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Pages 12-15

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From page 12...
... A previous IOM committee concluded that the evidence is consistent with a causal relation between DPT and acute encephalopathy (IOM, 1991~. In light of that conclusion and the new data from the NCES showing that children who experience acute neurologic illness are at risk for developing chronic nervous system dysfunction, the current committee believes that conclusions, however limited, regarding the relation between DPT and chronic nervous system dysfunction can be drawn.
From page 13...
... Thus, the committee concludes that some children who receive DPT and who experience a serious acute neurologic illness within 7 days thereafter would be expected to go on to experience chronic nervous system dysfunction or die. (All subsequent discussions of the risk of chronic nervous system dysfunction following serious acute neurologic illness should be interpreted to include the risk of death as a sequela to the acute illness.)
From page 14...
... That is, the presence of underlying brain or metabolic abnormalities might predispose the child to react to DPT with an acute neurologic illness, but it is the underlying abnormality that is the cause of the chronic nervous system dysfunction, not the acute illness. DPT vaccination in this context would be a kind of "provocative challenge" unmasking the underlying abnormality.
From page 15...
... rule out the possibility that only children with underlying brain or metabolic abnormalities react to stimuli such as DPT with acute neurologic illness, and no other studies establish or rule out such a possibility, the committee concludes that the evidence is insufficient to indicate whether or not DPT increases the overall risk in children of chronic nervous system dysfunction. The NCES data are consistent with the possibility that some children without underlying brain or metabolic abnormalities might experience serious acute neurologic illness within 7 days after receiving DPT and that acute illness could have chronic nervous system sequelae.

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