Infantile spasms and immunisation
Many parents believe that their children's infantile spasms were caused by a DTP shot, and specifically by the pertussis (whooping cough) immunisation. This is an emotive issue, because compensation may be available if a causal effect can be shown. Parents are therefore motivated to believe that a DTP shot is the cause, whereas the authorities are motivated to dispute this.
It is clearly the case that many children (including Marchant) first exhibit infantile spasms shortly after a DTP shot. What is less clear is that this is cause and effect.
The best analysis is still that done by Bellman (1983). This studied 269 cases of infantile spasms in the UK, and showed on a statistical basis that there was no significant correlation between infantile spasms and pertussis immunisation within the 28 days preceding onset. However, to quote from the paper:
"There was, however, some clustering of cases immunised with either diphtheria - tetanus - pertussis [DTP] or diphtheria - tetanus vaccines in the 7 days before onset. The excess, compared with controls was compensated for by a corresponding deficit over the remaining period of 28 days. It is suggested that these vaccines do not cause infantile spasms, but may trigger their onset in children in whom the disorder is destined to develop."
Further studies are required; the number of cases studied by Bellman is inadequate to support his conclusions, and there have been changes in DTP practice, particularly in the US.
However, the most reasonable explanation remains that that given by Bellman, that the DTP shot does not cause infantile spasms, but rather that it triggers their onset in children already destined to develop the syndrome. This trigger might be some specific factor in the DTP shot, but could equally just be the stress caused by the immunisation.
The characteristic age of onset of infantile spasms (4 to 7 months) seems to be the same in groups that do not have DTP immunisation, and this raises the question of whether their might be some other trigger factor. We have speculated that the onset of infantile spasms might be related to the weaning of the child and that there could be some prophylactic in mothers milk which prevents infantile spasms. This is clearly relevant to the question of what makes the ketogenic diet work.
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(checked: 15 November 2002)
(update 1.1: 8 November 2002)
(issue 1: 12 January 1998)