By Dan Olmsted and Mark Blaxill
As the white-hot glare of attention begins to pull away from the outbreak of tics among students at LeRoy Junior/Senior High School in Western New York, most medical and media sources appear to have settled on “conversion disorder” as their default diagnosis.
Newsweek acknowledged the families’ belief that something physical must be wrong, but the author insisted on “a very inconvenient truth: the cluster in Le Roy is, by all reasonable judgment, a mass hallucination. Aided by media of all sorts, what the girls are suffering from is perhaps the ultimate disease of our era.”
The New York Times, without bothering to name LeRoy, published an article titled “Hysteria and the Teenage Girl”: “Female adolescence is — universally — an emotionally and psychologically intense period. It is during this time that girls become aware of the emergence of womanhood, with both the great joy and promise that come with it, and also the threat of danger.” As evidence, the writer noted that a LeRoy cheerleader – not a linebacker – was one of the first stricken.
“Well, that’s the kind of nutty story that only happens once, or so I briefly thought,” wrote Caitlin Flanagan, “until more focused Googling quickly led me to an almost identical episode, this one in 2002, in a high school in rural North Carolina. Once again, a cheerleader was first to manifest the strange symptoms, and once again other girls, some of them cheerleaders, were struck with the same condition.”
Though the writer is a woman, the supposed susceptibility of peppy, excitable female cheerleaders versus stolid, masculine football players is Freudian paternalism dressed up for a new century – a misogynist’s dream. (It was our skepticism of conversion disorder that drew us to this story, having addressed it in a chapter titled “The Age of Hysteria” in our book; we will have more to say about its shaky foundations in upcoming articles.)
Responding to community pressure, the LeRoy school district has grudgingly commissioned a new round of environmental tests while asserting “the school is safe,” a balancing act that left many in the community dissatisfied. (The school board this week approved the new tests, expected to cost as much as $75,000. Some parents and environmental groups are pushing for broader tests than are so far planned. ) Local TV stations have stopped airing videos that show the girls’ tics, concerned that might spawn more “psychogenic” cases. The neurologist in Buffalo who originally diagnosed conversion disorder has become more emphatic about the diagnosis, even as four more cases arose in the past week in and around LeRoy. He hints darkly that some of the girls have had such awful experiences that, if only we knew, we would understand – pinning responsibility on the families as well as the victims’ own psyches.
The National Institutes of Health offered to evaluate the students (about 15 total at the school, possibly including one boy) for PANDAS – an autoimmune neurological reaction to strep infection. But it is downplaying the idea in advance. The lead NIH researcher who coined the term told a local news site that simultaneous outbreaks among adolescent girls would be unprecedented and unlikely.
That appears to leave only the girls, their parents and a small corps of advocates – Erin Brokovich’s group, environmental and school safety activists, a doctor who found evidence of strep infection in most of the girls – to push for continued attention to physical causes.
Based on our own reporting and analysis, they are correct to do so. Real illness remains the likeliest explanation with the suggestion that these dramatic symptoms are provoked by stress a convenient excuse for avoiding a rigorous investigation of environmental risk factors . Here are six possible risks that need to be raised, followed by a key question that needs to be answered:
Mycotoxins on playing fields?
In any inquiry into a novel medical condition, identifying significant changes in the environment is a priority. In LeRoy, as we’ve reported, several new factors converged in May 2011, when the first girl was affected there, according to a report from the New York State health department.
That month, a statewide ban against pesticides – insecticides, herbicides, fungicides -- took effect for every school in the state. The ban coincided with the rainiest spring ever in Buffalo and the second rainiest in Rochester – LeRoy is located between them -- followed by more downpours in late summer. One of the warmest winters on record has followed.
The school district confirmed last week that it “has not applied pesticides to any of the high school athletic fields since September 2010.”
That month, a product called Turf Herbicide was “used to spray broadleaf weeds on varsity football and soccer field.” In summer 2009, Roundup Weed killer was used in mulch beds, but not in 2010. (The law banning pesticides was passed in April 2010 and may have affected spraying that summer.)
This probably explains the orange substance that cropped up on playing fields at the school last year – so thick that it coated students’ shoes and clothes, so widespread some thought it was pesticide sprayed from an airplane. Officials said it was a harmless grass fungus called rust. Ironically, these fungal outbeaks may point to a counterintuitive new development: the complete and sudden absence of pesticides on school grounds.
Based on that and a history of flooding and water problems at the school, which is partly sited on a FEMA flood hazard area and wetlands, we speculated that harmful metabolites of a fungus – otherwise known as a mycotoxin -- might also have gained a foothold. One possibility: ergot alkaloids, toxic products of fungi that can grow on rye and other grasses. We told the story of a man in the village of Bath, about 70 miles from LeRoy, who developed similar symptoms last September. He lives next to a field that was planted last summer in ryegrass and not harvested, adjacent to a swamp and a levee. He draws his water from a well in the back yard.
Since then, local news outlets have spoken to experts debunking the possibility of mycotoxins, but no specific tests have been done. (For Leroy a Fungal Theory and Expert Doesn't Buy Ergot Theory.)
In December, the school district tested several places inside the school for mold spores and found none, although they did not do “destructive” tests – cutting open walls and the like – to look for hidden sources. Many experts say that it is the only way to completely rule out mold. They also did one test of the air outside the building – location not given – as a “control” to see if inside readings were higher.
One negative test was for a fungus called a. fumigatus, which can produce ergot alkaloids. A June 2005 study in the journal Applied and Environmental Microbiology found, according to its title, “Abundant Respirable Ergot Alkaloids From the Common Airborne Fungus Aspergillus Fumigatus.”
“Ergot alkaloids are mycotoxins that interact with several monoamine receptors, negatively affecting cardiovascular, nervous, reproductive, and immune systems of exposed humans and animals,” the report said. The alkaloids develop in especially high quantities on maize (corn) and latex paint, according to the study. In a comparison chart, ergot alkaloid production was far higher in latex paint than in any other medium.
That is intriguing because one substance the LeRoy school sprays annually on its grounds is white latex paint, to create the lines that mark playing fields. In the buildings and grounds report, the district said it has used Super Stripe Athletic Paint and Field Marking Paint, two latex brands, every year including 2011.
That might offer an alternative explanation for the Cheerleader Syndrome others have noted. Simply put, cheerleaders spend their time on the sidelines. (And they wear fewer clothes than running backs.) At LeRoy, four of the first 12 girls affected were cheerleaders and two were soccer players, according to the state health department report. In the 2002 North Carolina cluster cited in the Times article, five of the 10 students were current or former cheerleaders.
Managing Editor's Note: New CDC autism prevalence numbers due out later today. Mark Blaxill wrote this in 2009. How many children have been diagnosed in 5 years?