58. Measles Outbreak In The Republic of Ireland

It has been reported by the UK DoH that there has been an epidemic of measles in the Dublin area, and that two children have died:

• One child suffering from malnutrition, other had other complications, so probably spurious to automatically link deaths to lack of vaccination. Details of cause of death not known. Also 6 intensive care cases, same lack of information - but see below.
• According to the PHLS of Ireland, the Informed Immunisation Network Dublin and Eurosurveillance Weekly, the year-2000 outbreak grew thus: by Feb 2000 there were 16 hospitalisations, but 9 were under age of vaccination and 4 vaccinated. Only 3 out of 16 cases were therefore children who had avoided vaccination.
• By June 2000, there were 844 cases, of which 101 were hospitalised. The highest attack rate was in ages 6-14 months, i.e. under the age of MMR. By end September 2000 there were 1523 cases
• What the UK DoH does not quote about Ireland is numbers of deaths following vaccination. Any recorded numbers also likely to be underestimate because paediatricians do not always link with MMR.

Autism is reported as rising sharply in Ireland. A survey of Cork found 33 cases in a population of just 13,000 (source: Ms. Miriam Twomey, Chairwoman of the Hope Project, Cork). The children had generally become autistic before the age of two years, and following vaccination.

59. MMR In Japan

The DoH has asserted that Japan doesn’t use MMR and the consequence has been 69 deaths from measles. The UK Channel 4 News and the UK Daily Mail checked out the facts, on 29/01/01 and 7/2/01 respectively:

• In 1989, for four years, MMR was recommended. Then evidence of side effects built up (research done by Sunshuke Fuji?). More than 1000 children suffered side-effects. Of 3,969 medical claims for damage, over 30 years, 25% were for MMR in these 4 years. By 1993, 1.8m children had received MMR. Adverse reactions included non-viral meningitis, damaged hearing, blindness, loss of control of limbs, death (3), but no info on autism (link not suspected at that time)
• Doctors now give separate injections, and no boosters. Public confidence badly damaged, vaccination rates lowered as consequence.
• Sunshuke accepts that between 1994 and 1998 there were 4,500 cases of measles and 69 deaths, but such levels of deaths were the case in MMR era too. Daily Mail quotes 94 deaths from measles in 5 years. Measles cases 1994-98 were mainly in the under-ones, and these would not have had MMR anyway, as they were too young.
• Analysis of MMR over three months showed 1/900 children having problems. Japan then switched to another make of MMR, but adverse reaction rate remained high at 1/1755.
• UK DoH quoting Japan case as "dire warning of what happens if you shun MMR" is irrelevant and inaccurate. Real warning is that Japan shows what happens if you betray trust of parents, by using unsafe product, and take-up (even of single vaccines) falls as consequence.
• Government reconsidered MMR in 1999, but decided against it. Quoted that three single vaccines costs twice as much as one MMR, but considers price worth paying (this implies that re-licensing single vaccines and switching over from MMR, if adopted in the UK, would involve a doubling of expenditure).

60. Autism In Finland

(See also Patja et al study)

• A study paper, Autism In Northern Finland, was published by Kielinen, Linna and Moilanen in European Child & Adult Psychiatry, Volume 9 No. 3, 2000. The stated purpose of the study was to estimate the prevalence of autism in the two northernmost provinces of Finland, Oulu and Lapland.
• The study showed the cumulative incidence in 15-18 year olds to be 6.1/10,000, and in 5-7 year olds to be 20.7/10,000, almost three and a half times the rate for the older children.
• The study population comprised those born 1979-94, representing the age group 3-18 years, and totalling 152,732. The criteria used was ICD-10 and DSM-IV. The children’s records were reviewed against these criteria. The original criteria had varied over the years. The population of autistic children and adults was found to be 212.
• In the youngest age group, 5-7, the cumulative incidence was 20.7/10,000. The previously-reported rate in a study by Vinni and Timonen in 1991 was 4.75/10,000. The Kielinen rate for this age group was therefore nearly four and a half times higher. The cumulative incidence rate for the entire Kielinen study population was 12.2/10,000, still over two and a half times higher
• The explanation of the Kielinen study team was better recognition,, improved sensitivity of case-finding, greater healthcare consciousness and possible changes in diagnostic practices or in-migration - all of which might be expected to have only marginal impact. The huge increase is therefore largely unexplained.