MMR doctor to begin his defence

MMR doctor to begin his defence
The doctor who first linked the MMR vaccine to increased risk of autism is due to defend his reputation at a General Medical Council hearing.

Dr Andrew Wakefield, along with two colleagues, is charged with serious professional misconduct.

His research paper, published in the Lancet in 1998 but since disowned by the journal, sparked widespread fears that the MMR triple jab was unsafe.

The current hearing focuses on alleged irregularities in his research methods.

Dr Wakefield is accused of violating ethical guidelines, and of acting against the clinical interests of the children who took part in his trial.

It is alleged that he took blood samples from children at a birthday party while offering financial inducements.

He is also accused of acting dishonestly in failing to disclose to the Lancet that he was advising solicitors acting for parents who had alleged their children had been damaged by MMR.

A further charge relates to his alleged failure to disclose his involvement in a patent application for a potential single measles vaccine.

The GMC hearing will not examine the safety of MMR, designed to protect against measles, mumps and rubella.

The scientific community has repeatedly stressed that the vaccine is safe, and several large authoritative studies have comprehensively dismissed any link between MMR and autism.

However, a crisis of public confidence in the vaccine in the wake of Dr Wakefield’s original research saw vaccination levels fall, with experts warning that children were being exposed to a raised risk of measles.

Although the infection is usually mild, it can be serious, and in rare cases life threatening.

If found guilty of serious professional misconduct, Dr Wakefield faces being struck off the medical register.

Also facing professional misconduct charges are Professor John Walker-Smith, and Professor Simon Murch

Alcohol ban advised for pregnancy
Women should not drink any alcohol during pregnancy, NHS adviser the National Institute for Health and Clinical Excellence (NICE) has said.

It says if they must drink, they should not do so in the first three months and should limit consumption to one or two units once or twice a week afterwards.

It brings NICE in line with government advice and replaces previous guidance saying small daily amounts were fine.

However, NICE concedes there is no evidence to support the change.

Not everyone agrees with such a tough approach, but research into the impact of alcohol is patchy.

The Royal College of Obstetricians and Gynaecologists said there was no evidence that a couple of units once or twice a week would do any harm to the baby – but could not categorically rule out any risk.

"Unfortunately not all women are getting the support they need at the moment"
Dr Gillian Leng
NICE deputy chief executive

Q&A: Alcohol and pregnancy

NICE, which is responsible for the promotion of good health in England, Wales and Northern Ireland, decided to tighten its guidance partly because of concern that people are now drinking more than in the past.

Previous draft guidance suggested pregnant women could drink a unit of alcohol a day.

NICE deputy chief executive Dr Gillian Leng said people, and in particular women, were drinking more and the NHS advisory body wanted to send a “clear message”.

“I think it reinforces the advice which came out last year. Women should be advised not to drink.”

See table of alcohol units

The Department of Health in England revised its guidance last year, calling for no drinking while pregnant or while trying to get pregnant.

Professor Sir Liam Donaldson, Chief Medical Officer for England, welcomed the new guidance from NICE, stressing that it was particularly important not to drink at the beginning of pregnancy, when the risk of miscarriage was highest.

Drinking heavily in pregnancy can cause foetal alcohol syndrome, which can leave children with features like small heads, widely spaced eyes and behavioural or learning problems.

Supplements

NICE also made a number of other recommendations for the care of women in England and Wales who were pregnant or planning to get pregnant.

It said vitamin D and folic acid supplements should be offered by health staff to help ward off conditions such as rickets and spina bifida.

And screening for sickle cell diseases by week 10 and Down’s syndrome between 11 and 14 weeks using the most up-to-date methods should be available.

Officials also called for local health bosses to ensure peer support schemes where mothers encourage new parents to breastfeed are set up.

Much of what NICE is recommending is already happening although provision is patchy and officials said they wanted to make sure women got “gold standard” care.

Dr Leng added: “Unfortunately not all women are getting the support they need at the moment.”

NICE also called for improvements in the care of pregnant women with diabetes.

About 20,000 pregnancies each year are affected by diabetes and, therefore, carry higher risk of miscarriage, birth defects and still birth.

The guidance said women should get access to advice and support, in particular to achieve good blood sugar control, before they get pregnant.

During pregnancy, access to specialist multi-disciplinary teams of doctors, nurses and midwives was essential, it added.

UNITS FOR ALCOHOLIC DRINKS

Drink	Volume	Strength	Units
Normal beer/lager/cider
half pint	284ml	4	1
large can/bottle	440ml	4.50%	2
Strong beer/lager/cider
half pint	284ml	6.50%	2
large can/bottle	440ml	6.50%	3
Table wine
small glass	125ml	12.50%	1.5
medium glass	175ml	12.50%	2
large glass	250ml	12.50%	3
bottle	750ml	12.50%	9
Spirits
single shot	25ml	40.00%	1
bottle	750ml	40.00%	30
Alcopops
bottle	275ml	5.00%	1.5
Office for National Statistics

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Toll of teenage drinking revealed
Teenagers are drinking an average of 44 bottles of wine or 177 pints of beer a year each, a study suggests.

Almost 10,000 15-to-16-year-olds in the North West of England were questioned as part of the study into underage drinking and violence.

The report, produced by Liverpool John Moores University, found as many as 40% of teenagers in poor areas binge drink.

Recent high-profile murders in the region were carried out by teenagers who had been drinking heavily.

On Thursday,Brendan Harris, 15, was convicted of murdering 20-year-old Sophie Lancaster in a Lancashire park after drinking two litres of cider, peach schnapps and lager.

In February, three teenagers were jailed for life for murdering Garry Newlove, 47, from Warrington, in an act that the judge described as “drunken aggression” carried out for entertainment.

"These figures highlight the sheer quantity of alcohol being consumed by under-age drinkers across the North West."
Professor Mark Bellis

The latest report into teenage drinking was produced by the university’s Centre for Public Health in conjunction with the Home Office and Trading Standards North West.

Researchers also estimate that of 190,000 15-to-16-year-olds in England,57,000 binge by drinking five or more drinks in one session.

Just under half of those surveyed drank at least once a week, with 40% of girls and 42% of boys later involved in violence.

The report also found that poor children were 45% more likely to be violent after drinking than children in affluent areas.

‘Ongoing challenge’

Professor Mark Bellis, co-author of the report, said: “These figures highlight the sheer quantity of alcohol being consumed by under-age drinkers across the North West.

“Sadly, there is still practically no information publicly available on what is a safe amount of alcohol for children to consume or on how parents can best moderate their children’s drinking.

“Without a clear message that under-age drunkenness will not be tolerated, we will continue to see the high levels of alcohol bingeing and related violence identified in this study.”

Dominic Harrison, deputy regional director of public health in North West, said the research confirmed the “almost daily experience” of people who saw the rising problem of young, drunk people across the region.

“The principal cause of the increased risk is lower prices and increased availability, but culture and the increasing social tolerance of drunken behaviour is also a factor,” he said.

More than a third of the teenagers questioned admitted buying their own alcohol – described as an “ongoing challenge” for trading standards officers.

North West officer Richard Lindley said: “Under-18s continue to obtain alcohol by asking strangers outside shops and also friends who either look, or are over 18, to buy for them.

“These purchasers need to be aware they are fuelling problems in our communities and committing criminal offences themselves for which they can face police fines.

Gay men risk of HIV ’still high’
Gay men are being urged to get HIV tests more regularly and practise safe sex in a bid to halt the high numbers of new cases in the UK.

The Health Protection Agency made the warning after new diagnoses among gay men topped 2,600 for the third year.

But the figures do seem to have begun to plateau after a surge at the turn of the century.

Overall, the number of new cases hit an estimated 6,840 in 2007 – a fall of 1,400 from the previous year.

"Gay men continue to be the group most at risk of acquiring HIV within the UK"
Dr Valerie Delpech

The HPA said this was mostly due to a decline in cases among those infected heterosexually in Africa.

But experts said the new cases among gay men was still at worrying levels.

There were 2,630 diagnoses – a slight fall on previous years, but much higher than the annual figures in the 1990s which tended to hover around 1,500.

HPA head of HIV surveillance Dr Valerie Delpech said: “Gay men continue to be the group most at risk of acquiring HIV within the UK.

“We need to reinforce the safe sex message for gay men that the best way to protect yourself from contracting HIV is practising safe sex by using a condom with all new and casual partners.”

She also urged more regular testing so treatment could be started earlier and to reduce the risk of transmission to partners.

The figures are only provisional as they also take into account the expected delays in diagnosis.

Genevieve Clark, of the Terrence Higgins Trust, said it was “good news” that the figures for gay men seemed to be levelling off.

But she warned the number of cases was still too high and called for easier access to testing as some places had long waits for access to sexual health clinics.<P