the vaccine war



Tom Delbanco, M.D.
April 23, 2010 14:46
Tom Delbanco M.D.A professor of medicine at Harvard Medical School and a primary care physician at Boston's Beth Israel Deaconess Medical Center, he also served as senior consultant for this program.

Several respondents comment here about the (apparent) increase in the prevalence of autism. Two questions about it, and the film addresses both: 1) Is it real? 2) If it is, why is it happening? I'll offer a few observations on the first question here, but when the film airs Tuesday (April 27), FRONTLINE will post an extended q&a with an expert in this area. Take a look.

Suffice to say that measuring prevalence (how many people have condition x at a given point in time) has never been easy, and there have been some real goofs along the line. For example, acute rheumatic fever (ARF) was a common illness in this country in the 1950s, and systemic lupus erythematosus (SLE) was rare...until investigators began to decide that quite a few patients labeled with ARF were afflicted with SLE...AND penicillin began killing streptococci that caused ARF. So: ARF began to disappear, SLE grew...and who knows exactly what meant what?

Autism brings up the same issues. As a medical student at Columbia, my first patient on my psychiatry rotation was an autistic child who collected newspapers and was obsessed by the subway gratings on New York's streets. A talented young boy with a brain that did many things marvelously, he was spooky, fascinating, and tearing his family apart. His parents were in agony: guilt-ridden, angry, grateful that their two other children were fine, and seeking answers to why...and where do they go next...

Almost 50 years later, I don't think we're a lot closer to the answers, and as the definitions shift, it remains difficult to measure prevalence. My own suspicion is that it has indeed increased, and I come to that conclusion in a highly un-scientific way. We have friends who are teachers in elementary schools, and they really know kids. They are convinced they're seeing more autism...full blown.

Why? More later...

posted april 27, 2010

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