I, like many of you, run the risk of misunderstanding the significance of this event due to my lack of knowledge about several of its key components. So I am going to try to summarize, with every effort to avoid bias or opinion, my understanding of the case of this 9-year old girl and what the Vaccine Injury Compensation Program (Vaccine Court) has found.
If you would like to gain a much better understanding of how the Vaccine Court works, take the time to read this excellent summary.
The case is about 9-year old Hannah Poling who, according to her parents and their attorneys, developed autism at around 18 months of age (in July 2000) after she received routine childhood vaccinations.
At the time she was vaccinated, she was experiencing a high fever. Additionally, she had been ill (with ear infections and fever) on and off for almost a full year leading into that doctor's visit, and several times vaccinations had been delayed as a result.
Soon after (within 48-96 hours) receiving her vaccinations, her health began to deterioriate. Not only was she ailing physically, but she also began to present "features of autism". It was later determined that she suffers from mitochondrial dysfunction.
The government, or more specifically HHS (Department of Health and human Services) has agreed to compensate Hannah Poling for injuries she received from vaccines. They are stating that the vaccines she received significantly aggravated a rare, underlying mitochondrial disorder and that this resulted in regressive encephalopathy including "features of autism" (FYI - I keep putting quotes around that phrase since most reports are also doing so. Apparently Hannah was not presented in court as being autistic, but instead was presented as exhibiting features of autism. More on that later...)
Here is a link to the Huffington Post page on which the Concession Document has been posted, in case you would like to read it for yourself.
Mitochondria are organelles that exist in most of the cells in our bodies. They serve several functions, the most important being the creation of ATP - a chemical source of cell energy. Oxidative stress can interfere with the proper functioning of mitochondria's role in this process, and also explains in part why mitochondrial functioning diminishes with age.
Mitochondrial Dysfunction can result from Mitochondrial Disease (which is genetic, passed almost exclusively through the maternal DNA, and is associated with Parkinson's disease and ataxia, among other diseases) or other mitochondrial dysfunction (which can have variable causes including genetic and environmental and has been associated with numerous neurological disorders such as Bipolar disorder, dementia, and Alzheimer's disease, among others).
Hannah Poling apparently has a mitochondrial disease that her mother also has. This disease was unknown at the time of her vaccinations. Currently, vaccinations are recommended for most sufferers of Mito.
If you would like to read a very interesting take on autism and mito from someone who is intimately familiar with both, please read this blog entry by SL.
The Autism Link
Hannah was presented to the court as exhibiting "features of autism". At least 10 specific features were mentioned in the case documentation, only 3 of which relate directly to DSM-IV diagnostic criteria. More on that (subjective analysis) here.
Hannah was originally included in the Autism Omnibus case, but was subsequently removed from that group of litigants. I am unsure as to why this is, but have read in several spots that her underlying Mito would prevent her from being classified alongside the 4800+ cases that make up the Omnibus proceedings.
EDIT 3/7: Please read the comments section, where Dad of Cameron has
provided a good overview, with links, of some of the possible
factors relating to the decision to exclude Hannah Poling from the Autism
Of particular interest to me was an excerpt from the Journal of Child Neurology / Volume 21, Number 2, in which Dr. Andrew Zimmerman, who performed a case study on Hannah Poling, said:
It is unclear whether mitochondrial dysfunction results from a primary geneticSummary
abnormality, atypical development of essential metabolic pathways, or secondary
inhibition of oxidative phosphorylation by other factors. If such dysfunction is
present at the time of infections and immunizations in young children, the added
oxidative stresses from immune activation on cellular energy metabolism are
likely to be especially critical for the central nervous system, which is highly
dependent on mitochondrial function. Young children who have dysfunctional
cellular energy metabolism therefore might be more prone to undergo autistic
regression between 18 and 30 months of age if they also have infections or
immunizations at the same time.
Clearly there are issues here that deserve and will certainly garner additional discussion and, yes, research. I have many questions stemming from this information as well as several early thoughts/opinions, but I will save those for another post. For now, I simply wanted to provide a summary of events so that interested people can have a well-rounded understanding of the case of this little girl from Georgia.
I am not a scientist and have no special knowledge in any of these areas. Many of my readers, however, are. If I have missed the mark in any of this objective discussion, please inform me in the comments section and provide a link to substantiate your recommended correction. I will then edit this post accordingly.
Other links that you may find useful (I certainly did):
Autism Vox (read the comments section on this one)
S.L. (lots of good posts here)
Left Brain/Right Brain (This article guest-blogged by S.L.)
Joy of Autism (Two good posts here)
Grey Matter/White Matter (A good overview of how elements of the autism community are reacting by Sullivan)
Club 166 (Expressing ire with the way this case is being presented in the media)
DFMP (a mother's and biologists' perspective)
Asperger Square 8 (for some well-needed humor)