They really worked
hard on this one.
The makers of Channel
4’s MMR: What The Never Told You
in the Dispatches strand should
perhaps have thought twice before
engaging journalist Brian Deer to
present a hatchet job on Dr Andrew
Wakefield.
Presumably, they
would have done better engaging
Ms Heather Mills of Private Eye,
to give Dr Wakefield a long,
slow... well, we'll leave it
there.
According to Deer, Dr
Wakefield, the gastroenterologist at
the centre of the MMR controversy,
was little more than a snake oil
salesman who led a Royal Free medical
school conspiracy to discredit the
MMR triple vaccine and make money
from a vaccine it was developing
itself.
Strictly speaking, Mr
Wakefield is a gut surgeon.
Deer also claimed that
when Wakefield voiced his concerns
about the triple jab, he had already
tested for and failed to find measles
in the autistic and gut-diseased
children he was treating...
If
“gut-disease” includes
constipation, which has been
reported with unusual frequency
in autistic children since before
MMR was ever introduced, and we
are talking about molecular
tests, as the programme made
clear, this sentence is correct.
... and moreover that
those children were abused in the
name of his flawed research.
Brian Deer reported
the opinion of a Royal Free
consultant, who Deer had
interviewed on the telephone.
This was made clear in the
programme.
There were plenty of
other allegations thrown into the mix
but those are the main ones and
certainly the ones over which
m’learned friends are currently
rubbing their hands.
It's unlikely that
m’learned friends are
rubbing their hands. In fact, in
October 2005, they spent some
£120,000 of the Medical
Protection Society's money unsuccesfully trying to stall Dr
Wakefield's threats to sue
Channel 4, after the broadcaster
told him to "put up or shut
up" over such threats. They
ended up paying something like a
million quid, after abandoning a "gagging
writ" libel suit, and paying
Deer compensation.
What Deer failed to
point out is that until Wakefield
voiced concerns over MMR, he was a
high flyer at the forefront of
advances in understanding and
treating inflammatory bowel diseases.
Wakefield attracted
praise with a 1989 paper
describing the vascular processes
in Crohn’s disease. But even
by the mid-1990s he was damaged
by controversy surrounding his
eccentric claim that inflammatory
bowel disease was caused by
measles virus - even then an
opinion that commanded little
respect among his peers. It would
be fairer to describe Dr
Wakefield as a middle-ranking
academic gut surgeon doing
laboratory work in the Royal
Free's medical school.
Yet Deer made no mention
of Wakefield’s previous career
or credentials; no mention of the
science which preceded the
controversial 1998 paper which Deer
claims started the MMR scare...
The Private Eye text
really needs to be read aloud to
get a sense of the gushing,
barely-contained hysteria that
lies behind the printed words. As
it happens, Dr Wakefield’s
claims to have identified measles
virus in Crohn’s disease -
using microscopic antibody
staining techniques - was called
into question when other
researchers found that the
antibodies he had used in
apparently controlled tests
didn't appear to be specific for measles virus, but binded
to a human protein [that was
presumably present in both
Crohn's and control group
subjects]. So, folk wondered, how
did Dr Wakefield get his results?
Answers on a postcard.
... no mention of the
research since (including that which
has found measles virus in the guts,
spinal fluid and in one case the
brain of an autistic child).
Such claims are for
the most part presented in a
house journal not found on the
international database Pubmed
(and therefore not generally
recognised as even part of the
medical literature), or verbally,
without controls, and generally
without accompanying sequences
which can be verified by other
scientists. These claims fall
below the threshold of
reliability to be accepted as
fact.
Dr Wakefield and his
supporters have been reduced to
publishing such claims in the
Journal of American Physicians
and Surgeons, house magazine of a
right-wing American fringe group,
the Arizona-based Association of
American Physicians and Surgeons,
which campaigns against US
vaccination policies. The
association is also vocal in
opposing moves to combat fraud by
private doctors, and medical
professional efforts to reduce
deaths from domestic firearms. In
2005, Time Magazine reported that
the association had only 4,000
members. Although cited by
Private Eye in stories attacking
MMR, the association's journal -
recently renamed from the Medical
Sentinel, presumably for the
purpose of attempting to give its
ideologically slanted material
the aura of science - is barely
credible as an independent forum
for such material. No objective
medical scientist with important
information of any standard would
submit it to such a publication,
unless they couldn't get it
published anywhere else.
Nor was there any
acknowledgment that the controversial
paper in question - only partially
retracted last year - did indeed
identify a new disease process in
these children’s guts.
The retraction
concerned a previously-claimed
possible link between autism and
MMR - in short, what this whole
thing is about. Retractions of
this kind are extremely unusual,
and it attracted considerable
public and professional interest.
A high incidence of
gut problems in autistic children
has been reported since before
MMR. The "lymphoid nodular
hyperplasia", referred to in
the paper, sounds impressive to
the uniformed, but is actually
nothing more than swollen glands
near the join between the small
and large intestine - long
recognised by Wakefield's own
collaborators as a frequent
finding in young children,
without developmental disorders.
This hyperplasia makes great pictures, but multiple
standard reference sources describe it as a
"benign", or even a
"normal", finding. Many
parents of autistic children -
and it appears Private Eye
journalists - were evidently
misled into thinking that this
was a newly discovered condition,
distinctive to autism.
The paper also talks
of nonspecific colitis
(inflammation of the colon). But
despite viewing multiple
presentations by Dr Wakefield
over a period of some years,
Brian Deer has yet to see him
illustrate his talks with
pictures of this colitis in
autistic children. Despite the
inclusion of colour slides in the
Lancet paper, none is of colitis.
Where video is available, colitis
is not seen. In a Panorama
investigation, for instance, the
child in question's colon was
found to be normal, as
it was in a Royal Free hospital
video news release,
issued in 1998 as part of the
attack on MMR. Considerable
evidence suggests that the
claimed "new disease
process" mentioned by
Heather Mills, doesn't, in fact,
exist.
Deer’s personalised
documentary follows his allegations
earlier this year in The Sunday Times
that when Dr Wakefield’s paper
was published, he had not yet
declared that he had become an expert
adviser to the children in the UK
litigation against the vaccine
manufacturers.
This falsely
represents both Brian Deer’s
investigation and the conflict of
interest, which impelled 10 of
the 13 authors of the Lancet
paper to vote to retract the finding of a possible link
between MMR and autism.
Deer’s revelation was that
when Dr Wakefield started the
research on the children, he did
so in execution of a contract
from a solicitor, who was
authorised by the Legal Aid Board
to pay him £55,000 to carry out
“clinical and
scientific” tests on 10
claimant children, in a bid to
prove that the vaccine was
dangerous. In the event, two
cheques for £25,000 are confirmed as having been paid
by Richard Barr's firm Dawbarns.
The details of this deal weren't
even disclosed to the closest
medical colleagues of Dr
Wakefield, who, six years later,
greeted the revelations in The
Sunday Times with astonishment
and dismay. You can even hear
such a reaction in MP3 audio at this website.
That Dr Wakefield
was also an expert witness,
advising solicitors and
barristers - and drawing £150 an
hour, plus expenses, from the
litigation - is a separate issue,
and should be unravelled in due
course. The key question here
was: where did Dr Wakefield get
the 12 autistic children for the Lancet
paper? He was specifically asked
this at a special meeting called
by the Medical Research
Council in March 1998. In
reply, Dr Wakefield dissembled.
Later, he was asked squarely,
with reference to research
including the Lancet 12:
"Who funded your
study?" Again, he didn't say.
But now we know
where he got them. We even know their names, their legal aid
numbers, and when they were
admitted to the Royal Free.
Although the issue of a
conflict of interest was actually
raised in the Lancet six years ago,
its resurfacing in the Sunday Times
has led to Dr Wakefield and two
others from the Royal Free’s
research team now defending the
charges in an unprecedented hearing
before the general medical council.
This wording is sly.
Nothing "resurfaced". A
letter from a doctor, published in The
Lancet after the paper
of February 1998, and shown by
Brian Deer to one senior author
of the paper before The Sunday
Times revelations were published,
challenged Dr Wakefield on a
speculated conflict of interest.
Dr Wakefield’s answer was to
explictly deny any such conflict,
and was sufficiently
cleverly-phrased to leave the
medical profession, including
both of the two fellow
researchers who are facing a GMC hearing, in the dark about
his legal contract. Both of those
colleagues - interviewed by Brian
Deer and later by the editor of
the Lancet - denied all knowledge
of Dr Wakefield's legal contract.
The editor of The Lancet also
denied knowledge of it, saying
that, had he known of it, he
would never have published Dr Wakefield’s
paper in the first place.
The retraction of
the paper in 2004 is
widely-regarded as a significant
victory for investigative
journalism. Sucks, boo, yaa, Ms
Mills.
Deer’s most recent
demonisation of Wakefield and his
theory was based on the fact that
nine months before publication of the
1998 paper, Wakefield and the Royal
Free sought to patent a treatment,
called Transfer Factor, with a
spin-off vaccine and that this had
been kept secret until now. The team
at the Royal Free were indeed at one
stage intending to carry out a
treatment trial of a method of
boosting immune response to measles
virus using cell lymphokines, part of
the body’s defence mechanism.
And it was derived
from passing measles virus
through mice, extracting their
white cells, passing alleged
transfer factors “three
times” through pregnant
goats, before drawing the goats'
colostrum, in a methodology that caused every
expert Brian Deer spoke to on the
subject to laugh.
The technology which
attracted the interest of the
1000-bed Royal Free's medical
school was largely the brainchild
of Professor Hugh Fudenberg of
Spartanburg, South Carolina -
Wakefield's named co-inventor on
the patent documents. In a
videotaped interview in 2004,
Professor Fudenberg claims to
cure autism with his own bone
marrow, rolled out, he says, on
his kitchen table "like
pasta" into a sheet,
“three molecules deep”,
which he says he keeps in his
refrigerator. Professor Fudenberg
is referenced in The Lancet paper
of 1998, and in ethics committee
applications, where he is named
as an investigator on Dr
Wakefield's project - which
produced the frank claim by Dr
Wakefield, in the very first
sentence of an undisclosed patent
document, to have invented a vaccine.
Professor Fudenberg,
who was banned indefinitely from prescribing
medicines in 1995, was
interviewed in Deer's Dispatches
documentary, saying that Dr
Wakefield offered him £60,000 a
year for them to go into business
together.
Pity they didn't,
really.
In the event this was
never pursued by the Royal Free:
there was no trial, no treatment and
no vaccine.
Right. They flopped.
For all Dr Wakefield's commercial
ambitions, and all the trouble he
caused, the stuff was crap.
Nevertheless, it was pursued to
the point of expensive patent
applications, and an ethics committee
submission [also filed before
the famous press conference of
February 1998]. Money was
allocated to the project by the
group Allergy-Induced Autism, and
a contractor in Colorado was
recruited by another Wakefield
organisation, Visceral, to make
capsules for autistic children.
In a recent statement, Dr
Wakefield says that the plan
lapsed when he left the Royal
Free in December 2001 - which was
3.5 years after the first patent
application in the vaccine/autism
series was filed.
Dr Wakefield also
started a company,
Immunospecifics Ltd (intended to
be launched as Carmel Healthcare)
in which one of his fellow
shareholders was Professor John
O'Leary - to exploit his patented
theories through the sale of
diagnostic kits to parents.
Another was Professor Roy
Pounder.
A patent was, however,
granted in 1999. But contrary to
Deer’s suggestion, Wakefield did
declare it. The Eye has seen a letter
he wrote to the Lancet in 1999
informing the editor of the patent.
The Lancet decided not to mention it.
This stuff is so
disingenuous it blows your mind.
Brian Deer has long had a copy of
the same letter, although he
hasn't verified that it was
actually sent to, or received
by,The Lancet. It says: “Dr
Wakefield is named inventor on a
UK patent for measles virus
diagnostics”. It doesn't
mention a vaccine, or a
treatment, or even “a
complete cure” for
inflammatory bowel disease and
autism - the claims in the
applications filed in 1997 and
1998.
Indeed - to the
further embarrassment of Dr
Wakefield, Ms Mills and Private
Eye - it might equally refer in
its vagueness to an earlier
series of undeclared Wakefield
patent applications, first lodged
in March 1995 - the
month before Dr
Wakefield and the Royal Free
hospital medical school called an
earlier televised press
conference, concerned with a previous
poor-quality paper in the Lancet:
claiming a possible link between
measles-containing vaccines and Crohn’s
disease.
Two series
of Wakefield patent
applications... two
papers soon after in the
Lancet... two
heavily-promoted press
conferences that inflamed public
opinion. Spot a pattern yet?
In any event, the
earlier undeclared patent series
- with a priority date of March
28 1995 - is called, would you
believe, “Diagnosing
Crohn’s disease or
ulcerative colitis by detection
of measles virus.”
Ooops.
The patent is also
mentioned on at least three
subsequent research papers.
Ho ho. Ms Mills, you
should quit. These papers were
published after Brian
Deer’s Sunday Times
investigation. Kawashima et al
(2000); Wakefield, Anthony et al
(2000); Furlano et al (2001);
Torrente et al (2002); Uhlmann et
al (2002); Ashwood et al (2003) -
in fact all of Dr Wakefield's
research papers from this period
- contain no mention of any
patents (or indeed his
contractual and financial
relationships with lawyers). Nor
do any of Dr Wakefield’s
discussion papers during these
years, such as the notorious
"Through a glass
darkly," (2000), which
further stoked public opinion
against MMR. The first paper to
mention any patent appears to be
Bradstreet et al, in the
right-wing fringe publication,
published in the summer of
2004 - after Deer had first
challenged Dr Wakefield over his
commercial ambitions, and after
production had commenced on
Deer's television documentary,
MMR: What They Didn't Tell You.
Dr Wakefield's belated
disclosures in his papers are
welcome admissions that such
acknowledgements should properly
be made, but again, the
description was vague enough to
attract no attention.
Why Private Eye
makes this claim is somewhat
disturbing as to motivation,
competence in this field, or
both.
Wakefield voiced general
concerns about the combined measles
vaccines as early as 1992, many years
before the Royal Free patent
application was filed in 1997.
As previously noted,
Dr Wakefield speculated, and
lodged patents on his claim, that
measles virus was the cause of
inflammatory bowel disease - a
claim quickly rejected by
specialists in this field. These
days, it's regarded as a joke. An
international conference in
Oxford in the Summer of 2004, on
the spookily appropriate topic of
"the pathogenesis of
inflammatory bowel disease",
didn’t even include measles
virus as a topic of discussion.
Nor was it raised by anybody.
When the proposition was mooted
by Channel 4's programme-makers,
participants at the conference
laughed. The chief organiser said
he only knew of one person who
claimed that measles virus caused
IBD: "Dr Wakefield".
Perhaps the most
disingenuous part of Deer’s
programme was that viewers may have
been left with the impression that
not only was there no reason to
believe measles virus present in the
Royal Free children’s gut at the
time the paper was published...
Here indeed is the
heart of the matter. Let's recap.
As Dr Wakefield sat at the press
conference of February 1998, and
took part in a video news release, launching panic
over MMR and calling for its
"suspension" in favour
of single shots, he knew, but
didn’t say:
(a)
That his research project on
autistic children had begun
with a commission from
lawyers attempting to
sue MMR manufacturers, and
who believed MMR's suspension
would help them sue - a fact he
didn't disclose to his
closest medical colleagues.
(b)
That he'd laid claim, in a
patent application, to extraordinary
products, which could
only have succeeded if
MMR’s reputation was
damaged. These included, in
the first sentence
of the patent document, his
own single vaccine: against
measles. Nice one Andy.
(c)
That his own laboratory had
tested the autistic children
for measles virus - the
presence of which he alleged
to be the ultimate culprit
for their disorders - and found no trace of the virus,
using methods [RT-PCR and
NASBA] that he'd personally
validated.
... but that is still
the case today.
On this point, the
documentary actually made no
reference to today.
This is untrue on both
counts - unless one of the
world’s leading pathologists,
Professor John O’Leary, chair of
pathology at Trinity College, Dublin,
is seriously in error.
It’s far from
clear that Professor John
O’Leary, at his lab in the
Coombe women’s hospital,
would make such a lofty claim for
his status. Brian Deer's
consultations with noted US
authorities in the field of Aids,
in which O'Leary is said to be an
important figure, produced
statements that they had never
heard of him. In any event,
Professor O’Leary hadn't carried out the
tests referred to on
these samples at the time the
Lancet paper was published. His
work, published in 2002, has
subsequently been the subject of
controversy in High Court
proceedings, where very
serious error is indeed
alleged. Surprisingly, Professor
O'Leary reported finding measles
virus in between 96% and 97% of
Wakefield samples, apparently
taken from consecutive autistic
children with bowel symptoms,
recruited through solicitors,
parent campaign groups and media
coverage. Through solicitors,
Professor O'Leary denies
misconduct.
But he wasn't even
relevant to the position 4.5
years previously.
Before publication of
the 1998 paper, researchers had
already found measles virus protein
in the gut tissue, although not the
virus itself. Further, at the site of
the inflammation in the gut there
were clusters of cells that are
typically seen in chronic virus
infection.
This must surely
have been dictated to Ms Mills by
Dr Wakefield. The microscopic
methods employed - similar to
those used in his Crohn’s
work - were so rough-and-ready
that experts in this field say
that, were these methods to
detect evidence of measles virus
[as Dr Wakefield apparently
claims in a paper still not
published eight years later], it
would be next to impossible for
the virus to fail to be
identified by molecular RT-PCR
methods. How Dr Wakefield claims
to have seen evidence of
something under the microscope
that evaded established and
carefully verified molecular
detection methods is another of
the mysteries awaiting solution.
The Royal Free
medical school was so impressed
with Dr Wakefield's work in this
area that it issued a press release. Check it out Ms
Mills.
Other scientists,
meanwhile, have separately and
independently stated to Brian
Deer that they looked at slides
presented by Dr Wakefield as
purported evidence of the
presence of measles virus in
Crohn's tissues, and have
declared that they couldn't see
what Dr Wakefield says he saw.
Dr Wakefield's
methods involved looking at
slides for evidence of a brown
stain. Brian Deer can suggest
where to look for one now.
On the programme, both
of Wakefield’s former
collaborators told Brian Deer that if
the measles virus was there they
would have found it.
Correctamundo. A big
moment in the programme. And, as
molecular biologists who worked
on Dr Wakefield's project, they
would be in better position to
know than a Private Eye hack.
But at the time they
shared Wakefield’s concerns that
the methods and equipment (now
obsolete)...
The methods are not
obsolete, and have been found by
widely-published authorities in
this field of science to be as sensitive as
Professor O'Leary's. The technique,
reported by Wakefield and
colleagues, was found to be
capable of detecting "as few
as ten functional measles
virions". The idea that
these methods - more
sophisticated than those which
discovered HIV - would accomplish
this (and also find virus in
control tissues), but repeatedly
and consistently miss a
persistent viral infection -
allegedly capable of causing an
inflammatory bowel disease
capable of eating through the gut
wall to release peptides into the
bloodstream that are supposed to
go on to cause autism - is
somewhat off-the-wall. Even by Dr
Wakefield's standards.
... used to detect the
virus DNA was not sensitive enough.
They put their names to the negative
finding research paper which
Wakefield himself insisted was
published even though it went against
his own hypothesis.
The paper in
question (on inflammatory bowel
disease in adults, not
autism in children) merely noted
that either the virus was absent,
or it was present in quantities
below detection. That is not a
statement that the method
"was not sensitive
enough". Given the number of
collaborators on the project, Dr
Wakefield could hardly have done
otherwise than agree to
publication of that paper. It was
also the topic of a PhD thesis
being written in his lab.
It concluded:
“These results show that either
the measles virus DNA was not present
in the samples or was present below
the sensitivity limits known to have
been achieved.”
The co-authors were
baffled by how it could be that
Dr Wakefield, a surgeon, claimed
that measles virus could be
identified by microscopic
methods, but they, specialists in
these technologies, couldn't find
it by RT-PCR molecular methods.
Their conclusion in the
inflammatory bowel disease paper
- drawn up under the supervision
of the corresponding author - Dr
Wakefield - was a correct
statement of the facts.
The position was
made clear in the programme: that
both of Dr Wakefield’s
collaborators interviewed - one
of them a full professor
specialising in these techniques,
and the other Dr Wakefield's
research assistant - believed
that the virus wasn't present in
the autistic children whose cases
were included in the 1998 Lancet
paper.
The tests on the
children - carried out by
Nicholas Chadwick, under the
direction of Professor Ian Bruce,
and personally supervised by Dr
Wakefield - were specified, with
the investigators named, in the founding protocol
and study description of the Lancet work.
Brian Deer believes that Dr
Wakefield was not fairly entitled
to unilaterally and
retrospectively decide that the
results were "false negatives", when they didn't
suit his theory.
And so it proved to be.
As with Dr
Wakefield’s clinical
interest in the children - which
began in 1996 with a protocol document specifically naming
a “new paediatric
syndrome” before research
was carried out that might have
discovered any such syndrome - so
it was with the molecular
virology. Dr Wakefield appeared
to intuit results of laboratory
tests in advance of the tests
actually being performed.
Scientists often regard such
foresight as worrying.
In a statement, issued after the
Dispatches documentary, Dr
Wakefield seems to imply that he
didn't announce the negative
results from his lab, reported to
him in 1997, because they would
be contradicted years later
by Professor John O’Leary.
At the time, he hadn't even met,
and quite possibly had never
heard of, O'Leary.
Incidentally, there
is no mention at all here of Dr Kawashima, a key player at
the time, whose results appear to
be included in patent documents
and submitted to hospital
authorities in a pregnant goat
protocol, as substitutes for
the Chadwick-Bruce work. This is
all very mysterious indeed.
Shortly afterwards the
samples were sent to Prof
O’Leary.
If about a year
later is “shortly
afterwards”.
As indicated,
Professor O'Leary became a
business colleague of Dr
Wakefield's: in the company
Immunospecifics. They met through
the intervention of one of the
litigant parents involved in the
Lancet series, who was also a
member of the group
Allergy-Induced Autism, run by
Mrs Rosemary Kessick, one of Dr
Wakefield's closest
collaborators, and parent of a
child enrolled in his
lawyer-commissioned research.
Using state-of-the-art
viral detection methods and
equipment, he found measles virus in
the guts of children with autism.
Professor John
O’Leary’s techniques
have been compared with others,
and not found to be more
sensitive. The benefits of his
approach are largely to do with
quantification and convenience.
Professor O’Leary has faced
multiple claims that his
laboratory - built and operated
with £800,000 from the MMR
litigation, for which records
show he tested samples from
approximately 60 autistic
children, and another £250,000
[yup, a cool quarter million
sterling] from Dr Wakefield's
organisation Visceral - is a
victim of contamination, very
common with PCR work - an
allegation he denies. Professor
O’Leary declined to take
part in an inter-laboratory
quality control survey, which
might have resolved the matter.
The world's leading authority on
measles virus says he was
approached with a view to
collaborating with Wakefield and
O'Leary, but withdrew after
identical coded samples were
returned to him from O'Leary's
lab with, first, positive, then
negative, results.
Oddly, Professor
O'Leary reports finding measles
virus in substantial quantities
[up to 300,000 copies] -
quantities which would certainly
be expected to have been found by
the technique approved by Dr
Wakefield at the Royal Free
hospital. This compounds the
mysteries over why they weren't.
Did the virus get into the
tissues afterwards? Or did
something else happen? Government
labs have tried to obtain Royal
Free samples to test, but
requests have apparently been
rejected.
Professor
O’Leary’s paper was
published 4.5 years after the
Lancet paper. Professor
O’Leary has still failed to
publish the sequences of the
viruses which he says he has
found. Experts say that
sequencing viruses is standard
laboratory practice, and to fail
to supply them on request to
other investigators is highly
unusual, and raise questions
about the basis for publication.
A mystery also surrounds the
extraordinary cost of Professor
O’Leary's tests [which many
scientists would send off to a
contracting lab like the rest of
us send holiday pictures to the
chemist, and which he costed elsewhere at a fraction of
what he was apparently paid]. He
has denied any problems, was the
subject of a High Court order requiring access to
his raw data, and has removed his
name from a recent Wakefield
paper in the rightwing house
magazine.
If Ms Mills is
impressed by the
Wakefield-O'Leary collaboration,
she might ask Dr Wakefield for
the meales virus test results
from Professor O'Leary's lab on
three healthy control subject
children: Wakefield C, I and S.
Oh dear, oh dear,
indeed.
It has since been found
in the spinal fluid and brain.
Brian Deer knows of
no authoritative publication in
which this claim is
substantiated.
That work does not prove
a link with autism, but it should at
least raise alarms.
When such work
involves Dr Wakefield, the lack
of alarm is perhaps
understandable, given his past
record in manufacturing alarms
(twice in close proximity to
patent applications).
The response has always
been that the O’Leary tests have
not been replicated, but then other
methods have always been used.
This is wrong. John
O’Leary’s equipment, a
Taqman PCR machine, is a standard
item of laboratory equipment,
albeit frequently held out to
parents by Dr Wakefield's
supporters as being some kind of
wonder device. It's about the
size and general finish of a
desktop Xerox machine. Experts in
this field guess that there might
be thousands in the UK alone.
Other equipment has been shown to
be equally, or more, effective at
detecting measles virus.
Only now in the US are
researchers seeking to properly
replicate the work in what both sides
of the debate are looking to as a
definitive study. Prof Ian Lipkin of
Columbia University, NY, who is
leading the research, is
internationally renowned for his work
in immunology and viruses.
Waiting for his
results might at least keep
someone employed at Private Eye
for another year or so.
Meanwhile, British researchers
are writing-up a large study, expected to be
published in 2005, looking for
measles virus in autistic
children, complete with a large
control arm and the use of a
Taqman PCR machine. Rumour has it
that it has refuted the Wakefield
theory again. And bigtime.
Deer’s allegation
that Wakefield “abused” the
Royal Free children by subjecting
them to invasive procedures...
Brian Deer made no
such allegation.
... might have carried
more weight if it had come from
parents. But they consented to their
children’s treatments as part of
the ongoing clinical investigation.
Lumbar punctures -
reported to be used on 30 children in a search for measles
virus - aren't part of
the clinical investigation of
either autism or inflammatory
bowel disease. In a recorded
conversation, one mother of a
"Lancet 12" child told
the programme-makers she didn't
believe that her son was a victim
of MMR, or that he needed a
lumbar puncture, but was
persuaded on both counts while at
the Royal Free hospital. After
lumbar puncture at the Royal
Free, her son was admitted as an
emergency, by ambulance, from his
home to another hospital,
suffering from apparent adverse
effects. Headaches from lumbar
punctures can last up to a year,
and the investigators described
the procedure as "high risk". Consents
improperly obtained are invalid.
Parental desperation is no cover.
Those children were
being treated for appalling and
painful gut disease - many had
impacted bowels or persistent
diarrhoea.
Almost all had
severe, impacted, constipation,
often with overflow - a common
problem recognised in autism and
mental disability before MMR was
ever introduced. This can cause
pain, and unnatural posturing,
often due to solid blockage of
the colon. Constipation was reported as common in autistic
children, as in many children
with neurological disabilities,
before the first MMR product was
even licensed, in the US in 1971.
Doctors at the Royal
Free were diagnosing and treating,
and in many cases alleviating,
symptoms. They were not merely using
the children for research.
The programme said
that. For the most part, the
clinical team were relieving
constipation with encopresis.
This shouldn't have
required any invasive
procedures, which were carried
out for research purposes, as
defined by the Royal College of
Physicians. Constipation can
be diagnosed by plain x-ray.
Constipation with
encopresis is a staple of
paediatric gastroenterology. It's
often intractible to treat in
non-autistic children, often
requiring elaborate dietary and
behavioural interventions by
parents. It's a pity that
Wakefield's clinical colleagues -
led by an eminent paediatric
gastroenterologist - failed to
discuss this in the Lancet paper.
While they were at it, they might
have said that they had
previously published on lymphoid nodular
hyperplasia, reporting it to be
a common finding in children.
Deer focused exclusively
on Wakefield’s past...
Dr Wakefield's
present and future were unknown
to the programme-makers, except
for a brief moment when Brian
Deer met him at a conference in
Indianapolis - when Dr Wakefield
attacked the camera and fled.
... and did not consider
any of the other relevant science.
MMR: What They
Didn't Tell You wasn't a science
programme. However, "other
relevant science" has
contradicted every aspect of Dr
Wakefield's campaign.
For example, in the week
of the Channel 4 attack, a team from
the John Hopkins University School of
Medicine in Baltimore...
You mean Johns
Hopkins.
... looking at brain
tissue of autistic patients, found
chronic inflammation triggered by
abnormal immune response. Although it
was a small study of 11 autistic
people who had died, they also found
similarly high levels of inflammatory
cytokines (messengers that run
between cells) in the spinal fluid
from six autistic children. The
researchers found an immune reaction
similar to that found in dementia
associated with HIV virus.
Did they say
anything about MMR? Nope.
These sort of studies
suggest Dr Wakefield is not the lone
lunatic that Deer would have us
believe.
Lunatic? That must
be Fudenberg and the goats. Even
Ms Mills must think that
stuff’s crazy.
Despite allegations to
the contrary, Private Eye is not
anti-vaccine...
No. It only
published a newsstand supplement
by Heather Mills attacking MMR,
god knows how many stories, based
on the unsubstantiated views of
Wakefield, Barr, Limb, Fletcher,
Kessick et al, and two thirds of
a page attacking Brian Deer - as
it similarly attacked him in
February 2004 - for the sake of
balanced discussion.
I see.
... and has never said
Dr Wakefield hypothesis is right. We
have merely maintained that his work
deserves proper investigation and
that single jabs, used long before
MMR, should be made available as a
precautionary measure to keep up herd
immunity.
This appears to be a
transparent, and rather sad,
effort to lay down something to
quote in the future. It’s
telling that Heather Mills
appears to have neither the guts
to stick with her long-running
campaign against MMR, nor to
admit that she didn’t know
about the legal contract, the
patent applications for a vaccine
and treatments, the crazy guy in
Spartanburg, the measles virus
results...
That proper
investigation is finally taking place
in the US; but until Prof Lipkin and
others report, the jury is still out.
Does that mean you
keep your job awhile longer, or
what?
Interestingly, in Lancet
editor Richard Horton’s book on
the MMR controversy, he disclosed how
“one of the protagonists in the
affair had said openly and publicly
that his intention was to ‘rub
out’ Wakefield”. The
protagonist in question? Step forward
Brian Deer.
Brian Deer’s
conversations with Dr Horton were
recorded, and nowhere is the
reported expression, or anything
like it, used by Deer.
