Friday, March 7, 2008

Autism, Mito, Vaccine Court, and the Polings

The purpose of this post is to lay out as clearly as I can my understanding of the Vaccine Injury case that was announced today in the national media.
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 Background
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 Concession
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.

Mitochondrial Dysfunction
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
Omnibus proceedings.

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 genetic
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.
Summary
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)


11 comments:

Foresam said...

Steve,
The important thing that happened today was not the specifics of the science involved but the fact that the media covered it. Now the floodgates will open, neurodiversity will shut down operations and disabled children will get treatment for their conditions. Isn't that great for our kids!!!

Steve D said...

John Best (Foresam)-
Mitochondrial disorders are reported to affect perhaps 1 in 4000 people. that equates to approximately .025% of the population. If you want to use the term 'floodgates' to describe this occurrence, you'll have to leave me behind.
I have heard that some treatments are effective in treating mito- disorders, but I don't have any knowledge of them.
Your opinion on ND 'shutting down' is disregarded since you have not the slightest understanding of it.

Foresam said...

Steve,
I consider myself an expert on Neurodiversity. Maybe that's because I became an expert on propaganda in the military. Once the liars are exposed, they have no point in continuing the scam. In fact, it would probably be dangerous.
I don't care about stat's on mitochondrial stuff. The fact that thimerosal is involved and it was discussed on national TV is all that's important for now.

Do'C said...

Hi Steve.

I'm glad you took the time to write about this. Although I haven't had time to write about it myself, I would like to make a comment about one of your statements.

"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."

Here's what an attorney, apparently involved with the PSC in the Omnibus Autism Proceeding, wrote to the court back in November of last year:

"Within the past week we learned that the respondent is conceding in one of the potential cases [redacted] that vaccines caused the "significan aggravation" of an underlying condition. That concession places the [redacted] case in procedural posture that makes it inappropriate as a test case for hearing in May 2008."

Source

So perhaps this part (being removed from the group of OAP litigants), is as simple as something along the lines of a settled case simply can't be presented as a test case, because there is no longer an active claim - it's being settled (and the family compensated). It's interesting to note that the attorney makes absolutely no claim of concession that "vaccines caused autism".

Here's a bit from the courts:

"In sum, DVIC has concluded that the facts of this case meet the statutory criteria for demonstrating that the vaccinations CHILD received on July 19, 2000, significantly aggravated an underlying mitochondrial disorder, which predisposed her to deficits in cellular energy metabolism, and manifested as a regressive encephalopathy with features of autism spectrum disorder. Therefore, respondent recommends that compensation be awarded to petitioners in accordance with 42 U.S.C. § 300aa-11(c)(1)(C)(ii)."

Source

It seems pretty clear that the conclusion of the court is quite specific about what was demonstrated according to the statuatory criteria. While not equal to scientific certainty (and probably rightfully so), it would seem that this case is unlikely (based on the relative rarity of mitochondrial disorders) to be representative of any significant portion of the OAP cases.

Info on the apparent rarity

In a pool of 4,900 children, maybe it shouldn't be surprising that at least one or two children have a mitochodrial disorder.

media watcher said...

I'm so happy to know whence John Best got his propagandizing skills. Military propaganda tends to be of the "kill them, kill them now, kill them dead," sort. This would seem to be the level of subtlety that Best has attained. Perhaps he was Generation Rescue's PR adviser before they showed him the door. GR has not gained any subtlety in his absence, however. He taught them well.

Mr. Beast, Neurodiversity as a highly valued idea will be around next month even stronger and stronger in the following month and so forth. Whereas the GR is staggering under the weight of all the egotism, narcissim, self-aggrandizing, lies, and then there's Stagliano's hyper-inflated opinion of her sexiness and writing skill.

Foresam said...

Media watcher,

Neurodiversity was knocked out yesterday. Some think they are still in the fight but the winer has already been crowned.
They're embarrassing themselves now. It's just a matter of time before treatments are required for all on the autism spectrum. Deprogramming from the cult mentality will be available.

Club 166 said...

Steve,

Thanks for putting this together. It's nice to have a summary of what's happened.

It's disgraceful that the family is using this to manipulate the media into thinking this has something to do with vaccines causing autism.

Joe

Steve D said...

Do'C -
Thanks for the info and links. I'm going to edit my post to reference your comment.

Joe -
I have been attempting to withhold opinions about this case so far, since I feel that more info will come to light and help clarify some of the finer points. But I am feeling similar to you in that it seems like some unnecessary leaps of logic are taking place and turning this into a "Vaccines cause Autism" media circus. Once things calm down a bit, I think a better understanding will be had by all.

And, in general, I am very sorry for Hannah Poling that she has experienced an injury like this.

Emily, as some know me said...

"Some think they are still in the fight but the winer (sic) has already been crowned."

Heehee. Couldn't have said it better myself, except that I would have spelled "whiner" correctly. ;) I also enjoy mightily foresam's statement that the "specifics of the science involved" are not important, but that the media coverage is. That pretty much sums up the perspective from that corner of the world. I wouldn't recommend that the "Vaccines Are the Devil" movement select foresam as their spokesperson any time soon.

I had NO idea that "neurodiversity" had "operations." But I am relieved to hear that foresam has identified the cure for mitochondrial disorders. Phew.

Schwartz said...

Steve,

There is new information from Dr. Poling today that shines some light on a few comments in your post:

"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."

From the press release, her mother stated that Hannah had recovered from the recurring bouts of illness and had been healthy for several months leading up to the vaccination (which is why she presumably allowed them to proceed).

"Hannah Poling apparently has a mitochondrial disease that her mother also has. This disease was unknown at the time of her vaccinations. "

Dr. Poling posted on Age of Autism today a response to Dr. Novella's post. In it he clarifies disfunction and disease.

The summary is:

1) Neither Hannah nor her mother have or had Mitochondrial disease
2) The body of evidence does not point to the genetic marker inherited from her mother as playing any role in the Mitochondrial disfunction
3) There is evidence that Hannah no longer suffers from Mitochondrial disfunction.

One other point of interest WRT to your post is that Dr. Poling still recommends vaccination for children with Mito disfunction. He also states his opinion that 8 vaccinations at once is not a good idea and that all vaccines should be free of Thimerosal.

The post is very informative:

http://www.ageofautism.com/2008/03/dr-jon-poling-o.html

Anonymous said...

Just a curious question. My friends have kids who have been vaccinated and have still gotten chicken pox after the vaccine. If you get measles as a girl you will be immune for the rest of your life and so will your children. The measles vaccine is only a short term immunity (if at all), and the children of immunized parents have no immunity. We run the risk of all of these side efects after 87 percent of the people who got polio got it from the vaccine. In the vaccine is an adjuvant that makes the virus or bacteria in the vaccine cause more of a reaction by suppressing the immune system. Suppressing your immune system in a world where there's more people with auto immune disorders than you can shake a stick at.When Home First in the States takes care of over 30,000 unvaccinated children with 0% autism. What is the national average, 1 in 150. Please someone remind me why we vaccinate again?