restricted access 3. Thimerosal and Autism

From: Vaccine

The Johns Hopkins University Press colophon
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Thimerosal and Autism Today, U.S. parents worry that certain vaccines cause or trigger certain health problems. Of all these perceived adverse effects, none elicits more anxiety than the belief that vaccines might cause autism. Autism and the closely related diagnoses of Asperger’s Syndrome and Pervasive Developmental Disorder— Not Otherwise Specified are collectively called Autism Spectrum Disorders or ASD. Informally, among members of the public and in the language of activist groups, they are simply grouped together under the label of autism. The term autism was coined by Hans Asperger in 1938. Its modern use originated in a 1943 report by Leo Kanner of Johns Hopkins University Hospital about eleven children with remarkable similarities in their behaviors. Kanner described the children’s disinterest in normal relationships with other people and their apparent desire for “aloneness” and “sameness.” He concluded, “these children have come into the world with an innate inability to form the usual, biologically provided affective contact with people, just as other children come into the world with innate physical or intellectual handicaps .” Throughout much of the twentieth century, reported cases of autism were incredibly rare, so much so that the American Psychiatric Association did not even include precise criteria for it in its Diagnostic and Statistical Manual of Mental Disorders until 1980. It took another decade before public schools in the United States began using the category of autism, which was followed by increasingly high rates of diagnoses. A broad range of impairments and capacities are associated with autism, from severe social impairment and mental disabilities to high functioning individuals with unusual interests or communication styles. As with other syndromes or disorders, autism is not considered a disease because medical science has not identified an underlying cause that explains the symptoms that usually occur together. Rather than being labeled as diseases , syndromes and disorders are constellations of symptoms that suggest the presence of an abnormality, an injury, or a disease. The symptoms that frequently occur in people diagnosed with autism include a lack of social 3 Thimerosal and Autism 69 skills and ability to interact easily with others, delayed development of speech, lack of imaginative play, a fixation on repetitive and ritualistic behaviors, and unusual eating habits. Today, parents usually identify symptoms of autism within the first three years of life. A formal diagnosis is based on a child’s behavior rather than on an identified organic cause or a biological test. Over the last fifteen years there has been a substantial increase in the public’s awareness of autism, and a number of therapies have emerged to treat children diagnosed with it. Researchers today believe what we call autism is caused by a complex set of interrelated genetic and environmental factors, making the search for a single cause or a single therapy futile. Concerns about autism are significantly heightened by a recent large increase in the number of children diagnosed with an Autism Spectrum Disorder . Some studies, such as one commissioned by the California legislature in 1999, reported that the number of children diagnosed as autistic nearly tripled from 1990 to 2000. In 2007, the CDC’s Autism and Developmental Disabilities Monitoring Network reported that one in every one hundred fifty eight-year-old boys and girls in the United States had a diagnosable autism spectrum disorder. The CDC also reported that boys are four times more likely than girls to be diagnosed as autistic; one in ninety-four boys is diagnosed as autistic. In 2009, the CDC reported that the frequency of children diagnosed with an ASD in its most recent study was one in one hundred and ten, and as high as one in seventy boys. Shortly after the release of the movie Rain Man in 1988, a wave of public figures, including Dan Marino, Doug Flutie, and Don Imus, began discussing the “autism epidemic,” and media outlets like the New York Times, CBS News, and Time were asking questions about the “shocking report” of a “mysterious upsurge” in autism and asserting that “cases of autism and closely related disorders like Asperger’s are exploding in number, and no one has a good reason for it.” Over the last several years, the assertion that new cases of autism have reached epidemic proportions has been accepted as a fact by a substantial number of Americans, and several recent books on the subject are based on an assumed epidemic of autism in the United States. Scientists now believe that genes exert significant influence in causing or...