NJ cluster

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U.S. investigates possible autism cluster
Tuesday, January 19, 1999

By LINDA A. JOHNSON
The Associated Press
-- TRENTON
When Bobbie Gallagher's 2-year-old daughter Alanna, still barely talking, took up strange, repetitive behaviors in early 1993, such as spinning in circles, she began wondering what was wrong.
But when Alanna and the Gallaghers' third child, Austin, both were diagnosed with autism over the next two years -- and the couple kept learning of other autistic Brick Township children the same age -- they began worrying something was wrong in their environment.
Was it the air? The local landfill? Or the nearby Metedeconk River, which supplies drinking water to the blue-collar bedroom community's 71,000 residents?

"It just seemed too much to be coincidental," Gallagher said last week. She and her husband Billy, a commercial fisherman, began organizing other parents of autistic children and seeking help from the government 2 1/2 years ago.
Coincidence or not, health officials are so concerned that two federal public health agencies last spring began investigating what could well become the nation's first documented cluster of autism, the third-most common developmental disorder, according to the Autism Society of America, in Bethesda, Md.

Experts aren't sure some toxic substance is causing autism in the township's boys and girls. But they're convinced that the 40 or so cases among Brick's 6,000 children ages 3 to 10 is excessive: That's 12 times the estimated prevalence. "I think there is a cluster here. I don't know why," said Jacquelyn Bertrand, the developmental psychologist heading the investigation for the National Center for Environmental Health at the Centers for Disease Control and Prevention. "If [we find] it's something that can be taken out of the community, that will be done," she said, adding that the researchers are eager to solve the puzzle here because of escalating calls the last few years about possible, but less credible, clusters elsewhere in the nation.

Last week, staff from the CDC and the Agency for Toxic Substance and Disease Registry spent a few days in Brick, about 40 miles east of Trenton, updating parents on their probe and asking about any chemicals they might have been exposed to during pregnancy.
Autism, a poorly understood disorder, is thought to occur early in pregnancy. In moderate to severe cases, autism makes it difficult to communicate or relate to the outside world, and drives some to obsessively repeat certain motions, even hurt themselves or others; in mild cases, it triggers behavioral problems, and so was blamed previously on bad parenting or mental illness.
"The prevailing theory is that [the cause is] some combination of genes and something else," such as a toxin, virus, immune response to something, trauma at birth or diet, according to an adviser on the project, Dr. Eric London of the National Alliance for Autism Research outside Princeton. Autism appears to be getting more common, although better diagnosis may be the reason. "I've been studying what I believe is a serious increase in autism," said Bernard Rimland, director of the Autism Research Institute in San Diego. He blames industrial pollution, food additives, vaccines given when the immune system is still developing, and overuse of antibiotics, which impairs the immune system.

The few published studies on autism show little has been proven regarding its cause, possible links to toxins, or even its prevalence, federal researchers told dozens of Brick families at meetings Tuesday and Wednesday. Bertrand said that based on a few foreign studies and preliminary results of a small study in metropolitan Atlanta, the CDC estimates 1 in 500 children has mild to severe autism.
Some parents who attended the meeting said they were concerned that the measles-mumps-rubella vaccine triggered their children's autism, but scientists disagree on the plausibility of that.

Using school, medical, and psychological records, Bertrand has been identifying children in Brick believed to have autism. Questionnaires are also going to some families who previously lived there.

Of the 40 cases identified, the diagnosis has been confirmed in 15 of the 16 children examined so far, said Dr. Audrey Mars, assistant professor in neurodevelopmental pediatrics at the University of Medicine and Dentistry of New Jersey-Robert Wood Johnson Medical School. They include two sets of siblings; two more sets await testing.

"Nobody stands out at this point as specifically environmental" in cause, said Mars, who also is hunting for any common characteristics that could offer clues.

Meanwhile, researchers at the toxic substance registry are collecting data on surface and ground water quality in Brick and any contamination from industrial sites, chemical spills, and waste dumping. That will be compared with the data on the children, and some preliminary conclusions could be brought to the families this summer.

"These kids got it. Maybe somebody else is going to contract the anomaly that we could" spare, said Rep. Christopher H. Smith, R-Trenton, who secured $2 million in extra funds for ATSDR and now is proposing $7.5 million for a comprehensive autism research program.
Some families' autistic children have deliberately moved to Brick, lured by the local school district's highly regarded program for such children, one of the first in the state, township administrator Scott McFadden said.

Bobbie Gallagher knows some families with autistic children are moving in but thinks something worse is at work.
"If indeed there's something that created problems . . . we're hoping that whoever is responsible will own up and help these kids get through," she says.

Gallagher knows the federal investigation won't help Austin, now 6, or Alanna, nearly 8, but disagrees with other parents of autistic children who don't see any point in participating in the study.

"This isn't for the ones who are autistic. This is for the ones who aren't born yet," she says.

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