Shaken Baby Syndrome or Vaccine-Induced Encephalitis?
Harold E. Buttram, MD
In a study devised to provide an animal model for the systemic and neurological complications observed following the pertussis vaccine in children, Steinman and coworkers discovered a lethal shock-like syndrome in mice after immunization with pertussis vaccine and sensitization to bovine serum albumin. Post-mortem examination of the brains revealed diffuse vascular congestion and parenchymal hemorrhages in both cortex and white matter.(54)
As early as 1975, Urbaschek described the role of pertussis endotoxin in bleeding and coagulation disorders.(55) More recently, McCuskey et al described the initial responses to endotoxemia as microvascular inflammation with activation of endothelium from its normal anticoagulation state to a procoagulation state.(56) Harrison’s Principles of Internal Medicine also points out that the endotoxin from gram negative bacteria activates several steps in the coagulation process.(57)
Platelet injury by endotoxin may result in a dramatic rise in serotonin, which can initiate coronary chemoreflex causing hypotension, bradycardia, and cardiac collapse, sometimes seen in premature infants following vaccination.(58) It is also said that the hemorrhagic complications from the “black plague” of the Middle Ages were simply due to an unusually virulent form of endotoxin, a property common to all disease-causing bacteria (R. Reisinger, personal communication, 2000).
Consideration must also be given to the possibility that the various vaccines, given in combination, may be synergistic in causing hypersensitivity and autoimmunity.
At least two of the vaccines, H. influenza type b (Hib) and pertussis, are noted for their sensitizing potencies(59) and are routinely given together in infancy.
A New Syndrome? Based on observation and a limited but suggestive body of medical literature, it appears that we may be witnessing in many SBS cases the adverse effects from interactions of highly potent vaccines given in combination. These potentially include: Hepatitis B (hemorrhagic vasculopathies, autoimmune reactions, neuropathies), Hemophilus influenza (hypersensitization), tetanus (hyper-sensitization), and pertussis (hypersensitization, brain edema, and the effects of endotoxin in causing vascular inflammation and hyper-coagulability).
There now appears to be a new syndrome that develops within a 12-day period following immunizations, and which may include elements of adverse reactions from each of the vaccines listed above. The most important of these include brain edema and inflammation of blood vessels, resulting in increased fragility and friability of blood vessel walls. These in turn may lead to spontaneous hemorrhages from a shearing of subdural blood vessels and the development of subdural hematomas, thus mimicking what is now thought to represent the SBS.
These findings are as yet largely unrecognized because unsought. In the name of justice to those now wrongfully imprisoned for child abuse leading to the SBS, and to those who will be accused in the future, let us hope that this area receives the investigation that it deserves.
The Latent Period Following Immunizations: According to the current guidelines of the Congressional Childhood Vaccine Injury Act of 1986, the onset of encephalitis must occur within a specified time period, depending on the vaccine, for the vaccines to be recognized as having caused the encephalitis. (The accepted latent period for pertussis vaccine reaction is 3 days, and that for measles vaccine, 7 days). Inaccuracy in designating this time range could cause many misdiagnoses.
Most early literature dealing with vaccine-induced encephalitis is related to the pertussis vaccine. In 1930, Flexner noted a strong tendency for the nervous system manifestations to declare themselves between the 10th and 13th days.(61) In a review of 108 cases recorded before 1929,(62) the onset of encephalitis was strikingly constant, usually observed between the 10th and 12th days following vaccination, commonly with a febrile period on the 7th and 8th days followed by recovery until the onset of encephalitis. In 1929, an increase in severe neurological complications following infections and inoculations was noted, occurring on about the 11th day after vaccination.(63)
More than 50 years later, Munoz found the same latent period of 11 to 13 days in a mice study of experimental encephalomyelitis elicited by injection of pertussigen.(34)
Literature in the 1980s and 1990s reported an entirely different pattern, with the onset of encephalopathy largely falling within a 3-day period following immunization.(64-66) We can only speculate the reason for this changing pattern. Perhaps it could be attributed to the fact that, in those early years, children may have been given the pertussis vaccine alone or possibly in combination with tetanus and diphtheria vaccines, whereas in recent years they have been receiving the polio, hepatitis B, and Hib vaccines at the same time.
Other studies throwing light on the latent period include one from Japan, showing two peaks of histamine sensitivity in mice from pertussis vaccine, one on the 4th day and another on the l2th day.(67) In 1976, 20 percent of cases of severe neurologic damage following DPT vaccine occurred later than 3 days post-vaccine.(68)