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Other candidates for promoting autism in susceptible children exist besides rubella (German Measles). Zecca , et al. at the New Jersey Medical School's Children's Hospital of New Jersey in Newark compared rubeola (measles) virus titers between autistic and normal children. They found a 3-fold increase in rubeola titers over expected normal range among 16 children diagnosed with autism from their clinical practice. A Wilcoxon-Kruskal-Wallas test comparing 13 rubeola titers from normal children revealed a statistically significant p-value of 0.005 for the difference between autistic and normal children.
V.K. Singh1 demonstrated an association between past viral infection (which can be vaccine-derived) and brain auto-antibodies in autism, as well as other neurological diseases. Elevated titers of anti-measles antibodies, for example, in autistic children could signify a chronic activation of the immune system against this neurotropic virus. A significant number of autistic children exhibit positive titers of measles and MMR antibodies, which, in the majority of cases, is associated with the presence of MBP (myelin basic protein, or brain) autoantibody.2
Fifty-eight percent of children with autism have been shown to have a high incidence of circulating autoantibodies to myelin basic protein, compared to healthy children, children with mental retardation, and children with Down's syndrome.3 Many also have antibodies to neuron-axon filament protein (NAFP), compared with healthy children or children with other disabilities.4 Another study found a significant increase in the incidence of anti-NAFP and anti-GFAP among autistic children, but not among mentally retarded children.5 Clinically, these autoantibodies may be related to autoimmune pathology in autism.
The levels of markers of immune activation (associated with auto-immunity), particularly IL-12 (interleukin-12) and interferon-gamma (IFN-gamma) were significantly higher in autistic patients than in controls. Alpha-interferon, interleukin-6, alpha-tumor necrosis factor, and soluble intercellular adhesion molecule-1 were not significantly different.6 IL-12 and IFN-gamma increases are thought to indicate antigenic stimulation of Th-1 cells, linked to vaccines and pathogenetically linked to autoimmunity in autism.
Subacute viral infections of the central nervous system have been postulated to play a role in children who develop normally before undergoing autistic regression. Singh described a case of a healthy boy having a typical case of roseola (HHV-6) at 15 months, who then experienced severe regressions of language and social behavior soon afterwards. The presence of antibodies against MBP and NAFP along with the clinical course and elevated levels of HHV-6 antibodies suggested to Singh that an autoimmune response to the virus had triggered the autistic regression.
Immunological abnormalities (including CNS auto-immunity) found in autism has been linked to the major histocompatibility complex (MHC), which comprises a number of genes that control the function and regulation of the immune system. The MHC is also associated with the increased serotonin levels found in the blood among autistic children.
On the MHC genes, complement C4b, encodes for a product that is involved in eliminating pathogens, including viruses and bacteria, from the body. Again, these immunological abnormalities can be wild virus or vaccine virus induced.7,8 A deficient form of the complement C4b gene, termed the C4B null allele (no C4B protein produced) has an increased frequency in autism and other neurodevelopmental disorders,9 perhaps offering a lead for why some children are more susceptible to vaccine damage than others.
Deficiencies in complement C4b are also associated with auto-immune disease. 10 Autistic children and their mothers had significantly increased phenotypic frequencies of the complement C4b null allele compared with healthy controls. The siblings of the autistic subjects also had an increased frequency of the C4B null allele, but this was not significant. The fathers did not display this allele. All family members had normal frequencies of the C4A null allele, all normal C4A and C4B alleles and all BF and C2 alleles.
The two alleles of the DR beta 1 gene of the MHC are also increased among autistic subjects. The incidence of B44-SC30-DR4 was increased by almost six-fold among autistic children compared to healthy children.11 The total number of extended haplotypes expressed on chromosomes of autistic subjects was significantly increased as compared with those expressed on the chromosomes of healthy subjects.
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Measles is not benign. In May, 2000, measles killed at least 300 people, mostly children, in the impoverished Central African Republic in May, 2000, reported its Health Ministry.12
"More than 2,000 people have been infected, and the disease was spreading", ministry official Gerard Grezengue said.
In one of the worst-affected areas, at least 90 people died in the northern village of Oudda-Djalle, whose population numbered just 2,000.
Health officials blamed a lack of resources in Central African Republic, one of the world's poorest countries, saying there had been no systematic vaccination for the disease since 1992.
Before measles vaccine was licensed in the United States in 1963, some 400,000 cases of measles were reported on average each year. By the early 1980s, however, the annual incidence of reported measles cases had been reduced by more than 99 percent - to less than 1,500 cases.
Later in that same decade, the vaccination rate decreased and an outbreak of measles occurred between 1989 and1991, when more than 55,000 cases and greater than 120 measles-related deaths were reported in the United States.
This increase was attributed to two major types of outbreaks: those among unvaccinated preschool-age children and those among vaccinated school-age children; this latter group was susceptible because approximately 5 percent of those receiving a single dose of measles-containing vaccine do not mount a protective immune response.
As a result of this resurgence, a two-dose strategy for measles vaccination was recommended in 1989. The first dose of vaccine was to be given as measles, mumps and rubella vaccine (MMR) at age 15 months, and the second dose also as MMR at entrance to middle school or junior high school.
As of 1997, the Academy, the American Academy of Family Physicians and the Centers for Disease Control and Prevention (CDC) recommended that the second dose be administered at school entry. By 2001, their national goal is that all school-age children will have received two doses of measles-containing vaccine.
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Program Director, Continuum Center for Health and Healing,
Beth Israel Hospital / Albert Einstein School of Medicine