This book reaches far beyond microbiology. It reviews aspects of the distressing story of autistic children, their emotionally and financially exhausted, totally desperate parents, and of interest groups trying to pinpoint an external cause of autism and to pursue class-action lawsuits. Autism is a severe impairment of social interaction abilities of young children who develop aggressive behaviour or 'walk as if in a shadow, and live in a world of their own where they cannot be reached'. Much work has gone into researching the cause(s) of this devastating condition. In the late 1990s, some doctors in the UK came up with the theory that the measles mumps rubella (MMR) vaccine may be one of the causes of autism, and vigorous publication of this claim led to a significant decrease in vaccine uptake and to small outbreaks of measles, a vaccine-preventable disease, including a few deaths. It took many large epidemiological studies before the theory was finally repudiated. The discovery of the vested interests of the researchers involved did not help their case. But the damage was done. Parents, mistrusting vaccinations, were looking for other possible causes, and thimerosal, a mercury-containing disinfectant added to many vaccines, was accused as another possible culprit. The discussions became increasingly heated and political, and again years passed before the results of large epidemiological studies abrogated this hypothesis. The observation that within a period of 6 years when thimerosal had been removed from vaccines in several countries, the numbers of local cases of autism did not drop, but rather increased, was the final counterargument. The book contains an impressive chapter in which the proceedings of a court case on MMR vaccine as a possible cause of autism with all its ramifications (personal tragedy, heated accusations and replies, cross-examination of witnesses, etc.) are described. Furthermore, many therapies of autism were found to be 'diverse, expensive, and unproven'. Doctors using them were accused of working up parents who were 'hooked on hope'.

The book discusses interrelationships between science and the media, science and society and the difficulties of achieving a public understanding of science in matters which are loaded with emotions. Whilst the stories of claims of and objections to theories of the cause of autism and the description of various cures offered to treat autism make fascinating reading, I felt that the evaluation of credible causes of autism (chapter 11) was not comprehensive.

Paul Offit is very perceptive on issues at the interface of medicine, science, public health and the law. He is determined to mediate mutual understanding among representatives of different perspectives by describing the backgrounds and basis on which people operate and act. Dr Offit's great abilities in this respect were already obvious in his engaging books The Cutter Incident and Vaccinated.

It is highly desirable that this book gains a wide readership among health care workers of all specialties, scientists in academia, government and industry, public health opinion leaders, lawyers, interested students of the biomedical sciences, and, last but not least, members of the wider public.