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Kill The Messenger

Crohn's DiseaseIn ancient times, tyrants would sometimes kill messengers who brought them bad news. The story of Dr. Andrew Wakefield suggests that Big Pharma is continuing the practice – at least on a symbolic level.

Dr. Wakefield Finds A Link

A distinguished physician and researcher, Dr. Wakefield was trained at St. Mary’s Hospital in London. Subsequently he went to Toronto where he spent several years doing research. In the late 1980s, he returned to England to devote his time to research. Within a decade, he had risen to prominence as a senior lecturer at the Royal Free Medical School in London and was directing the inflammatory bowel disease group at the Royal Free Hospital.

One of Dr. Wakefield’s primary areas of research was investigating a possible link between measles and Crohn’s Disease, a debilitating inflammation of the large intestine. By the 1990s he had published several scholarly papers on the subject.

Although it was identified as early as the 18th Century, it was not formally named until 1932, when a group of researchers including Dr. Burrill Bernard Crohn published a study of fourteen patients with the condition.

Crohn’s most frequently strikes young people between the ages of 15 and 30, with as many as 20% of all people suffering from the disease being children or adolescents.

An important fact about Crohn’s is that like other autoimmune diseases, its incidence has been skyrocketing. Once so rare that it was frequently misdiagnosed as everything from Tropical Sprue to Ulcerative Colitis, Crohn’s now afflicts as many as 600,000 people in the U.S. alone, with 44,000 new cases diagnosed annually. Indeed, in 1973, a study reported that the incidence of Crohn’s Disease in the U.S. was 4.5 per 100,000. Today it is 8.8 per 100,000 – nearly double!

So you would think that any light Dr. Wakefield could shed on the causes of this growing epidemic would be welcome – but you would be wrong.

An Explosive Discovery

Unfortunately, Dr. Wakefield’s research revealed something Big Pharma didn’t want to hear – not only was there a possible link between the rising incidence of Crohn’s Disease and the introduction of the combined Measles, Mumps and Rubella vaccine, it looked like there was a link to autism as well!

Dr. Wakefield and his research team at the Royal Free Medical School had noticed that some children who suffered from regressive autism, also suffered from “a novel and characteristic inflammatory disease of their intestine.” In other words, Crohn’s.

The team also determined that the disease was “consistent with a viral cause,” and postulated that it might cause “toxic damage to the brain.”

But what was truly striking is that they discovered that the measles virus was present in the intestines of the majority of the children with regressive autism in their study. In contrast, the virus was present in only a small portion of the children in the study that were developmentally normal.

Then they dropped the real bombshell.

The strain of measles virus they found in the intestines of autistic children was the one used in the MMR vaccine!

They concluded that children with regressive autism appeared to have an abnormal immune response to the measles virus.

When the results of their study were published in the Journal, Lancet, they were shocked by the reaction.

A Firestorm Erupts

A firestorm of controversy erupted and the main target was Dr. Wakefield.

No less a figure than Sir Liam Donaldson, England’s chief medical officer charged that Dr. Wakefield was guilty of peddling “poor science.”

Continuing, he claimed that the Wakefield study, as it had come to be known, was flawed and had been criticized by “independent experts around the world.”

Of course, he didn’t bother to say just who those experts were.

The body that licenses doctors in England, the General Medical Council, announced that it was opening an investigation into the way Dr. Wakefield conducted his study.

Even the Prime Minister weighed in, urging parents to ignore the report and continue to have their children vaccinated declaring:

“There’s absolutely no evidence to support this link between MMR and autism.”

And in a direct slap at Dr. Wakefield and his colleagues:

“I hope now that people see that the situation is somewhat different to what they were led to believe, they will have the triple jab because it is important to do it.”

As if this weren’t enough, Dr. Richard Horton, the editor of Lancet, turned on Dr. Wakefield. He charged that the Journal should never have published the article because it was flawed due to “a fatal conflict of interest.”

Apparently, Dr. Wakefield was conducting another study at the same time for the British Legal Services Commission to determine if a group of parents who claimed that their children had been damaged by the MMR vaccine had a case. Some of the children in that study were also used in the one linking the measles virus to Crohn’s disease and autism.

The Lancet editor asserted:

“In my view, if we had known of the conflict of interest Dr. Wakefield had in this work I think that would have strongly affected the peer reviewers about the credibility of this work and in my judgment it would have been rejected.”

Of course, using data in more than one study is nothing new. Scientists do it all the time. The only real issue is whether the data is valid. But it gave Dr. Wakefield’s critics an opening, and they took full advantage of it.

The piling on continued.

Big Medicine’s Big Guns Weigh In

John Reid, the British Health Secretary called on the General Medical Council to investigate Dr. Wakefield “as a matter of urgency.”

Dr. Wakefield, however, refused to knuckle under pressure. He noted that since the controversy exploded, his data:

“…have now been confirmed independently by reputable physicians and pathologists.”

Initially, The Royal Free Medical School, his employer, backed Dr. Wakefield. It made sense that they would, the institution had just made him a Fellow of the Royal College of Pathologists in recognition of his research.

But just one month later, the pressure got to be too much.

Wakefield was forced to resign from the position he had held for fourteen years.

As he explained it:

“I have been asked to go because my research results are unpopular.”

To Dr. Wakefield it all came down to a matter of principal.

“This is where one’s career goes downhill. It’s one thing to describe a new disease. But this is a case where the medical profession was wrong and the parents were right. What was I supposed to say when the parents pointed to the MMR – ’ Look, I’m terribly sorry but that’s inconvenient so please go find another doctor?”

Even as the establishment was doing its best to destroy Dr. Wakefield, however, his support among the general public was growing, especially with people like Rosemary Keswick. It had been her son’s case that caused Dr. Wakefield to investigate the MMR-Crohn’s-Autism link.

An Outraged Parent

In 1996, Rosemary Keswick was at her wits end. Several years earlier her son William, until then a normal, healthy infant, was given the MMR vaccine – what the British refer to as the “triple jab.”

What followed was a nightmare.

“He was absolutely normal but after he had his MMR, within days he started to show some very strange reactions. He had swollen lymph glands, he had a strange look and color and he started head banging, which he never did before.”

Since his deterioration had begun right after the first vaccination, she was convinced that there had to be some connection, yet when she attempted to raise the issue with her pediatrician and other physicians her concerns were dismissed out of hand.

As she put it:

“Most of them were like, ’Oh, don’t worry your little head about the MMR.”

But Rosemary was not about to be ignored.

After William had been diagnosed with autism, she had immersed herself in the literature, learning as much about the disease as she could. The more she learned the more frustrated and angry she became. She was stunned to realize that the medical community didn’t even agree on the actual rate at which autism was increasing and didn’t have a clue as to the cause. Some doctors even argued that there wasn’t really an increase, but rather that cases which had been misdiagnosed, or had gone undiagnosed were now being counted, leaving an impression that rates were rising.

Then she met Dr. Andrew Wakefield.

A Fateful Meeting

She told him that she was convinced that the MMR at least contributed to William’s autism, but that no one would listen.

Dr. Wakefield did.

After reviewing the case data on William, he, too, was convinced that there was at least a possibility of a connection between the MMR, autism and Crohn’s. After testing William, he embarked on the study that was to generate a firestorm of controversy and make him a pariah among his medical colleagues.

Why, then, was there such a huge reaction to the Wakefield study, and more important, is he right?

Follow The Money

The answer to the first question is simple and far too common when dealing with contemporary medical issues: money!

The real reason the British medical establishment reacted so explosively to the Lancet study was the cost of providing an alternative to the MMR or “triple jab,” as they call it.

Keep in mind Dr. Wakefield was NOT arguing against vaccination per se. Rather, he was arguing against combining the three vaccinations in a triple shot – something many other researchers have questioned as well.

Their concern arises from the danger of overloading the developing immune systems of infants by subjecting them to three different infectious agents (and that is what you do when you vaccinate) at once.

The trouble is that whereas the “triple jab” is relatively inexpensive, giving three separate vaccinations would cost about $300 per patient – an expense the cash-strapped British National Health Program didn’t want!

In fact, Health Service officials were so adamant that they often reverted to heavy-handed tactics to force parents into accepting the “triple jab.” They have even gone so far as to remove the names of families refusing the MMR from the “patient lists” at local clinics, effectively canceling their health care!

The simple truth is that the British medical establishment is more concerned about budgets than about patient care – so much so that they embarked on a $30 million PR campaign to convince the public to accept the “triple jab,” and science be damned!

But what is the scientific evidence?

The Evidence

Big Medicine claims that there is no evidence of a connection between Crohn’s Disease, Autism and the MMR. The trouble is that all of their so-called evidence is based on broad, population-based studies – in particular a Danish study of 500,000 children born over an eight-year period that looked at adverse reactions from the MMR.

Epidemiological studies while helpful in tracking diseases are worthless in examining subpopulations – smaller groups within the whole that may have some special characteristics, such as developing autism – and that is a key consideration in looking at the MMR, and its potential link to various conditions.

The much-heralded Danish study made no provision for such analysis.

But when a group of researchers LOOKED AT THE SAME DATA, this time trying to determine the SPECIFIC affect of the MMR on autism rates, they came to a very different conclusion: children who had taken the MMR were more likely to develop autism!

Another problem with the inability of epidemiological studies to look at subpopulations is that they do not take into account genetic predisposition.

A basic assumption underlying the connection between the MMR and conditions like autism and Crohn’s Disease is that there is some genetic or environmental factor that makes some children more susceptible to an adverse reaction from the MMR than others. Indeed, if this were not the case, EVERY child that took the vaccine would exhibit symptoms and that clearly is not the case.

But that’s not the only problem with studies like the one conducted in Denmark.

The Trouble With Vaers

They rely on the FDA’s Vaccine Adverse Event Reporting System (VAERS) and similar systems in other countries for their data. But by the FDA’s OWN ADMISSION, only 1% to 10% of all adverse reactions are actually reported. Worse, they only include reports of reactions that occur within a few hours, or at most a couple of days after the vaccination.

But it can take weeks or even months for conditions such as autism or Crohn’s to be diagnosed, long after the VAERS reporting deadline, and therefore never make it into the database!

Still, the fact that there are serious deficiencies in the system for reporting vaccine reactions does not mean that Dr. Wakefield is right. In order for his argument to be credible, other research would have to support his findings, and his critics claim there is none.

The facts, however, appear to contradict this claim.

Findings Confirmed!

In 2001, at the height of the controversy, and just after Dr. Wakefield was fired, Dr. Timothy Buie, a researcher at Harvard/Mass General Hospital reported the findings of his independent research – and they should have been a bombshell!

Dr. Buie had conducted over 400 gastrointestinal endoscopies with biopsies on children. The procedure involves inserting a flexible tube into the intestine that is equipped with a small camera. The physician is able to examine the organ via the camera and can also insert a medical instrument through the tube to take a tissue sample.

Dr. Buie’s analysis of the tissue samples taken from autistic children found a significant number of cases with the exact inflammation of the intestinal tract Dr. Wakefield had found. Other research conducted at the University of Maryland by Dr. Karoly Horvath obtained similar results.

Nor are these the only studies that support Dr. Wakefield’s conclusions.

Testifying before the U.S. Congress in 2002, Dr. Wakefield cited no less than eleven other scientific papers that agree with his thesis.

Despite this clear evidence, Big Pharma and Big Medicine remain intransigent.

They would rather keep their heads in the sand and put our children at risk than admit that they had made a mistake! But if Andrew Wakefield has his way, they may have no choice but to do so.

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