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Antivaccine nonsense Autism Medicine

The mercury zombie rises again…this time, in the grandchildren of Pink disease (infantile acrodynia) sufferers

Here we go again.

Starting sometime in 2007, back when the idea that mercury in vaccines was the cause of the “autism epidemic” of the late 1990s and into the new century, I started referring to the “mercury/autism” hypothesis as being dead, dead, dead, as in pining for the fjords dead. Then, depending on what kind of mood I was in, I’d start liberally quoting more from Monty Python’s famous Dead Parrot Sketch, including pointing out that the mercury/autism hypothesis passed on! This hypothesis is no more! It has ceased to be! It’s expired and gone to meet its maker! It’s a stiff! Bereft of life, it rests in peace! Its metabolic processes are now history! It’s off the twig! It’s kicked the bucket, it’s shuffled off its mortal coil, run down the curtain and joined the bleedin’ choir invisibile!! THIS IS AN EX-HYPOTHESIS!!

I know, I know. I use that bit perhaps more than I should, but if there’s a bit that’s appropriate to describe the state of the mercury/autism–particularly the claim that it was mercury in the thimerosal preservative that used to be in vaccines in the U.S. until around 2001–it’s the most appropriate one I can think of. Well, not quite, there’s always the Black Knight sketch, in which each time the Black Knight and King Arthur engage in combat Arthur lops off one of the Black Knight’s limbs, after which the Black Knight brushes off the injury, proclaiming things like, “It’s just a flesh wound.” With each new scientific and epidemiological study published that’s inconsistent with the mercury/autism hypothesis, the Black Knight of the Mercury Militia brushes it off as though it’s a flesh wound, even as he sits on the stumps of his amputated legs telling scientists to come back and fight so that he can bleed on them some more.

So it is again with the mercury militia’s embrace of a rather curious, puzzling, and not-so-impressive study hot off the presses.

Worse, even the mainstream media is getting it wrong. Rachael Dunlop (a.k.a. Dr. Rachie) herself sent me a link to an article in the Australian press that pretty much takes the story at face value entitled Mercury link backs autism cause theory, which proclaims:

A FAMILY history of mercury poisoning has emerged as a significant risk factor for developing autism, researchers say.

A survey by Swinburne University in Melbourne of 522 Australian survivors of Pink disease – a form of mercury poisoning common in the early 20th century – found one in 25 of their 398 grandchildren aged six to 12 had an autism spectrum disorder.

The prevalence is six times higher than the one-in-160 diagnosed in the general population.

The study, published this week in the Journal of Toxicology and Environmental Health, found the grandchildren did not have elevated rates of other conditions such as epilepsy, Down syndrome or attention deficit hyperactivity disorder.

Before I get into the study itself, let me just point out that that particular journal looks very, very, familiar. Very familiar indeed. So I invoked the “search” function of my blog to see if I had blogged about any studies before that appeared in this particular journal. Surprise! Surprise! I have. And–surprise! surprise!–the papers I’ve blogged about were–shall we say?–not of the best quality and–shall we say?–supportive of the vaccine-autism hypothesis. For instance, the Journal of Toxicological and Environmental Health has published at least one paper by incompetent mercury-autism quack Mark Geier (who is currently in the process of having his medical licenses suspended in more than one state) and a truly awful paper by Gayle DeLong trying to link vaccines with autism. So, right off the bat I knew I was probably dealing with badness. Then I dug into the paper itself, entitled Ancestry of Pink Disease (Infantile Acrodynia) Identified as a Risk Factor for Autism Spectrum Disorders by Kerrie Shandley and David W. Austin. Here’s the abstract:

Pink disease (infantile acrodynia) was especially prevalent in the first half of the 20th century. Primarily attributed to exposure to mercury (Hg) commonly found in teething powders, the condition was developed by approximately 1 in 500 exposed children. The differential risk factor was identified as an idiosyncratic sensitivity to Hg. Autism spectrum disorders (ASD) have also been postulated to be produced by Hg. Analogous to the pink disease experience, Hg exposure is widespread yet only a fraction of exposed children develop an ASD, suggesting sensitivity to Hg may also be present in children with an ASD. The objective of this study was to test the hypothesis that individuals with a known hypersensitivity to Hg (pink disease survivors) may be more likely to have descendants with an ASD. Five hundred and twenty-two participants who had previously been diagnosed with pink disease completed a survey on the health outcomes of their descendants. The prevalence rates of ASD and a variety of other clinical conditions diagnosed in childhood (attention deficit hyperactivity disorder, epilepsy, Fragile X syndrome, and Down syndrome) were compared to well-established general population prevalence rates. The results showed the prevalence rate of ASD among the grandchildren of pink disease survivors (1 in 25) to be significantly higher than the comparable general population prevalence rate (1 in 160). The results support the hypothesis that Hg sensitivity may be a heritable/genetic risk factor for ASD.

Whenever I see a study like this, I ask a couple of questions. Well, I ask more than a couple of questions, but chief among the questions I ask are three. First, what’s the hypothesis being tested? Second, are the methods adequate for testing the hypothesis? And, third, do the authors demonstrate a background knowledge of their topic adequate to give me some confidence that they know what they’re doing? Regarding the hypothesis, it is not, as at least one anti-vaccine commenter has claimed, a “beautifully thought out hypothesis.” I’ll show you what I mean from the authors themselves:

Mercury contained in vaccines (as a preservative under the tradename Merthiolate, but more commonly known as thiomersal/thimerosal), dental amalgams (silver fillings), seafood, and the atmosphere is argued to be the primary set of sources of Hg exposure for infants both in utero and in their early years (Austin 2008). However, not all children exposed to such sources of Hg develop an ASD, suggesting, as was the case with pink disease, that a hypersensitivity to the adverse effects of Hg needs to be present in addition to the Hg exposure for the condition to manifest. Therefore, the Hg-autism hypothesis is, in reality, a two-part hypothesis that states that Hg exposure combined with a genetic/physiological sensitivity to Hg or a predisposition to impaired Hg excretion capacity leads to a chronic elevation of Hg in the brain and body (Bernard et al. 2001).

The purpose of the present study was to test the Hg-autism hypothesis. If the hypothesis is indeed correct, and a sensitivity to Hg is heritable (genetic), the prevalence of ASD among the descendants of a cohort confirmed as having a hypersensitivity to Hg (pink disease survivors) should be higher than a comparable general population prevalence.

Let’s take a look at this. First, note how the authors cite “studies” from anti-vaccine stalwarts like Sallie Bernard and the infamous paper she published in Medical Hypotheses back in 2001. This is not an isolated citation, either. The authors copiously cite Mark and David Geier’s “work,” a paper by Mark Blaxill and Boyd Haley, Bradstreet’s paper from the infamous Ayn Randian rag of pseudoscience and quackery, the Journal of American Physicians and Surgeons, the Windham’s paper trying to correlate air pollution near freeways with autism, Palmer’s paper trying to relate autism prevalence to proximity to coal-fired power plants, and a wide variety of other really bad studies performed and/or promoted by the anti-vaccine movement. Right away, these citations tell me that the authors don’t know enough about the background of what they’re studying to be credible, nor do they understand good research methodology. If they did, they would never credulously cite such dreck in support of their “hypothesis.”

What about their hypothesis? A good hypothesis should be based on good data and sound observations. The authors propose a “two-hit” model of autism causation: genetic susceptibility coupled with mercury exposure. The idea is clearly to support the vaccine-autism hypothesis, even though they aren’t studying vaccines in this study. One problem, of course, is that the amount of mercury to which infants were exposed in vaccines, even at the height of the use of thimerosal as a vaccine preservative in the 1990s, is nowhere near what babies who developed Pink disease were exposed to. The difference is many orders of magnitude; so even if the authors did find a result in which the offspring of parents with Pink disease had a higher prevalence of autism or autism-spectrum disorder (ASD), it would not be particularly strong evidence that thimerosal causes autism. True, the authors don’t state that this is what they are testing, but their choice of citations makes it pretty clear that that’s what they’re interested in. Moreover, the fact that the mercury exposure associated with Pink disease was not even the same chemical form as thimerosal, the mercury being mercurous chloride in the case of Pink disease and thimerosal in the case of vaccines also makes the comparison tenuous at best. Finally, as has been pointed out time and time and time again, they symptoms of mercury poisoning do not resemble the symptoms of autism, except on a very superficial level.

It’s obvious that the authors’ hypothesis is not well supported, either by scientific observation or by reason. Nor does the observation that only a relatively small subset of children exposed to mercury-containing teething powders developed infantile acrodynia necessarily support the argument for a genetic susceptibility of some kind to mercury. It might, but it might not. Absent some background evidence demonstrating that dose doesn’t matter that much in children who developed Pink disease, it’s difficult to have much enthusiasum for a hypothesis of genetic susceptibility. It’s not entirely implausible, true, but it is for the most part unsupported. Remember again that the dose makes the poison, and the doses of mercury that we are dealing with in infantile acrodynia are very high. More importantly, no reliable study has ever truly correlated mercury dose with probability of developing Pink disease. As pointed out by Sullivan, it is very possible that the children who developed Pink disease could well be the children whose exposure to mercury was the highest. We really don’t know. The association between mercury-containing teething powders and infantile acrodynia wasn’t figured out until 60 years ago, and epidemiological methods and lab-based assays were much cruder then than they are now. It’s also not as though we could “repeat the experiment” now; mercury-containing teething powders are, fortunately, no longer manufactured or used.

So let’s look at the methodology of this paper. First, it’s impossible not to note that this study relied solely on questionnaires distributed to the Pink disease survivors, all of whom are now old enough to be grandparents, given how long ago mercury-containing teething powders were identified as the culprit in Pink disease. In other words, the diagnoses of ASD reported by the elderly respondents to the survey were not verified. Second, there was no real effort to control for potential confounding factors, such as urbanicity, socioeconomic status, etc. that can affect the rate of diagnosis of ASD. Indeed, all we really have are ages, where the respondents live, gender, how they responded (mail, telephone, or online). Moreover, even though the investigators managed to garner 522 responses, that was only a 23% return rate for the surveys. The authors tried to minimize the possibility of response bias, in which responders respond to a survey because they believe that the hypothesis is likely to be true (as in vaccine-autism studies, where parents of children with autism are far more likely to respond than other parents if the survey is about vaccines and autism), but I don’t know that they really did:

The PDSG maintains a membership database and sent out the survey to all of its past and present members, in addition to advertising the study on its website (www.pinkdisease.org). In order to minimize response bias, the true purpose of the study was not included on recruitment materials sent out to potential participants; instead, recruitment materials indicated that the purpose of the study was to investigate the general health outcomes of the descendants of pink disease survivors.

How is this “hiding the purpose of the study”? It’s not, except only partially. Pink disease survivors who believe that Pink disease left them or their descendents with health problems would be more likely to respond. Why would that not include people with children or grandchildren with ASD? It wouldn’t. We can therefore answer question two rather confidently: The methods used were poor methods to test the hypothesis of the study.

Then there are the results.

The authors do veritable backflips of logic to try to explain how a “genetic susceptibility” to the effects of mercury that led to Pink disease could manifest itself as an increased autism prevalence not in the children of Pink disease survivors but only in their grandchildren. The authors don’t state specifically, but the answer is implied: It’s the mercury in the vaccines that the grandchildren got. Of course, arguably the children of the Pink disease cohort would have been exposed to more mercury from products of daily living (remember mercurochrome solution for cuts and scrapes?), from pollution, and from laxer standards in manufacturing that allowed more mercury exposure. But the real elephant in the room is the question of why there wasn’t a higher prevalance of autism or ASD in the actual Pink disease cohort itself. After all, this group received a very high dose of mercury. If the same “genetic susceptibility” that led to Pink disease in response to mercury exposure also leads to autism (which is part of the authors’ hypothesis, by the way), then why don’t we see higher levels of ASD in the people who had Pink disease?

The authors drop some more howlers in trying to overcome the logical lapses in their very own hypothesis:

As identified earlier, numerous studies demonstrated a relationship between ASD and Hg (Agency for Toxic Substances and Disease Registry 1999; Austin and Shandley 2008; Bradstreet et al. 2003; Geier and Geier 2006a; 2007; Nataf et al. 2007; Adams et al. 2009; Geier et al. 2009; Holmes et al. 2003; Gallagher and Goodman 2010; Palmer et al. 2006; 2009; Windham et al. 2006), and our results add further compelling evidence in support of this relationship. The unique contribution of this study is that, to our knowledge, it is the first to examine the “individual susceptibility” variable inherent in the Hg-autism hypothesis. Our results suggest that this variable may have a heritable component and therefore, of course, a genetic basis. What our results do not do, however, is enable an understanding of the degree to which the susceptibility is inheritable and the mechanism by which this may occur.

That last statement wins the award for understatement of the year, if not the decade. Also note the multiple studies by the Geiers, Bradstreet, and other luminaries of the anti-vaccine movement. Again.

Near the end, the authors plop another howler into their discussion:

The Hg-autism hypothesis engenders passionate debate on both sides; however, the cumulative science in this field is now of such depth and breadth that it is difficult, if not impossible, to be completely dismissive of the Hg-autism link. Furthermore, our findings clearly suggest that individuals with a family history of pink disease are at significantly greater risk of having a grandchild with an ASD than the general population.

Uh, no. It is not difficult, much less impossible, to be dismissive of the autism-mercury hypothesis. There is copious evidence refuting the hypothesis, and the only evidence supporting it these days comes from cranks like the Geiers. As for the authors’ conclusion, I’m not even sure they can say that a family history of Pink disease is associated with autism, given that the authors never verified the cases of ASD reported and there isn’t yet a solid estimate of ASD prevalence in Australia. In other words, the study says…nothing!

Unfortunately, I doubt this will be the last we hear of this nonsense. A press release tells us that Shandley and Austin are “are now extending their research by examining cellular and genetic characteristics of Pink Disease survivors and people with autism” and that the results are likely to be published in 2012.

Oh, goody. I can hardly wait. No doubt it will be published in the Journal of Toxicology and Environmental Health, and no doubt the merry band of science-challenged anti-vaccine propagandists at Age of Autism will be ignorantly trumpeting it as “yet another study” that will “add to the growing list of research showing that autism can be connected with exposure to mercury.”

ADDENDUM: Oh, dear. It’s been pointed out to me that one of the authors has in the past published even worse dreck than this current study.

By Orac

Orac is the nom de blog of a humble surgeon/scientist who has an ego just big enough to delude himself that someone, somewhere might actually give a rodent's posterior about his copious verbal meanderings, but just barely small enough to admit to himself that few probably will. That surgeon is otherwise known as David Gorski.

That this particular surgeon has chosen his nom de blog based on a rather cranky and arrogant computer shaped like a clear box of blinking lights that he originally encountered when he became a fan of a 35 year old British SF television show whose special effects were renowned for their BBC/Doctor Who-style low budget look, but whose stories nonetheless resulted in some of the best, most innovative science fiction ever televised, should tell you nearly all that you need to know about Orac. (That, and the length of the preceding sentence.)

DISCLAIMER:: The various written meanderings here are the opinions of Orac and Orac alone, written on his own time. They should never be construed as representing the opinions of any other person or entity, especially Orac's cancer center, department of surgery, medical school, or university. Also note that Orac is nonpartisan; he is more than willing to criticize the statements of anyone, regardless of of political leanings, if that anyone advocates pseudoscience or quackery. Finally, medical commentary is not to be construed in any way as medical advice.

To contact Orac: [email protected]

71 replies on “The mercury zombie rises again…this time, in the grandchildren of Pink disease (infantile acrodynia) sufferers”

There’s a severe flaw in their argument. If high susceptibility to Hg would lead to ASD, the most susceptible pink disease survivors should all have developed severe ASD. As such they would have been classified retarded at the time and were unlikely to procreate (or answer a survey 60 years later). Therefore, this would be negative selection against the trait, and the grandchildren of survivors should have less of an incidence of ASD than the control group.

Whenever I see something like this, I come back to the observation that, even if there were some link between mercury and autism, vaccines are one source of mercury exposure that we can rule out as being relevant with a VERY high degree of confidence.

This is, of course, simply because autism rates haven’t plummeted since use of thimerosal as a preservative was halted for almost all vaccines.

Whenever I see a study like this, I ask a couple of questions. Well, I ask more than a couple of questions, but chief among the questions I ask are three

Five questions being right out, of course.

You bring up an important point:

(remember mercurochrome solution for cuts and scrapes?),

My age cohort practically swam in the stuff – it stung less than tincture of iodine so our Moms used it all the time. Instead of having to diffuse from muscle after a vaccination, in a cut it could go directly into the bloodstream.

So why didn’t The Epidemic of Autism occur in the 1940s and ’50s?

fusilier
James 2:24

So why didn’t The Epidemic of Autism occur in the 1940s and ’50s?

‘Cause it’s the vaccines! They’re guilty!! Hang ’em high – we’ll find the evidence later!

On a side but related note, I’ve been getting notices that one Mr. Bolen claims Mark Geier has been “invited by the United Nations to lead the charge against the vaccine industry.”

remember mercurochrome solution for cuts and scrapes?

Until the early 1970s there was also a disinfectant soap called Neko,
which contained about 0.5 percent mercuric iodide. I believe it’s still available in some countries.

Todd, is this the same United Nations that sent me an email yesterday telling me that I needed to contact someone about “standing in” for an “inheritance” or whatever????

They are also cherry picking their prevalence rates to buff up the RR. What about the recent korean study that showed a prevalence approaching 1/33 if all kids are universally screened, or the often quoted “epidemic” of autism rates at 1/100? Seems like if they had done their thorough quack reading they wouldn’t be using using 1/160. Sounds less like incompetence and more like shenanigans.

Whenever I see a study like this, I ask a couple of questions. Well, I ask more than a couple of questions, but chief among the questions I ask are three. First, …? Second, ….? And, third…

when you ask those questions, do you wear a nice red uniform?

Teresa Conrick is already on the case with an article @ AoA today.

I don’t know why the *idee fixee* of mercury continues: perhaps those who roll this way are in the age cohort that saw photos of Japanese victims of Minamota *disease* ( i.e. mercury poisoning) during a critical period in their own development.

While Orac desctibes how the authors do “veritable backflips of logic” to extrapolate, another image comes to mind that illustrates the tortured logic of connect-the-dots “science” for me- Rube Goldberg created outlandishly funny collections of unlikely objects and machines to do relatively simple tasks ( if you’ve never seen one- fire up the google). Often woo-meisters un-parsimoniously postulate similarly unrealistic series of steps to explain unlikely alternatives to SBM explanations of cancer causation ( or aging) as well as cures that utilise their own pet theories ( usually, nutrition or toxin-based). Various mechanisms touted at AoA have that Rube Goldberg stamp.

Although the degree of unreality takes my breath away I have to admit that I find this stuff rather entertaining. Thank you, Orac for lifting all of our spirits in this *interesting* economic climate.** However, this too, shall pass. Woo-meisters are starting to chime in with their own economic revelations and *advice*: invest in gold and buy my products.

** -btw- while I find myself surprising uninjured by the current situation I do offer my own economic forecast:

In the short run, we’ll see increased volatility and uncertainly.
In the long run, we’re all dead.

*facepalm* I was wondering how the Mercury Militia was ultimately going to try to spin the preponderance of evidence for a genetic cause of autism. I see “spin” is the right word, as they are doing a veritable dance to try to make their hypothesis sound plausible.

Studies like this irritate the CRAP out of me because these people are still operating under the delusion that only children who were vaccinated on schedule have developed ASD where I know for a fact that is INCORRECT! My son has autistic disorder and was not vaccinated on schedule. One of the most well know anti-vaccine supporter’s second child was not vaccinated at all (after the ASD diagnosis of their first and believing it was from vaccines) and yet still developed ASD. Amazingly she still attributes the ASD in her second child to vaccines the first child got (Wha?!?) I know personally several other parents of children who were not vaccinated at all because they believed the hype and yet their child still developed ASD.

Something else they fail to grasp the concept or reality of… how long as it been since thimerosal was removed from vaccines? Have rates of ASD dropped? NO, they have risen. Of my six children, five were vaccinated on schedule with vaccines that would have contained thimerosal, and are perfectly fine, where as my one child who wasn’t vaccinated on schedule, and wouldn’t have received vaccines with thimerosal in them anyway, has developed autism. But in their warped perception of things, they tell me I’m a liar, my son must not really have autism and even if he does it doesn’t count because he wasn’t vaccine injured. Hmm…

Have any of them looked at the rates of the increase in prevalence and how much they correspond with changes to the DSM over the years as well as better diagnostic criteria? HAS anyone looked at that? Granted there is something more going on then that, but I believe the increases could be attributed to just a better understanding of the symptoms, broadening of the spectrum umbrella and more awareness all around. I still predict the diagnosis of new cases of ASD will drop profoundly once PDD-NOS is removed from the DSM-V. I wonder what kind of spin on vaccines the lawyers and financial experts will put on that? I believe it needs to be pointed out that typically when these studies come from the anti-vaccine camp, they aren’t always done by anyone with a medical background. And those that are done by people with medical background are questionable at best and down right laughable at worst. Although there really isn’t anything funny about chemically castrating children just because you have a hunch that no real medical expert will ever take seriously.

Sorry if I went off a bit there, but this particular issue is irksome to me. It effects me and my son directly because these whack-jobs are taking resources away from real research that can help people and is instead funding study after study to try as hard as they can to incriminate vaccines as the one and only cause of autism, which fails every time when real medical and science experts look at the studies they produce. Why can’t they give up? It’s like a little kid who is told they can have a prize if they help Daddy find his keys and the child keeps coming back with everything BUT Daddy’s keys expecting the prize. COME ON People! It’s not that hard to figure out, it just takes opening your mind and letting go of some of your pride and being able to say to yourself and others, honestly, “I could be wrong, let’s see what other alternatives there are.”

“Pink disease (infantile acrodynia) was especially prevalent in the first half of the 20th century. Primarily attributed to exposure to mercury (Hg) commonly found in teething powders, the condition was developed by approximately 1 in 500 exposed children.”

A key point others have alluded to is that this commonplace mercury exposure should have led to autism being far more common in the first half of the 20th century. However, antivaxers who blame thimerosal in vaccines for autism insist that it’s a relatively new disease and that cases have exploded in tandem with the childhood immunization schedule. Something doesn’t fit here.

And if their argument is that autism was unrecognized in the first half of the 20th century and really was widespread then, they’re conceding belief in diagnostic substitution, something they have adamantly insisted is an illegitimate concept that does not explain the rise in reported autism cases in recent decades.

Sloppy science aside, there are major risks for antivaxers who are latching on to this new study.

Venna – that seems to be the problem with most of the “autism = vaccines” groups is that they consider Autism to be some kind of monolithic disease/illness/syndrome with a single cause, when it is actually a very variable set of diagnoses to fit witin the DSM model.

Of course, they also don’t discuss how the diagnosis of mentally handicapped children has decreased at almost the same rate as diagnoses of autism has risen (so these kids are now considered autistic & not mentally-challenged as they would have been before the DSM).

And you’re right, try pointing out the removal of thimersol didn’t effect autism rates or that most vaccines never had it & they completely dodge the issue.

For most of them, it doesn’t matter – they are convinced they are right, despite all of the evidence to the contrary.

@Denice Walter:

I don’t know why the *idee fixee* of mercury continues:

One hypothesis is that many parents of autistic children chelated their children, saw improvement, and become convinced of the effectiveness of the chelation therapy because of the post hoc ergo propter hoc fallacy.

@Venna

One of the most well know anti-vaccine supporter’s second child was not vaccinated at all (after the ASD diagnosis of their first and believing it was from vaccines) and yet still developed ASD. Amazingly she still attributes the ASD in her second child to vaccines the first child got (Wha?!?)

If this is who I’m thinking of, I believe it was her third child that is completely unvaccinated and still has ASD and that she blamed it on vaccines that she (the mother) received.

“Pink disease (infantile acrodynia) was especially prevalent in the first half of the 20th century. Primarily attributed to exposure to mercury (Hg) commonly found in teething powders, the condition was developed by approximately 1 in 500 exposed children.”

I acctually have a book on this entire subject. People pointing the fact that if there was an association then autism rates should have skyrockted and then dropped are entirely correct. The substance’s exact name from which people contracted Pink’s disease is a calomel or Mercury(I) chloride. The scary fact is that up until the 1950’s the substance was actually easily obtainable.

My own survey of 80-year-olds, asking them to describe their grandchildren, found that they were reporting a higher rate of bad musical tastes, poor manners and diction, and lack of respect, compared to other surveys of the population as a whole.

Also the 80-year-olds reported a higher level of young people not getting off their lawn.

I am sure that this demonstrates something profound and I will write it up shortly for the Journal of Toxicological and Environmental Health.

@Herr Doktor #20: When I was young, the kids didn’t give lip back to their parents, and their music wasn’t crap. That all changed after the chicken pox vaccine. Just coincidence? I think not!

I first read the abstract over on LB/RB, and it’s been bugging me for days now. Without even considering the self-selection bias, there’s another big problem with the study group. It’s pink disease survivors who are now grandparents! Answering surveys! How could that possibly be representative? What about the descendents of pink disease survivors who have already died? And shouldn’t the control group be the grandchildren of grandparents who had confirmed exposure to the same amount of mercury compounds as those who had Pink Disease?

The study doesn’t even begin to address their hypothesis, let alone support it. This study doesn’t seem to tell us anything at all.

@fusilier and anon: merthiolate…ah…merthiolate. Those were the days. It was used by everyone I knew. My mom used it on EVERYTHING – splinters, cuts,scrapes – any injury that broke the skin at all. My aunts used it on my cousins’ umbilical cords (recommended at the time by the docs instead of alcohol or letting it air dry). We used it to paint ourselves to play cowboys and indians. It got in our eyes, our mouths, our ears. My friends had moms who splashed it on any open wound too. Wonder why the children of the 1960s and 1970s didn’t have rampant autism rates? Goodness knows, what with the vaccines with thimerosol and the external/internal merthiolate exposure, we should have ALL been autistic.

@ fusilier: Yes, I remember the small (0.50 oz., at most) brown bottle of mercurochrome…with a small glass solid tube with a rounded bulb on the end to dab on cuts and scrapes on knees and shins…it was a staple in the bathroom medicine chest. You didn’t even have to go home when you fell off your bike or skates, every one of my childhood chums’ moms treated you “in the field”. It was a 2 % solution either aqueous based or in tincture form…I suspect mom’s little brown bottle was alcohol-based because it did sting a bit.

As I got older, approaching my teens, all the moms switched to merthiolate (thimerisol) antiseptic which came in a larger brown bottle and was dabbed on open cuts and scrapes with a wad of cotton. How prescient of them…or not…maybe moms realized that in the 1950s kids weren’t getting enough thimerisol in the limited number (DPT only) of vaccines we had received. So, swabbing away was the only way to introduce thimerisol directly into the bloodstream. Why isn’t there a birth cohort of ASD adults born since 1919 when mercurochrome was licensed and since 1931 when merthiolate was licensed and used extensively for childhood cuts and scrapes?

@ Venna: “I still predict the diagnosis of new cases of ASD will drop profoundly once PDD-NOS is removed from the DSM-V”

I wish I had your faith. While “slumming” at AoA I have noticed their “push” to have “wandering behavior” included in the DSM-V and they are now celebrating that wandering behavior is scheduled to be included. Of, course this will broaden the criteria of ASD, once again. I found a terrific blog about this inclusion which addresses the unintended consequences of this inclusion by keying in:

Wandering Behavior Autism DSM-V

Mercury contained in vaccines (as a preservative under the tradename Merthiolate, but more commonly known as thiomersal/thimerosal), dental amalgams (silver fillings), seafood, and the atmosphere is argued to be the primary set of sources of Hg exposure for infants both in utero and in their early years (Austin 2008)

This is interesting. The authors cite Austin (2008) as listing seafood and the atmosphere as sources of Hg exposure. But turning to that paper (described by Orac as “even worse dreck than this current study”), we read

In Pink Disease exposure [to mercury] was primarily via oral ingestion, whereas in modern times, the major exposure is intra-venous (direct to infant vaccination) or via the placenta and/or breast milk in the case of maternal amalgams and vaccines.

Evidently in 2008 David Austin inhabits a world where dietary mercury (fish) does not exist. Nor did he mention the atmosphere.

Conclusion: Austin can not even be trusted when he’s citing his own feckin’ paper.

Also note “maternal vaccines”… Austin is seriously arguing that there is so much mercury sequestered in women’s bodies from the vaccinations they received several decades previously, that when it magically desequesters itself during pregnancy, the amount entering the infant is enough to cause autism.

And ‘maternal amalgams’. Oh dear.

Roadstergal:

Does that mean that the Chicken Pox vaccine is responsible for Autotune?

THE BASTARDS!!!!!! KILL THEM ALL!!!!!

Somehow, when we passed the Clean Air and Clean Water Acts, resulting in less pollution in our environment, we caused the toxins to go directly from industry into our bloodstreams, bypassing the environmental route altogether. It used to be that plants and animals absorbed all the toxins, which is why we had massive environmental damage, but no autism. Even when our products were laced with toxins, including heavy metals, it wasn’t a problem until the EPA came along and removed out environmental buffer. This is why everyone should vote for Michelle Bachmann. She’s going to shut down the EPA, and then autism will go back to being a rare occurrence.

(And, yes, typing that DID make my head hurt).

herr dokter bimler (quoting the 2008 Austin paper):

the major exposure is intra-venous (direct to infant vaccination)

Intra-venous! One classic way to determine that someone is under educated about vaccines is claiming that they are injected in veins.

Notice also that Austin believes in mother-to-infant transmission of sequestered mercury as a major risk factor for autism. Thus his theories predict an increased rate of autism amongst the children of mothers who have had Pink Disease. So echoing Sullivan, one wonders why Shandley & Austin ignored children and asked about grandchildren instead.

Correct me if I’m wrong, as I Am Not A Scientist ™, but: isn’t it a bad idea to work a hypothesis that contains two contingent ideas? “If it’s heritable AND if it’s related…” Shouldn’t you establish those things separately?

Also, my limited understanding of genetics and biology would suggest to me that it still doesn’t make it mercury, even if they’re right about the higher incidence of ASD. It would indicate that there’s a genetic variation which can produce susceptibility to pink disease and is comorbid with a higher incidence of ASD, surely?

herr doktor bimler

So echoing Sullivan, one wonders why Shandley & Austin ignored children and asked about grandchildren instead.

Dollars to donuts it is because examining the children of those exposed did not support their hypothesis.

@ Matthew Cline:

Fearing mercury goes way beyond its imagined role in autism- alt med providers often test adults to determine how much they are “poisoned” by mercury and other metals which “cause” brain fog and eventual MS and Alheimer’s ( tons of articles on NaturalNews/ Gary Null.com): mercury is found in vaccines, power plant emissions, and silver amalgam dental fillings ( thus holistic dentists who remove them). Chemical chelation is advocated although using green juices and green powders (where
the chelator is chlorophyll)are at-home alternatives.

I think that the shiny silvery appearance of mercury scares these folks – too sci fi, not crunchy or leafy enough.

Sounds like the study might be citable if you wanted to work up a good study on how greater amounts of mercury exposure lead to less autism. Oh, wait…that wasn’t what they wanted to show?

In the land of fantastic comedy, it appears that Tim Minchin’s “Thank you God” (Also known as, “Sam’s Mum”) is back on the interwobz: http://youtu.be/umnV-o_Tvx4
Hilarious. I actually went to itunes and paid for a copy of the song, because I assume youtube will pull the video soon.
(Except of course, that Tim Minchin is *intentionally* funny with his piece, unlike the mercury militia who appear to be quite serious.)

Then, depending on what kind of mood I was in, I’d start liberally quoting more from Monty Python’s famous Dead Parrot Sketch, including pointing out that the mercury/autism hypothesis passed on! This hypothesis is no more! It has ceased to be! It’s expired and gone to meet its maker! It’s a stiff! Bereft of life, it rests in peace! Its metabolic processes are now history! It’s off the twig! It’s kicked the bucket, it’s shuffled off its mortal coil, run down the curtain and joined the bleedin’ choir invisibile!! THIS IS AN EX-HYPOTHESIS!!

No. it’s just pining for the fjords of Age of Autism!

Ah, how the mercurochrome/methiolate discussion takes me back to my childhood in the 1960s, growing up in my grandparents’ home. My grandma painted me with mercurochrome at the rate of about once a week during the summer months, seeing as how unlike the children on Thingy’s planet, I played hard both on and off the sidewalk and had scuffed knees and elbows more or less constantly. Fortunately, I also had any and all vaccines that were available at that time, although I had caught the measles when I was very little and still remember being deathly ill. I was far from autistic, despite all this and the amalgam fillings I had from the age of fifteen to about 30, when they fell apart and I had to have them replaced. My son, despite being vaccinated right on schedule starting in 1992 and being born to a mercury-toxic mother, was also not autistic, although he was distressingly hyper for a while there, and hasn’t shut up once since he learned to talk – early. Hmmmm. I guess this makes us the exception that proves the rule? 🙂

@lilady #25

I remember several months ago when I was sent the email asking to participate in a study questionnaire on wandering or eloping in autism. I answered the questions truthfully and when the results were all in they said the ‘study’ shows a significant number of autistic individuals over the age of 7 wander or bolt and it causes stress and worry to the care givers (I don’t remember what the percentage was and figured Viktor didn’t apply since he isn’t yet over the age of 7.) I think though a lot of it is lack of proper repetitive training of the autistic loved one.

When Viktor was younger he would try to run into the street to get spinning tires. He tried to grab the spinning tires of bikes riding by. When he out grew his stroller, I was concerned so I brought it up with his therapists and they said to get him a backpack with a leash. I did and he tried to bolt a couple of times, but in doing so he ended up unable to go very far and was snapped backward and fell on his bottom. If I hadn’t had the leash though, he would have been hit by a car. He did eventually learn that when he has his backpack on and I have hold of his ‘handle’ (I don’t call it a leash to him because it too much makes me think of a dog) he knows he can’t leave and doesn’t try to bolt anymore. He has, for the most part lost interest in spinning things though. He still lines things up and he rocks a lot more now then he used to (before it was spinning things, any things.) He stopped flipping pages in books about the time the spinning fascination died.

Anyway, I don’t personally think that wandering in and of itself could should be considered an autistic trait or mode to diagnosis. How many little children are just naturally curious and will wander off to go see something that piques their interest? If it isn’t accompanied by the other symptoms, the wandering as a symptom should be null. I don’t think enough autistic people wander to make it part of the official diagnosis, but to a degree, if it is a problem with many of them, putting in the diagnostic manual, will allow some kind of intervention to be done and possibly covered by insurance (E.g. a backpack with a leash?) Just a thought…

Mercurochrome/methiolate was for sissies – we used Iodine because if didn’t hurt it wasn’t helping.

It’s called epigenetics, and yes it does affect successive generations.

If mercury exposure does have a neo-Lamarckian epigenetic effect — and I see no evidence for that, outside the cargo-cult science of alt-health practitioners — then Shandley and Austin will be able to prove it, by studying the children of Pink Disease cases. Yay!

Hi Venna: You will definitely love this blog:

esteeklar.com

Estee is a mom whose son Adam is autistic. She writes about her life with her son in very direct terms that include her reactions to her situation and when some difficulties arise with Adam. She is also a very strong advocate for Adam and has involved herself in advocacy for all developmentally disabled people. She is totally on board with our philosophy about the pseudoscience of vaccines causing autism and has blogged extensively about the forum provided by TV stars (Oprah, Larry King) to Jenny McCarthy, Handley and the other anti-vaxers…much as in the style of Orac (ouch!).

I spoke about the possible “unintended consequences” of placing “wandering behavior” as a diagnostic criteria for ASDs, that include exclusions from mainstream educational programs, to decrease staffing ratios in residential schools, group homes and state-run facilities by isolating kids, use of chemical and physical restraints and possible lack of behavioral interventions if the “wandering behavior” is part of the diagnostic criteria.

If you key in “DSM-V wandering behavior” on her blog, she has reprinted a letter signed by large advocacy groups including TASH (The Association for Persons with Severe Handicaps), sent to the CDC about their recommendation for “wandering behavior” inclusion. And, the survey you participated in, is also mentioned in that letter.

Clever remark about getting insurance to pay for the back-pack/leash. More at issue with health insurance, many states have recently written into their regulations that expensive and extensive therapies (ABA) in the home must be covered. In this political climate with the economy in the toilet, instead of taking a bogus anti-vax stand, parents of children on the Spectrum should be lobbying to keep those expensive therapies in place.

These people are so obsessed with Mercury that they have it coming out Uranus. I’m off to listen to some Holst, now.

I missed this one before: Mercurochrome solution hasn’t been out of use that long. I was born in 1980, and mercurochrome was the default treatment for cuts and abrasions in my childhood, at least in Australia. My own parents didn’t use it, but I remember a doctor painting it across a second-degree burn I’d suffered on my chest and stomach in around 1990.

Somehow, until reading this, I never quite twigged that it involved mercury.

@ Sami: In the United States it was an over-the-counter antiseptic available in all drug stores and used until 1998, when the FDA forbade its sale across state lines, judging it as not safe and not effective as a topical antiseptic.

It may still be available in other countries, however. Posters, how about weighing in on its availability in other countries?

I believe certain eye drops for glaucoma treatment may contain thimerisol as a preservative. The EPA has an interesting site with a table of products that may contain mercury:

Table of Products That May Contain Mercury And Recommended Management Options

It’s called epigenetics, and yes it does affect successive generations.

A belated thought… Austin (2008) specifically describes “maternal amalgams and vaccines” as a source of exposure to mercury.
The 2010 paper specifically includes “Mercury contained in vaccines” among “sources of Hg exposure for infants […] in utero”.

No, this is not called epigenetics. But the creative misunderstanding of epigenetics in alt-health circles does provide an interesting form of bullshit for some enterprising blogger to pick up on.

So let me get this straight….

Claim is from a survey with significant selection bias that 1 in 25 descendants have autism, which is way more common that the accepted prevalence of autism (1 in 60? 1 in 100? 1 in whatever??)

Seems the original sufferers of pink disease did themselves NOT get autism, despite having A) a genetic susceptibility and B) having massive mercury exposure.

And it seems that there should have been a general autism epidemic back in the 1950s because of all the mercury exposure that was going on (several orders of magnitude greater than through any recent vax schedule) but there wasn’t.

Conclusion?

Whenever I see a study like this, I ask a couple of questions. Well, I ask more than a couple of questions, but chief among the questions I ask are three.

I didn’t expect a kind of Spanish inquisition.

@dt

Conclusion?

These children are 7,500 times more sensitive to mercury than their grandparents?

[That’s based on 2 doses of 42 milligrams of mercury in teething powders per month for 18 months, coming to 1.5 million micrograms of mercury, and 200 micrograms of mercury (I’m being generous) in the entire childhood schedule of vaccines when there was still thimerosal in them.]

ORAC, the highly paid vaccine defender is at it again, has to be, you see his pathetic income is at stake.

Kreb, you’re so totally missing the potentiating factor of the intravenous injection of the thimerosal, right into the bloodstream!.

joejoe didn’t take long to announce that he can’t refute or even understand anything Orac says, therefore he has to activate a robotic, unoriginal ad hominem circumstantial in desperation.

@Mu,

Kreb, you’re so totally missing the potentiating factor of the intravenous injection of the thimerosal, right into the bloodstream!

Dammit, you’re right, maybe not all the mercury in the teething powder was absorbed – in rats only about 20% of ingested mercuric chloride is absorbed.

But I also missed the fact that mercuric chloride is much more toxic than thimerosal, in rats and mice at least e.g. mercuric chloride LD50 in rats 1 mg/kg, thimerosal LD50 in rats 75 mg/kg. That’s nearly 2 more orders of magnitude. So I divide by 5, multiply by 75 – I think that means the grandchildren of the Pink Disease sufferers must be 113,000 times more sensitive to mercury than their grandparents. Those Lamarckian epigenetics are something else!

@Helkie:

It’s called epigenetics, and yes it does affect successive generations.

As far as I can tell, the authors of the paper in question are saying that there’s an allele which makes one vulnerable to mercury poisoning, not that there’s any inheritable epigenetics invovled.

All this work to scientifically prove what we already know is true. Why do some people get more drunk than others when they consume the same amount? Why do some people develop lung cancer in their 30’s while others are still smoking without it in their 60’s. Why does breast or ovarian cancer often occur in siblings in the same family to the degree that some get ovaries removed as a cancer prevention method. Some people will develop autism or ADD or whatever as a result of being exposed to mercury, a known neurotoxin. Why would anyone put mercury in their bodies intentionally to tempt a fate that could impact their children when it can be relatively easily avoided. This has gotten to be as stupid as the climate change argument (why wouldn’t we want a less polluted earth by reducing energy use and investing in green technology). Seriously, go study something useful.

Some people will develop autism or ADD or whatever as a result of being exposed to mercury, a known neurotoxin.

[citation needed]

Why would anyone put mercury in their bodies intentionally to tempt a fate that could impact their children when it can be relatively easily avoided.

Because there’s no known harm at the doses in question and it helped keep the vials sterile, thereby preventing infection. Now that they’re not kept sterile that way, individual doses are necessary – and more costly.

Yay for wasting money avoiding a nonexistent danger!

It’s funny, Jennifer. You’re engaging in quite a bit of denialism towards stuff we all already know. Of course we know that mercury is toxic at certain doses. The vaccines that do contain some kind of mercury compound are far below the doses which cause problems.

This has been the pro-vax stance since the scare was manufactured. I know it. You know it. We all know it. And yet, you still choose to lie by implying that we don’t believe what we believe about mercury. Why?

Common knowledge you appear to be in denial of:

1. Denial of the difference between elements and compounds. Thimerosal is not mercury. It’s a mercury compound that breaks down into a different mercury compound. Not all mercury compounds are the same.

2. “The dose makes the poison.” Everything is toxic at some level. Even pure water. This means that small amounts (varying on substance in question) can be safe or at least minimally harmful. Think about it: Milk. Fish. They contain small amounts of mercury, but I don’t hear you raising a fuss about them. There’s no magical black-and-white line dividing “safe” substances from “toxic” ones.

Of course, this is the point where other trolls I’ve discussed those well-known facts with tend to start bringing up conspiracy theories to say that all the chemists and toxicologists in the world are lying to us in a centuries-old conspiracy, dating to before the conception of the periodic table of elements.

And then some of them try to advertise a book about a hocus-pocus detox regimen.

This may have been brought up before, but I was wondering. Isopropyl alcohol is kind of nasty. It’s highly flammable. It’s used in all kinds of industrial ways (de-icer, specimen preservation, as a solvent and cleaning fluid). It can put a person into a coma if enough is drunk.

… so somewhere out there is there someone who thinks rubbing an antiseptic swab containing isopropyl alcohol on their child’s arm is the same as handing them a cup of it to drink? Don’t people generally get the difference between drinking a gulp of alcohol, of *any* type, and having a tiny amount rubbed on your arm, even if it’s rubbed into a cut so some non-zero amount gets into your body? Why is it so hard to get with vaccines?

lalalalala. My kids and I all got the full mercury vaccines. We’re fine. I am not anti-vaccine. I was just trying to say that the study points out what anyone could already tell you. Everyone has a slightly different genetic makeup and physiology that will cause them to react differently to various toxins. No one will ever prove without a doubt that mercury vaccines or fillings or tooth powder caused a specific disease because everyone reacts differently to these variables as well as everything else they encounter in life. I subscribe to the precautionary principle, I don’t give a crap whether you do or not.

@herr doktor: Just thought I’d ask, given the undercurrent of this particular thread, how are Messrs. Hilter and Viventropp these days?

Except there’s no particular indication that anything about different genetic makeup and physiology had anything at all to do with it. Differing doses is entirely adequate to account for the variation.

No one will ever prove without a doubt that mercury vaccines or fillings or tooth powder caused a specific disease because everyone reacts differently to these variables as well as everything else they encounter in life.

Actually, we can indeed prove that when it’s a real connection. For instance, it is proven beyond a meaningful doubt that what happened at Minamata was mercury poisoning. What you actually mean is that you don’t care what evidence proves that your particular claimed cause is false, you’re going to insist that 1+1=7 anyway.

I subscribe to the precautionary principle, I don’t give a crap whether you do or not.

What you’re saying has not a whit to do with the precautionary principle. In particular your insistence on ignoring what we do know about the actual risks involved.

Jennifer, it sounds like you’re endorsing an idea that medical knowledge is impossible.

Of course, if people can have these unknowable vulnerabilities, doesn’t it also mean that we can’t be sure mercury is a toxin, because we can’t know if any given person might have a resistance?

Which is it? Can we know if something is toxic or not for most humans? Can vulnerabilities be predicted or not?

And, if we have to go for precaution, does that mean we have to treat every chemical as potentially dangerous? If not, why should exceptions be made?

I’m starting to think you’re literally reading from a script someone handed you, someone else is using your name, or that you aren’t thinking about the interaction of those ideas.

Genetics and the unknown are messy business, but that’s more reason to find and follow the evidence. The precautionary principle you’re proposing sounds a lot like hiding under the bed to me.

My take on the “precautionary principle” in regards to what we know about vaccines is that if you truly believed in that kind of risk assessment you would never ever, not in a million years get into a motor vehicle. They are so much more dangerous.

how are Messrs. Hilter and Viventropp these days?

3rd corollary of Godwin’s Law: For a sufficiently long comments thread involving Monty Python, the probability approaches 1 that someone will mention the “Boarding house in Minehead” skit.

The term “precautionary principle” is frequently abused in arguments by those who wish to see no action implemented if there is even a possibility of risk. It is mostly used to imply someone should not take unecessary risks, or that they should do nothing unless it has been proved safe, but those are meaningless platitudes, demanding far too high a threshold of certainty.

Properly stated the PP should be “Do not proceed with a course of action which may have potentially serious consequences until you have conducted a proper risk analysis based upon sufficient available evidence.” Then one can make a proper informed choice.

One must also weigh the desirability of outcome against the known risks involved in trying to achieve the outcome. So the importance of what you are hoping to achieve is also a crucial element in the risk analysis. (eg Imagine telling a patient bitten by a rabid animal that it would be better not to give rabies vaccine because it entails potential risk)

Venna @ #39 and lilady@42

Eloping and wandering in children,is a very serious problem,and does not always mean being “just naturally curious and will wander off to go see something that piques their interest”.

I speak as a former autistic,meaning someone who for most of their life,was thought to have a combination of an ASD,and a couple of other diagnoses in the DSM,as well,but has since been found to have a very rare disorder of folate and B12 metabolism.

I started eloping when I was three years old,as soon as I was able to walk.I continued to do this well into adulthood,when my metabolic disease was finally found.It is usually associated with blackouts,and episodes of transient dementia,that can last for hours.During such episodes,you are not only unable to speak,but you are usually unaware of the world around you.When you do come around hours later, you have no idea how you got where you are.It can be very scary,especially for a little kid.

It is a common feature of both chromosomal diseases,like Fragile X,and a number of metabolic diseases,including mitochondrial diseases,like Niemann-Pick,and others.All known causes of “autism”.

I can’t stress enough how important it is for parents of children with “autism”,and other medical problems to keep looking for a real cause for their children’s condition.It may be a very rare,or ultra-orphan disease,99% of doctors have never heard of.

Autism,like seizures,is not a monolithic condition,but is merely one of many features of any number of different genetic syndromes.

Sorry aspies,but it’s true.

Oh and Elizabeth at@60,
I live in a Neighborhood where there are a lot of homeless drunks.Rubbing alcohol,and mouthwash is tied for the third most popular beverage of choice,after Steel Reserve,and cheap vodka.

@ Roger Kulp: Of course wandering can be a serious/dangerous behavior that should be addressed and ameliorated or remedied with a behavior program. “Wandering behavior” does manifest itself in some individuals who have developmental disabilities, not just with kids on the autism spectrum.

My son resided in a group home and a few of his housemates had wandering behaviors…but they were mentally retarded in the severe and profound ranges. Many of them like my son have “autistic-like behaviors” (self stimulatory and self injurious), but they are rightly classified as mentally retarded…not autistic. Those who have severe and profound intellectual impairments have a very high incidence of “autistic-like” behaviors.

If you have been following this blog for a while where I frequently post, you would know that I have been involved in advocacy for the developmentally disabled for years. My posting directed at Venna above, offered another view of incorporating ICD-9-CM wandering into the DSM-V. A number of national organizations (approximately forty) are against this new ICD code including TASH and the ASAN (Autism Self Advocacy Network) for the unintended consequences that may occur. They have valid concerns that I share including segregating restrictive school environments, exclusion from vocational training programs and employment and the potential for use of chemical and physical restraints.

I’ve visited many school programs (including residential schools) many group homes and many state institutions for the developmentally disabled. It’s all about the money; money for enriched staffing and for providing the least restrictive educational and residential settings for people, so that our most vulnerable citizens partake in activities that are available in a community setting.

The ASAN has a copy of the letter on their website:

Joint Letter to CDC On Proposed ICD-9-CM Wandering

Yes, we are in agreement that parents should be amenable to genetic testing, if suggested by their doctor. But, I also feel that some parents are fixated on the bogus vaccine-autism link to the exclusion of any other reason for their child’s disability.

I wonder if they have also studied families who had neurosphilis. Syphilis was the 7th leading cause of death in 1914 in New York City…and one in NINE males between ages forty and sixty died of GPI (General Paresis of the Insane). This is from the book The Age of Autism.

@ Leslie Khalsa: I don’t quite understand your posting and I definitely don’t understand your choice of reference. “This is from the book The Age of Autism.”

I have a better reference for you, which details the causes of deaths in NYC during 1914. Note the number of deaths in childhood from vaccine preventable infectious diseases…before the licensing of the recommended childhood vaccines. I bet the authors of your reference book…Olmstead and Blaxill didn’t provide the information about infectious diseases deaths. BTW, the 7th leading cause of death was not syphilis:

THE HEALTH OF NEW YORK CITY DURING 1914. (From Department of Health Bulletin.) The year 1914 marked the lowest death rate ever attained In the city or New York, and definitely placed this city among the most healthful of the large cities of the world. The number of deaths reported during the year was 74,803. with a rate of 13.40 per 1,000 of the population, as against 73,902 deaths and a rate of 13.76 for the year 1913. Thus there has been a decrease in the death rate of .36 of a point, which is equivalent to saying that if the death rate of 1913 had prevailed during 1914 2,010 more death would have been recorded than actually took place.

The most noteworthy feature of the decreased mortality was the splendid record in infant mortality, only 95 Infants dying out of every 1,000 born. This is the lowest Infant death rate attained in the city of New York, the Infant death rate In 1913 having been 102 per 1,000 births.

The following causes of death showed a considerable decrease In mortality: Typhoid fever, measles, Scarlet fever, all forms of acute respiratory diseases and diarrheal diseases under five years of age. There were 10,286 deaths reported from all forms of tuberculosis, as against 10,031 deaths in 1913; an increase in the absolute figures of 255 deaths, the rate per 1,000 of the population being 1.84 during 1914, as against 1.87 in 1913, a slight decrease in the rate. There were 16,804 deaths reported from the combined causes of organic heart, kidney and brain diseases, as against 16,194 in 1913, an increase of 610 deaths, the number of deaths reported from cancer was 4,463. an increase of 240 over the figure of 1913; 4,516 Infants died from congenital causes, such as malformations, marasmus, prematurity, etc., and 4,982 met with violent deaths. The death rate from purely accidental deaths decreased somewhat, while that from suicides increased considerably, there having been 915 deaths reported from this cause; 13,312 children died before the completion of the first year of life. 19,515 children died under the age of five years. There were 41,235 deaths reported of males as against 33,568 deaths of females; 30,825 deaths were reported from institutions; 29,561 from tenements; 11,819 from dwellings; 746 persons died in hotels, and 1,852 died In rivers, streets, etc. The year 1914 also witnessed the greatest number of births that ever occurred in the history of the city of New York, there having 149,647 children born during that year, an increase of 5,513 births over 1913. The number of marriages reported during the year was 53,052. as against 51,268 In 1913, an Increase of 1,784.

Source: The World Almanac and Book of Facts: Leading Causes of Death, New York City, 1914

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