6. 100.00%
90.00%
Milk
Egg white york
Egg
80.00%
Gluten
Peanut
Soy bean
70.00%
Cheese
60.00%
Goat Milk
50.00%
Almond
Wheat
Eel
Yorget
40.00%
Pineapple
Grapefruit
30.00%
Rice
Yeast
20.00%
Green bean
Cod
Kidney Bean
10.00%
M
ilk
Ch
ee
Eg se
gy
ork
Gl
ute
n
Yo
rg
et
Ye
as
t
Co
d
W
he
at
Pe
an
Ki
ut
dn
ey
Be
an
0.00%
Jul.15.2008
Louis LEE,M.D., H.M.D., N.M.D.,M.B.A.
Milk
Goat Milk
Cheese
Egg white
Egg york
Almond
Gluten
Grapefruit
Yorget
Soy bean
Yeast
Eel
Cod
Pineapple
Wheat
Rice
Peanut
Green bean
Kidney Bean
6
7. Avoid the allergic Foods
&
Detoxify the Antibodies
1.
2.
3.
4.
5.
6.
Dairy products
Egg ( York & white)
Gluten
Peannut
Soy
Almond
Jul.15.2008
Louis LEE,M.D., H.M.D., N.M.D.,M.B.A.
7
15. Where are the toxic from?
Jul.15.2008
•
•
•
•
•
•
•
•
•
Pb
Hg
Al
Sb
As
Ba
Bi
Cd
Ni Louis LEE,M.D., H.M.D., N.M.D.,M.B.A.
15
16. OFFICIAL STATEMENT:
US Centers for Disease Control
and Prevention (CDC)
• “Mercury occurs naturally and is found
everywhere in the environment.”
• “The level of mercury exposure from
vaccines is low.”
• “Evidence is accumulating of lack of harm
resulting from exposure to thimerosal in
vaccines.”
Jul.15.2008
Louis LEE,M.D., H.M.D., N.M.D.,M.B.A.
16
17. Mercury and Vaccines (Thimerosal
Thimerosal is a mercury-containing preservative
used in some vaccines and other products since
the 1930s. There is no convincing scientific
evidence of harm caused by the low doses of
thimerosal in vaccines, except for minor
reactions like redness and swelling at the
injection site. However, in July 1999, the Public
Health Service agencies, the American Academy
of Pediatrics, and vaccine manufacturers agreed
that thimerosal should be reduced or eliminated
in vaccines as Louis LEE,M.D., H.M.D., N.M.D.,M.B.A.
a precautionary measure.---CDC
Jul.15.2008
17
18. Since 2001
• , with the exception of some influenza
(flu) vaccines, thimerosal is not used
as a preservative in routinely
recommended childhood vaccines --CDC
Jul.15.2008
Louis LEE,M.D., H.M.D., N.M.D.,M.B.A.
18
21. • FAMILIES: KEY TO THIS STORY
• SCIENCE PART I: CAUSES OF AUTISM
• LAW: COMPENSATION, LITIGATION,
INVESTIGATION
• POLITICS: PHARMA & THE FEDS
• SCIENCE PART II: SEARCH FOR A
“CURE”
Jul.15.2008
Louis LEE,M.D., H.M.D., N.M.D.,M.B.A.
21
22. THE SCIENCE:
SEARCH FOR A CAUSE
The etiology of autism
Jul.15.2008
Louis LEE,M.D., H.M.D., N.M.D.,M.B.A.
22
23. AUTISM BY THE NUMBERS:
US & EUROPE
•
•
•
•
USA - 1980’s: 1-2 per 10,000 children
USA – Late 1990’s: 1 in 500 (20 per 10K)
USA – 2000: 1 in 250 (40 per 10K)
USA – 2004: 1 in 166 (60 per 10K)
------------• UK – 2004: 1 in 166 (60 per 10K)
• Denmark – 2004: 1 in 1,300(7.7 per 10K)
Jul.15.2008
Louis LEE,M.D., H.M.D., N.M.D.,M.B.A.
23
24. OTHER POSSIBLE
ENVIRONMENTAL “TRIGGERS”??
•
•
•
•
•
•
•
•
Mercury in fish/air/amalgams
Pesticides
PCB’s
Flame retardants
Jet fuel
Live virus in vaccines (MMR)
As-yet unidentified virus
Rampant cell phone use
Jul.15.2008
Louis LEE,M.D., H.M.D., N.M.D.,M.B.A.
24
25. KNOW YOUR MERCURY (Hg)
TYPE
SOURCE
EXPOSURE
Elemental Hg
Thermometers Vapor
Amalgams
Lights/batteries
Inorganic Hg
(hydrophilic)
Coal power plants
Volcanoes
Air pollutants
Organic Methyl Hg
(lypophilic)
Fish
Ingestion
Organic Ethyl Hg
(lypophilic)
Thimerosal
Fish(?)
Jul.15.2008
Vaccines
OTC Topicals
Louis LEE,M.D., H.M.D., N.M.D.,M.B.A.
25
26. ETHYL VS METHYL
•
Main chemical difference: Ethyl form contains extra carbon
compound on molecule, making it larger.
•
Some scientists contend extra carbon compound makes
ethylmercury less likely to cross the blood-brain barrier.
•
Methylmercury shown to remain in blood longer than ethyl (1/2 life
of 50 days vs. 7 days for ethyl); it accumulates more readily in the
body. But ethyl converts more readily to inorganic Hg, which
appears to remain in brain longer.
•
Despite these differences, FDA researchers assumed that the two
forms of mercury were equal in toxicity.
•
Arsenic is “less toxic” than cyanide.
Jul.15.2008
Louis LEE,M.D., H.M.D., N.M.D.,M.B.A.
26
27. HOW MUCH Hg IS TOO MUCH?
EPA SAFETY LIMIT: 0.1 mcg* per kg per day
(Methylmercury)
Avg. 6oz TUNA STEAK (@17mcg/oz): 102 mcg
Avg. 6oz SWORDFISH STEAK (@30mcg/OZ) 180 mcg
Avg. VACCINE: 25mcg
________________
EPA SAFETY LIMIT FOR:
165 lb man = 8 mcg/day
110 lb woman = 5mcg/day
16 lb infant = 0.7mcg/day
(6 Months old)
Tuna
12.8x
20.4x
--
22.5x
36.0x
--
Swordfish Vaccine
3x
5x
35.7x
*1mcg = 1 millionth of a gram
Jul.15.2008
Louis LEE,M.D., H.M.D., N.M.D.,M.B.A.
27
28. Maximum Hg exposure in 1st year of life US Childhood Schedule - 1992-200?
AGE
SHOTS
HG CONTENT
BIRTH
Hep B
12.5mcg
8lb infant (3.6kg)– EPA Hg limit: 0.36mcg = 35 times over
4lb infant (1.8kg) – EPA Hg limit: 0.18mcg = 70 times over
2 MONTHS
Hep B
HIb
DTaP
12.5mcg
25.0mcg
25.0mcg
(subtotal for visit):
62.5mcg
Avg. weight: 10lbs/4.5kg EPA limit: 0.45mcg = 138 times over
4 MONTHS
HIb
DTaP
25.0mcg
25.0 mcg
(subtotal for visit):
50.0 mcg
Avg weight: 14lbs/6.5kg EPA limit: 0.65mcg = 72 times over
Jul.15.2008
Louis LEE,M.D., H.M.D., N.M.D.,M.B.A.
28
29. Maximum Hg exposure in 1st year of life US Childhood Schedule - 1992-200?
AGE
SHOTS
6 MONTHS
HiB
DTaP
(subtotal for visit):
HG CONTENT
25.0mcg
25.0mcg
50.0mcg
Avg. weight: 16lbs/7.3kg EPA limit: 0.73mcg = 68 times over
12 MONTHS
HiB
DTaP
(subtotal for visit):
25.0mcg
25.0mcg
50.0mcg
Avg. weight: 20lbs/9kg EPA Hg limit: 0.9mcg = 55 times over
TOTAL Hg EXPOSURE IN FIRST
Jul.15.2008
Louis LEE,M.D., H.M.D., N.M.D.,M.B.A.
YEAR: 212.5mcg
29
30. Bolus vs. Chronic Exposure
FDA’s “Interpretation”
• FDA totaled 4 large “bolus” doses at birth, 2, 4, & 6
months (162.5mcg) and divided by 180 days.
• 162.5mcg divided by 180 = 0.9mcg per day.
• This “average” daily exposure was just above the EPA
limit, but below FDA and CDC limits.
• Analogy: You can take 2 tylenol a day for 60 days and
be fine. But 120 tylenol in one day is a lethal dose.
Jul.15.2008
Louis LEE,M.D., H.M.D., N.M.D.,M.B.A.
30
31. Safe Minds: Common Symptoms of Autism
& Mercury Poisoning
IMPAIRMENTS IN SOCIABILITY
Mercury Poisoning
Autism
Social deficits, shyness, social withdrawal
Social deficits, social withdrawal, shyness
Depression, mood swings; mask face
Depressive traits, mood swings; flat affect
Anxiety
Anxiety
Lacks eye contact, hesitant to engage
others
Lack of eye contact, avoids conversation
Irrational fears
Irrational fears
Irritability, aggression, temper tantrums
Irritability, aggression, temper tantrums
Impaired face recognition
Impaired face recognition
Schizoid tendencies, OCD traits
Schizophrenic & OCD traits
Repetitive, stereotypic behaviors
Repetitive, stereotypic behaviors
Jul.15.2008
Louis LEE,M.D., H.M.D., N.M.D.,M.B.A.
31
32. IMPAIRMENTS IN SPEECH AND LANGUAGE
Mercury Poisoning
Autism
Loss of speech, failure to develop speech
Delayed language, failure to develop speech
Dysarthria; articulation problems
Dysarthria; articulation problems
Speech comprehension deficits
Speech comprehension deficits
Verbalizing & word retrieval problems
Echolalia; word use & pragmatic errors
Hearing loss; deafness in very high doses
Mild to profound hearing loss
Poor performance on language IQ tests
Poor performance on verbal IQ tests
Jul.15.2008
Louis LEE,M.D., H.M.D., N.M.D.,M.B.A.
32
33. SENSORY AND MOTOR ABNORMALITIES
Mercury Poisoning
Autism
Abnormal sensation in mouth & extremities
Abnormal sensation in mouth & extremities
Sound sensitivity
Sound sensitivity
Abnormal touch sensations; touch aversion
Abnormal touch sensations; touch aversion
Impaired visual fixation
Problems with joint attention
Involuntary jerking movements – arm flapping,
ankle jerks, circling, rocking
Stereotyped movements - arm flapping, jumping,
circling, spinning, rocking
Deficits in eye-hand coordination; limb apraxia;
intention tremors
Poor eye-hand coordination; limb apraxia;
problems with intentional movements
Gait impairment; ataxia – from incoordination &
clumsiness to inability to walk, stand, or sit; loss
of motor control
Abnormal gait and posture, clumsiness and
incoordination; difficulties sitting, lying, crawling,
and walking
Difficulty in chewing or swallowing
Difficulty chewing or swallowing
Unusual postures; toe walking
Unusual postures; toe walking
Jul.15.2008
Louis LEE,M.D., H.M.D., N.M.D.,M.B.A.
33
41. 1999 MSDS:
“Nervous System and Reproduction Effects; Effects
of exposure include fetal changes; Mercury poisoning
may occur; Exposure in children may cause mild to
severe mental retardation; Hypersensitivity to mercury
is a medical condition aggravated by exposure;
Hazardous substance, toxic waste disposal."
1991 MSDS:
“Use of chelating agents may be needed to
treat ingestion of mercury”
41
43. What is CHELATION?
•
•
•
•
From Greek chele, or claw.
Developed for lead poisoning by Army.
Sulfur-based agents bind with heavy metals.
Use ONLY under doctor’s supervision.
• Two main agents currently in use:
DMSA: Di-Mercapto-Succinic Acid
IV, or more typically in children, orally
DMPS: Di-Mercapto-Propane-Sulfonate
Transdermal patch (untested, controversial, more potent?)
Jul.15.2008
Louis LEE,M.D., H.M.D., N.M.D.,M.B.A.
43
44. TOTAL Hg BURDEN AND AUTISM
RATES IN CALIFORNIA 1985-98
Jul.15.2008
Louis LEE,M.D., H.M.D., N.M.D.,M.B.A.
44
45. BRADSTREET ET. AL. – Autistic
kids excrete 6 times more Hg
Jul.15.2008
Louis LEE,M.D., H.M.D., N.M.D.,M.B.A.
45
46. Mercury is high, cadmium & lead
levels similar (autistic vs. controls)
Jul.15.2008
Louis LEE,M.D., H.M.D., N.M.D.,M.B.A.
46
49. • 89 in 125 = 69.6% autistic
children have both Lead and
also Mercury
Jul.15.2008
Louis LEE,M.D., H.M.D., N.M.D.,M.B.A.
49
50. Mady Hornig – Columbia University
Hornig used one mouse strain with genetic Hg
sensitivity and autoimmunity and two strains without
them, then replicated the immunization schedule
using thimerosal-containing vaccines.
•
Sensitive mice showed significant delay in weight gain.
•
Sensitive mice had enlarged brains, noted in autistic children,
vs. controls.
•
“Behavioral impoverishment” was highly significant the
sensitive strain.
•
40 percent of sensitive mice were “self-mutilatory” at six
months, ie, frantically grooming or biting tails.
•
One mouse groomed through partner’s skull.
50
51. THIMEROSAL EXPOSURE & AUTISM RATES IN
SWEDEN: 1980-1996
Jul.15.2008
Louis LEE,M.D., H.M.D., N.M.D.,M.B.A.
51
52. THIMEROSAL EXPOSURE & AUTISM RATES IN
DENMARK 1981-2000
Jul.15.2008
Louis LEE,M.D., H.M.D., N.M.D.,M.B.A.
52
53. OFFICIAL STATEMENT:
World Health Organization (WHO)
before 2001
“The latest studies do not support concerns
over safety of thiomersal in vaccines.
There is no reason to change current
immunization practices, since the benefit
outweighs any unproven risks.”
Jul.15.2008
Louis LEE,M.D., H.M.D., N.M.D.,M.B.A.
53
54. OFFICIAL STATEMENT:
Committee on Safety of Medicines
(CSM) –United Kingdom
“There is no reliable evidence of
neurological adverse effects caused by
thiomersal in vaccines. The balance of
benefits and risks of thiomersal-containing
vaccines therefore remains
overwhelmingly positive.”
Jul.15.2008
Louis LEE,M.D., H.M.D., N.M.D.,M.B.A.
54
56. Generation “Zero”
Nov-Dec 1999
Recently rediscovered. First run of the
numbers. Very high relative risks for
outcomes.
Autism RR = 7.6
UNPUBLISHED STUDY OBTAINED THROUGH
FOIA
56
57. Generation 1
Verstraeten 2/2000
Verstraeten reruns numbers, risks are
lower.
Still, significant outcomes “just won’t go
away.”
Autism RR = 2.48
UNPUBLISHED STUDY OBTAINED THROUGH FOIA
Jul.15.2008
Louis LEE,M.D., H.M.D., N.M.D.,M.B.A.
57
58. Generation 2: Simpsonwood
- ACIP 6/2000
CDC, FDA, AAP, PHARMA, etc. meet in
secret on Hg and NDDs.
Verstraeten presents at public CDC
meeting, says RR’s for outcomes increase
with rising exposure.
Autism RR = 1.69.
SIMPSONWOOD MINUTES OBTAINED THROUGH FOIA –
ACIP MINUTES NEVER POSTED ONLINE
Jul.15.2008
Louis LEE,M.D., H.M.D., N.M.D.,M.B.A.
58
59. Generation 3: IOM 7/2001
Verstraeten presents at IOM on same day
he begins work at Glaxo. By this time,
more children have been added to study
population, and RR’s have been reduced
even further. HMO C shows no
“consistent” evidence of harm.
Autism RR = 1.52.
Jul.15.2008
Louis LEE,M.D., H.M.D., N.M.D.,M.B.A.
59
60. Generation 4: Pediatrics 11/2003
Final version of study published 4 years
after it began.
Relative risks for all outcomes reduced to
null or near null.
Autism RR: NO LONGER STUDIED.
Jul.15.2008
Louis LEE,M.D., H.M.D., N.M.D.,M.B.A.
60
64. VSD Generation 4: Autism
(Pediatrics Article, 11/2003)
V ol 112 No. 5 Novem ber 2003,
.
pp. 1039-1048
Jul.15.2008
Louis LEE,M.D., H.M.D., N.M.D.,M.B.A.
64
65. Generation 4: All Outcomes
• HMO A: Cumulative exposure at 3 months resulted in a
significant positive association with tics (RR:1.89)
• HMO B, increased risks of language delay were found for
cumulative exposure at 3 months (RR: 1.13) and 7
months (RR: 1.07)
• HMO C, no significant associations were found.
• CONCLUSION: No consistent significant associations
were found between for neuro-developmental outcomes.
Conflicting results were found at different HMOs for
certain outcomes.
Jul.15.2008
Louis LEE,M.D., H.M.D., N.M.D.,M.B.A.
65
66. GEN 0
Autism Risks Across 5
Generations
GEN 1
GEN 2
GEN 3
7.62
2.48
1.69
Evidence of Harm
1.52
GEN 4
67. COMPLIANCE RATES AND OUTCOME
RATES AT THREE HMO’S
HMO B
(NCK)
HMO A
(GHC)
HMO C
(HP)
Population size
114,965
15,929
17,547
Compliance rate
15%
60%
65%
NDD rate
1.3%
3.9%
n/a
Speech delay rate
2.6%
3.9%
4.5%
(at three months of age)
Jul.15.2008
Louis LEE,M.D., H.M.D., N.M.D.,M.B.A.
67
69. David Kirby – Evidence of
Harm
UPDATE ON RECENT
DEVELOPMENTS IN THE MERCURYAUTISM DEBATE
Autism One
May 2007 - CHICAGO
Jul.15.2008
Louis LEE,M.D., H.M.D., N.M.D.,M.B.A.
69
70. “NEW” CDC findings – ONE IN 150 -- Feb 8, 2007
8 year olds in 2000 and 2002 (born 1992 & 1994)
Average ASD was 6.7 per 1,000 for 8-year-olds in 2000 (1992 birth
cohort) and 6.6 per 1,000 8-year-olds in 2002.
About 1 in 150 children. Most sites found 5.2 to 7.6 per 1,000. (A
46% difference).
Prevalence was much lower (3.3 per 1,000) in Alabama and higher
(10.6 per 1,000) in New Jersey in 2002.
Prevalence increased 10% from 1992 cohort to 1994 cohort in the six
sites with data for both years (HiB, HepB, Rho-D added 1988-1992).
Jul.15.2008
Louis LEE,M.D., H.M.D., N.M.D.,M.B.A.
70
71. SF: ASD kids more likely born in polluted areas
•
284 ASD children & 657 controls, born in 1994 in Bay Area.
•
Assigned exposure level by birth tract for 19 chemicals.
•
Risks for autism were elevated by 50% in tracts with the highest
chlorinated solvents and heavy metals.
•
Highest risk compounds were mercury, cadmium, nickel,
trichloroethylene, and vinyl chloride.
•
Risk from heavy metals was almost twice as high as solvents.
•
“Our results suggest a potential association between autism and
estimated metal concentrations, and possibly solvents, in ambient
air around the birth residence.”
ENVIRONMENTAL HEALTH PERSPECTIVES – Vol. 114 No. 9, September, 2006
Jul.15.2008
Louis LEE,M.D., H.M.D., N.M.D.,M.B.A.
71
72. TOXICOLOGY AND APPLIED PHARMACOLOGY - 15.3 (March, 2006)
•
Urine samples from 100s of French children yielded “evidence for a link
between autism and heavy metals.”
•
Samples from ASD children had high levels of porphyrins – used to
produce of haem, the oxygen-carrying component in haemoglobin.
•
Heavy metals block haem, causing porphyrins to accumulate in
urine.
•
Coproporphyrin was 2.6 times higher in autism cases than controls.
•
One author said it was “Highly likely heavy metals are responsible for
childhood autism in a majority of cases.”
Jul.15.2008
Louis LEE,M.D., H.M.D., N.M.D.,M.B.A.
72
74. Mercury remained in some
vaccines until 2003
“The latest vaccines that
contained any thimerosal
as a preservative, with the
exception of some flu
vaccines, were completed
in 2001 and outdated in
Dr. Harvey Fineberg, IOM President
2003.”
“Meet the Press,” August 7, 2005
Jul.15.2008
Louis LEE,M.D., H.M.D., N.M.D.,M.B.A.
74
75. Coal use goes way up in China
1996-2010:
2010:
2,666 million short tons
1996:
1,500 million short tons
Jul.15.2008
Louis LEE,M.D., H.M.D., N.M.D.,M.B.A.
75
Source: DOE/EIA, 1998, reference case
76. THE SHANGHAI PLUME
(Moves up and down Pacific Coast)
Jul.15.2008
Lower
Louis LEE,M.D., H.M.D., N.M.D.,M.B.A.
urban mercury plume. 10-day traverse from South China Sea,
ending May 5, 2002. Trajectory calculations by N.O.A.A.
76
79. Early Intervention Producing More
Diagnoses Among 3-5 Year Olds?
Average Age of
Diagnosis 1990:
5.3 years
Average Age 2000:
4.4 years
Average Age 2006:
3.1 years
Jul.15.2008
Louis LEE,M.D., H.M.D., N.M.D.,M.B.A.
79
80. California – Autism cases
White vs. Asian/Hispanic (1st Quarter)
14,000
12,000
10,000
8,000
6,000
White
2003
2004
2005
2006
2007
9,296 10,715 11,812 12,725 13,811
Asian/Hispanic 7,301 8,781 10,135 11,560 13,335
Jul.15.2008
Louis LEE,M.D., H.M.D., N.M.D.,M.B.A.
80
81. Vaccination News
Comprehensive Daily News On Vaccines
http://www.vaccinationnews.com/default.htm
Redflagsdaily.com
Health News, Column, Features, and Investigation
http://www.redflagsweekly.com/
Toxic Exposure Study Trust (TEST) Foundation
"Absence of proof is not proof of absence."
http://www.testfoundation.org/
MMR and Vaccine Information
The latest press on the MMR vaccine and autism
http://www.jabs.org.uk/pages/mmr/main.asp
Jul.15.2008
Louis LEE,M.D., H.M.D., N.M.D.,M.B.A.
81
82. Autism : Is there a vaccine connection? (1999)
F. E. YAZBAK, M.D. & K.YAZBAK,B.A., M.A.
Part I. Vaccination after delivery.
http://www.garynull.com/Documents/autism99b
Part II. Vaccination around Pregnancy.
http://www.garynull.com/Documents/autism99b
Part III. Vaccination Around Pregnancy, The
Sequel
http://www.garynull.com/Documents/autism99b3.htm
Autism, MMR and 60 Minutes (11/12/2000)
Another Pediatrician’s Perspective
F. Edward Yazbak, MD, FAAP
http://lib.tcu.edu/www/staff/lruede/60minutesc
Jul.15.2008
Louis LEE,M.D., H.M.D., N.M.D.,M.B.A.
82
83. “All truth goes through three
stages.
First it is ridiculed.
Then it is violently opposed.
Finally, it is accepted as selfevident.”
-Arthur Schopenhauer
Jul.15.2008
( 德國哲學家叔本華 )
Louis LEE,M.D., H.M.D., N.M.D.,M.B.A.
83