Statement from Dr Andrew Wakefield

Serious allegations have been made against me and my colleagues in relation to the provision of clinical care for children with autism and bowel disease, and the subsequent reporting of their disease.

These allegations have been made by journalist Brian Deer who has expressed, in front of witnesses, his aim of destroying me.

All but one of the allegations, which are grossly defamatory, have been shown to be baseless. One allegation remains against me personally.

That is, that I did not disclose to the Lancet that a minority of the 12 children in the 1998 Lancet report were also part of a quite separate study that was funded in part by the Legal Aid Board .

It is the Lancet's opinion but not mine that such a disclosure should have been made since it may have been perceived as a conflict of interest. This is despite that fact that the funding was provided for a separate scientific study.

It needs to be made clear that the funds from the Legal Aid Board were not used for the 1998 Lancet study, and therefore I perceived that no financial conflict of interest existed.

The Lancet defines a conflict of interest as anything that might embarrass the author if it were to be revealed later. I am not embarrassed since it is a matter of fact that there was no conflict of interest. I am, however, dismayed at the way these facts have been misrepresented.

Whether or not the children's parents were pursuing, or intended to pursue litigation against the vaccine manufacturers, had no bearing on any clinical decision in relation to these children, or their inclusion in the Lancet 1998 report.

It is a matter of fact that there was no conflict of interest at any time in relation to the medical referral of these children, their clinical investigation and care, and the subsequent reporting of their disease in the Lancet.

As far as the 1998 Lancet report is concerned, it is a matter of fact that we found and reported inflammation in the intestines of these children.

The grant of £55,000 was paid not me but to the Royal Free Hospital Special Trustees for my research group to conduct studies on behalf of the Legal Aid Board. These research funds were properly administered through the Royal Free Hospital Special Trustees.

The Legal Aid research grant to my group was used exclusively for the purpose of conducting an examination of any possible connection between the component viruses of the MMR - particularly measles virus - and the bowel disease in these children. This is entirely in line with other studies that have been funded by the Legal Aid Board (latterly the Legal Services Commission) and reported in the BMJ . If and when this work is finally published, due acknowledgement will be made of all sources of funding.

It is unfortunate that, following full disclosure of these facts to the editor of the Lancet, he stated that in retrospect he would not have published facts pertinent to the parent's perceived association with MMR vaccine in the 1998 Lancet report. Such a position has major implications for the scientific investigation of injuries that might be caused by drugs or vaccines, such as Gulf War Syndrome and autism, where possible victims may be seeking medical help and also legal redress.

Health Secretary John Reid has called for a public enquiry. I welcome this since I have already called for a public enquiry that addresses the whole issue in relation vaccines and autism.

It has been proposed that my role in this matter should be investigated by the General Medical Council (GMC). I not only welcome this, I insist on it and I will be making contact with the GMC personally, in the forthcoming week.

This whole unpleasant episode has been conflated to provide those opposed to addressing genuine concerns about vaccine safety with an opportunity of attacking me - an attack that is out of all proportion to the facts of the matter.

I stand by everything that I have done in relation to the care, investigation and reporting of the disease that I and my colleagues have discovered in these desperately ill children.

My family and I have suffered many setbacks as a direct consequence of this work. As a family, we consider that our problems are nothing compared with the suffering of these children and their families. For the sake of these children, this work will continue.

Comment in: Dig Dis Sci. 2001 Mar;46(3):658-60.

Detection and sequencing of measles virus from peripheral mononuclear cells from patients with inflammatory bowel disease and autism

Kawashima H, Mori T, Kashiwagi Y, Takekuma K, Hoshika A, Wakefield A.

Department of Paediatrics, Tokyo Medical University, Japan.

PMID: 10759242 [PubMed - indexed for MEDLINE]

http://www-east.elsevier.com/ajg/issues/9509/...

The American Journal of Gastroenterology
Editorial
September 2000
Volume 95, Number 9
Pages 2154-2156

Autism and the Gastrointestinal Tract

Eamonn M. M. Quigley, M.D., F.A.C.G.,a and David Hurley, M.B.a

excerpts

"The gut-brain connection is now recognized as a basic tenet of physiology and medicine, and examples of gastrointestinal involvement in a variety of neurological diseases are extensive "

"Wakefield et al. first reported prominent ileal lymphoid nodular hyperplasia (LNH) and ileocolitis in an uncontrolled study of 12 autistic children and went on to speculate a link to MMR vaccination (6). The same group had previously postulated a similar link between measles, MMR, and inflammatory bowel disease in adults (11, 12). In this issue of the Journal, Wakefield et al. report on a total 60 children with developmental disorders (primarily autism) and compare their ileocolonoscopic findings (both macroscopic and histological) with those of 22 "control" children and 20 with ulcerative colitis. In all, 93% of affected children had LNH in comparison to 29% of "controls" and chronic colitis was identified in 88% of affected children in comparison to 5% of "controls" (13). The authors conclude that children with developmental disorders frequently exhibit a new variant of inflammatory bowel disease: "autistic enterocolitis"

"Wakefield et al. (13) are to be congratulated on opening yet another window onto the ever-broadening spectrum of gut-brain interactions. Their findings raise many challenging questions that should provoke further much-needed research in this area, research that may provide true grounds for optimism for affected patients and their families. "

**** http://www.thelancet.com
Volume 351, Number 9103
28 February 1998
Early report
Ileal-lymphoid-nodular hyperplasia, non-specific colitis, and pervasive developmental disorder in children
A J Wakefield, S H Murch, A Anthony, J Linnell, D M Casson, M Malik, M Berelowitz, A P Dhillon, M A Thomson, P Harvey, A Valentine, S E Davies, J A Walker-Smith

Inflammatory Bowel Disease Study Group, University Departments of Medicine and Histopathology (A J Wakefield FRCS, A Anthony MB, J Linnell PhD, A P Dhillon MRCPath, S E Davies MRCPath) and the University Departments of Paediatric Gastroenterology (S H Murch MB, D M Casson MRCP, M Malik MRCP, M A Thomson FRCP, J A Walker-Smith FRCP,), Child and Adolescent Psychiatry (M Berelowitz FRCPsych), Neurology (P Harvey FRCP), and Radiology (A Valentine FRCR), Royal Free Hospital and School of Medicine, London NW3 2QG, UK

********* Walkefield's testimony on June 19, 2002 before Congress

14 documents you can research there

1. Wakefield AJ, Murch SH, Anthony A, Linnell J, Casson DM, Malik M, et al. Ileal LNH, non-specific colitis and pervasive developmental disorder in children. Lancet 1997; 351: 637-641.

2. Wakefield AJ, Anthony A, Murch SH, Thomson M, Montgomery SM, Davies S, et al. Enterocolitis in children with developmental disorder. American Journal of Gastroenterology 2000; 95:2285-2295

3. Furlano RI, Anthony A, Day R, Brown A, McGavery L, Thomson MA, et al. Colonic CD8 and ?d T cell infiltration with epithelial damage in children with autism. Journal of Pediatrics 2001;138:366-372

4. Torrente F, Machado N, Ashwood P, et al. Enteropathy with T cell infiltration and epithelial IgG deposition in autism. Molecular Psychiatry 2002;7:375-382

5. Uhlmann V., Martin CM., Shiels O., Pilkington L., Silva I., Lillalea A. Murch SH., Wakefield AJ., O’Leary JJ. Potential viral pathogenic mechanism for new variant inflammatory bowel disease. Molecular Pathology. 2002;55:1-6

6. Kawashima H., Takayuki M., Kashiwagi Y., Takekuma K., Hoshika A., Wakefield AJ. Detection and sequencing of measles virus from peripheral blood mononuclear cells from patients with inflammatory bowel disease and autism. Digestive Diseases and Sciences. 2000;45:723-729

7. Wakefield AJ and Montgomery SM. Measles, mumps, rubella vaccine: through a glass, darkly. Adverse Drug Reactions & Toxicological Reviews 2000;19:265-283.

8. Wakefield AJ and Montgomery SM. Autism, viral infection and measles mumps rubella vaccination. Israeli Medical Association Journal 1999;1:183-187

9. Wakefield AJ, Puleston J., Montgomery SM., Anthony A., O’Leary JJ., Murch SH. Review article: the concept of entero-colonic encephalopathy, autism and opioid receptor ligands. Alimentary Pharmacology and Therapeutics 2002; 16: 663-674

10. Shiels O., Smyth P., Martin C., O’Leary JJ. Development of an allelic discrimination type assay to differentiate between strain origins of measles virus detected in intestinal tissue of children with ileocolonic lymphonodular hyperplasia and concomitant developmental disorder. Pathological Society of Great Britain and Ireland. Journal of Pathology. 2002 .A20

11. Wakefield AJ, Anthony A. Clinical characteristics of children with autism and entero-colitis comparing recipients of one and more than one measles-containing vaccine (submitted).

Publications by others

1. a. Singh V., Lin S., Yang V. Serological association of measles virus and human herpesvirus-6 with brain autoantibodies in autism. Clinical Immunology and Immunopathology. 1998:89;105-108

2. a. Singh VK. Neuro-immunopathogenesis in Autism. 2001. New Foundations of Biology. Berczi I & Gorczynski RM (eds) Elsevier Science B.V. pp447-458

3. a. Horvath K, Papadimitriou JC, Rabsztyn A, Drachenberg C, Tildon JT. Gastrointestinal abnormalities in children with autism. Journal of Pediatrics 1999; 135: 559-563

******** The Autism Autoimmunity Project
Vijendra Singh, PhD
Selected research on autism

****** http://www.thelancet.com.
You will need to register to read - registration is free

Home The Journal Back Issues Correspondence Volume 359, Number 9307 23 February 2002

Correspondence

Autism, bowel inflammation, and measles

Sir--I was the senior clinician in the preliminary study of ileal-lymphoid-nodular hyperplasia, non-specific colitis, and pervasive developmental disorder reported in 1998.1 Apart from one letter after our report,2 I have remained silent, except for coauthorship on several articles on this topic.3,4

Second, in such highly selected children, Uhlmann and colleagues5 have now provided new evidence that measles might be involved, by use of molecular techniques to show the presence of measles virus genomes in 75 of 91 children with ileal-lymphoid-nodular hyperplasia, enterocolitis, and developmental disorder, compared with five of 70 control children. Measles virus was mainly localised in dendritic cells in reactive follicular hyperplastic centres in the ileum. This localisation mirrors that of HIV-1. "

"Furlano and colleagues' work on the inflammatory changes and the intestine in autism was reviewed in the Medical Research Council's 2001 report. Some criticisms were made but the work was certainly not refuted. "

"Am I too naive to ask all people of goodwill on both sides of this debate to speedily agree on an independent research agenda that will finally resolve this matter? Such an agenda must involve non-epidemiological research, focusing on the bowels of these children. It is self-evident that this whole question is going on far too long and is causing so much heart-ache in parents. Although the original observation has been extended and refined with additional evidence, resolution of this matter seems as far off as it did then. Studies reported lately provide evidence that measles virus might have a role. There is now a case to be answered. This study finding needs urgent confirmation and elaboration of its importance."

John Walker-Smith

Murch SH, Anthony A, et al. Ileal-lymphoid-nodular hyperplasia, non-specific colitis, and pervasive developmental disorder in children. Lancet 1998; 351: 637-41. [Text]

2 Walker-Smith JA. Autism, inflammatory bowel disease, and MMR vaccine. Lancet 1998; 351: 1356-57. [PubMed] http://www.ncbi.nlm.nih.gov/htbin-post/PubMed...

3 Wakefield AJ, Anthony A, Murch SH, et al. Enterocolitis in children with developmental disorders. Am J Gastroenterol 2000; 95: 2285-95. [PubMed]

4 Furlano RI, Anthony A, Day R, et al. Colonic CD8 and gamma delta T-cell infiltration with epithelial damage in children with autism. J Pediatr 2001; 138: 366-72. [PubMed]

5 Uhlmann V, Martin CM, Silva I, et al. Potential viral pathogenic mechanism for new variant inflammatory bowel disease. http://mp.bmjjournals.com/cgi/content/full/... 54/6/DC1 (accessed on Feb 19, 2002).

6 Morris A, Aldulaimi D. New evidence for a viral pathogenic mechanism for new variant inflammatory bowel disease and developmental disorder? http://mp.bmjjournals.com/cgi/content/full/... 54/6/DC1 (accessed on Feb 19, 2002).

Wellcome Trust Centre for History of Medicine at UCL, London NW1 1AD, UK (e-mail:johnwalker_smith@hotmail.com)
You can write John Walker Smith!

**** From Paul Shattuck

As far as any research proving that MMR or measles vaccine virus DOES NOT cause autism - there is none. There is NO other research in bowels of children with autism - with associated inflammatory bowel diseases - disproving this.

This latest report http://212.111.35.3/clinicalevidence.org/Upda...

claims that the authors have conducted the most extensive review covering the past 50 years and 2000 papers. In that case, the authors have been incredibly selective. Every paper (bar one) they review is purely epidemiological and plays the numbers game. They trot out all the usual papers (eg Taylors, the various Finnish papers) all of which have been dissected. In the case of some of the Finnish studies, even the Medical Research Council (MRC) report comments that they are of little relevance or should be treated with cautions yet here they are and all churned out again as if we have never heard of them.

Being a review - there is not one iota of original research. The paper represents the considered opinion of the two authors and nothing more. Their attitude to all of these papers is completely uncritical and even the most dubious interpretations (Barlow's and Taylor's papers for example) are accepted without comment.

The one paper which does look at patients is the original Wakefield paper of 1998 for which the work was conducted 5 years ago. This was on 12 subjects (as we all know). They have totally ignored and failed to mention any other papers which look at the patients. Thus the papers which confirm the intestinal damage in a further 150 subjects (Furlano)and which demonstrate the intestinal immune problems (Torrente) are not mentioned. The papers from O'Leary's (Dublin) team and from Kawashima's team in Japan are not mentioned at all. Both of these groups found the genetic material of measles in the bodies of children with this regressive form of autism (O'Leary did guts and Kawashima did blood). Both have appeared in peer reviewed journals and both are ignored.

Work from Singh and others in the States is not mentioned. All that is mentioned was the very first pilot study which we all know was a pilot investigation.

The conclusion is that there is "no evidence to support.....". That is absolute "balderdash". There is only "no evidence" if you studiously ignore it or otherwise fail to look. They have, effectively, examined the prosecution case and not bothered to listen to the defence.

The phrase "There is no evidence......" always agitates me. You hear it most in programs where the villain always says "You ain't got no proof". I would accept that absolute and totally convincing proof of a causative link between MMR and autism may be lacking.

However, the claim that "there is no evidence" is untrue and obviously so.

I think we've been over this before.
Absence of evidence does not mean evidence of absence. As soon as they look in the bowel of children with autism with associated bowle problems! As soon as they look at all or a huge percentage of all of these children with a nice little control group of ***UNVACCINATED*** children, and examine for vaccine-version measles virus, then we'll know for sure. But they are SCARED to death to. Why else are they NOT doing the definitive, look-in-the-bowel study. They won't look there because they KNOW what they will find.

http://66.70.140.217/a/thrower.html#45 Part E: The MMR Original Safety Trials Debate

STUDIES THAT HAVE BEEN USED TO DENY AN MMR/AUTISM LINK (and why they are worthless)

Studies that point toward an MMR link

Broad Conclusions & Questions

Paul Shattock

Press release - No evidence that MMR vaccine is associated with autism or bowel disease

June 12, 2002

If you want to actually read the report you can get ot on the website http://www.clinicalevidence.com... and click on the appropiate places.

The report claims that the authors have conducted the most extensive review covering the past 50 years and 2000 papers. In that case, the authors have been incredibly selective. Every paper (bar one) they review is purely epidemiological and plays the numbers game. They trot out all the usual papers (eg Taylors, the various Finnish papers) all of which have been disected on this list. In the case of some of the Finnish studies, even the Medical Research Council (MRC) report comments that they are of little relevance or should be treated with cautions yet here they are and all churned out again as if we have never heard of them.

Being a review - there is not one iota of original research. The paper represents the considered opinion of the two authors and nothing more. Their attitude to all of these papers is completely uncritical and even the most dubious interpretations (Barlow's and Taylor's papers for example) are accepted without comment.

The one paper which does look at patients is the original Wakefield paper of 1998 for which the work was conducted 5 years ago. This was on 12 subjects (as we all know). They have totally ignored and failed to mention any other papers which look at the patients. Thus the papers which confirm the intestinal damage in a further 150 subjects (Furlano) and which demonstrate the intestinal immune problems (Torrente) are not mentioned. The papers from O'Leary's (Dublin) team and from Kawashima's team in Japan are not mentioned at all. Both of these groups found the genetic material of measles in the bodies of children with this regressive form of autism (O'Leary did guts and Kawashima did blood). Both have appeared in peer reviewed journals and both are ignored.

Work from Singh and others in the States is not mentioned. All that is mentioned was the very first pilot study which we all know was a pilot investigation.

The conclusion is that there is "no evidence to support.....". That is absolute balderdash. There is only "no evidence" if you studiously ignore it or otherwise fail to look. They have, effectively, examined the prosecution case and not bothered to listen to the defence.

The phrase "There is no evidence......" always agitates me. You hear it most in programes like "The Bill" where the villain always says "You ain't got no proof". I would accept that absolute and totally convincing proof of a causative link between MMR and autism may be lacking. However, the claim that "there is no evidence" is untrue and obviously so.

Don't just believe me - take a look for yourself if you do not believe me.

Paul Shattock