By F. Edward Yazbak, MD, FAAP

Although 2001 was filled with news of the MMR vaccine controversy, discussion of the enormity of the autism explosion and its impact has been minimal.

A National Autistic Society survey had found that 1 in 110 children under 11 has autism.

The vaccine authorities still assert that the reported increase is unrelated to the use of the MMR vaccine but offer no other reasonable cause. The toll in human suffering is immense, and the actual financial cost per child for a lifetime of care and support services is a staggering 2 million plus British pounds.

In the United States, the atrocities of September 11, the Anthrax letters and the present war in Afghanistan have certainly touched every one. But life goes on.

For the parents of children with autism, each day's battle is overwhelming and their lives have changed forever. There is no final victory they can look forward to and no end to their war in sight.

Each morning brings new problems, new challenges and more concerns about funding cuts and decreased services. Every night, the same awful dream recurs "What will happen to my child when I am gone?"

According to the Department of Education annual reports to the US Congress, autism cases in children aged 6-21 in US schools increase yearly by approximately 25%

In the last three months of 2001, it is more than likely that between 600 and 700 new cases of autism were diagnosed and accepted into the system in California alone. If the average incidence of new cases of autism in the remaining 49 states averages only 1/8th of the California rate -- a very conservative estimate, indeed -- we should expect that approximately 4000 new cases of autism have been diagnosed nationwide in the last 3 months.

In the United States, the cost per child over a lifetime is soon to surpass 2 million dollars.

One can only imagine the outcry if there was an outbreak of 4000 cases of any other pediatric illness in the same 3-month period. The CDC specialists would be clamoring for a cure and seriously looking for clues to the epidemic. Why aren't they?

We witnessed the reaction that followed 15 cases of anthrax on the East Coast. Before anyone without personal experience with autism rushes to criticize this statement, I respectfully submit that 10 out of the 15 cases of anthrax went on to complete recovery.

As for the five deaths from anthrax, they are certainly sad and most unfortunate but children with severe autism have brain damage, and "die" every day even if they are still breathing and moving. Every day, their parents and grand parents die a little too.

Research into the causes of autism is being carried out nationwide. Many studies dealing with biochemical and genetic causes are published and only receive transient interest. It is likely that many studies concerning genetics now in progress will go similarly unnoticed, as it is impossible to have an epidemic of genetic diseases.

The impressive mercury study undertaken by a group of dedicated parents in New Jersey is different. It deserves our attention and gratitude, and supports the original Redwood theory of mercury damage. It now appears that the CDC also carried out a study, which suggested some relationship between mercury in vaccines and neuro-developmental disorders in infants.

A special committee of the Institute of Medicine (IOM) held hearings on the subject of mercury and autism, and recommended removing thiomerosal from all pediatric vaccine formulations.

The American Academy of Pediatrics (AAP) and the CDC had also recommended an all mercury-free vaccine schedule. All three organizations believe that mercury-containing vaccines have not actually caused damage to children.

Concern over mercury has attracted the attention of the manufacturers of adult vaccines. On November 21, 2001 the FDA announced that a single-dose influenza vaccine for adult use, with only a "trace" of thiomerosal, is now available.

Our own research seems to indicate that, certain children have reacted unfavorably and were "set-up" by mercury-containing vaccines in year one and then have regressed into autism following another antigenic insult in their second year of life.

The auto-immune theory of autism and the possible relationship between autism and MMR vaccination have captivated many minds since they were formulated in 1998.

Although no one has proved conclusively that MMR vaccination has contributed to the increase in autism in the western world, no one has convincingly proved that it has not.

While the vaccine lobby and authorities have adamantly and viciously condemned Andrew Wakefield and his findings, hundreds of parents are totally convinced he is right.

These parents have no doubt that their previously normal children became symptomatic after their first MMR vaccination and then regressed into autism, and many have videos, pictures and doctors' notes to prove it. A further regression after the second MMR, at age 5, seems to have convinced some of those parents even more.

The identification of measles by intricate PCR testing in the British pathological specimens and the later revelation that these measles strains were of vaccine origin, by independent Japanese researchers, do offer more support to the hypothesis. The likelihood that any investigator would try duplicating these findings after witnessing Dr. Wakefield's public lynching is remote.

In London, many children with autism have been investigated carefully and found to have abnormal pathology in the colon, the terminal ileum and the esophagus. A group of children in the US have also been found to have identical pathological findings.

In March 2001, an IOM committee looking at autism and MMR, reported that, "evidence favors rejection of a causal relationship at the population level between MMR vaccine and autistic spectrum disorders."

A little later in the report, the committee conceded that it could not "exclude the possibility that MMR vaccine could contribute to ASD in a small number of children," and went on to recommend further research on the subject.

The media propaganda asserted that the committee took the MMR "off the hook" but failed to highlight the similarity between the committee's conclusions and Wakefield's own: that the MMR vaccine could contribute to autism in a small group of genetically predisposed children, and that good research is urgently needed.

It is tragic that while all this discussion about administering three live viruses at the same time is going on, the authorities in both the US and the UK have decided to add the chicken pox vaccine to the present MMR formulation.

Not too long ago, health care providers had to wait a month between the administration of MMR and the chicken pox vaccine. Now they are assured that giving them together in the same syringe does not affect their safety and efficacy.

Other vaccines to treat less serious illnesses are being developed at a frantic pace and will be certainly added to the present "routine" schedule.

Mega-combinations are promised and well known infectious disease specialists and immunologists have no difficulty stating that a child's immune system can comfortably deal with all these simultaneous antigenic assaults, even if he is very young, febrile, and on antibiotics.

Empathic and qualified pediatricians and pediatric nurse practitioners are urgently needed to control the present autism epidemic. A high index of suspicion, an early work up, and a firm diagnosis are imperative to assure timely initiation of therapy and limitation of brain damage.

The above is my personal opinion and may not reflect that of organizations to which I belong.

F. Edward Yazbak, MD, FAAP December 13, 2001