone from claiming that mercury in vaccines was the prime cause of the "autism epidemic." Now, even if you accept David Kirby's hypothesis and his figures, at the very most and by Kirby's own estimate only 1% of autism could possibly be vaccine-associated. That's the highest estimate Kirby could come up with, even by torturing what little data there is. If that's not defeat, I don't know what is. I reiterate again that it is certainly worth studying whether there is a definite role for mitochondrial dysfunction in the pathogenesis of autism and ASD. However, the twisted web of causation proposed by Kirby is so far ahead of the science that it's not just in another time zone, but I question whether it's even on the same planet.
Of course, in the real world, there isn't even any credible scientific evidence to support blaming even 1% of autism on vaccines. Science just doesn't support it. So the question becomes: Why does Kirby bother? The reason, of course, is that it's all about the vaccines. It always was all about the vaccines. It always will be all about the vaccines, no matter how often or how vociferously Kirby or any other antivaccinationist piously lectures you otherwise or tells you that they are really for "safe" vaccines. (As if scientists and physicians aren't for safe vaccines!)
What really worries me about this new attention to mitochondrial disorders is not that they might actually implicate vaccines as a factor related to autism. As far as I'm concerned, the science will be done and the chips will fall where they may. What worries me is what the autism quackery industry will do with this. After all, the discredited idea the mercury in vaccines causes autism resulted in a huge cottage industry of quackery, the most popular form of which was chelation therapy for "detoxification" of the mercury that supposedly caused autism, a therapy that puts children at risk and has resulted in at least one death. It doesn't take a psychic to predict that there will soon be all sorts of unvalidated "tests" for mitochondrial disorders marketed to parents with autistic children based on the idea that mitochondrial disorders plus vaccines somehow cause autism. Nor does one need to be a psychic to predict that autistic children will likely soon in large numbers be subjected to workups for mitochondrial disorders, up to and including muscle biopsies or even more invasive procedures or that all sorts of dubious "cures" for autism that claim to reverse mitochondrial dysfunction will be marketed to the parents of autistic children, just as chelation therapy and various other biomedical interventions have been in the past.
It also doesn't require a psychic to predict that, assuming, as is likely, that science fails to find the smoking gun link that Kirby postulates here, he will happily move on to another tortured version of science that somehow, some way, manages to blame vaccines for autism.
That's because, above all, it's still all about the vaccines.
Medicine & Health
Comments
My mucus-laden head continues to pound, and my hacking cough continues to put me into an ill mood.
There's this homeopathic remedy for colds I want to tell you about. It's the mucus of a cold sufferer distilled to 1 part in ten billion...
Posted by: John S. Wilkins | March 28, 2008 9:39 AM
Yeah, but does the body-wracking sneezing, coughing and chills count as succussion?
Posted by: NJ | March 28, 2008 10:07 AM
We know a fetus exposed to Rubella in the 1st month has a 30% chance of some problems-deafness, autism, etc. If the anti-vaxers succeed, how many autism cases will be due to not getting the MMR? More than 1%?
Posted by: Ruth | March 28, 2008 10:10 AM
Having your rear end handed to you on a platter like that must really hurt. Notice he won't even admit the thimerosal is out of the vaccines? He says "thimerosal levels have been significantly reduced in most childhood vaccines." The salient parts there are "significantly reduced" (which is not synonymous with "removed" on my planet) and "most childhood vaccines" (which is not synonymous with "all"). You're saying that the thimerosal has been been removed.
I don't think he'd make a good science fiction writer, speaking as a science fiction writer. Science fiction has to be plausible within its postulated universe (that is, based on actual or postulated physical laws and principles), and it has to be internally consistent. I think you've just demonstrated that Kirby wouldn't know consistency if it bit him on the leg...
Posted by: Interrobang | March 28, 2008 10:17 AM
Cottage industry for mitochondrial disorder testing and diagnosis is pretty much the same notion that I had bouncing around my head earlier this week (I think after making the mistake of reading the comments in the CDC's AJC op-ed rebuttal to Kirby's call-out). I'm sure that will be the next thing over the next year or two either by DAN! practitioners or by opportunistic clinicians of varying stripes. Lots of blood and muscle for a pretty minimal yield, not to mention freaked out parents.
Let's not forget that even though Kirby is slooooowly backing away from the direct causation of thimerosal to autism, he still likes to talk about good old environmental exposure to heavy metals as the cause of mitochondrial defects (aside, of course, from his newer bone, paternal inheritance).
Posted by: Doc Strange | March 28, 2008 10:31 AM
Actually, there remain trace amounts in some vaccines, but only one vaccine (the flu vaccine) still uses the standard amount of thimerosal as an antibacterial agent, and even that is available in thimerosal-free forms. The bottom line, of course, is that mercury exposure due to vaccines is at the lowest level it's been since at least the 1980s, and there has been no sign of autism rates falling. That's about as strong epidemiological evidence as can be found that thimerosal in vaccines does not cause autism. On a purely technical level, of course, Kirby is correct to say that thimerosal levels have been "significantly reduced"; he just neglects to mention that the reduction is down to trace levels. Of course, some antivaxers claim that even those traces cause autism, but if that were the case then why wouldn't autism rates have been as high 20-30 years ago, the last time mercury exposure from vaccines was this low? Can't have it both ways.
Posted by: Orac | March 28, 2008 10:31 AM
Cottage industry for mitochondrial disorder testing and diagnosis is pretty much the same notion that I had bouncing around my head earlier this week (I think after making the mistake of reading the comments in the CDC's AJC op-ed rebuttal to Kirby's call-out). I'm sure that will be the next thing over the next year or two either by DAN! practitioners or by opportunistic clinicians of varying stripes. Lots of blood and muscle for a pretty minimal yield, not to mention freaked out parents.
Let's not forget that even though Kirby is slooooowly backing away from the direct causation of thimerosal to autism, he still likes to talk about good old environmental exposure to heavy metals as the cause of mitochondrial defects (aside, of course, from his newer bone, paternal inheritance).
Posted by: Doc Strange | March 28, 2008 10:33 AM
Kirby: "TRIGGER ONE: An early environmental "adversity" occurs in the womb or during the neonatal period, perhaps caused by prenatal exposure to heavy metals, pollutants, pesticides and medicines. Or, it occurs in early infancy, through environmental toxins, thimerosal exposure, or even the Hepatitis B vaccine "birth dose."
This is so classically brain-dead antivax.
Is there a mitochondrial disorder of gray matter that prevents these people from grasping that AN INFECTION might be the mysterious "trigger"? Or that vaccines guard against some of these infections?
Posted by: Dangerous Bacon | March 28, 2008 10:57 AM
No Bacon, you don't understand. An infection might result in a natural fever and we all know that the body, even if you have a mito disorder, can handle natural fevers. But a fever induced by a vaccine is an artificial fever...very bad!
disclosure: No, I am not being serious.
Posted by: ozzy | March 28, 2008 11:04 AM
Okay, I might have asked this before, but...
Is it at all possible that some cases of autism, a fever (even in the absence of underlying mitochondrial disorder) can cause worsening, where the child goes from behaving relatively normally (especially to a parent who is not suspecting autism) to clearly displaying autistic behaviors, and that in kids who are vaccinated, sometimes the vaccination is the triggering event, while in kids who are not vaccinated, it's some other trigger like a viral infection? In this case skipping vaccinations would not prevent autism unless you could also keep the kid in a bubble for life to ward off all viral infection, but it might explain some cases where the parent sees a link based on timing. To make it clear, I am NOT suggesting vaccines cause autism. It's clear they don't. I'm wondering if fevers sometimes cause a step-wise worsening of apparent symptoms and if anyone's looked at that in a controlled way.
Has anyone done a prospective study, looking at kids before and after their routine childhood vaccinations, to try to objectively clarify how many kids are "suddenly" autistic afterwards?
Posted by: Elizabeth Reid | March 28, 2008 11:12 AM
No, Elizabeth in fact it's the opposite. Recent research suggests that when autistic children have fevers, their autistic behaviors are reduced. And other research has suggested that when children are diagnosed with autism and then researchers retrospectively review videotape of those children taken BEFORE diagnosis (before any concern was brought up by the parents, pediatrician, etc), autistic behaviors are noticeably present. In other words, the children already were autistic, they just hadn't been diagnosed. Anecdotaly, that was always the case--parents would review old family movies and realize their babies were already not interacting, making eye contact, and so on, but the parents never realized that was abnormal until the children grew a little older and the developmental disabilities became more marked.
Posted by: Liesele | March 28, 2008 11:39 AM
Elizabeth Reid said "Has anyone done a prospective study, looking at kids before and after their routine childhood vaccinations, to try to objectively clarify how many kids are "suddenly" autistic afterwards? "
Actually, as it turns out there are very few who turned out to be "suddenly" autistic afterwards. Looking at home movies, the kids showed symptoms before any vaccines.
Also, what other fevers are you going to rule out? Even fully vaxed kids get other viruses and bacterial infections that cause seizures (Yikes, I just had a 13 year old child wake up this morning with a stye!) How about other factors like the gastrointestinal bug that caused my year old baby to get dehydrated and then have seizures?
When do those goal posts get permanently installed and stop moving?
Posted by: HCN | March 28, 2008 12:00 PM
As I was working my way through Kirby's latest it occurred to me that, no wonder he tries to strike such a "serious" tone of supposed "objectivity"----he's really going on nothing, or is rather playing hard and fast with figures and small studies dredged out from databases, and carefully inserts just the right among of rhetoric to plant seeds of doubt in parents and readers.
Yes, it is all about the vaccines for Kirby and not about autism----not that it ever was.
Posted by: kristina | March 28, 2008 12:04 PM
OT: John Best's blog has made it onto Portal of Evil. Bout time.
http://friends.portalofevil.com/sfs.php?si=3&fi=000041699
Posted by: Laser Potato | March 28, 2008 12:09 PM
As I was working my way through Kirby's latest it occurred to me that, no wonder he tries to strike such a "serious" tone of supposed "objectivity"----he's really going on nothing, or is rather playing hard and fast with figures and small studies dredged out from databases, and carefully inserts just the right among of rhetoric to plant seeds of doubt in parents and readers.
Yes, it is all about the vaccines for Kirby and not about autism----not that it ever was.
Posted by: kristina | March 28, 2008 12:09 PM
Haha, love the "Blogging on Pseudoscience" icon :)
Posted by: DrFrank | March 28, 2008 12:17 PM
There will be no Friday Dose of Woo this week.
I know it's not an adequate substitute, but in its place, perhaps we could all go point and laugh at Demi Moore. Just to keep in practice, as it were.
Posted by: Eamon Knight | March 28, 2008 12:23 PM
As I was working my way through Kirby's latest it occurred to me that, no wonder he tries to strike such a "serious" tone of supposed "objectivity"----he's really going on nothing, or is rather playing hard and fast with figures and small studies dredged out from databases, and carefully inserts just the right among of rhetoric to plant seeds of doubt in parents and readers.
Yes, it is all about the vaccines for Kirby and not about autism----not that it ever was.
Posted by: kristina | March 28, 2008 12:34 PM
As I was working my way through Kirby's latest it occurred to me that, no wonder he tries to strike such a "serious" tone of supposed "objectivity"----he's really going on nothing, or is rather playing hard and fast with figures and small studies dredged out from databases, and carefully inserts just the right among of rhetoric to plant seeds of doubt in parents and readers.
Yes, it is all about the vaccines for Kirby and not about autism----not that it ever was.
Posted by: kristina | March 28, 2008 12:50 PM
It's nowhere near as easy to falsify as the original mercury hypothesis.
You hit the nail in the head. Kirby started out with something that looked like science. Now that it failed, he'll latch on to stuff that is not very easy to test, where there can always be room for doubt.
Posted by: Joseph | March 28, 2008 12:58 PM
It's funny how they talk about the "number of antigens" presented in the vaccine. A bacterial infection or a cold would typically result in the presentation of a number of antigens as well. If this type of immunological response causes autism then getting a cold or bacterial infection would do the same thing as a vaccine.
Posted by: JordanT | March 28, 2008 1:04 PM
Dude, seriously, enough about your cold. It's not that I don't care, but, ... wait. No. It is that I don't care.
Posted by: Dan McKinley | March 28, 2008 1:16 PM
Actually, I don't care that you don't care.
Posted by: Orac | March 28, 2008 1:22 PM
To both people who told me that old home movies show signs of autism in children subsequently diagnosed with autism, yes, I've read that study. As I said, I fully understand that the condition predates vaccine age/typical age of diagnosis; comparing vaccinated to unvaccinated populations makes it clear that vaccination doesn't cause autism, and as you say, children who are subsequently diagnosed can be shown not to have been developing normally long before the diagnosis. I put "suddenly" in scare quotes up there to indicate that obviously the kids aren't suddenly autistic, but that certainly seems to be the parental perception some of the time.
What I'd like to know is, are vaccines are one possible (and highly salient) cause of an obvious worsening of symptoms to the point where a layperson can recognize the condition. Hmm, trying to think of a reasonable analogy. Okay, everybody's baby teeth fall out sooner or later, but maybe children who enjoy toffee tend to lose their loose baby teeth while eating it because it's sticky. A person who had only observed a few toffee-eating children lose baby teeth might think that toffee causes harmful tooth loss, whereas in fact it just precipitated it *at that particular moment* in those children. Those parents are observing a genuine relationship between eating a sticky food and losing a tooth, but they're wrong that sticky foods are causing the overall phenomenon.
The old thimerosal-causes-autism goalposts aren't mine, so I'm not moving 'em. I'm completely convinced that vaccines don't cause autism, both my kids are vaccinated, etc. I just think if someone could explain the normal kid + vaccinations = autistic kid stories in a more convincing way, or at least thoroughly prove this doesn't happen at rate higher than any other short period, it might finally help reconcile these parents with the mainstream.
Posted by: Elizabeth Reid | March 28, 2008 1:23 PM
A 3,500 word post whilst in the evil grip of the death crud...couldn't have been that bad. ;-)
Posted by: David C. Brayton | March 28, 2008 1:33 PM
Quite. I have been arguing over on the Spectator magazine blog in the UK about this very pertinent fact. Febrile reactions are far less common with a vaccine than with natural infection with most of these childhood illnesses such as pertussis, measles, rubella etc, so may actually be protective. I argued that mitochondrial disorders should be an indication for vaccination, possibly in a planned fashion with suitable antipyretic cover.
Gues who agrees with me? None other than David Kirby!
But then, because so much of what he says in utter BS, perhaps I will now have to rethink my hypothesis.....!
Posted by: DT | March 28, 2008 1:37 PM
Quite. I have been arguing over on the Spectator magazine blog in the UK about this very pertinent fact. Febrile reactions are far less common with a vaccine than with natural infection with most of these childhood illnesses such as pertussis, measles, rubella etc, so may actually be protective. I argued that mitochondrial disorders should be an indication for vaccination, possibly in a planned fashion with suitable antipyretic cover.
Guess who agrees with me? None other than David Kirby!
But then, because so much of what he says in utter BS, perhaps I will now have to rethink my hypothesis.....!
Posted by: DT | March 28, 2008 1:39 PM
I have a detailed analysis of the paper on fever acutely resolving the behavioral symptoms of autism.
http://daedalus2u.blogspot.com/2008/01/resolution-of-asd-symptoms-with-fever.html
I am quite sure it is real and is exactly and completely consistent with my low NO hypothesis of ASDs.
It is an acute effect. An acute fever can acutely resolve ASD symptoms but the chronic effect of repeated fevers is to make the ASD symptoms worse. That occurs due to the non-linear regulation of physiology, hysteresis in regulation of lots of things, and the different time scales under which many of these different regulatory pathways work. I call this the "low NO ratchet". Each time the immune system is activated from a basal state of low NO, the acute activation is higher (due to reduced inhibition of NFkB from the low initial NO state) which results in higher levels of iNOS and NO, which then lowers NO in the basal state via feedback inhibition of expression of eNOS and nNOS.
Many people with ASDs do have symptoms of mitochondrial disorders, the major "symptom" being increased lactate. That "symptom" is the generic symptom that comes from not enough mitochondria. Not enough mitochondria from any mechanism will cause increased lactate. One can have 100% perfectly normal mitochondria, and if you don't have enough of them you will have increased lactate.
The most important regulator of mitochondria number is NO. NO is what triggers mitochondria biogenesis. If you don't have "enough" basal NO, you won't have enough
"basal mitochondria biogenesis". I have put that in quotes because it is "complicated" and regulated in each cell in each tissue compartment independently.
Any severe immune system activation can cause mitochondrial shutdown and results in not enough mitochondria. That is the immediate cause of death during septic shock. The mitochondria get shut down (by mechanisms I will discuss in a future blog), without enough mitochondria your cells can't generate enough ATP and you develop multiple organ failure and you die. Short of death, a large shut down of mitochondria can result in a state with not enough mitochondria long term. That is what chronic fatigue is, not enough mitochondria.
Posted by: daedalus2u | March 28, 2008 2:10 PM
A 3,500 word post whilst in the evil grip of the death crud...couldn't have been that bad. ;-)
Posted by: David C. Brayton | March 28, 2008 2:14 PM
Elizabeth Reid wrote, "A person who had only observed a few toffee-eating children lose baby teeth might think that toffee causes harmful tooth loss, whereas in fact it just precipitated it *at that particular moment* in those children. Those parents are observing a genuine relationship between eating a sticky food and losing a tooth, but they're wrong that sticky foods are causing the overall phenomenon."
I'm simply an interested layman, but the answer to your question has been pointed out numerous times on this blog alone. Not to mention dozens of other places. As I understand it, the point where a child has matured enough to show obvious symptoms of autism is also close to the time when vaccines are administered. For this reason there is a correlation, but no causation.
To use your metaphor, it would be like we recommend not giving a child a haircut until they are six years old and then notice that their front baby teeth fall out within a couple years after their first haircut. A correlation would exist, but no causal path can be shown.
Your toffee suggestion is flawed because we can demonstrate a link between a sticky substance being chewed by teeth and mechanical stress put on the attachment point of the tooth to the jaw. There has been no demonstratable linkage between autism and vaccines, even though plenty of people have looked for one.
Yet, consider the possibility of a group in our hypothetical society which believes all haircuts are an evil tool of the devil. Such a group which maintains haircuts are evil may also claim that haircuts cause teeth to fall out. That's what the anti-vaccination group is looking for; any excuse to link something bad to vaccines so they can stop the administration of them.
Back to the autism and vaccine non-link. I've occasionally wondered if pediatricans may be noticing possible autistic traits when they administer a vaccine and ask for the child to be brought back in a couple of weeks for more extensive testing.
If I were a pediatrician who thought I saw something during a routine office visit, like a vaccination, I certainly would be careful about mentioning it to a parent until further testing was done. After all, my own intuitive judgement may be faulty and it would be causing needless worry for the parents if my judgement was wrong.
Of course, my reflections must be taken with a grain of salt, I'm an electrical engineer with no training or experiance in medicine. Cheers!
Posted by: Flex | March 28, 2008 2:42 PM
FWIW, double posting,
Interestingly enough, when I hit the 'post' button. The page was read, but not refreshed.
Upon opening a new browser window, I noticed that my message had been posted.
Then I got the server error on my first browser page. About a minute after I hit post, and after I verified that my post had been taken.
Posted by: Flex | March 28, 2008 2:47 PM
Actually, there remain trace amounts in some vaccines... On a purely technical level, of course, Kirby is correct to say that thimerosal levels have been "significantly reduced"; he just neglects to mention that the reduction is down to trace levels.
Well, how do the "trace levels" of thimerosal in these vaccines compare to the "trace levels" of normal mercury one would find in drinking water? (Google indicates the EPA allows about 1-2 ppb.)
Posted by: Coin | March 28, 2008 2:52 PM
These nutcases use the same approaches as creationists (e.g. raising questions that were answered years ago) but have even less evidence.
Posted by: TheMonkeyMan | March 28, 2008 2:54 PM
Yes it is taken out of most required childhood immunizations, however there is still mercury in flu shots and a host of others.
Posted by: j | March 28, 2008 2:55 PM
I thought the big news a few weeks ago was that California was supposed to remove all the thimerosal but FAILED TO DO SO.
Am I just mis-remembering this?
Posted by: Jordan Lund | March 28, 2008 3:16 PM
I thought the big news a few weeks ago was that California was supposed to remove all the thimerosal but FAILED TO DO SO.
Am I just mis-remembering this?
Posted by: Jordan Lund | March 28, 2008 3:18 PM
Elizabeth Reid said "To both people who told me that old home movies show signs of autism in children subsequently diagnosed with autism, yes, I've read that study."
Only one, which one was it? There have been several. Did you read the Italian, French, UK or the American studies?
Your point of suggesting yet another study, when in fact dozens have been made was a way of moving the goal post yet again. No matter how many studies done in many countries have shown no relationship between vaccines and autism, you went and proposed another one!
To show the complexity, today in the news was an article on the vast genetic factors in schizophrenia. From:
http://www.washingtonpost.com/wp-dyn/content/article/2008/03/27/AR2008032703144.html?hpid=moreheadlines
( or http://www.reuters.com/article/scienceNews/idUSN2728018520080327 ) there was this bit:
Begin Quote
"If the genetics tells us that schizophrenia is really 10 different disorders, then let's have 10 treatments that optimize the outcomes for everyone and not just use the same drugs for everybody," said Thomas Insel, director of the National Institute of Mental Health, which helped fund and conduct the study.
The work also offers evidence that autism shares some genetic roots with schizophrenia.
"Take away schizophrenia's hallucinations and delusions," said Jon McClellan, a child psychiatrist at the University of Washington and a leader of the study, published in yesterday's online issue of the journal Science, "and the symptoms that remain, the lack of social interest and withdrawal, are what we call autism. There is clearly an intersection of the brain systems involved."
....
Yet environmental factors also contribute. Pregnant women who experience famine are at increased risk of giving birth to children who will get schizophrenia. Childhood infections may also add to the risk. Further muddying the picture, most schizophrenics have no family history of the disease. That suggests that, to the extent the disease is genetic, the mutations often arise spontaneously either at conception or during fetal development, perhaps after having inherited a general propensity to get such mutations.
End Quote
Posted by: HCN | March 28, 2008 3:18 PM
"Yes it is taken out of most required childhood immunizations, however there is still mercury in flu shots and a host of others"
NO, it has been taken out (reduced to trace levels) of ALL required childhood immunization.
The flu is not a required immunization.
Posted by: ozzy | March 28, 2008 3:28 PM
Talking of mitochondrial woo: apart from "Dichloroacetate is the new chelation", I am waiting to see someone at DAN or a similar place start recommending "Mitochondrial energy enhancing" Coenzyme Q10 supplements for all children. You heard it here first.
Damn - on second thoughts should have patented the idea and got rich...
Posted by: Dr Aust | March 28, 2008 5:19 PM
Orac,
In case some of your readers wanted to know, the mitochondrial DNA only encodes for 37 genes: the 12S and 16S ribosomal RNA, the NADH dehydrogenase subunits, 2 ATP synthase subunits, cytochrome b and cytochrome c oxidase subunits I-III. The rest of the mitochondrial genes have migrated to the nuclear DNA during the past billion years or so.
There are at least three mitochondrial genes that have been implicated in autism - two are on the mitochondrial DNA (TRNK and TRNL1 - tRNA genes) and one (SLC25A12) is on the nuclear DNA.
There are over 70 nuclear DNA genes that have been associated with autism, including CNTNAP2 (found in 4% of autistic subjects in a recent large study) and EN2 (which may account for as much as 40% of autism).
Given the large number of genes associated with autism, it is not surprising that a few of them would be mitochondrial genes. I have no doubt that when more studies have been completed, we will find that autistic people have more mitochondrial gene disruptions than the general population, but they will also have more non-mitochondrial gene disruptions.
I predict that there will soon be a rush by questionable practitioners and dubious laboratories to make "mitochondrial testing" available to concerned parents. The resulting flood of false-positive results will not only increase parental anxiety but will also lead to many unnecessary (and expensive) tests to run these false alarms to ground.
Prometheus
Posted by: Prometheus | March 28, 2008 6:25 PM
To emphasize some of what Prometheus said. All mitochondria in all animals have the same 13 mitochondrial proteins coded for by mitochondrial DNA (with only a very few exceptions). Plants have those same 13 proteins plus a few more (Arabidopsis thaliana has 57 mitochondrial genes total). The other 99+% (there are ~2000 total) are coded for in the nucleus. Presumably the migration of those genes to the nucleus occurred before eukaryotes diverged. It is complicated because the coding scheme is different for nuclear DNA and mitochondrial DNA. In other words mitochondrial DNA moved to the nucleus wouldn't express properly (and vice versa).
A lot of the tests that show "mitochondrial disorders" may only be showing mitochondrial depletion. The "disorder" may relate to the regulation of mitochondria biogenesis and not necessarily be associated with any protein that is actually contained within mitochondria. For example the transcription factors that regulate the expression of mitochondrial proteins from nuclear DNA are obviously important, but they never end up inside mitochondria.
If someone does have mitochondria depletion, DCA may be the last thing you want to give them. DCA blocks glycolysis. If you don't have enough mitochondria to make enough ATP, blocking glycolysis could be very bad.
Posted by: daedalus2u | March 28, 2008 8:55 PM
Slightly off topic: why are people who market these "cures" and "treatments" allowed to do business in the United States? Why aren't supplements regulated as prescription drugs are? It makes no sense to me. I get that we all have the right to do what we will to ourselves and our children, (until actual harm to the child) but that is meaningless when considering the risks the people who practice these things are creating. I can cause all the harm I want to my body but it should be illegal for someone else to knowingly contribute to that harm. I don't understand it at all. Anyone?
Posted by: Liesl | March 28, 2008 9:47 PM
ozzy - OB/GYNs often push as much (unnecessary) testing and interventions as possible - their behavior preys on the fears associated with the hormonal state of pregnancy. they also do tend to push the flu vaccine - "you wouldn't want to get the flu while you're pregnant." so while it may not be required, some (less informed?) women might feel that it is.
Posted by: wicked_blu | March 28, 2008 11:48 PM
"Yes it is taken out of most required childhood immunizations, however there is still mercury in flu shots and a host of others. "
"For the 2007-08 season, there is one product licensed for 6-23 month old children (the product is thimerosal-free). Given the uptake of influenza vaccine among children [less than] 2 years of age to date and the anticipated increase in vaccine coverage this season, CDC projects that the vaccine supply for this agegroup will be adequate to meet demand."
http://www.cdc.gov/flu/about/qa/thimerosal.htm
Posted by: Do'C | March 29, 2008 12:13 AM
Liesl said "Slightly off topic: why are people who market these "cures" and "treatments" allowed to do business in the United States? Why aren't supplements regulated as prescription drugs are? It makes no sense to me."
Ah, why indeed! It seems that some lawmakers live in states that produce those supplements, and actually might be making money from them!
A good clue is in this book:
http://www.amazon.com/Natural-Causes-Politics-Americas-Supplement/dp/0767920422/
Posted by: HCN | March 29, 2008 2:09 AM
Your writing is very unbecoming from a scientist's perspective. For details, see the following post:
http://blog.nawaz.org/2008/03/29/objectivity-in-the-scientific-community-lip-service/
Posted by: Dude | March 29, 2008 9:52 AM
Two words for you, "Dude":
Concern troll.
That's what you appear to be.
Posted by: Orac | March 29, 2008 10:20 AM
Your description of Kirby reminds me of an old joke:
Posted by: khan | March 29, 2008 12:47 PM
Thanks for the link, HCN. I'd love to see what these practioners and practicers of "natural" medicine would do if they knew they would die without taking a doctor prescribed med. I think we'd all point and laugh at the idiots running to the pharmacy as fast their homeopathic supported legs would carry them. Gah! the whole thing is so essentially distasteful.
Posted by: Liesl | March 29, 2008 6:33 PM
Are you really that stupid to keep saying after so much
science they have found nothing. gerberdine said the IOM
looked at this and found nothing. what is this: Dr. McCormick, for example, in speaking of the CDC, noted that the
agency
"wants us to declare, well, these things are pretty safe on a
population
basis." (See Exhibit 1 at page 33). " later on she says what walt wants walt generally gets"
And this
When byronchild asked CDC spokesperson Curtis Allen for a copy of the
contract that would detail the agreement between the IOM and the CDC,
Allen
stated that the contract would be available only in a heavily
"redacted" or
blacked-out format." note Leaked because people saw and heard things that scared them " not sheeple like you
The IOM stated "no comment" to byronchild about the leaked transcript or its
use in the pending civil court case.
This my friend is like saying let's play a hand of cards.
after I have stacked the deck
verstreaten last words after the CDC destroyed his earlier work. "I did not find a positive or a negitive I found a
netural" so you have nothing here. and why did the CDC
destroy his earlier work? Oh! I know so real scientist could not trace back the fraud.
Denmark study done buy the manufactures of thimerosal
no conflict of interest here, just out and out fraud.
You see Autism cannot go up at the same time it's apparently going down: But more importantly, a review of e-mails exchanged between the Danish researchers and the CDC reveals that the statement "From 1991 until 2000 the incidence increased and continued to rise after the removal of thimerosal from vaccines, including increases among children born after the discontinuation of thimerosal" may not have been true.
In an e-mail on 11/13/2002 at 09:24, "co-author" Marlene B. Lauritsen informed Drs. Madsen, Thorsen and Schendel of the CDC:
"But the incidence and prevalence are still decreasing in 2001".
The sentences, before and after that unequivocal statement, were blackened with a magic marker before they were released through the Freedom of Information Act. (Exhibit
II)
From what I hear the elizibeth miller study was so bad
she asked If she had to give the money back to the CDC
Burbacher had to comment on this absurd finding. and remember it was funded by the NIH
The latest study that the thimerosal clears the blood
quicker than we thought before: Just as fraudulent,
you see it appears to clear the blood but really it is
seeking out organs to attache it self to. Resource
Sigma Aldrich deposition of the corporate invironmental
compliance person. He was admitting that thimerosal
targets the brain, and the lining around the brain,
and the CNS, that kind of goes along with this : Burbachers findings " Inorganic mercury lingers in the brain for a year or more, potentially altering c