NewburyportNews.com, Newburyport, MA

January 30, 2013

Mysterious hiccuping has school under scrutiny

By Ethan forman
staff writer

---- — DANVERS — Local and state health officials are investigating reports that more than a dozen students are exhibiting mysterious vocal tics or hiccups at Essex Agricultural and Technical High School.

“The school is willing to do whatever the town and the Massachusetts Department of Public Health want to do,” said Essex Aggie Superintendent-Director Roger Bourgeois. “The health and well-being of our kids is our No. 1 priority.”

Essex Aggie, as it is nicknamed, serves about 500 students from throughout the county, among them students from the Newburyport area.

Bourgeois declined to speculate on what may be the cause.

“As soon as we were made aware of it, we contacted the health officials of the towns and the Mass. Department of Public Health,” Bourgeois s@text1:aid. “We are cooperating fully with the experts.”

“The Department of Public Health has been contacted by local officials, and it is providing technical assistance to the community,” said Anne Roach, media relations manager for the Massachusetts Department of Public Health. “It is too early in the process to provide further details at this point.”

Danvers health director Peter Mirandi said that no case has been confirmed through a physician. In the absence of a diagnosis from a doctor or lab tests, Mirandi said health officials cannot determine what may be at work.

“I have no confirmed cases of something we don’t know if it’s a contagious disease or an environmentally induced disorder. It’s not responsible for me to say anything further on it,” said Mirandi, who was concerned that drawing attention to the issue could do more harm than good.

The Department of Public Health provided Mirandi with a copy of its Center for Environmental Health May 2006 study called “Evaluation of a Potential Cluster of Motor and Vocal Tic Disorders Among Children in Ipswich, Massachusetts” after neurological motor tics were reported in that town. The study did not find any environmental or other cause for the tics in school-age children.

At Essex Aggie, around the November-December time frame, two to three parents contacted Mirandi’s office. There was a meeting of school officials, nurses and the towns’ health officials, and the state Department of Public Health was notified.

North Shore Technical High Superintendent-Director Dan O’Connell said the school’s principal, Brad Morgan, sat in meetings about the tics, including two meetings at Danvers Town Hall. In November, Morgan said North Shore Tech had “a handful of incidences prior to the holiday break,” but they have since disappeared. “Since then, we have had no incidents at all.”

It is unknown if the incidents at the two schools are connected. North Shore Tech is merging with Essex Aggie and Peabody High’s vocational programs. At Essex Aggie, a new $133 million regional school is being built on the north side of Route 62 adjacent to the Berry Building. The construction is across the street from where students attend classes.

Morgan said state officials did not speculate on a cause of the tics. The state is in the process of reaching out to pediatricians on the North Shore, he said.

The incidents on the North Shore seem to mirror ones shown on TV’s “Today” a year ago, in which 12 high school girls at Le Roy High School in upstate New York suffered tics and vocalizations similar to Tourette’s syndrome. One of the girls told the show that stress worsens her symptoms.

Outside studies of the New York school did not find any substance in the environment that might trigger the symptoms. In the report, Dr. Laszlo Mechtler of the Dent Neurologic Institute of Amherst, N.Y., found that what may be going on was called mass psychogenic illness, conversion disorder or mass hysteria, which is brought on by stress. According to reports, the phenomenon is rare and the young women would get better.

Not everyone agreed with that diagnosis, however. According to various reports, Dr. Rosario Trifiletti of New Jersey said the diagnosis may be Pediatric Autoimmune Neuropsychiatric Disorder Associated with Strep, or PANDAS, a disorder of vocal and motor tics associated with a strep infection.

The DPH study on Ipswich dealt with incidents in 2004, in which two families reported to the Center for Environmental Health that their children and others had been diagnosed with tic disorders, a local doctor was treating several children, and an adult had also reported symptoms, though the adult case was ruled out.

In all, eight children, seven boys and a girl, were reported to have neuro tic disorders, and five boys’ medical records were reviewed by the study. Four were diagnosed at different times with a motor tic disorder and three had verbal tics, with tics getting worse according to stress or physical excitement. The study also looked at the town’s water source, PANDAS and Lyme disease. The state was asked to look into environmental factors due to swimming and boating in the Ipswich River.

The study found that “the prevalence of motor and vocal tics in Ipswich children does not appear to be high” and that “transient motor and vocal tic disorders are relatively common among children,” and can affect 5 to 24 percent of children, most often in kids ages 5 to 7.