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Thursday, 15 February, 2001, 02:41 GMT
Autism rates 'not rising'
The MMR vaccinations have been linked to a rise in autism
The MMR vaccinations have been linked to a rise in autism
Claims that there is an "autism epidemic" are unfounded, according to a leading academic.

Eric Fombonne, a psychiatrist from the Maudsley Hospital in London, said any apparent rise in cases was due to wider recognition of the condition.

And he said that the measles, mumps and rubella (MMR) jab was not to blame, as some scientists suggest.

In the piece in the New Scientist he said: "Trying to link this with MMR is complete nonsense."


Trying to link this with MMR is complete nonsense

Dr Eric Fombonne,
Psychiatrist

Dr Fombonne added that those researchers who say the combined MMR vaccine triggers autism wrongly point to an apparent rise in cases since the vaccine was introduced in the late 1980s.

Before the 1980s, one in 2,500 children was diagnosed as autistic. Now the figure is closer to one in 250.

Dr Fombonne said rates of one particular type of autism, "regressive autism", which has been linked to MMR, had not changed since before the vaccine was introduced.

He said: "That rates in recent surveys are substantially higher than 30 years ago merely reflects the adoption of a much broader concept of autism, a recognition of autism among normally intelligent subjects and an improved identification of persons with autism."

'Meagre evidence'

In an article for Pediatrics journal this month, Dr Fombonne said the evidence for an increase in autism-like disorders was "meagre and negative".

He said research limitations affected the reliability of recent reports of an increase in cases, though he admits there is a major problem which had been underestimated in the past.

"But there is no need to raise false alarms of putative epidemics, nor to practise poor science to draw the attention to the unmet needs of large numbers of seriously impaired children and adults," he added.

He called for better monitoring of cases.

The piece criticised 1999 research from California, which is widely quoted as evidence of a dramatic rise in autism.

Dr Fombonne said it does not take into account a rise in the state's population during the key years.

He said other factors, including the earlier diagnosis of autism, had affected figures.

One graph in particular, often used as evidence, had been misinterpreted because it could be seen as showing how many people were diagnosed through the1980s with autism in California.

Dr Fombonne said that the graph actually showed how many were diagnosed in a single year - 1991 - and the year of their birth.

Further study

In a further, unpublished, study, he looked at whether the number of children with regressive autism had changed.

MMR and other environmental factors have been blamed for cases of this kind of autism.

But after comparing a study by the Maudsley of autistic children born before 1980 with one of autistic children in Stafford born before 1992 and 1995, he found there had been no change in the numbers with this particular type of autism.

His comments follow research, published on the British Medical Journal's website earlier this month, which showed the number of autism cases had continued to rise while MMR coverage remained the same.

A spokesman for the National Autistic Society (NAS) said Dr Fombonne's analysis was "reasonable", but that he had not proved the increase was just due to changes in diagnosis.

He added: "There are no baseline figures to compare with. Maybe there is an environmental factor - but we don't know what it is.

The NAS estimates there are 91 cases of autism spectrum disorders per 10,000 people.

The NAS spokesman added that it was difficult to accurately plot how many cases of autism there were because there was no central register, and no way of measuring year on year trends.

"Such figures are still not being collected in the UK. Anecdotal reports suggest that there is a significant increase in numbers of cases of autism.

"However, even the California data which is often quoted as demonstrating a vast increase in cases is not as high as the prevalence figure for autism spectrum disorders estimated by the NAS.

"Until figures are collected systematically we will continue to have to guess at the true number of cases and whether it represents a real increase."

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See also:

09 Feb 01 | Health
MMR 'cleared' of autism link
21 Jan 01 | Health
Doctor renews MMR safety doubts
08 Apr 00 | Health
Marchers demand autism register
01 Dec 99 | Health
Autism gene link
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