The Cedillo Omnibus hearing, by the numbers

The following is a guest blog contributed by a gracious anonymous reader who wanted to see a summary of the Cedillo hearing coverage. There were 2,916 pages of transcript, and something like 50+ hours of audio recording. Autism Diva had hit a sort of Autism Omnibus crash and burnout after reviewing that testimony (listening to Ms. Chin-Caplan, lawyer for the Cedillos, was particularly excruciating toward the end of the hearing, parts of Autism Diva's primary auditory cortex are still recovering). Autism Diva didn't have the desire to try to tie it all up in one post properly. So, here is gift from a less legality and measles morbidity and mortality beleaguered guest blogger. A brief summary of the Cedillo hearing:

It’s been nearly three months since the first part of the Autism Omnibus trial. Autism Diva did an amazing job (starting here) summarizing the day-by-day happenings. I thought it might be a good time to look back and summarize in one place what happened. Sort of the “Cliff’s Notes” version. (links are to Autism Diva’s blog—she is the gracious host after all. For a different take on the trial, check the a-champ blog).

Most cases of vaccine injury are handled according to a "table”. This lists known adverse reactions and makes it straightforward to demonstrate that an injury could have been caused by a vaccine. There is no table entry for autism—vaccine injury has never been proven in the court as a cause of autism. Consider that about 4,800 families are claiming vaccine injury caused autism and that the vaccine court only publishes about 40 decisions a year. It would take far too long to try them all individually. So the "omnibus"approach was taken where a few test cases will be presented as examples of the different ways that vaccine injury is proposed to cause autism. These cases would decide if table entries for autism should be created, and if so what they should be. Three proposed methods of vaccine injury causing autism will be explored: (1) mercury from vaccines; (2) the MMR (Mumps, Measles, Rubella) vaccine and (3) a combination of mercury in some vaccines and the MMR vaccine. This case was to explore possibility (3) cause the autism of Michelle Cedillo.

The vaccine court is a "no fault" court, so the testimony is mostly given by expert witnesses. These varied from (1) world experts in autism, Measles, and the laboratory methods used, to (2) doctors with direct experience with Michelle Cedillo and children with similar cases, to (3) professional expert witnesses who had problems even defending their own CV's.

The proposal was put forth that (1) Michelle was developing normally, (2) she received a vaccines with mercury which suppressed her immunity at the time she got her MMR vaccine, (3) this allowed the Measles in the vaccine to cause a real and persisting infection and (4) this persistent Measles infection resulted in brain damage that caused autism. The rebuttal witnesses argued that (1) Michelle showed signs of autism before her MMR vaccination, (2) there is no mechanism shown where mercury causes immunosuppression, especially seven months later, (3) evidence shows that people with suppressed immune systems do not catch measles from the vaccine, (4) People either recover from Measles or die from it—they don't have persistent infections and they don't develop autism, and (5) the data showing a persistent Measles infection were all false positives due to procedural mistakes and contamination.

There are still eight more cases to be heard on the three proposed scenarios for vaccine injury causing autism. Much of the evidence presented in the Cedillo case goes to the idea of whether the MMR can cause autism. So, this case will not only have an impact on the other mercury+MMR cases, but also on the MMR alone cases.

Autism Diva would add to the above, two (wordy) clarifications according to her understanding of testimony by Drs. Ward and Griffen regarding measles vaccine and a immunosuppressed people. Dr. Ward explained (on Day 8, starting on page 1805 that Zimbabwean children who were HIV positive received the measles vaccines unless they were obviously sick on the day they would otherwise have received the vaccine. So even though they had an immune problem already, they tolerated the measles vaccine. But Dr. Griffin explain starting on page 2793 that patients with AIDS (more seriously ill, with badly damaged immune systems) should not be given the measles vaccine because it's a live, but weakened, virus that their immune systems can't necessarily clear. So in those rare cases where people with profound immunosuppression from advanced AIDS can catch a vaccine strain measles infection from the vaccine that will hang around and eventually cause pneumonia, but not a brain infection. She explains on the next two pages why they give the measles virus to very young HIV infected babies, to give them a chance against the wild-type measles since there's a good chance that their immune system will continue to decline.

People can get a kind of persistent measles infection from wild-type measles, where the virus is not cleared out by the immune system, gets into the brain and sort of lives there quietly replicating and killing brain cells until it gets to a tipping point and takes off, killing more and more brain cells until the person dies (a rather horrible death) from subacute sclerosing panencephalitis, SSPE, described on page 2786 to 2788:

So my assumption of the pathogenesis, and as I say, we never are able to look, we don't have any animal models for this and we can't identify these kids at the time they get their infection and then find out what's happening, is that the virus probably enters the brain in those children at the time of the original infection. Again, often these children are said to have had mild measles, so you wonder whether they mounted a really appropriate immune response at that time. Then the virus, it must just replicate very slowly and spread very slowly through the nervous system through all those years and eventually the thought is it builds up to a threshold that is enough damage and enough virus replication that there are some symptoms.

Once that occurs, as I say, the virus is very widespread and essentially all of those children die, usually within a year or two of the onset of the neurologic symptoms.

Q. What are, you mentioned some intellectual deterioration. What are the other --

A. Intellectual deterioration. There are movement disorders. One thing that's known as myoclonus is a common one. They eventually become mute and bedridden. Really pretty profound and progressive change over that period of time. There's characteristic EEG abnormalities, what they call burst suppression pattern. So one of the ways of trying to diagnose it is that way. Another way to diagnose it is they often have very very high levels of antibody in the cerebrospinal fluid indicating that they're making an immune response locally to the virus that's present in the nervous system. Those are all the kinds of things one looks for.

The imaging CTs or MRIs show big ventricles, shrinking brain, basically.

Q. Necrosis?

A. Well, yes. You're getting cell death presumably due to the infection, the widespread infection that's in the brain. So it's really quite a characteristic picture which fortunately has essentially disappeared from the U.S. with immunization. We basically don't see this diseases any more.

Our guest blogger was correct in saying that measles virus does not hang around and cause autism, if it hangs around in the brain it destroys more and more brain cells until the poor person thus infected dies. And at any rate, there's no evidence than any autistic child ever had a persistent measles infection of any sort, though Dr. Wakefield claimed to have found measles in the guts and CSF of autistic children (and people with Crohn's disease), in fact he never did find any measles. They were a figment of his imagination, not unlike the fictional teapot orbiting the sun between mars and the earth that is too small to be seen by any telescope and the existence of which must be accepted with credulity or not at all.



Autism Diva
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