AGE OF AUTISM

Tics and Toxins: Evidence Points to Environment, Infection in LeRoy Outbreak

By Dan Olmsted and Mark Blaxill

As the white-hot glare of attention begins to pull away from the outbreak of tics among students at LeRoy Junior/Senior High School in Western New York, most medical and media sources appear to have settled on “conversion disorder” as their default diagnosis.

Newsweek acknowledged the families’ belief that something physical must be wrong, but the author insisted on “a very inconvenient truth: the cluster in Le Roy is, by all reasonable judgment, a mass hallucination. Aided by media of all sorts, what the girls are suffering from is perhaps the ultimate disease of our era.”

The New York Times, without bothering to name LeRoy, published an article titled “Hysteria and the Teenage Girl”: “Female adolescence is — universally — an emotionally and psychologically intense period. It is during this time that girls become aware of the emergence of womanhood, with both the great joy and promise that come with it, and also the threat of danger.” As evidence, the writer noted that a LeRoy cheerleader – not a linebacker – was one of the first stricken.

 “Well, that’s the kind of nutty story that only happens once, or so I briefly thought,” wrote Caitlin Flanagan, “until more focused Googling quickly led me to an almost identical episode, this one in 2002, in a high school in rural North Carolina. Once again, a cheerleader was first to manifest the strange symptoms, and once again other girls, some of them cheerleaders, were struck with the same condition.”

Though the writer is a woman, the supposed susceptibility of peppy, excitable female cheerleaders versus stolid, masculine football players is Freudian paternalism dressed up for a new century – a misogynist’s dream. (It was our skepticism of conversion disorder that drew us to this story, having addressed it in a chapter titled “The Age of Hysteria” in our book; we will have more to say about its shaky foundations in upcoming articles.)

Responding to community pressure, the LeRoy school district has grudgingly commissioned a new round of environmental tests while asserting “the school is safe,” a balancing act that left many in the community dissatisfied. (The school board this week approved the new tests, expected to cost as much as $75,000. Some parents and environmental groups are pushing for broader tests than are so far planned. ) Local TV stations have stopped airing videos that show the girls’ tics, concerned that might spawn more “psychogenic” cases. The neurologist in Buffalo who originally diagnosed conversion disorder has become more emphatic about the diagnosis, even as four more cases arose in the past week in and around LeRoy. He hints darkly that some of the girls have had such awful experiences that, if only we knew, we would understand – pinning responsibility on the families as well as the victims’ own psyches.

The National Institutes of Health offered to evaluate the students (about 15 total at the school, possibly including one boy) for PANDAS – an autoimmune neurological reaction to strep infection. But it is downplaying the idea in advance. The lead NIH researcher who coined the term told a local news site that simultaneous outbreaks among adolescent girls would be unprecedented and unlikely.

That appears to leave only the girls, their parents and a small corps of advocates – Erin Brokovich’s group, environmental and school safety activists, a doctor who found evidence of strep infection in most of the girls – to push for continued attention to physical causes.

Based on our own reporting and analysis, they are correct to do so. Real illness remains the likeliest explanation with the suggestion that these dramatic symptoms are provoked by stress a convenient excuse for avoiding a rigorous investigation of environmental risk factors . Here are six possible risks that need to be raised, followed by a key question that needs to be answered:

Mycotoxins on playing fields?

In any inquiry into a novel medical condition, identifying significant changes in the environment is a priority. In LeRoy, as we’ve reported, several new factors converged in May 2011, when the first girl was affected there, according to a report from the New York State health department.

That month, a statewide ban against pesticides – insecticides, herbicides, fungicides -- took effect for every school in the state. The ban coincided with the rainiest spring ever in Buffalo and the second rainiest in Rochester – LeRoy is located between them -- followed by more downpours in late summer. One of the warmest winters on record has followed.

The school district confirmed last week that it “has not applied pesticides to any of the high school athletic fields since September 2010.”

That month, a product called Turf Herbicide was “used to spray broadleaf weeds on varsity football and soccer field.” In summer 2009, Roundup Weed killer was used in mulch beds, but not in 2010. (The law banning pesticides was passed in April 2010 and may have affected spraying that summer.)

This probably explains the orange substance that cropped up on playing fields at the school last year – so thick that it coated students’ shoes and clothes, so widespread some thought it was pesticide sprayed from an airplane. Officials said it was a harmless grass fungus called rust. Ironically, these fungal outbeaks may point to a counterintuitive new development: the complete and sudden absence of pesticides on school grounds.

Based on that and a history of flooding and water problems at the school, which is partly sited on a FEMA flood hazard area and wetlands, we speculated that harmful metabolites of a fungus – otherwise known as a mycotoxin -- might also have gained a foothold. One possibility:  ergot alkaloids, toxic products of fungi that can grow on rye and other grasses. We told the story of a man in the village of Bath, about 70 miles from LeRoy, who developed similar symptoms last September. He lives next to a field that was planted last summer in ryegrass and not harvested, adjacent to a swamp and a levee. He draws his water from a well in the back yard.

Since then, local news outlets have spoken to experts debunking the possibility of mycotoxins, but no specific tests have been done. (For Leroy a Fungal Theory and Expert Doesn't Buy Ergot Theory.)

In December, the school district tested several places inside the school for mold spores and found none, although they did not do “destructive” tests – cutting open walls and the like – to look for hidden sources. Many experts say that it is the only way to completely rule out mold. They also did one test of the air outside the building – location not given – as a “control” to see if inside readings were higher.

One negative test was for a fungus called a. fumigatus, which can produce ergot alkaloids. A June 2005 study in the journal Applied and Environmental Microbiology found, according to its title, “Abundant Respirable Ergot Alkaloids From the Common Airborne Fungus Aspergillus Fumigatus.”

“Ergot alkaloids are mycotoxins that interact with several monoamine receptors, negatively affecting cardiovascular, nervous, reproductive, and immune systems of exposed humans and animals,” the report said. The alkaloids develop in especially high quantities on maize (corn) and latex paint, according to the study. In a comparison chart, ergot alkaloid production was far higher in latex paint than in any other medium.

That is intriguing because one substance the LeRoy school sprays annually on its grounds is white latex paint, to create the lines that mark playing fields. In the buildings and grounds report, the district said it has used Super Stripe Athletic Paint and Field Marking Paint, two latex brands, every year including 2011.

That might offer an alternative explanation for the Cheerleader Syndrome others have noted. Simply put, cheerleaders spend their time on the sidelines. (And they wear fewer clothes than running backs.) At LeRoy, four of the first 12 girls affected were cheerleaders and two were soccer players, according to the state health department report. In the 2002 North Carolina cluster cited in the Times article, five of the 10 students were current or former cheerleaders.

Tics and Toxins: Pesticide Ban, Rainfall Could Point to Poisonous Fungus as Factor in Student Outbreaks

By Dan Olmsted and Mark Blaxill

LEROY, N.Y., February 6  -- Last year, during the wettest spring ever recorded across large swaths of New York state, a little-noticed law took effect: As of May 18, pesticide use was banned from the grounds of every school in the state. That same month, a girl at the junior/senior high school here, and another at a high school near Albany, developed a mysterious tic disorder. The total number of cases in LeRoy has now risen to 15.

This convergence adds a new possibility to the list of suspects already being scrutinized in this picturesque Western New York village of 4,400, suspects that range from a 1970 train derailment that spewed toxic chemicals, to an autoimmune disorder called PANDAS, to leaks from gas wells on school grounds that may or may not have employed “fracking." The new possibility: Poisoning from a fungus that grows on a grass commonly planted on school grounds.

The fungus is called ergot, and it can grow when ryegrass – used on most athletic playing fields – sprouts a floweret that gets infected. That most often happens during wet spring months and on low-lying or marshy areas. (This photo was taken on school grounds last week.)

Two other tic cases have been reported in girls who attend Corinth High School, north of Albany. Both are members of the school softball team; the first girl collapsed unconscious in May during the first inning of a softball game and began twitching and convulsing, according to the Albany Times-Union; in LeRoy, at least 6 of the first 12 cases were among athletically active girls – four cheerleaders and two members of the soccer team.

And as we have reported, a 35-year-old man in the village of Bath, about 70 miles from LeRoy, was stricken with the same symptoms in September. He lives close to a field that was planted last spring in rye and not harvested; there is a swamp and a levee nearby; and his water comes from a well in his yard. (This is a photo of the swamp.)

In Corinth, the first girl was affected in May; according to a report from the New York State Department of Health released Friday, the first case in LeRoy was also in May, followed by three more cases in weeks that began in September, two cases in October, one case in November, and one case in December. The state report dismissed environmental or infectious factors and embraced the official diagnosis of “conversion disorder,” in which stress or trauma are subconsciously converted into physical symptoms (several cases at once is called “a mass psychogenic event”).

Tics and Toxins: Similar Case in County Near LeRoy May Point to Environment

By Dan Olmsted and Mark Blaxill

BATH, N.Y., February 3 – “I’ve always been a fighter,” Bryan Tremblay says, and that’s not just a metaphor. Now 35 but still a slight 112 pounds at 5 foot 1, he was a bully magnet as a child and learned early to defend himself. That was an advantage when he wrestled for his high school team.

But now Tremblay, who lives in the Steuben County village of Bath in the Finger Lakes region, is battling a demon he can’t control. Since September, he’s suffered from a major tic disorder. It goes on, unpredictably, for hours a day. Even on three heavy-duty medicines, he has seizure-like episodes that leave him sitting dazed for half an hour.

 

The disorder keeps him at home. It makes it hard to study for his online degree in graphic design from the Art Institute of Pittsburgh – and well-nigh impossible to look for work after being laid off early last year from his job at a furniture factory. It creates inevitable fears for his health, his wife, his future.

“It’s so frustrating,” he says. “I just want an answer to what I’ve got.”

Whatever Bryan Tremblay’s got is remarkably similar to the tic-like illnesses that have afflicted 15 students at LeRoy Junior/Senior High School about 70 miles away. Many of the LeRoy students, all but one a girl, came down with the disorder about the same time Tremblay did (he didn’t hear about that until much later). Most were diagnosed with “conversion disorder,” and since so many cases were involved, medical experts have declared it a “mass psychogenic event,” in which stress or trauma is supposedly converted unconsciously into physical symptoms and spreads among affinity groups. School and state health officials say they’ve ruled out environmental or infectious causes and insisted again on Wednesday that the school the girls attend “is safe.”

No one is suggesting conversion disorder in Tremblay’s illness. No one he knows has anything like it. Extensive neurological workups have turned up nothing. He’s due for another follow-up in a couple of weeks at the University of Rochester Medical Center. Tremblay doesn’t drink or use prescription or recreational drugs, nor has he been to LeRoy.

He is no publicity seeker. His sister mentioned his situation in a comment on a story we wrote about LeRoy. She gave us his contact information when we asked, and we reached out to Tremblay.

In an e-mail, he responded: “The symptoms seemed to appear almost out of thin air. It started with uncontrollable body spasms and convulsions in my mid to upper body area. These convulsions lasted from approximately 15 minutes to a 30 minute span.

“Soon the spasms started moving to my head and neck area and the movement was similar to a strong neck-whip similar to that of whiplash, sharp and strong and completely random. I did seem to notice that the amount of stress was a factor in the strength of the tics. The problem is the stress level increases once it starts and the tics become stronger and increase as well.

“I noticed that after five months the tics have become vocal, more yelling and humming with points of time where I repeat noises over and over. I find myself spacing out for large amounts of time and daydreaming with difficulty recovering.

“I have also started hand and arm movements.”

In almost every way, Tremblay’s life circumstances could not be more different from the LeRoy cases. But one common factor was evident during a visit – water. Water everywhere. Tremblay lives in a low-lying area. His house backs up to a levee less than a football field’s length behind his house.

Tics and Toxins: Leroy Put Student Playing Fields on FEMA Flood Hazard Land

By Dan Olmsted and Mark Blaxill

LEROY, N.Y., February 2 – School officials who say environmental factors can’t be responsible for the outbreak of tics at the Junior/Senior High School might want to check last year’s record rainfalls – and the flood-prone ground right under their feet.

The tics broke out after an unusual pattern of heavy rain, followed by a mild winter that has kept the ground from freezing and left lots of standing water at Leroy Junior/Senior High School.

That should be no surprise. Part of the school grounds -- including athletic fields -- are right on top of a federally designated FEMA Flood Hazard Area. While a county official told us that the school itself sits on a slope just above the hazard area, the zone cuts right across the girls’ softball diamond, as well as the football/track field and another, larger baseball field.

The land in the flood hazard area generally correlates with other mapping that shows less optimal and more flood prone Canandaigua soil covering the site.

In fact, we’ve been told by local residents that some fields, including the girls’ softball field just built in 2009, had to be dug up and rebuilt within the last year because the ground was so wet. The building itself has not escaped water and structural woes – the gym could not be used when the school was first opened a few years back because the floor buckled and sank, and the opening of school was delayed one year for a week by flooding, according to a former student.

School officials won’t comment, but Superintendent Kim M. Cox issued a new statement Wednesday, mostly blasting national press attention and the involvement of famed advocate Erin Brockovich, who has cited a train derailment of hazardous material a few miles from town in 1970 as a likely cause. Cox said new tests have shown drinking water inside the school – which comes from neighboring Monroe County – is safe.

Citing state and federal experts, she said: “All of these agencies and professionals from these agencies have assured us that our school is safe. There is no evidence of an environmental or infectious cause. Environmental causes would not discriminate. We would see a wide range of people affected.”

But no one seems to be looking up at the sky or down at the ground. LeRoy, like other New York state and Northeastern U.S. locations, has seen an epic amount of rain during the past 12 months. We put this chart together to show 2011 rainfall versus normal amounts in Buffalo and Rochester. LeRoy is located between them.

Tics and Toxins: Just Before Mystery Illnesses Hit Leroy NY, School Built New Playing Fields

By Dan Olmsted

LEROY, N.Y., January 30 -- New playing fields, including one for girls' softball, were completed the year before the outbreak of tics and other ailments began afflicting girls at Leroy Junior/Senior High School.

Aerial photographs compiled by the Genesee County assessments office clearly show the construction in progress in 2009, here:

The 2010 photo shows the completed fields, here:

 

The smaller field to the immediate left of the school is the girls' softball field, according to a former student at the school. All but one of the students affected so far are girls. There are unconfirmed reports that one boy was also stricken.

School officials said earlier this month that two reports they commissioned of indoor air quality and mold had ruled out any environmental cause. New York Health Department officials concurred and a spokesman told me last week, "The school is safe." Most of the girls were diagnosed at a Buffalo neurological clinic with "conversion disorder," in which psychological stress or trauma is supposedly converted into physical symptoms that clusters of people can display at the same time.

But parents and the girls themselves have rejected that diagnosis, and other theories have been advanced; school officials now say they are ordering another round of tests. I reported last week that the first testing did not include any outside areas of the school grounds, except for reviewing school pesticide logs. Because those logs were in order, environmental factors outside the school building were ruled out. State health officials also say no infectious agent was involved.

But in any investigation of a new illness, the question of what's new in the environment -- from medicines a person is taking, to places they have been, to changes in where and how they live -- needs to be ruled out first.

Building ballfields within the past two years certainly qualifies as new. That could hypothetically create new risks, either from stirring up toxins such as pesticides on the site, or importing materials such as fill or sod that was previously contaminated. New attention has been given to a railroad derailment several miles away in 1970 that spilled both cyanide and TCE, a highly toxic manufacturing agent. Environmental activist Erin Brockovich has suggested that the school site was contaminated by runoff from that incident, or that dirt from that area was used to construct the school in the early 2000s.

Tics and Toxins: LeRoy Officials Gave Little Attention to Schoolyard Before Ruling Out Environment

By Dan Olmsted

Health experts say they’ve eliminated every possible environmental and infectious cause for the “tics” afflicting 12 girls at LeRoy Junior/Senior High School in New York state. They’ve scoured the building for mold and carbon monoxide (nothing, they say), considered illnesses that might cause the symptom (none), even checked on vaccinations (not all girls had the same shot).

However thorough that workup may have been, it seems to have stopped at the schoolhouse Exit sign. Except for checking a log of pesticide spraying, there is no evidence they considered toxins in the schoolyard or on playing fields. Yet the symptoms occurred during mild weather when students would have been outside, and the school grounds are surrounded by intensively farmed land from which chemicals could conceivably have seeped or drifted.

The school is required to keep annual pesticide logs that were reviewed by a consulting firm looking into environmental factors, and therefore pesticides were ruled out. As best I can determine, that’s as far as it went.

That may not be far enough, given that parents and some of the students involved don’t accept the psychogenic diagnosis they have been given, and that a number of Web commentators familiar with the school have raised concerns about the grounds and how the relatively new building is sited.

Public health officials remain adamant that the case is closed.

"The LeRoy school is safe,” Jeffrey Hammond, a spokesman for the state Department of Health, replied Friday after I raised the issue in a telephone call. “The environment or an infection is not the cause of the students’ tics. There are many causes of tics-like symptoms. Stress can often worsen tic-like symptoms.

“All of the affected students have been evaluated and some have shown signs of improvement. Vaccines (Gardasil) have been ruled out."

While the department has been careful for privacy reasons to avoid naming the illness, a doctor treating the girls has now gone public, with their permission, by calling it “conversion disorder.” Known less gingerly as mass hysteria, the diagnosis is rooted in 19^th century Freudian psychology: Stress or trauma is subconsciously transformed into physical symptoms that can occur in several people at the same time. 

In part because the LeRoy diagnosis took months to emerge, and in part because many people – including parents and affected children – find conversion disorder a suspect explanation, multiple theories continue to arise. Those include concerns about the school building and grounds, expressed in online comments:

-- An environmental study “would be the first logical step, knowing that the school was built in a swamp and that a number of classrooms were underwater the first year as well as the gym you would think it would be the first thing the school would address- even if only to disprove it.”

-- “Girls started feeling sick in September, sounds like pesticide spraying At the end of summer before the fall to protect late crops.” (The girls’ symptoms began as early as September 10, according to published accounts.)

 -- “Have the doctors considered that the condition may be related to the school's having been built on swampy land? Water in the building continues to be a problem. A second story that should be pursued by the press and others is why this new school was built and why it was built on this particular piece of land.”

A quick look look at Google Earth (click the plus sign to see the school and grounds in detail)  shows the setting. The high school’s Web site  has an aerial photo that appears to show a large pool of standing water close to the school, with a rivulet coming even closer; it appears to be dry in the Google photo.

Farming, despite its idyllic image in American lore, is a highly chemical-intensive practice, and Western New York is no exception. For that and other reasons, it can be dangerous. In October, a few miles west of LeRoy in Genesee County, two people became ill when a pesticide being applied to a potato field wafted in their direction.  The substance was a toxic fumigant being injected into the soil in preparation for planting this year’s crop. Officials said humidity might have helped spread it.

Obviously, that incident had nothing to do with the LeRoy illnesses, but it does give a sense of time and place missing in accounts of the area, as well as suggesting weather is an unpredictable vector. 

But in such a scenario, why would only girls be affected? That's unclear, but there are a number of possibilities that environmental triggers could help explain. For instance, in some cases of mass illness in high schools, the victims were male football players and the problems were traced to toxins where they played. Being male was not a susceptibility factor, but it pointed to the exposure nonetheless. (In another case, marching band members suffered the same problem for the same reason.)

It is possible that more has been done to consider toxins outside the school building, but if so nothing has been done to communicate it to the national media.

In fact, opportunities continue to be missed. The two consultant reports and the school district’s official statement make no mention of looking for anything amiss outside the building itself ,except to note the water supply comes from neighboring Monroe County's public system. "No history of building water damage or site contamination was found," it states.

Neither the district nor the consulting firm it hired would talk to me Friday when I told them I was seeking information on whether risks outside the school building had been investigated.

--

Dan Olmsted is Editor of Age of Autism and co-author, with Mark Blaxill, of “The Age of Autism – Mercury, Medicine, and a Man-made Epidemic,” published by Thomas Dunne Books.

LeRoy New York Girls' Plight Highlights The Durability of Sheer Medical Nonsense

Editor's Note: It is clear from Tuesday's Today Show Segment (confirmed on Wednesday) that doctors believe the "tics" afflicting teen girls in LeRoy, New York, are a psychiatric illness -- specifically, conversion disorder. (That's all that's left when you rule out infectious and environmental factors, at least as I understand those terms.) For that reason, we're re-running my recent post about this dubious diagnosis and its roots in Freudian nonsense that has still not been acknowledged and discredited. 

By Dan Olmsted

Events have conspired this year to bring attention to psychiatry as it relates to autism and other disorders that we believe share environmental roots. The focus is not at all flattering.

There’s the American Psychiatric Association’s re-jiggering of the upcoming DSM-V so that the parameters of autistic disorder will change, fuzzing the real increase and making its environmental nature harder to discern. Then there’s French psychiatrists banning a documentary called The Wall, which portrays them (accurately) as clinging to the discredited parent-blaming paradigm.

There’s the book Anatomy of an Addiction by Howard Markel, which portrays Sigmund Freud as – how shall we put it -- coked out of his freaking mind while cooking up some of his big ideas. And there’s a well-received new film, A Dangerous Method, which describes how Freud and Jung dealt – poorly -- with a prominent case of “hysteria.”

The miserable performance of psychiatry on these fronts is not news to us. In our book The Age of Autism – Mercury, Medicine, and a Man-made Epidemic, Mark Blaxill and I put forward a new theory about Freud’s first “hysteria” cases in the late 1800s. We argue that many if not most of those dozen or so case studies – which included both men and women – were actually organic illnesses triggered by toxins, and in particular by mercury exposure from medicine and manufacturing.

We won’t recapitulate that theory here (see our chapter, “The Age of Hysteria”) except to say that Freud himself noted that most of the severe patients he saw were tending fathers with long histories of syphilis – treated with mercury – or were otherwise employed in nursing – where mercury dressings and treatments were then standard. Our examination of his key case histories, from “Dora” to “Anna O.,” documented the close connection. In the case of Dora, Freud treated her father for syphilis before seeing her as a patient a few years later – having triggered, we believe, the very mental problems that he then treated as psychiatric! Nice work if you can get it.

From the Editor: Plus ca change

A description of 1960s France in a book I'm reading: "Tonsils, chickenpox, measles, flu, bronchitis, and all the other mundane afflictions occupy the doctors, along with the births and deaths that march through the years everywhere." Quaint.

 

Hysteria, Autism, and the Durability of Sheer Nonsense

By Dan Olmsted

Events have conspired this year to bring attention to psychiatry as it relates to autism and other disorders that we believe share environmental roots. The focus is not at all flattering.

There’s the American Psychiatric Association’s re-jiggering of the upcoming DSM-V so that the parameters of autistic disorder will change, fuzzing the real increase and making its environmental nature harder to discern. Then there’s French psychiatrists banning a documentary called The Wall, which portrays them (accurately) as clinging to the discredited parent-blaming paradigm.

There’s the book Anatomy of an Addiction by Howard Markel, which portrays Sigmund Freud as – how shall we put it -- coked out of his freaking mind while cooking up some of his big ideas. And there’s a well-received new film, A Dangerous Method, which describes how Freud and Jung dealt – poorly -- with a prominent case of “hysteria.”

The miserable performance of psychiatry on these fronts is not news to us. In our book The Age of Autism – Mercury, Medicine, and a Man-made Epidemic, Mark Blaxill and I put forward a new theory about Freud’s first “hysteria” cases in the late 1800s. We argue that many if not most of those dozen or so case studies – which included both men and women – were actually organic illnesses triggered by toxins, and in particular by mercury exposure from medicine and manufacturing.

We won’t recapitulate that theory here (see our chapter, “The Age of Hysteria”) except to say that Freud himself noted that most of the severe patients he saw were tending fathers with long histories of syphilis – treated with mercury – or were otherwise employed in nursing – where mercury dressings and treatments were then standard. Our examination of his key case histories, from “Dora” to “Anna O.,” documented the close connection. In the case of Dora, Freud treated her father for syphilis before seeing her as a patient a few years later – having triggered, we believe, the very mental problems that he then treated as psychiatric! Nice work if you can get it.

It’s a simple and stark idea, and we seem to be the first to propose it. If we’re right, it’s consequential, calling into question the theories derived from such a fundamental mistake. And it supports our argument for a much longer and deeper history of mercury poisoning in humans than mainstream medicine has understood or is willing to acknowledge (the thesis of our book).

Take A Dangerous Method, which its producers describe thusly: “On the eve of World War I, Zurich and Vienna are the setting for a dark tale of sexual and intellectual discovery. Drawn from true-life events, A Dangerous Method explores the turbulent relationships between fledgling psychiatrist Carl Jung, his mentor Sigmund Freud and Sabina Spielrein, the beautiful but disturbed young woman who comes between them.” The outcome forever changes “the face of modern thought.”

The latter is no doubt true. Freud and his apostles and apostates did indeed shape modern intellectual history. It was not just what went on in the 50-minute hour, but how we think about sexuality, the role of childhood and art and culture, and the relations between men and women. Which makes it worth examining what exactly was the matter with Sabina. According to one review on celebrities.com:

An Elaborate Fraud, Part 10: In Which the BMJ Suppresses the Truth About a Child’s Treatment and Recovery From Autism

One of the 12 children on a doctor visit not long after the BMJ articles were published in January.

By Dan Olmsted

The British Medical Journal began its attack on Dr. Andrew Wakefield last January by telling the story of Child 11, one of the case histories Wakefield allegedly altered to manufacture "the appearance of a link" between the MMR shot and autism.

Contrary to Wakefield's claims, Child 11’s autism symptoms began before he got the shot, author Brian Deer wrote. The father, he said, was outraged by Wakefield’s "fraud.” Even the child’s autism diagnosis was questionable, Deer wrote, because it was solely based on parental “recall.” 

As we’ve shown in earlier articles, the BMJ was dead wrong on both counts – the shot did come before the symptoms, and the autistic regression that followed was all too real. Both facts were described and documented multiple times by outside doctors before the family got anywhere near Wakefield or the Royal Free Hospital in London, where he worked. They do not provide any basis to allege fraud or question Wakefield’s version of the child’s medical history.

There are three more critical facts about Child 11 – facts that contradict this “fraud” scenario -- that the BMJ suppressed:

The father did believe the MMR shot caused his son’s regression.

The child was treated accordingly.

And, according to the father, the child recovered.

“Our dedicated effort to save our son's life has been fruitful,” the father wrote Wakefield on January 7, 1997, when he first sought to have him evaluated at the Royal Free. “As a small child unable to communicate, he has now entered a normal kindergarten class with assistance of a tutor. He is quite intelligent and continues to progress, but is still fighting the [bowel] disease which we believe is viral, from the vaccine.”

Yes, from the vaccine. After the father saw how he had been portrayed in the BMJ, he said: "Mr. Deer’s article makes me appear irrational for continuing to believe that the MMR caused difficulties which predated its administration."

And how, exactly, did the child recover from what the father believed was a vaccine injury? The letter reports: “In March of 1994, we met with Dr. [name omitted] and his immunological panel of tests indicated an underlying immunodeficiency as you can see by his report. His suspicions of the MMR vaccine in my son's case are mentioned in his letter. He was immediately put on 400 mg/kg of IVIG every four weeks at [clinic name omitted], and he responded quite well to the treatment.”

IVIG is intravenous immunoglobulin, administered to boost antibody levels in immune deficient patients and, at high doses, to regulate autoimmune conditions.

The father took his son to another leading immunologist, who reported that his measles virus titer was above measurable limits. Workups by a third doctor revealed his son “was suffering from indeterminant inflammatory bowel disease.”

This was the apparent new syndrome the Royal Free doctors were treating and that Wakefield was investigating – indeterminate or non-specific inflammatory bowel disease and autistic regression, in most instances associated in time by parents or  doctors with the MMR shot. The father learned of the work at the Royal Free from his American doctors and was the first to fly his child across the Atlantic because he believed his son was showing the same pattern. The first case series, on 12 such children including Child 11, was published in The Lancet in 1998.

But this clear sequence – vaccination, illness, regression, chronic bowel inflammation, treatment, recovery – is nowhere to be found in the BMJ account of Child 11, even though Deer met with the father twice, in California and London, and also communicated with him via e-mail.

Absent, too, is the fact that Child 11 is now in college in California after graduating from high school with a 3.75 academic average.

The treatment the father cited, and the rationale for it, has been described in detail by the U.S. doctor who administered it. “A number of immunological abnormalities have been observed in patients with autism,” according to the text of comments he subsequently made at a meeting of an autism group. He said all the children he treated, which included child 11, had regressed after the MMR shot.

“Natural killer cells … that appear to play an important role in defense against virus infected cells and tumor cells are decreased both in numbers and functions in patients with autism. This deficiency may play a role in increased susceptibility to various infections that may in turn play a role in the pathogenesis of autism.”

He goes on to describe the use of IVIG in this context, at the 400 mg/kg dose the father cited. “IVIG has been used in a number of primiary immunodeficiency syndromes, and autoimmune and immunoinflammatory disorders including demyelinating polyneuropathy, multiple sclerosis, Guillain-Barre syndrome."

In his autistic patients, "The results of IVIG treatment show that a noticeable improvement, although to a variable degree, was observed in reciprocal social interaction, verbal and non-verbal communication, and repertoire of activity and interest in all children. One of these patients has been 'completely cured' and is attending regular school."

Deer had every opportunity to gather and report these crucial facts yet chose not to. Why? This more complete narrative would have contradicted his claims of fraud in the BMJ. You simply can’t have a child being treated for a presumed vaccine injury, and according to the father, recovering, if you’re trying to make the case that the shot came after the onset of regressive autism, that the sequence was manipulated by Wakefield, and that the father is outraged about the deception.

Instead, Deer spun a story using only fragments of the truth and, exploiting a typographical error in a discharge document, claimed that Wakefield faked the data on autistic regression and bowel disease.

Amazingly, multiplied by 12, such sleight-of-hand lies behind the entirety of the BMJ’s fraud claim. Speaking at the U.S. National Institutes of Health, BMJ Editor Fiona Godlee cited “multiple discrepancies” by Wakefield in the description of "inflammatory bowel problems, regressive autism, and the parental claim that MMR was the underlying cause. What these articles [in the BMJ] also say [is] that when those three things didn't come up trumps on the twelve children included, and the subsequent series of children, Andrew Wakefield altered the data to make those three things emerge."

Actually, in its treatment of Case 11, it was the BMJ that “altered the data to make those three things” disappear.