Studies that Count, Studies that Don’t Autism and the Vaccine debate

web page ^ | February 25, 2004 | F.Edward Yazbak, MD, FAAP

[pwatson]

February 25, 2004

Studies that Count, Studies that Don’t

Parents in England have a big choice: They can believe Andrew Wakefield or they can believe Tony Blair, Liam Donaldson and Richard Horton. They can trust Andy or they can trust the experts from the Committee on Safety of Medicines and the Joint Committee on Vaccination and Immunization, several of whom have ties with the drug company that distributes the MMR in England.

We in the United States also have a choice between on one side, clinical research, with real children and on the other, one more epidemiological study by the CDC.

The following quotes from presentations on February 9, 2004 to the Vaccine Safety Committee of the Institute of Medicine deserve attention:

“In light of encephalopathy, presenting in children as autistic regression closely following MMR vaccination … The findings confirm a highly significant statistical association between the presence of MV RNA in CSF and autistic regression following MMR vaccination.” Jeff Bradstreet MD, Director, International Child Development Resource Center, Melbourne, Florida.

“The current genetic research estimates that no more than 10% of all autistic cases are genetic in origin. Simply put, the remainder 90% of autistic cases is sporadic with a non-genetic etiology. I tend to think that the sporadic form is by and large an “acquired” subset involving autoimmunity. This subset is likely triggered by a virus, possibly measles virus or MMR vaccine... Based upon our experimental research, it is plausible to postulate that an atypical measles infection that does not produce a typical measles rash but manifests neurological symptoms might be etiologically linked to autoimmunity in autism. The source of measles virus could potentially be MMR vaccine or a mutant measles strain, but more research is necessary to establish either of these two possibilities…Fundamentally, I tend to think that autistic children have a problem of their immune system, which is the “faulty immune regulation.” Hence they have abnormal immune reactions to measles virus and/or MMR vaccine” Vijendra K. Singh, Ph.D., Research Associate Professor of Neuroimmunology, Utah State University, an international expert in the autoimmune causes of autism:

US Representative Dave Weldon, a physician, commenting on the on-going clinical research said: “Mind you, half of Dr. Wakefield’s theory has been proven correct and accepted in the medical community. Hundreds of children with regressive autism and GI dysfunction have been scoped and clinicians are seeing the inflammatory bowel disease he first described. The NIH is finally funding an attempt to repeat Dr. O’Leary’s findings of measles RNA in Wakefield’s biopsy specimens, though I am disappointed it has taken this long..A clinician in New York was poised to repeat Wakefield’s work two years ago, but he ultimately was refused by his IRB and then subsequently had his clinical privileges withdrawn.”

Instead of telling parents why they are suddenly losing their children, the CDC just published another long, pedantic and rather useless MMR “damage-control” epidemiological study: Age at First Measles-Mumps-Rubella Vaccination in Children with Autism and School-Matched Control Subjects: A Population-Based Study in Metropolitan Atlanta by Dr. Frank DeStefano and others [Pediatrics Vol. 113 No. 2 February 2004, 259-266].

The authors did not discuss the causes of the present epidemic now affecting the United States (1) and the world (2), but simply stated that the MMR was unlikely to be the cause of regressive autism because children diagnosed with autistic disorders in Atlanta, Georgia received their first MMR vaccine at about the same age as unaffected children.

The CDC had previously published two local epidemiological studies, in which serious increases in autism were documented (3, 4). It also funded a third study in Denmark (5) that, though much publicized, was flawed and irrelevant to the situation in the United States. That study also seemed to have been primarily intended to exonerate the MMR vaccine and it will be discussed in some detail later.

The CDC has never proposed, designed, funded or carried out a single clinical study on autism.

The only credible way to prove that the MMR vaccination does or does not precipitate autistic symptoms in children, who are genetically predisposed and have been previously exposed to Thimerosal-containing vaccines, is to compare affected children who have received the MMR vaccine with children who have not. This is obviously practically impossible because most children in Atlanta have received the MMR vaccine. The theoretical question is therefore: “How many children in Atlanta would have developed autism if they had not received the MMR vaccine?”

A relatively easy study would be to compare the age of onset of autistic symptoms in children vaccinated at 15 months and those vaccinated at 30 months in Atlanta. I believe, from my own research, that such a study will show that: 1. Autistic behavior follows MMR vaccination and 2. That fewer cases and less severe manifestations are noticed among the cohort vaccinated at 30 months, since vaccination at a younger age appears most damaging. Another easy study would be to compare Measles, MMR and Myelin Basic Protein antibody titers of children who developed autism shortly after MMR vaccination in Atlanta to an equal sample of normal children similarly vaccinated.

Dr. DeStefano states [under conclusions, page 259] “Similar proportions of case and control children were vaccinated by the recommended age or shortly after (ie, before 18 months) and before the age by which atypical development is usually recognized in children with autism (i.e. 24 months).” The CDC, certain pediatricians and the MMR lobby have consistently argued that autism is not due to the triple vaccine because autistic symptoms are “usually first noted” around the time the MMR is administered and that therefore the relationship between the two events is casual and not causal; in other words just a coincidence. Historically, this is not so.

Kanner’s autism was known as Infantile Autism because affected children exhibited symptoms in early infancy. The more recent form of the disease, Regressive Autism, occurs at a older age with symptoms usually starting at 18 to 24 months or later: A child, most often a boy who is developmentally, socially and verbally on par for his age, suddenly stops acquiring new words and skills in the second year of life and then actually regresses, losing speech, cognitive abilities and social dexterity. Many parents have reported and documented such regression in their children after MMR vaccination.

Bernard Rimland, Ph.D., Founder and President of the Autism Research Institute (ARI), a full-time professional research scientist in the field of autism for 45 years, stated after a thorough analysis of the extensive ARI database: “Late onset autism, (starting in the 2nd year), was almost unheard of in the ‘50s, ‘60s, and ‘70s; today such cases outnumber early onset cases 5 to 1, the increase paralleling the increase in required vaccines.” (6) The study by DeStefano, though dazzling with figures and tables proves little, just like the epidemiological studies by Taylor, Kaye and Dales that were supposed to have previously “convincingly proven that there is no relationship between MMR vaccination and autism”. Interestingly, Kreesten Meldgaard Madsen, author of “A Population-Based Study of Measles, Mumps and Rubella vaccination and Autism”, (5) the study funded by the CDC stated “Studies designed to evaluate the suggested link between MMR vaccination and autism do not support an association, but the evidence is weak and based on case-series, cross-sectional, and ecologic studies; No studies have had sufficient statistical power to detect an association, and none has a population-based cohort design” (References 10-16).” In the Madsen bibliography, reference 10 is the first Taylor study (The Lancet); reference 11 is the one by Kaye (BMJ) and reference 12 is the study by Dales (JAMA). For reasons known only to him, Dr. DeStefano still mentioned the Taylor, Kaye and Dales studies as reliable and listed them as references 23, 22 and 19 respectively. Dr. DeStefano and Associates describe the Madsen MMR study as “particularly persuasive”. In fact, that study, because of an integral flaw in its design, could not have shown, that indeed there had been an increase in autism after routine MMR vaccination was initiated in Denmark. The following is part of the analysis by Dr. Gary Goldman and myself of data from the Danish Psychiatric Central Register, the same data that Madsen used. It clearly shows that there has been a serious increase in autism in children under 14 in Denmark in the last few years. (Graph I)

Graph I Incidence of Autism in Denmark by Age Group Source: The Danish Psychiatric Central Register.

The MMR vaccine was introduced in Denmark in 1987. It has been estimated that only 70% of the 15-month old children received the triple vaccine in 1987-1988. The percentage of vaccinated toddlers then reached and remained at 80 to 88% for several years. It is estimated that in the last three years about 95% of the 15-month old children in Denmark received the MMR vaccine.

The present rise in autism in Denmark has clearly started 4 to 5 years after the introduction of the MMR vaccine and it appears to correspond with the percentage of children who received the MMR.

The mean age at the time of diagnosis in Denmark is probably around 4.7 years (“The mean age at diagnosis for autism was 4 years, 3 months, and for autistic spectrum disorders 5 years, 3 months.”) Approximately 25% of autism cases in Denmark are reported in children under the age of 5 with the remainder 75% of affected children being reported when they are 5 to 19 years old. Given these percentages, any inferences about disease in the under-5 group, in which the disease has not yet become manifest, are potentially flawed.

The 2,129,864 person-years reported in the Madsen study divided by the number of children 537,303 indicates that the average age of the children in the study is less than 4 years (range 1 to 7 years). Those children would be 5 to 12 years old in 2003. Because the mean age at diagnosis is 4.7 years in Denmark, the Madsen study could NOT have detected many of the cases of autism that were subsequently diagnosed when these children were older, thereby missing the temporal connection between MMR vaccination and autism.

The 0-4 year old group of children (Graph I, black) remains the lowest from 1980 to 1991, because autism was/is rarely diagnosed under the age of 4 in Denmark. The prevalence of autism in that age group starts climbing after 1991, 4 years after the introduction of the MMR vaccine, to become the second highest by 1993.

The 5 – 9 age group is the earliest cohort that received the MMR vaccine after coverage has improved and is also old enough to be diagnosed. There are consistently more and more affected children in this age grouping.

The 10 –14 age group (dark green) represents the earlier cohort that first received the MMR vaccine, but at lower coverage rates. Those affected children aged 10 to 14 in 2003 were aged 1 to 5 in 1994. They reflect the startup of the autism increase associated with the startup and progression of the MMR vaccination program.

The 15 –19 age group (light green) were aged 1 to 5 in 1989; their number increases but at a much slower rate than in the younger age groups.

Lastly, the 20 – 24 age group (brown) shows only a slight increase starting in 1994 possibly because few if any of this cohort, received the MMR vaccine at a vulnerable age.

Even when one takes into account the classification change that took place in 1993/1994 and the addition of outpatients to the database in 1995, it is evident, when five additional years are considered, that the conclusions of the Madsen group are invalidated and that the data appears to support the hypothesis that increases in autism in Denmark, may be correlated with increases in percentage coverage and number of children receiving MMR vaccination.

It is likely that in Graph I, the 0 – 4 year group of affected children represents those who were not generally diagnosed earlier, that the 5 – 9 age group represents the highest increase that occurred after wide-spread coverage of the MMR vaccine and that the 10 – 14 age group represents the earlier cohort that first received the MMR vaccine, but at a low coverage rate.

It is possible that the rate of autism will now level off at the higher rate since children receiving MMR immunization have now saturated the age groups and replaced individuals in the age groups that were previously unvaccinated.

Approximately 65,000 babies are born every year in Denmark. Graph I shows the early slow ramp-up period due to low vaccination rates. When MMR vaccination coverage improved beyond a certain level, from 1993 to 2001, there was a steady and increasing trend in autism every year. That gradual rise leveled out after the entire cohort aged <10 was almost “completely” vaccinated (vaccine coverage at >95%). It is entirely possible that many of the children of the most affected 5 to 9 group, could have started with symptoms as early as the second year of life.

The prevalence rate of autism in Danish children under the age of 14 has increased by 729% from 17.67 per 100,000 Population in 1980 to 146.42 in 2002. (Graph II)

Graph II Children with Autism under Age 14 In Denmark per 100,000 Population. Source: The Danish Psychiatric Central Register.

The prevalence of autism in children and teens under the age of 14 in Denmark, which was 131.42/100000 in the 7 years before the MMR vaccine, increased by 542% to 843.73/100000 in the last 7 years. Indeed, the prevalence of autism in that group was 11% higher (146.42/131.42) in 2002 alone than in the combined 7 years before the introduction of the MMR vaccine.

Two doses of MMR are administered in Denmark, one at age 15 months, and one at age 12 years. The data suggest that the main concern is the vaccination given at age 15 months.

The prevalence of autism in Denmark in the 0 to 14 year-olds leveled off in the last 3 years, when toddler MMR coverage reached the 95 – 98% level. The reason why this did not take place in the United States in the 90’s was probably because pediatric vaccines in the US contained Thimerosal, further supporting the argument that the study was flawed in principle because countries with strikingly different vaccination practices cannot and must not be compared.

Conclusions

Autism has increased in Denmark after the introduction of the MMR vaccine as evidenced by the fact that the rate ratio i.e. the incidence of autism after vs. before MMR vaccination is 8.8 (95% C.I., 6.3 to 12.1) among 5 to 9 year old Danish children. The Madsen study did not reveal this statistically significant increase.

Dr. DeStefano and his colleagues at the CDC should research the causes of Regressive Autism rather than defend a vaccine in trouble.

Parents are more likely to forgive errors than cover-ups.

References:

1. Yazbak FE. Autism in the United States: a Perspective. J Am Phys Surg 2003;8:103-107 Available at http://www.jpands.org/vol8no4/yazbak.pdf. (accessed February 10, 2004)

2. Yazbak F E. Autism seems to be increasing worldwide, if not in London. BMJ 2003;328:226227. Available at http://bmj.bmjjournals.com/cgi/content/full/328/7433/226-c (accessed February 10, 2004)

3. Prevalence of Autism in Brick Township, New Jersey, 1998: Community Report. Available at: www.cdc.gov/ncbddd/pub/BrickReport.pdf. (accessed February 10, 2004)

4. Yeargin-Allsopp M, Rice C, Karapurkar T, Doernberg N, Boyle C, Murphy C. Prevalence of autism in a US metropolitan area. JAMA 2003;289:49-55.

5. Madsen MK, et. al. A population-based study of measles mumps rubella vaccination and autism. NEJM 2002;347:1478-1482

6. The Autism Epidemic is Real and Excessive Vaccinations Are the Cause A Statement: Bernard Rimland, PH.D.July 14, 2003 Available at: http://autismautoimmunityproject.org/Rimland.htm (accessed February 10, 2004)

F.Edward Yazbak, MD, FAAP TL Autism Research, Falmouth, Massachusetts E-mail: TLAutStudy@aol.com © 2004

[pwatson]

For those of you with open minds with this topic or if you have or know of parents who have a child with Autism and would like my FAQ sheet for parents of kids with Autism email me at pwatsonascc@yahoo.com Regards, Paul Watson

[Born Conservative]

Thimerosal and the occurrence of autism: negative ecological evidence from Danish population-based data.

Pediatrics 2003 Sep;112(3 Pt 1):604-6    (ISSN: 1098-4275)

Madsen KM; Lauritsen MB; Pedersen CB; Thorsen P; Plesner AM; Andersen PH; Mortensen PB
Danish Epidemiology Science Centre, Department of Epidemiology and Social Medicine, University of Aarhus, Denmark. kmm@dadlnet.dk.

OBJECTIVE: It has been suggested that thimerosal, a mercury-containing preservative in vaccines, is a risk factor for the development of autism. We examined whether discontinuing the use of thimerosal-containing vaccines in Denmark led to a decrease in the incidence of autism. DESIGN: Analysis of data from the Danish Psychiatric Central Research Register recording all psychiatric admissions since 1971, and all outpatient contacts in psychiatric departments in Denmark since 1995. PATIENTS: All children between 2 and 10 years old who were diagnosed with autism during the period from 1971-2000. OUTCOME MEASURES: Annual and age-specific incidence for first day of first recorded admission with a diagnosis of autism in children between 2 and 10 years old. RESULTS: A total of 956 children with a male-to-female ratio of 3.5:1 had been diagnosed with autism during the period from 1971-2000. There was no trend toward an increase in the incidence of autism during that period when thimerosal was used in Denmark, up through 1990. From 1991 until 2000 the incidence increased and continued to rise after the removal of thimerosal from vaccines, including increases among children born after the discontinuation of thimerosal. CONCLUSIONS: The discontinuation of thimerosal-containing vaccines in Denmark in 1992 was followed by an increase in the incidence of autism. Our ecological data do not support a correlation between thimerosal-containing vaccines and the incidence of autism.

Major Subject Heading(s)	Minor Subject Heading(s)	CAS Registry / EC Numbers
Autistic Disorder [chemically induced] [epidemiology] Thimerosal [adverse effects]	Child, Preschool Child Denmark [epidemiology] Incidence Preservatives, Pharmaceutical [adverse effects] Registries [statistics & numerical data] Risk Assessment Thimerosal [chemistry] Vaccines [adverse effects]	0 (Preservatives, Pharmaceutical) 0 (Vaccines) 54-64-8 (Thimerosal)

Indexing Check Tags: Female; Human; Male; Support, Non-U.S. Gov't

Language: English

MEDLINE Indexing Date: 200310

Publication Type: Owner: NLM

Publication Type: Journal Article; Multicenter Study

PreMedline Identifier: 0012949291

Journal Code: AIM; IM

[Luke Skyfreeper]

Aren't most of the vaccines now thimerosal-free? And isn't thimerosal supposed to be the triggering agent?

[cripplecreek]

I have no firm beliefe on this issue but i do find the rate of autism and vaccination rates rising at the same level and time frame to be pretty suspect.

Personally i think we're an over vaccinated society anyway. In my case i missed the majority of vaccinations due to the fact that i had my spleen removed as a child. This made doctors reluctant to vaccinate me.

At 40 years old the doc says im healthier than most teenagers and ive only been bedridden sick about 3 times in my life.

[Luke Skyfreeper]

OK, so is it the vaccines themselves, irrespective of thimerosal content, that are provoking the development of autism?

[buffyt]

Our cousin's son was fine, perfectly normal and healthy, until he had his DPT shot. He was never the same. He was sickly, had physical problems, became retarede, never recovered from that shot, and he died when he was just a few years old. He was just fine until the day, minute, second, that he had that shot.

[buffyt]

My brother in law is a doctor and he said that he thinks lupus is caused by all the vaccines, allergy shots, etc. that we take. It makes our immune system overactive, just as AIDS does the opposite. Also, now they are saying that women who take a lot of antibiotics are at increased risk of breast cancer. My mother in law took antibiotics all the time for her sinuses, and she had breast cancer; she had chemo and radiation. She took allergy shots all the time, and she died of LUPUS. I am convinced that there is a relationship. But supposedly without vaccines more people would die?

[cripplecreek]

I have two sisters who have developed lupis. They both received all the recomended vaccinations. One sister is extremely allergic to penicillin. both had strong recactions to at least one of the vaccines they got. I remember that they were both hospitalized when i was a kid.

[Born Conservative]

OK, so is it the vaccines themselves, irrespective of thimerosal content, that are provoking the development of autism?

This particular study shows an INCREASE in autism after the removal of thimerosol. However, the vaccine had been given prior to the removal, so I don't think you can say that the vaccine itself causes autism.

Another key point to remember: autism has been around prior to the MMR vaccine; before modern day diagnostic criteria, more than likely it wasn't specifically identified as autism, so trying to research it prior to the vaccine would be difficult.

[Kay]

Interesting. If you died from pneumococcal pneumonia, your family could successfully sue your doctor for not giving you pneumococcal vaccine. They could win millions if you were not advised to get the vaccine. One of the first thing doctors do after a patient has a splenectomy is to give them pneumococcal vaccine.

Asplenic people are well known to be at much greater risk for overwhelming infections.

God has blessed you with good health.

In my opinion, if you ever get a fever over 101, you should remind your doctor that you are missing your spleen. Doctors need help remembering their patient's past medical histories.

[waverna]

I don't know what to think, I've seen a couple of these threads in the past few days. Of course, my 1-year old just had his MMR shot on Monday. Suffice it to say I am freaking out right about now.

[pwatson]

There does seem to be a connection between the cumulative effects of all vaccines given that contains mercury. However the more conclusive evidence is the finding of the live measles virus in the inflamed intestines of children with Autism. The RNA of that vaccine has been proven to be from the attenuated (Live) Measles virus used in the MMR triple combination vaccine and is not found in the Wild versions. Meaning the measles is only from the vaccine and not from the public. For some reason some toddlers at the 18 months old when given the MMR vaccine instead of developing T-cells to the vaccine instead become infected with the Measles virus itself. also see:

doi:10.1023/B:JOCI.0000010427.05143.bb
Journal of Clinical Immunology
23 (6): 504-517, November 2003
Copyright © 2003 Plenum Publishing Corporation
All rights reserved
Intestinal Lymphocyte Populations in Children with Regressive Autism: Evidence for Extensive Mucosal Immunopathology
Paul Ashwood
The Inflammatory Bowel Disease Study Group, Royal Free and University College Medical School, London, United Kingdom. Centre for Paediatrie Gastroenterology, Royal Free and University College, Medical School, London, United Kingdom; p.ashwood@rfc.ucl.ac.uk


Simon H. Murch
Centre for Paediatrie Gastroenterology, Royal Free and University College, Medical School, London, United Kingdom


Andrew Anthony
The Inflammatory Bowel Disease Study Group, Royal Free and University College Medical School, London, United Kingdom. Department of Histopathology, Royal Free and University College Medical School, London, United Kingdom


Alicia A. Pellicer
Centre for Paediatrie Gastroenterology, Royal Free and University College, Medical School, London, United Kingdom


Franco Torrente
Centre for Paediatrie Gastroenterology, Royal Free and University College, Medical School, London, United Kingdom. Gaslini Institute, Genoa, Italy


Michael A. Thomson
Centre for Paediatrie Gastroenterology, Royal Free and University College, Medical School, London, United Kingdom


John A. Walker-Smith
Centre for Paediatrie Gastroenterology, Royal Free and University College, Medical School, London, United Kingdom


Andrew J. Wakefield
The Inflammatory Bowel Disease Study Group, Royal Free and University College Medical School, London, United Kingdom. The International Child Development Resource Center, Florida

Abstract

Inflammatory intestinal pathology has been reported in children with regressive autism (affected children). Detailed analysis of intestinal biopsies in these children indicates a novel lymphocytic enterocolitis with autoimmune features; however, links with cognitive function remain unclear. To characterize further, the nature and extent of this disease we examined the mucosal infiltrate using flow cytometry. Duodenal, ileal, and colonic biopsies were obtained from 52 affected children, 25 histologically normal, and 54 histologically inflamed, developmentally normal controls. Epithelial and lamina propria lymphocyte populations were isolated and examined by multicolor flow cytometry. Adjacent biopsies were assessed by semiquantitative histopathology. At all sites, CD3+ and CD3+CD8+ IEL as well as CD3+ LPL were significantly increased in affected children compared with developmentally normal noninflamed control groups (p<0.01) reaching levels similar to inflamed controls. In addition, two populations—CD3+CD4+ IEL and LP CD19+ B cells—were significantly increased in affected children compared with both noninflamed and inflamed control groups including IBD, at all sites examined (p<0.01). Histologically there was a prominent mucosal eosinophil infiltrate in affected children that was significantly lower in those on a gluten- and casein-free diet, although lymphocyte populations were not influenced by diet.The data provide further evidence of a pan-enteric mucosal immunopathology in children with regressive autism that is apparently distinct from other inflammatory bowel diseases.


Keywords
Inflammation, mucosa, T lymphocyte, B lymphocyte, human

Article ID: 474304

[ScudEast]

In my case I didn't get a pertusis (whooping cough) vaccination as a child as the vaccination was causing concern. I caught it as part of the epidemic that followed this and have a weak chest to this date. I think every vaccination has to be considered in isolation with regard to risk and benefit.

[js1138]

Aren't most of the vaccines now thimerosal-free? And isn't thimerosal supposed to be the triggering agent?

Yes to both questions, which leads to the more obvious question of why the increase in autism is independent of vaccination levels. There has certainly been no increase in vaccination rates since the 1970s, and vaccines are more carefully made than ever, but autism continues to increase.

Asperger's syndrome link

[oceanview]

when was it removed? shouldn't data start to show the trend reversing itself amongst those vaccinated without it? that data would make this totally conclusive.

[Missus]

It's not just children who may have issues with vaccinations; just as I was getting ready to start college, they came out with a mandatory measles booster--because 5 Asian students the year before had arrived in the US with measles. This is nine months later, but it's a beaurocracy, after all.

I tried to decline the shot, letting them know I have extreme reactions to vaccines, and needed to have it done by my personal doctor--nothing doing! "Get it now, or you don't register." And, at 17, and six hours away from home, that was a little intimidating. So I got the shot.

Then I got the measles.

And ended up delaying school for a few weeks, after all.

I know many people for whom vaccines are not a problem. I'm not one of those. Physically, they cause me problems. Morally, with the "human cell lines" used in culturing some vaccines, they cause me problems.

(And, to reassure the Mom who's child was vaccinated Monday--if they've not gone into seizures and spiked a fever at this point, you're likely fine--and now you have some start points for your own research into whether or not you want to continue vaccinating. We stopped our first daughter's vaccs at 6 months, and never have started with the others... they're disgustingly healthy. :-) )

Regards

[pwatson]

First off, relax, many of the parent’s report their child showed a sniffle or had a cold or was sick at the time they went in for the vaccine. Most of the parents report instant changes with in 24 hours of the child screaming with pain and high fever and un-able to sleep. Watch them closely, currently the numbers are about 1 in 150 children come down with Autism after the MMR vaccine. Most of the reactions are short term. If they show any fever, skin rash, any un-usual behavior, or body changes report it to your doctor. If it’s the worst case situation of the Measles virus growing in their lower gut they will typically have long term diarrhea, or constipation and very smelly stools. Unfortunately short of a lower GI and scope view of the lower intestine, there is no blood or other way to test for Autism; it’s currently a clinical diagnosis not a medical diagnosis. The longer term reactions are the child talks less, and seems to become more pre-occupied with objects, often spinning them, lining them up in order instead of playing with them. They often look away and no longer look into your eyes.