Le Roy and Corinth, NY, USA: Unusual outbreak of Tourette-like symptoms in at least 22 people

[Digger]

Re: Le Roy, NY, USA: Unusual outbreak of Tourette-like symptoms in 15 students at Junior-Senior High School

NYS Health Department releases report on LeRoy girls

A doctor in Buffalo said today, he’s treating four more young girls with tics in LeRoy. He’s diagnosed three of them with conversion disorder.

Meanwhile, the New York State Health Department released a preliminary report today on the 12 original cases at LeRoy High School. It spells out, in detail, why certain environmental factors are not to blame for these symptoms.

Read More: http://www.whec.com/news/stories/S2482265.shtml?cat=565

The NYS Health Department Report can be found here: http://www.whec.com/whecimages/repos...ion_letter.pdf

added edit: Here is direct link to this report at New York State site:

http://www.health.ny.gov/press/relea...on_summary.pdf

It will be interesting to see the results of the other environmental testing that is ongoing. The EPA has stated that they have found environmental contamination in the LeRoy area but have stressed that does not effect the local water quality due to the 2003 addition of an outside community water source.

[Digger]

Re: Le Roy, NY, USA: Unusual outbreak of Tourette-like symptoms in 15 students at Junior-Senior High School

Leroy Chemicals Not Coming to WNY

Storage Drums, recently removed from the Lehigh Railroad derailment site, have been rejected by CMW in Niagra County. It is unclear where the hazardous material will now be stored.

Lockport (WKBW) State Senator George Maziarz said he was proud, he was relieved, and he was tired of being on the phone. This after a marathon of protesting the Environmental Protection Agency's decision to ship truck loads of chemicals from Leroy to Niagara County.

So local Congressional leadership decided to push the EPA to move those chemicals. The EPA agreed, and the proposed new home for them would be at the Chemical Waste Management (CWM) site in Niagara County.

The big question that remains is where will the chemicals go now? Maziarz and other local representatives said they don't know, as long as it isn't in Niagara County.

Read More: http://www.wkbw.com/news/Leroy-Chemi...138692539.html

[sharon sanders]

Re: Le Roy and Corinth, NY, USA: Unusual outbreak of Tourette-like symptoms in at least 22 people

The state report says:


"Based on the treating physicians’ diagnoses of conversion disorder and the
epidemiologic and environmental investigation, it was concluded that the cases did not have common infectious or environmental causes."


Several of us have discussed whether a combination of factors is at work in this situation. Is it possible that an accumulation of environmental poisoning + hormonal changes at puberty + personal susceptibility + life stressors + preexisting undiagnosed low level bacterial infection (or any combination thereof) is responsible?

Since many of these victims are athletes it must be asked - What chemicals are used in the treatment of the athletic fields? Could a common lawn pesticide or fertilizer increase the risk of environmental poisoning when coupled with other possible environmental hazards in adolescents?...or anyone?

[alert]

Re: Le Roy and Corinth, NY, USA: Unusual outbreak of Tourette-like symptoms in at least 22 people

It is certainly possible that several factors have combined to cause this unique outbreak. Of the 22 cases reported so far, it appears that 21 of them are female, 21 of them are under 18 years of age, 20 of them live in LeRoy, NY, and 19 of them attend the local Junior-Senior High School. Those have to be the first four places to start the investigation. Considering Wikipedia (http://en.wikipedia.org/wiki/Le_Roy_(town),_New_York) lists the population of LeRoy as 7,641, those 20 cases represent a significant attack rate (more than 1 in 400 residents).

In addition to the suspects above, this outbreak may pass ProMED's test for a possible mycotoxin (fungal-based toxin) based on the report below from an unrelated outbreak:

http://www.flutrackers.com/forum/sho...d.php?t=120674 [post #18]

Among all toxins able to produce a toxic encephalopthy, mycotoxins appear a distinct possibility for several reasons. I teach vet students about mycotoxins in animal feed, and key points I emphasize in my lectures are:

- The central nervous system is among the key organs often involved in mycotoxicosis.
- The disease symptoms are often novel and unlike known intoxications.
- There are no secondary cases, thus excluding transmissible disease agents.

Disease is usually acquired by consumption of food containing mycotoxins.

[Anne]

Re: Le Roy and Corinth, NY, USA: Unusual outbreak of Tourette-like symptoms in at least 22 people

perhaps you can search here http://www.environmentalhealthnews.org/


or

http://ehp03.niehs.nih.gov/search/simpleSearch.action?query=neurotoxicant&x=13&y=15

http://ehp03.niehs.nih.gov/article/fetchArticle.action?articleURI=info:doi/10.1289/ehp.114-a100

[alert]

Re: Le Roy and Corinth, NY, USA: Unusual outbreak of Tourette-like symptoms in at least 22 people

This might be relevant. Apparently one case of actual Tourette's Syndrome may have been confirmed.

http://www.reuters.com/article/2012/02/04/us-students-tics-newyork-idUSTRE8130S020120204

Parents urge more tests as twitches spread at New York school

LE ROY, New York | Sat Feb 4, 2012 5:52pm EST

LE ROY, New York (Reuters) - State health officials have added three more names to a growing list of students in this working-class town who are experiencing mysterious tics and twitching, while authorities on Saturday sought to assure parents the community's high school is safe.

Although the symptoms are typically associated with Tourette Syndrome, that has been ruled out in all but one case, causing fear and confusion among many residents of Le Roy, N.Y., about 50 miles east of Buffalo.



[snip]

Three of them had pre-existing medical conditions, including one confirmed case of Tourette's Syndrome

[alert]

Re: Le Roy and Corinth, NY, USA: Unusual outbreak of Tourette-like symptoms in at least 22 people

A bit of background on the only adult case so far. Several things here may stand out:

http://www.cnn.com/2012/02/03/us/new-york-students-illness/index.html

[snip]

Marge Fitzsimmons said her symptoms began in October, around the same time most of the others said their outbursts and twitching started.
Fitzsimmons, a nurse, hasn't worked since being diagnosed.

"When all your tests, all your blood work and all your samples, CAT scans and MRIs all come back normal you kind of start thinking maybe I'm crazy," she said.

Her doctor told her that long-suppressed memories of abuse as a child had suddenly "erupted like a volcano," she said.

CNN mental health expert Dr. Charles Raison said it is common for patients who have conversion disorder to have experienced trauma, like abuse.

Fitzsimmons believes that she has conversion disorder but she's keeping an open mind as federal and independent investigators look into possible environmental causes.

She told CNN that as a youngster she had often swum in the waters of a large quarry within 100 yards of the toxic spill site. It was a place where teenagers used to hang out during the summer. None of the sick other patients have said they had been to the quarry.

Fitzsimmons said even if the cause is determined to be environmental, it won't solve her main question: Will she ever get better?

"At this point I have to have faith in my doctors. All the CAT scans MRIs I have done have come back with in the normal range. So if it ends up being environmental then does that mean I don't have hope of getting better? These are thoughts that go through my head," she said.

[alert]

Re: Le Roy and Corinth, NY, USA: Unusual outbreak of Tourette-like symptoms in at least 22 people

Might this report of a second adult be new as well? Or might this simply be the counting of a 19-year-old high school senior as an adult? The 18 teens and two adults could be the same 20 people as the 19 teens and one adult reported earlier...

http://www.buffalonews.com/city/communities/batavia-genesee-county/article721293.ece

3 Le Roy students had pre-existing conditions
Early case may have led to mass hysteria, state health department report says

By Sandra Tan

Published:
February 3, 2012, 1:16 PM

Updated: February 3, 2012, 11:28 PM


snip

There are now 18 known cases of Le Roy students, as well as two adults, who have come down with illnesses involving involuntary twitches, movements and gestures, according to the Department of Health. Three have come to the attention of the Health Department in just the past few days.

All but one of the students are female.

This fast-moving story continues to change on a daily basis. On Friday, the Le Roy Central School District announced a community meeting will be held in the high school auditorium at 9 a.m. today to share plans for additional environmental testing by an outside firm.

Political leaders also raised new concerns about moving steel drums of potentially toxic material from a Le Roy Superfund site that stemmed from a 1970 train derailment and chemical spill.

In the Health Department's first published report on the Le Roy outbreak, state health officials accept and support the conversion disorder diagnosis of treating physicians for the bulk of the afflicted students.

Of the original 12 students, ranging in age from 13 to 19, eight were diagnosed by physicians as having conversion disorder, real physical symptoms stemming from an underlying psychological cause.

The department also said it is still awaiting a final diagnosis on most of the remaining cases.

The students diagnosed with conversion disorder "all had significant life stressors," the report stated.

The first case in the bizarre tic outbreak occurred in May. Three more cases appeared in September, and another four were identified in October, the month that the state Department of Health launched its investigation, according to the report.

Additional cases appeared in late November and December and more have popped up in Janurary and this month as international media attention on the tic outbreak has grown.

Of the original 12 cases, gender and attendance at Le Roy Junior-Senior High School was the only common factor. All 12 students were initially evaluated by WorkFit Medical, and eight of the 12 were subsequently evaluated by Dent.

"No common in-school or after school activities among the entire group were identified," the report stated. "Four participated in cheerleading and two participated in soccer.

[snip]

[Digger]

Re: Le Roy and Corinth, NY, USA: Unusual outbreak of Tourette-like symptoms in at least 22 people

Brockovich rep sends open letter to Le Roy superintendent

Bob Bowcock, investigator for environmental activist Erin Brockovich's team, has sent an ??open letter?? dated Monday to Le Roy School Superintendent Kim M. Cox.

The letter deals with issues surrounding the Tourette-like symptoms experienced by at least 15 Le Roy students, as well as the December 1970 Lehigh Valley train derailment and chemical spill in Le Roy.

Bowcock, who was asked by officials to leave the Le Roy High School property during a visit there Jan. 28, said the letter is ??my attempt to reach out and work collaboratively.

Read More: http://thedailynewsonline.com/news/a...871e3ce6c.html

[Digger]

Re: Le Roy and Corinth, NY, USA: Unusual outbreak of Tourette-like symptoms in at least 22 people

Neurologist Announces Diagnosis for LeRoy Girls

LeRoy, N.Y. ? A Rockland County Neurologist says his tests have found a common link between six out of eight teenagers in LeRoy who have come down with "tourette-like" symptoms.

Dr. Rosario Trifiletti told families that some of the girls show symptoms connected to an infection related to strep. He came to LeRoy last month to personally test the teens.

Read More:http://www.13wham.com/news/local/sto...cQhPEOZ1g.cspx

[alert]

Re: Le Roy and Corinth, NY, USA: Unusual outbreak of Tourette-like symptoms in at least 22 people

The detection of both Streptococcus and Mycoplasma is a very confusing development....

It appears we now have [at least] two competing theories as to what is going on.

http://thebatavian.com/howard-owens/mechtler-disputes-pandas-diagnosis-le-roy-girls-seen-new-jeresy-doctor/30337

Mechtler disputes PANDAS diagnosis for Le Roy girls seen by New Jeresy doctor
Submitted by Howard Owens on February 6, 2012 - 11:13pm

It isn't surprising, according to Dr. Laszlo Mechtler, that a doctor from New Jesery who makes a living diagnosing PANDAS came to that conclusion today in the Le Roy Illness case.

Dr. Rosario Trifiletti appeared on the Dr. Drew television show tonight and also released a statement saying that "five of eight girls show evidence of carriage of Streptococcus Pyogenes and seven of eight show evidence of infection with Mycoplasma Pneumonia."

"This is what everybody expected him to do," said Mechtler, who is part of the team at Dent Neurological Institute who diagnosed the girls with conversion disorder.

Mechtler added that Dent's physicians stand by their original diagnosis and added that other experts are ready to step forward, including Dr. Susan Swedo, who was the first doctor to write about PANDAS, to support the conversion disorder diagnosis.

[snip]

Mass psychogenic illness refers to passing of one symptomatic behavior from one person to another. While not all 12 girls originally knew each other, there is a chain of connection among all of the patients diagnosed with conversion disorder.

After the jump (click the headline to read more) is the full statement from Trifiletti:

I have now had the opportunity to review laboratory data collected in standardized fashion on eight of the nine girls I examined in Leroy, NY on 1/29/12. Five of eight girls show evidence of carriage of Streptococcus Pyogenes and seven of eight show evidence of infection with Mycoplasma Pneumonia. All eight girls tested show evidence of infection with at least one of these pathogens. Both of these agents have been associated with a PANDAS-like illness with the sudden onset of motor and vocal tics. Thus, a PANDAS-like illness is my working diagnosis, rather than a mass conversion disorder.

These findings provide a significant clue in the Leroy High School mystery, but certainly many questions remain. Streptococcus Pyogenes and Mycoplasma Pneumonia are common pathogens that children throughout the world are exposed to every day. Why this town? Why this particular child and not another? Why such a curious presentation resembling Tourette syndrome? Until these questions are fully answered, the cluster will remain a mystery. I suspect that genetic, environmental factors provide an immune background where the PANDAS-like response is possible to common pathogens. The infectious exposure is simply “the straw that broke the camel’s back”. However, the infectious exposure points the way to rational medical treatment for these children, which is of immediate importance. Such treatment, which involves antibiotics and anti-inflammatory agents, has already begun. Clearly, response to such treatment will be helpful in supporting my working diagnosis.

As with most illnesses, there is a complex interplay of genetic and environmental factors here. As with all illnesses, psychological factors likely play some role as well. All we have done here is provided evidence for exposure to two infectious agents as potential environmental factors. I would encourage efforts to further explore genetic and other environmental factors that likely are playing an additional role here.

[Emily]

Re: Le Roy and Corinth, NY, USA: Unusual outbreak of Tourette-like symptoms in at least 22 people

Mechtler from thebatavian.com article link in the previous post:

"That he is saying this is a PANDAS weakness related somehow to an environmental toxin is only going to tie it back to Erin Brockovich," Mechtler said. "This diagnosis is going to be huge for these guys."
[snip]
"... But if they say it's PANDAS and TCE, there's going to be lawsuits."

Sad but informative article here:

How Environmentalists Lost the Battle Over TCE
First of two parts March 29, 2006|Ralph Vartabedian | LA Times Staff Writer

Autoimmune links are there, but 'evidence' is in the eye of the beholder:

http://www.diabetesandenvironment.org/home/contam/tce

Autoimmunity

TCE has long been suspected of contributing to the development of autoimmune disease because of studies that have shown associations between TCE exposure (through drinking water or occupationally) and various autoimmune diseases, including systemic lupus erythematous (SLE) and scleroderma. People living in areas with TCE-contaminated drinking water have been found to have signs of autoimmunity or autoimmune disease (Keil et al. 2009).

As long as 15 years ago, TCE was found to induce autoimmunity in animals (Khan et al. 1995). Subsequent studies have confirmed that TCE can promote autoimmunity in genetically susceptible mice, using different doses and routes of exposure (e.g., Gilbert et al. 2006; Wang et al. 2007). A recent review examined experimental and human studies of the immune-related, especially autoimmune-related, effects of TCE. It found that the consistent findings of the studies and the similarities between studies in mice and humans support the idea that TCE may cause autoimmune disease (Cooper et al. 2009).

The health effects of TCE exposure during development (e.g., in utero) were not included in this review. Developmental exposures to TCE show that TCE affects the development of the immune system. These immune system effects occured at lower doses than those producing effects in adult animals (Peden-Adams et al. 2006). Do these developmental exposures promote autoimmunity in animals? This question has not yet been answered. Developmental exposure to TCE has not been found to increase autoantibody levels in mice (Peden-Adams et al. 2008), but on the other hand, at higher levels of exposure, TCE does affect cells in the thymus, which may have implications for the development of autoimmunity (Blossom and Doss 2007) (see the autoimmunity page for more on the thymus and how substances can be toxic to the developing immune system).

The effects of TCE exposure depend on the strain of mouse. Interestingly, Keil et al. (2009) found that at low doses, TCE did not contribute to the progression of autoimmune disease in genetically susceptible mice, but did lead to increased markers of autoimmunity in mice that were not genetically prone to autoimmune disease.

http://www.health.ny.gov/press/relea...on_summary.pdf

Water in an adjacent dolomite quarry has very low level of TCE (median value of five micrograms per liter, which is NYS drinking water standard for TCE). School officials reported that crushed stone from the quarry was used at the school in a road construction project and for subsurface drainage at a playing field. Residual TCE that might be present in stone from the quarry would be reduced or eliminated through evaporation during stone crushing and handling operations.

Somewhat of a pattern here with the disease following historical trends of industrialization, (and maybe coal use), and growing urban populations migrating out into what was once farmland and waste dumps.

http://www.cdc.gov/ncbddd/tourette/research.html

[maryf]

Re: Le Roy, NY, USA: Unusual outbreak of Tourette-like symptoms in 6 students at Junior-Senior High School

Digger..

Trying to find out what high school you're referring to Northern Indiana where the a number of tourette cases have come up?

Thanks

[sharon sanders]

Re: Le Roy and Corinth, NY, USA: Unusual outbreak of Tourette-like symptoms in at least 22 people

Welcome maryf.

Digger is not disclosing this publicly due to patient confidentiality issues. If you give permission, I can give him your email address that is registered with FluTrackers.

[alert]

Re: Le Roy and Corinth, NY, USA: Unusual outbreak of Tourette-like symptoms in at least 22 people

Hat-tip Pathfinder. It's a small world after all. This is the outbreak I referred to in post #109 above in Uganda that has a lot of similarities with this one. Click the link for a lot of revealing information:

http://www.monitor.co.ug/OpEd/Commentary/-/689364/1321424/-/1292e61z/-/

Nodding Disease: What do the Acholi and New Yorkers share?

Posted Tuesday, February 7 2012 at 00:00

The anguish, misery, frustration and hopelessness that has gripped the Acholi community in Pader, Kitgum and Lamwo and Ugandans of goodwill over the mysterious ‘nodding disease’ afflicting over 4,000 children and killed at least 200 according to local media reports, is now being shared thousands of miles away by people of New York in United States.

New York State Department of Health and US Centers for Disease Control (CDC) officials in Atlanta, Georgia, have now confirmed that at least 15 teenage children (14 girls and one boy) from Le Roy High School in Genesee County, New York, are suffering from a mysterious disease with similar symptoms of involuntary head nodding, epileptic-like seizures and slurred speech.

[snip]

---------

[That said, there are some important distinctions between the two outbreaks. The outbreak in Uganda is affecting younger children and appears to affect girls and boys equally. The outbreak in Uganda is almost certainly not, as suspected at one point in the above article, to be conversion disorder due to the number of fatalities (although many of the fatalities have been reported as the result of falling into a fire and other such accidents as a result of the involuntary motions). And there is a known link between the involuntary motions in Uganda and the sight of food, something that has not been reported in the New York outbreak. Nevertheless, these two outbreaks seem to have enough in common with each other and are alien enough to most other known illnesses that their cause may be somehow related. - alert]