The Mail on Sunday January 22, 2006

Does Laurence prove that some doctors want to hide the truth about MMR?
By Sue Corrigan

Dr Andrew Wakefield faces ruin because raised doubts about a controversial
vaccination,       but the astonishing story of this youngster's suffering -
and cure - could be the vital clue that shows the scientist was right all
along....

On the day just over three years ago that Prime Minister Tony Blair
first triumphantly claimed victory for the Govern­ment in the fight to prove
MMR safe, Sue McGowan was too busy even to notice.

She was focusing all her attention on keeping her ten-year-old autistic son,
Laurence, alive with the only thing he could still bear to swallow. 'Six
teaspoons of cranberry juice, every half-hour. That's how critical it got in
the end,' says the mother of four from Kenilworth, near Birming­ham. 'I took
Laurence out of school in 2001, when he first began refusing food and looked
after him at home by myself. Nobody came near us for the next two-and-a-half
years.'

It is just before Christmas and we are in a hotel room on Long Island, just
off the coast of New York, on the final stage in Mrs McGowan's eight­-year
quest to discover what is making her small, pale son so ill. In a few hours,
13-year-old Laurence is to undergo medical tests he could have had years ago
in Britain, but has repeatedly been denied by doctors and NHS hospitals. His
parents had to borrow £7,000 to finance the trip. But now he will get the
tests with two of the very few specialists in the world openly willing to
investigate him.
One is gastroenterologist and paediatrician Dr Arthur Krigsman, an associate
professor at New York University. The other is Dr Andrew Wakefield, the
clinical researcher driven out of Britain and now living in America after
suggesting a link between a new form of bowel disease - which Laurence
appears to suffer from - autism and the Measles, Mumps and Rubella (MMR)
triple vaccination.

With Laurence the first of a num­ber of autistic British children the two
men have agreed to treat, and parent activists claiming there are at least 2
000 sick children who can't get treatment in Britain, a great deal hangs on
the tests to be carried out on this snowy day in Long Island.

If they show Laurence has long been suffering from a painful inflamma­tory
disease that has gone untreated in the UK, as Dr Wakefield firmly believes
they will, then the entire British political and medical estab­lishment's
approach to the bitter MMR controversy will be open to new questioning.

On the other hand, if the endo­scopies, tissue biopsies and blood tests show
nothing, then the reputa­tion and standing of the already embattled Dr
Wakefield will be fur­ther undermined.


British doctors have repeatedly insisted there is nothing physically wrong
with Laurence. If he is indeed just a'fussy eater', or his bowel prob­lems
are a standard by-product of brain damage, 49-year-old Dr Wake­field knows
he'll be condemned for encouraging British parents to embark on an arduous
and expensive wild-goose chase.

Laurence began suffering from a strange, undiagnosed gut disorder from the
age of five. By nine, he was shunning all food and most liquids. With a
swollen, distended belly and stick-thin arms and legs, he weighed just
two-and-a-half stone.

Some time later he did start eating again, but that is when he also began
screaming for hours at a time, hitting out violently and waking repeatedly
through the night. Alternating between diarrhoea attacks and severe
constipation, he also suffered two bowel haemorrhages last year.

But the many doctors and hospitals his mother approached for help, responded
oddly. As soon as she men­tioned her son was autistic, appoint­ments were
refused or cancelled.

A letter in Laurence's thick file of medical notes reveals that a
gastro­enterologist at a Midland's hospital tried to have him admitted to a
psy­chiatric ward without even examining him. Staff at another hospital
sug­gested Social Services be called in, suspecting Mrs McGowan might be
starving her son deliberately. In view of Laurence's obvious ill health,
these responses bewildered his mother.

'Why not just investigate the child? It's pretty simple, isn't it?' Mrs
McGowan says indignantly. 'No one would even explain to me why he couldn't
have any tests, apart from just saying, over and over again, "It's his
autism. It's all just part of being autistic." The best one casualty doc­tor
could do, when I seriously thought Laurence was about to die, was sug­gest I
try organising his food in a dif­ferent pattern on his plate.'

So why couldn't the McGowans get medical help for their son any­where in
Britain? And what of par­ents' claims that thousands of other autistic
children around the UK are similarly being denied tests and treat­ment?

In a six-week investigation, The Mail on Sunday has talked to many parents
of autistic children throughout Britain about their experiences.

One mother says the same gastroenterologist who tried to get Laurence
admitted to a psychiatric ward refused to inves­tigate her desperately ill
daughter too, saying only that any tests would be 'inappropriate'..  What
would lead a doctor to say that to a mother pleading for help for her child?
And why would an NHS consul­tant in a London teaching hospital tell another
parent he would investigate her autistic son's intestinal problems if he
could, but 'I'm not allowed'?

The answer is that these children, and their symptoms, are the front line of
the battle over MMR, and of claims that the live measles virus in the MMR
triple vaccine may be caus­ing gut and brain damage.

In an article published in the Lancet medical journal in 1998, Dr Wakefield
and a team at London's Royal Free Hospital claimed to have discovered, in 12
brain-damaged children, a pre­viously unrecognised bowel disease, later
dubbed by Wakefield 'autistic entero-colitis'.


Colonoscopies performed on scores of autistic children and teenagers in the
United States, Italy and Venezuela have since backed up his claim of an
apparently new disease, differing in several crucial ways from the well
­recognised inflammatory bowel dis­eases Crohn's and ulcerative colitis.

Dr Wakefield's highly controversial assertion is that this new gut disease
may be causing brain damage in cer­tain vulnerable children, resulting in a
particular form of autism.

Even leaving aside the vexed ques­tion of whether or not MMR jabs could be
one cause of the bowel dam­age, this theory overturns decades of received
medical wisdom; that autism is a genetic brain disorder with which children
are born.

According to the British medical and scientific establishments, this is a
baseless medical scare story. They say there is no credible evidence a new
form of bowel disease exists in autistic children, let alone that the live
measles virus in the MMR jab, first given to children at around 13 months of
age, may be causing it.

Mr Blair declared the matter set­tled back in October 2002, when his
official spokesman boasted at a Downing Street media briefing: 'We are
winning the argument that MMR is safe.' The PR campaign designed to reassure
nervous parents still had some way to go, the spokesman con­ceded, but
'intellectually', the Gov­ernment was winning its case.

But this battle is not over, and caught in the middle of no-man's-land are
thousands of children just like Laurence, repeatedly being refused even the
most routine investigations. In many cases, doctors are refusing even to see
children before announ­cing that tests aren't necessary.

The very few gastroenterologists and paediatricians in Britain who are
agreeing to investigate and treat autistic children with bowel disease are
doing so not only in secrecy, but even fear. Their names are passed along a
network of parent and scien­tific activists and none was willing to speak
publicly.

A senior paediatric gastroenterolo­gist at a major London teaching hos­pital
did, however, agree to comment off the record. 'The points you raise about
children with autism having difficulty in accessing medical ser­vices in
Britain are well made and have been of concern to me for some time,' he said


One mother says her GP refused to refer her autistic child to the Royal Free
where some extremely ill children are still being investigated and treated,
on the grounds that the specialists there had been 'discred­ited' for doing
this work.

Finding any form of bowel disease in autistic children is not, it seems, a
smart career move these days, so many doctors are refusing even to look. Mrs
McGowan says: 'They've all seen what happened to Dr Wake­field and they're
petrified.'

Later this year, Dr Wakefield and two former colleagues from the Royal Free
face a hearing before the UK's General Medical Council on charges of
professional misconduct relating to their original research. If found guilty
all three could be struck off the med­ical register in the UK.



The charges relate to Sunday Times allegations that the research was begun
at the behest of lawyers act­ing for some 1,200 parents planning to sue
MMR's three manufacturers, and was partly funded by a £55,000 grant from the
Legal Aid Board. Freelance reporter Brian Deer claimed Dr Wakefield
concealed this from his fellow researchers and failed to declare the
apparent con­flict of interest to The Lancet when submitting the team's
findings.

Dr Wakefield, who now runs a clinic for autistic children in Austin, Texas,
is currently suing both Mr Deer and The Sunday Times for defamation, and
says he is confident he will be cleared by the GMC.

And he firmly believes the Long Island tests will show Laurence is suffering
from bowel disease.
Breaking a long, self-imposed media silence to speak to The Mail on Sunday,
he said: 'There's nothing ambiguous or uncertain about Laurence's condition
in my mind. He has all the appearances of a child with intestinal disease.
To stand back and watch a child continue to suffer as Laurence has suffered
would be professionally unacceptable and morally reprehensible.

'This is a battle for the soul of modern medicine. Do we listen to patients
- in this case those many parents who know their children bet­ter than
anyone else and who first raised the possibility that MMR might be the cause
of their children's problems - and treat their views and opinions with
respect? Or do we insist we doctors always know bet­ter and refuse to
listen?

'I have always believed my first duty to my patients is to treat with
respect what they have to say. If parents say their autistic children are
suffering from serious gut and bowel problems, then the medical profession
has a fundamental oblig­ation to investigate those claims.'

One of the arguments commonly advanced against parents who allege their
child has been damaged by a vaccine is that, stricken by guilt and grief,
they need to find some external cause to blame. It is also claimed that such
allegations are frequently motivated by hopes of huge damages pay-outs.

But Mrs McGowan, a 47-year-old housewife now studying part-time for a fine
arts degree, and her accountant husband, Alfred, are neither looking for
something to blame nor someone to sue.
She says: 'We have never at any stage made any claims about what caused
Laurence's illness, because we have no idea what his illness is. That is
what I am trying to find out.

'I have no idea if MMR is to blame, and have never suggested it might be.
But you only have to mention the word "autism" and the doctors fly into the
rafters.'

It is at this point she leaves for a clinic just off Long Island's Sunrise
Highway, finally taking her son for the medical tests she's sought for so
long. Seven hours later, she hands me Dr Krigsman's initial report, along
with endoscopy photographs of Laurence's intestinal tract which reveal a
'carpet' of small, surface ulcers and patches of inflammation. Along with a
later report from New York's Mount Sinai Hospital, the results conform in
every detail with the disease described by Dr Wake­field in 1998 as autistic
entero-colitis.

The Mail on Sunday has obtained independent confirmation of that fact from
four medical sources.



The next day, Dr Wakefield says the ulceration is among the most severe
either he or Dr Krigsman had encountered. Later he adds: 'These results
explain completely Laurence's refusal to eat or drink, his violent outbursts
and disturbed sleep, the dark rings under his eyes and pallor, his
pronounced failure to thrive and two bowel haemorrhages.  'Moreover, they
show his condi­tion is treatable with standard anti­ -inflammatory drugs,
exactly as we'd hoped.'

Mrs McGowan reports that within three weeks of starting to take
anti-­inflammatory drugs, Laurence is 'happily eating food he hasn't touched
for years and his mood and behaviour have been trans­formed'.. She also says
he is starting, for the first time in years, to speak more fluently.

None of this proves anything about the feared link between MMR, bowel
disease and autism, of course. That remains a theory that will only be
proved or dispelled by scientific and clinical studies that the Government
remains so reluctant to authorise.

But Dr Wakefield remains certain he will, sooner or later, be proved correct
'I couldn't possibly do any of this if I didn't think that,' he says.

A Department of Health spokes­man said: 'MMR remains the best form of
protection against measles, mumps and rubella. It is recognised by the World
Health Organisation as having an outstanding safety record and there is a
wealth of evidence which shows children who receive the MMR vaccine are no
more at risk of autism than children who don't.'

In the meantime, what is to be done about the estimated 2,000 autistic
children in Britain who, just like Laurence, apparently suffer from a bowel
disease the Govern­ment and medical establishment insist does not exist?

In 2001, a delegation of parents and doctors, including Dr Wake­field,
alerted the Government to their plight. At a meeting in Downing Street, the
then Deputy Chief Medical Officer, Professor Pat Troop, listened to their
pleas for specialist facilities to investigate and treat these children, and
promised to get back with the Gov­ernment's response.

They never heard another word. When I tried to ask Professor Troop, now head
of the Health Protection Agency, why there had been no response, she sent a
message back via her secretary that she couldn't comment because she no
longer had the relevant files.

Perhaps the time has now arrived when someone might care to dig them out?