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Choosing articles for Bandolier is often quite straightforward. Good quality evidence that is either understandable or can be explained, and about topics that are common, just about sums it up. If that evidence is not there, occasionally a quick review is very helpful.

The MMR and autism argument has been outside the straightforward, but several recent publications shed much more light. So this month we have examined evidence linking them, and Bandolier agrees with almost every other healthcare professional and government health service that there is no link .

The problem is that arguments, especially in the media, get mixed. They start by asking about the vaccination link, and end up by engaging in discourses about the cause of autism, how fast it is growing, and who or what is to blame. There are no easy answers.

There is evidence that better services increase apparent autism rates because of case finding [1]. There appears to be evidence linking autism to viral pandemics [2]. Some gene-environment interaction may be a factor [3]. There are systematic reviews [4, 5] on screening and diagnosis. But there's no answer and no certainty that we could find. The lesson is that with a little time and a helpful librarian it is possible to know a lot quite quickly, even is that is not enough.


  1. RE Hillman et al. Prevalence of autism in Missouri: changing trends and the effect of a comprehensive state autism project. Missouri Medicine 2000 97: 159-63.
  2. A Ticher et al. Circannual pattern of autistic births: reanalysis in three ethnic groups. Human Biology 1996 68: 585-92.
  3. EA London. The environment as an etiologic factor in autism: a new direction for research. Environmental Health Perspectives 2000 108 Suppl 3: 401-4.
  4. MM Bristol-Powers, G Spinella. Research on screening and diagnosis in autism: a work in progress. Journal of Autism and Developmental Disorder 1999 29: 435-8.
  5. PE Tanguay. Journal of American Academy of Child and Adolescent Psychiatry 2000 39:1079-95.

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