1 Editorial. Measles, MMR, and autism: the confusion continues. Lancet 2000; 355: 1379.

Sir--Your editorial,¹ to use your own words, raises far more questions than it answers. Perhaps I can add a few more questions, plus some hard and disturbing facts, to the debate. I should first mention that I am the parent of a child who became autistic after monovalent measles and MMR vaccinations.

Do children such as my son have typical autism? I believe not. My son, and others like him, do not possess the isolationist-behavioural or self-injurious features. They also have acute multiple food allergies and hyperactivity, which they also acquired shortly after vaccination. So is this autism at all, or is it brain damage that only partially resembles autism? And is the damage to the brain directly linked to gut permeability, as seems to be the case in children such as my son and the children studied by Wakefield and colleagues?² And what was it that damaged the gut in the first instance?

If there was a link with MMR, one might expect new-variant autism to start showing in official statistics. Why has autism among boys aged 3 years in part of east Surrey, UK, been running at one in 69 for the past 3 years? (C Clarke, Learning Disability Services, East Surrey Health Authority, personal communication, 1999).

Why did the education authority of Wakefield, West Yorkshire, UK, only have five autistic pupils in 1992, but had 111 by 1999? Can a 22-fold increase in just 7 years be credibly explained simply by better diagnosis of the condition?

Why is every autistic child in the Shetlands and the Western Isles of Scotland aged 12 years or under, with not a single case among children aged 13-19? Is this significant, given that MMR was introduced in 1988 (G Garson, Shetland Health Board, personal communication, 2000; and M Plant, Gilbert Brain Hospital, personal communication, 1999)?

Why is the USA also recording sharp increases in autism--eg, increases of 876% in 8 years (New Jersey), 627% in 6 years (Illinois), 13-fold in 6 years (Colorado), almost 1200% in 10 years (Broward, Miami), and so on (US state education data)?

Many accounts given by parents are consistent. I watched my son descend from a perfectly normal toddler of 14 months to a mentally-handicapped toddler of 16 months, after measles vaccination. It was a powerful experience to observe this at very close hand. At 14 months he could post square bricks through square slots, today at 13 years, he still cannot.

In evidence presented to the UK Bovine Spongiform Encephalitis (BSE) Inquiry the then Medicines Division was reported to be in a disordered and very seriously understaffed state in 1988, the very year that MMR was licensed. Is this an irrelevant coincidence, or does it provide an illuminating insight into the background to MMR's introduction into the UK?

MMR is said to be safe because there have been few reported adverse reactions. Yet degeneration into autism is not a recognised adverse reaction. The onset of autism after MMR has therefore not been monitored. Is it a new syndrome that has not been recognised, and then been missed, by most of the medical community?

All these pieces of the MMR-autism jigsaw fit together extremely well. They also fit well with the findings of Wakefield, O'Leary, and others. And there are no features among the children of parents like myself--not one--that do not fit into the Wakefield-O'Leary explanation.

David Thrower, Ampthill Square Medical Centre, London NW1 1DR, UK