By Dan Olmsted
Albert Einstein, master not just of the universe but of the simultaneously witty, profound and self-deprecating quote, once had this to say: "It's not that I'm so smart, it's just that I stay with problems longer."
That doesn't make me an Einstein, but it does make me feel better about the fact I've stuck like superglue to a couple of problems that go to the heart of autism. The one I'm writing about today is one I've tackled many times before -- the fact that the earliest cases show a strong association with the commercialization of ethyl mercury.
In the wake of the new study showing that the California autism numbers are continuing to climb, those who think the ethyl mercury vaccine preservative called thimerosal has been exonerated are having a field day. One of them -- Dr. Paul Offit -- has even written it was a mistake to phase thimerosal out of vaccines starting in 1999 because it signaled concern that mercury in childhood immunizations might really be a problem.
But -- here I go again -- the earliest cases of autism recorded in the medical literature send the same signal: The Age of Autism began with the first uses of ethyl mercury in medical and agricultural compounds, and it turned into an epidemic when the amount of mercury in "baby shots" soared starting around 1990. The fact that autism rates are still rising does not, to my mind, mean that thimerosal played no role in triggering the epidemic. In fact, it played the decisive role.
For more -- much more -- on that, see "Mercury Link to Case 2" on our home page, and Mark Blaxill's fine piece "Making Sense of the California Autism Numbers," written this week. What bugs me is how little of this evidence and analysis has penetrated the mainstream, given how powerful it is.
One explanation is the once-over-lightly approach of Big Media to covering autism; does even one news organization have a full-time beat reporter detailed to master its complexities and report them in a nuanced but accessible way? (The closest I've seen is Myron Levin at the Los Angeles Times, whose work is exemplary.) Without that level of commitment, the blah blah blah of the "experts" tends to drown out contrary arguments in a way that is detrimental to the future of our kids.
I got interested in the earliest reported cases of autism -- a 1943 paper by child psychiatrist Leo Kanner of Johns Hopkins about 11 children born in the 1930s -- when I realized how little had been written about them, and how inexact the references were. The first description of any disease is a critical moment, because it is then and there that its roots can be identified. Is it just better diagnosing? Did something happen in the environment to create the "big bang" of a brand new illness? What kind of people seemed susceptible based on those first reports?
AIDS is a perfect illustration. By identifying a cluster of sexual partners in New York and Los Angeles among the very first cases, CDC epidemiologists realized they were dealing with a microbe passed from person-to-person by intimate contact. In amazingly short order, the NIH (and the French) had identified the virus; a test had been developed, and researchers were finding treatments and tracing the river to its source -- Africa in the 1950s.
AIDS really was new, and the implications for both stopping and treating it were enormous. As I've argued many times, autism really was new, too, and the implications are equally enormous. But they are continually overlooked.
The latest example -- one that reminded me of the kind of inconsistent and vague reporting that started me down this road three years ago -- is in a generally fair piece in the Baltimore Sun this week, assessing the California study and giving decent space for people like Lyn Redwood to say why it's not the end of the argument over thimerosal.
But here's the sentence that got my attention: "Thimerosal, which is almost 50 percent mercury, has been a preservative in vaccines since the 1930 (sic). The first case of autism was identified at Johns Hopkins University in the 1940s."
Well, not exactly, and here exactness is everything. This is the way I'd put it: The first recorded use of ethyl mercury (thimerosal) in vaccines was 1931, the same year the oldest child in Leo Kanner's study was born. That's a heck of a coincidence by itself. And half a dozen parents of the first 11 cases were in the medical field, suggesting they might be early adopters of vaccination. But there's more: Thimerosal's inventor also patented the use of ethyl mercury in agricultural fungicides that came on the market at the same time, and three of the 11 cases show plausible exposure through that route. In fact, the father of Case 2, Frederick L. Wellman, was a U.S. government plant pathologist whose archive shows he was working with ethyl mercury fungicide 'dusts' at the same time his child was born. There's actually a sales brochure for one in the Memorabilia file in his archive: "Ceresan and new improved Ceresan are poisonous and precautions with all packages must be observed," the brochure says.
What am I getting at? First, the timeline is a lot tighter, and the evidence a lot more indicative of something new going on, than the simple statement that vaccines were used since the 1930s, and the first autism case was identified at Hopkins in the 1940s. (Actually, the first cases started showing up in 1935, and Kanner wrote that they all differed "markedly and uniquely from anything reported so far.")
Second, the fungicide connection suggests ethyl mercury, and possibly other organic forms, can trigger autism WITHOUT having to be in vaccines -- the exposure could be coming from the workplace, from farming, from anywhere. Yes, vaccine mercury looks like an awfully (in both senses) easy way to deliver mercury to the brain of a fetus, a neonate or an infant -- but what I'm arguing is that right from the START it appears to be coming at us from several directions at once.
So could thimerosal be out of most vaccines, yet mercury implicated in the rise of autism? And could it still be triggering cases? I vote yes: These days mercury -- the incredibly dangerous organic kind -- is saturating our environment, ending up in fish and rain and dirt and pregnant women and rivers and umbilical cords and Lord knows where else.
And the broader chemical connection just keeps revealing itself to anyone who's looking. I've written loads about that, too. A study in the 1970s found almost a quarter of autistic kids' parents were exposed to toxic chemicals in the workplace -- while the overall U.S. rate was just 1 in 100 workers. Put another way, the odds of having an autistic child were more than 20 times greater if you worked with toxic chemicals than if you didn't. How do we just ignore something like that?
Last week I was rooting around the National Library of Medicine in Bethesda and happened on a 1982 book called Autism: Nightmare Without End (a great title that I'm sure would drive some people batty). It was written by the mother of an autistic child. Here's the part I especially noticed: "We both obtained our doctorates in organic chemistry. ... After graduation we were fortunate in finding good jobs as chemists." Later she wonders why her son is autistic and muses about the toxic chemicals they worked with.
Or take a look at Born On a Blue Day, the autobiography of the Aspergian savant Daniel Tammet. He describes how, on the day his mother went in to labor, his father rushed home from the sheet metal factory to take her to the hospital, his clothes still covered in "dust" from the workplace. That's not good old dust you can just brush off, any more than mercury fungicide "dusts" are.
The earlier the case, the easier the chemical connection is to detect, because the huge increase in thimerosal exposure in the 1990s drowned out these signals by spreading the risk across virtually the entire population (except for pockets of never-vaccinated kids -- the other issue that I can't seem to let go of, and for the same reason).
What's so dispiriting about all this is that nobody but nobody in the mainstream media or medical community is paying one whit of attention. The 6,000-word piece I wrote about Frederick W. and the link to ethyl mercury fungicide was published last year in the Baltimore City Paper. I sought out that venue because that's where autism was first identified, and Johns Hopkins and the Kennedy Krieger Institute are in the thick of the hunt for autism's cause, sopping up grants from Autism Speaks and the CDC to do epidemiology studies. So I was excited that for one week last February, "Mercury Rising" was the bold cover headline staring out at those autism sleuths from bright yellow boxes all over town. (Subhead: "A Possible Link Between Chemical Exposure And Autism May Have Been Overlooked In The Very Earliest Cases At Johns Hopkins." Hard to miss, I'd say.)
But as far as I know that didn't prod anyone to take a fresh look at the early cases that are presumably still in the Hopkins archives. It didn't cause anyone to commission a crash study on the natural history of autism -- something that cracked the AIDS mystery wide open in a matter of months. So yes, it's frustrating to keep banging this drum -- some might call it beating a dead horse. But at times like this I ask myself a simple question: What would Einstein do? I think he'd tell me to stay with it.
Dan Olmsted is Editor of The Age of Autism