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Keith Gallicano and his five-year-old daughter, Giselle, who was diagnosed with autism two years ago. Photo by Dan Toulgoet.

Shot down?

By Jessica Werb-contributing writer

Five-year-old Kieran Stark lives with his single mother, Cynthia, a psychology student, in a cramped unit of UBC student housing. In many ways, he's like any other pre-schooler. He can count to 12, sing the alphabet and name all the colours. He's also learning his way around a computer, and will gladly show off his talents. With his elfish grin and tousled blond hair, he's the apple of his mother's eye.

But there's another side to this affectionate, cheerful boy. He still wears diapers. He drinks from a bottle. He speaks in sentence fragments, and doesn't know how to play with other children. His eye contact is fleeting, and he often avoids it. Sometimes, he'll be gripped by rages and bang his head against the wall.

Little Kieran is trapped in the mystifying, isolating world of autism. And while the medical establishment still says it doesn't know why, or how, autism strikes certain children, Stark believes she knows exactly what caused her son's retreat into darkness. The culprit, she says, is something that was meant to keep Kieran strong and healthy: vaccines.

It's not a view many Canadian doctors will entertain, never mind endorse. Nevertheless, Stark is just one of thousands of parents across North America and Europe who argue the coincidence is overwhelming: within weeks or even days of receiving the DPT-Diphtheria, Pertussis (Whooping cough) and Tetanus-and MMR-Measles, Mumps, and Rubella-shots, their previously normal children lost many of the developmental milestones they had attained.

"We noticed after his DPT shot that he was doing strange things, like arching his back and screaming," Stark recalls. "He had a very bad vaccine reaction, but the doctors kept telling us he was normal." Following this first set of shots, Kieran got his MMR jab, at the recommended age of 12 months.

Before the shot, Stark says, he could speak about 20 words and was walking. After the shot, he became very sick. "I remember it was the day before his 12-month birthday, and we had to drag him out of bed at noon. He sat there being really sick, and then we put him back to bed at three. He was projectile vomiting for two months... He didn't respond to his name, and if you tried to call him he would act like he was deaf. We were doing things like dropping pots behind him to see if he reacted, and he wouldn't."

A hearing test at 13 months ruled out deafness, and seven months later, Kieran was diagnosed with autism.

Startlingly similar is the story told by Keith Gallicano, a bioanalytical researcher in White Rock. He and his wife Cathy are the parents of five-year-old Giselle, who was diagnosed with autism at age three.

Before Giselle had the MMR vaccine at 13 months, says Gallicano, she could say her ABCs, count to 15, sing and talk in three-word sentences. "She was very social and had at least a 50 or more word vocabulary. She had very good eye contact." Gallicano said he and his wife noticed Giselle losing speech at around age two. She began to withdraw from interacting with other children. "My low point was when I would come back from a conference and she wouldn't even look at me. She couldn't understand the concept of love."

Giselle and Kieran are just two of an ever-increasing number of children globally diagnosed with autism spectrum disorders (ASD). Across Europe and North America, the rates of ASD are escalating exponentially. Twenty years ago in Canada, the rate of ASD was estimated at one in every 10,000 births. Now, the Autism Society Canada puts the rate at one in every 286 births, with some areas of the country showing even higher rates.

B.C. doesn't keep a central registry of children diagnosed with autism disorders, but figures from other provinces, such as Saskatchewan, give insight into what is being called, by some, an epidemic. Saskatchewan Education figures show an 80 per cent increase in students with an ASD condition from 1998 to 2000-from one in 500 in 1999 to one in 333 in 2000.

Until recently, the increased frequency of diagnoses was dismissed by most mainstream health professionals as the result of better, and more widely applied, diagnostic criteria. This past October, however, researchers at the University of California's Children's Hospital finally gave credence to the view that something else was to blame. A $1-million U.S. study funded by the California government and the Medical Investigation of Neurodevelopmental Disorders Institute at the University of California concluded that the exploding numbers of children diagnosed with autism in the state could not be explained by population growth or broader medical accounting.

California, widely recognized as having the most accurate and longest-running ASD registry in North America, has seen its ASD figures increase by an average of nearly 400 every three months. From 1983 to 1995, the state's autism caseload ballooned more than 200 per cent, although the population only increased by 20 per cent.

Researchers have speculated that environmental factors have contributed to the phenomenon, but have stopped short of blaming vaccines. Upon the release of the California study, Margaret Whelan, executive director of the Geneva Centre for Autism in Toronto admitted: "We sense there has been a real increase, but like everyone else, we don't know why."

One theory traces the rise in autism spectrum disorders in California to the Silicon Valley, where Asperger's syndrome-a milder form of autism that affects social functioning-is more prevalent. Bill Gates, for example, is widely suspected as having Asperger's. Socially awkward but possessing analytical and organizational skills, computer programmers working in Silicon Valley may carry a few of the genes which contribute to autism. When they have children with other programmers, there's an increased chance of these children being autistic, so the theory goes.

But the University of California study has also fuelled renewed discussion about the possibility of the autism-vaccine link. Edda West, president of the Vaccine Risk Awareness Network in Canada, says the California study merely bolstered her feeling that vaccines are to blame for the explosion in autism cases.

"How is it possible that [the medical establishment] can ignore it?" she asks. "They keep talking about environmental factors. What is this mysterious environmental factor? I hear the same stories over and over again. A few months after an MMR shot, a child begins to regress and to lose milestones. That's kind of the repeated broken record that keeps being told over and over and over. I see the MMR as the straw that breaks the child's health."

Concern over the MMR vaccine was first raised in 1998, when The Lancet published a study by Dr. Andrew Wakefield, then a gastroenterologist at the Royal Free Hospital in London, England. In his now notorious study, Wakefield reported finding the measles virus in the intestines of autistic children who had never had the disease. He theorized that the MMR vaccine was causing "autistic enterocolitis," a form of autism that he said resulted from an MMR-induced intestinal infection.

Wakefield later went on to publish another report in the British journal Adverse Drug Reactions in 2000, in which he claimed to have identified nearly 170 cases of autistic enterocolitis. Wakefield's research caused such an uproar, he was eventually forced to leave his post at the hospital in December of 2002 and now works as director of research at the International Child Development Resource Centre in Florida.

Since Wakefield's report, the causal link between the MMR vaccine and autism has been hotly debated, with the medical establishment on one side, angry parents on the other-and a handful of scientists in the middle producing studies to support either side. A 2001 report from the Institute of Medicine, a branch of the Academy of Science, that stated the MMR vaccine had not been proven to be linked to autism has done little to dissuade critics.

Scientists such as Dr. Walter Spitzer at McGill University, Dr. Vijendra Singh of the Utah State University in Logan and Dr. Bernard Rimland of the Autism Research Institute in San Diego have all continued to question the safety of the MMR vaccine. The most recent study comes from Dr. Singh, who, in August 2002, reported in the Journal of Medical Science that his team of researchers had found a strong association between the MMR vaccine and an auto-immune reaction thought to cause autism.

Dr. Singh and his colleagues analyzed blood samples from 125 autistic children and 92 children who did not have the developmental disorder. They found that the children with autism who had received the MMR vaccine had higher levels of measles antibodies than those without the disorder. More than 90 per cent of the samples from these autistic children were also positive for antibodies that Singh postulates are responsible for attacking the basic building blocks of myelin, the insulating sheath that covers nerve fibres. Given that the brain is made up of nerves, it's possible that demyelination could cause brain damage consistent with autism.

In addition to the MMR, other vaccines have come under suspicion in recent years, with the mercury-derived vaccine preservative thimerosal also standing accused of triggering autism. The Pfeiffer Institute in Illinois completed a study last year suggesting that autism may be caused by a malfunction of a protein that regulates metal metabolism and the growth of brain neurons, and protects against toxic exposures to heavy metals. "MT [metallothionein] is a family of proteins essential for many important processes in the body, and a dysfunction in this system can explain most of the classic symptoms observed in autism," said Dr. William Walsh, who led the study. "An MT disorder may affect the development of brain neurons and may cause impairments in the immune system and gastrointestinal tract, along with hypersensitivity to toxic metals."

The findings may lead to an early infant screening test for autism predisposition, and an advanced treatment to correct the metal-metabolism disorder.

Thimerosal, which contains ethyl mercury, has been used as an additive to vaccines since the 1930s because it's effective in preventing bacterial and fungal contamination, particularly in multidose containers.

In Canada, thimerosal has recently been removed from most childhood vaccines; a hepatitis-B vaccine without the preservative became available last year, and the DPT had it until the mid-1990s. However, it's still found in a vaccine for high-risk infants born to hep-B-infected mothers, and in the flu shot. It's also used in some meningitis vaccines, and in a number of special formulations for pertussis only.

It was never used in the MMR shot, but current thinking about the vaccine-autism-link is that the DPT first impairs the immune system with mercury poisoning, allowing the MMR shot to prompt an auto-immune response in the child's body. This, believes Cynthia Stark, is what happened to Kieran.

"Basically, I haven't met a single person with autism who can't trace it to the shots," she says. "Our stories are all the same: 'My kid had the DPT and he started getting sick. He had the MMR and we thought he went deaf. We gave him antibiotics for an ear infection or something like that, and suddenly he's going spinning and twirling and laughing for no reason.'You'd have to be an idiot not to see the connection."

Dr. Jonn Matsen, a North Vancouver-based nutritionist and author of the recently-published Eating Alive II, devotes an entire chapter in his book to thimerosal and mercury, which he feels are partly to blame for autism, among other health problems such as chronic fatigue and Sudden Infant Death Syndrome.

"We don't tell our patients not to vaccinate," says Dr. Matsen. "What we do say is draw the line that there's no more mercury going in your body. Make sure that any vaccine no longer has thimerosal in it... It's very easy to inject mercury into the body, and it's very slow to get out." The symptoms of mercury poisoning and autism are strikingly similar-they include social withdrawal, loss of speech, self-harming behaviour, colitis and low IQ.

Dr. Matsen has worked with many autistic children, administering chelation therapy, a controversial form of therapy said to remove heavy metals from the body through the ingestion of sulphur compounds. Both Kieran Stark and Keith Gallicano have undergone chelation, in addition to sticking to a strict dietary regimen that cuts out wheat and dairy products. Both families say these interventions have resulted in some clear improvements for their children. "When we took Giselle off gluten [wheat protein] and casein [milk protein], we noticed that her eye contact was much better," says Keith Gallicano. "Her whole awareness and cognitive ability was improved.

This diet is based on the premise, proposed by Dr. Paul Shattock of the University of Sunderland's Autism Research Unit, that many autistic children have a "leaky gut," which allows certain incompletely digested peptides from the breakdown of wheat and milk proteins to leak into the bloodstream and affect brain function.

This "opioid excess" theory contends that the peptides leaked into the bloodstream possess an opiate-like effect akin to heroin, resulting in abnormal opioid compounds measured in the urine of autistic children by Dr. Shattock.

The Gallicanos are now planning a move to California where they hope Giselle will benefit from greater acceptance of alternative autism theories and research.

"[In Canada] most of the physicians either know very little about it or don't want to get into the field. I spent quite a time giving them literature, articles, and helping to explain what's going on," says Gallicano, who knows of three other families who have turned to American physicians out of frustration with lack of autism expertise in Canada. "Most of these families have had some problems with excessive levels of mercury, which they think have been caused through the preservatives in vaccinations."

Of course, there are plenty of skeptics who see parents like Stark and Gallicano as well-meaning but misguided, hunting desperately for a cure that does not exist. Dr. John Blatherwick, chief medical officer for the Vancouver Coastal Health Authority, has little time for questions of vaccine safety, saying no one's ever been able to definitively prove a link between autism and vaccines.

"People theorize and they say: 'Well, you know, the mercury compound is found in this,' but they've never been able to show statistically that this is making a difference... They test these kids for everything, but they don't find anything. There isn't a cause found for autism, so they grasp at straws."

Dr. Blatherwick insists that vaccines, used in the "multiple millions every year," are safe and effective in preventing devastating diseases like smallpox, polio and tetanus. "In every study that ever looks at what is the most you can do in health care-all of the things like bypass surgery, operations, drugs, antibiotics-the number one thing that has the biggest bang for the buck is immunization. The truth is that the majority of B.C. families believe in immunization, get their children protected, and these kids do very, very well."

He adds the sooner the MMR vaccine is administered, the better, since the stronger immune system of an adult is more prone to an auto-immune reaction, with higher incidents of joint inflammation and numbness in adults following MMR vaccinations.

"It is much better to get it in childhood, and if you decide that your child's not going to get a vaccine like that, you've already decided that your child cannot probably have a career in health care, because it will be required, and then they would have to get it at a time when it's dangerous."

What parents like Cynthia Stark or Keith Gallicano will tell you is that they never realized they had a choice over whether to vaccinate or not, or that they had the option of seeking single vaccines for their children.

"I'm not completely anti-vaccine, but if I had known what I know now, I would have been very cautious in having vaccinations administered to Giselle," says Gallicano. "If I had the choice, I would want single vaccinations all the way through, rather than giving triple, or even quadruple vaccinations."

Stark adds: "I was told there would be an epidemic if I didn't give my kid his shots. I would tell parents to put as much research into immunizing your child as you would into buying a house."

Asked to imagine what her Kieran would be like had he not been given the MMR, she allows herself to dream.

"I think he would be able to walk up to a friend and ask them to play, and have them play with him. Instead, he just stands there and doesn't know what they're saying and walks away. They want to play and he wants to interact, and it's like they're a different culture with a different language. That's the saddest thing that ever happens."

Useful links

łAutism Society Canada: www.autismsocietycanada.ca

łNational Vaccine Risk Awareness Network: www.vran.org

łAutism Society of BC: www.autismbc.ca

łHealth Canada: www.hc-sc.gc.ca

łAutism Research Institute in San Diego offers a list of practitioners who follow the DAN (Defeat Autism Now) protocols, a set of treatment protocols collated by researchers and scientists: www.autism.com/ari

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