Mass psychogenic illness attributed to toxic exposure at a high school.
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BACKGROUND AND METHODS: Mass psychogenic illness may be difficult to differentiate from illness caused by bioterrorism, rapidly spreading infection, or toxic substances. We investigated symptoms attributed to exposure to toxic gas at a high school in Tennessee. In November 1998, a teacher noticed a 'gasoline-like' smell in her classroom, and soon thereafter she had a headache, nausea, shortness of breath, and dizziness. The school was evacuated, and 80 students and 19 staff members went to the emergency room at the local hospital; 38 persons were hospitalized overnight. Five days later, after the school had reopened, another 71 persons went to the emergency room. An extensive investigation was performed by several government agencies. RESULTS: We were unable to find a medical or environmental explanation for the reported illnesses. The persons who reported symptoms on the first day came from 36 classrooms scattered throughout the school. The most frequent symptoms (in this group and the group of people who reported symptoms five days later) were headache, dizziness, nausea, and drowsiness. Blood and urine specimens showed no evidence of carbon monoxide, volatile organic compounds, pesticides, polychlorinated biphenyls, paraquat, or mercury. There was no evidence of toxic compounds in the environment. A questionnaire administered a month later showed that the reported symptoms were significantly associated with female sex, seeing another ill person, knowing that a classmate was ill, and reporting an unusual odor at the school. CONCLUSIONS: The illness attributed to toxic exposure had features of mass psychogenic illness - notably, widespread subjective symptoms thought to be associated with environmental exposure to a toxic substance in the absence of objective evidence of an environmental cause. Alleviation of the anxiety surrounding an episode of mass psychogenic illness requires prompt recognition and a detailed investigation. (+info)
Public health aspects of the Rainbow Family of Living Light annual gathering--Allegheny National Forest, Pennsylvania, 1999.
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The Rainbow Family of Living Light (RFLL) is a loosely organized group that developed out of the late 1960s counterculture movement. RFLL has had a 2-week "Gathering for World Peace and the Healing of the Earth" in a different national forest each summer since 1972. For the June 21-July 10, 1999, gathering, RFLL selected the Allegheny National Forest in Pennsylvania. The site was not accessible by vehicle and was an hour's walk to the nearest road. No sanitary facilities were available, and water from streams was consumed without treatment. Approximately 20,000 persons attended from the United States and several foreign countries. The state health department requested federal assistance to establish and maintain public health surveillance and to advise on outbreak prevention and control. This report describes the public health aspects of the gathering and presents recommendations for the management of health risks at large outdoor events. (+info)
Mass psychogenic illness: role of the individual physician.
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Mass psychogenic illness is characterized by symptoms, occurring among a group of persons with shared beliefs regarding those symptoms, that suggest organic illness but have no identifiable environmental cause and little clinical or laboratory evidence of disease. Mass psychogenic illness typically affects adolescents or children, groups under stress and females disproportionately more than males. Symptoms often follow an environmental trigger or illness in an index case. They can spread rapidly by apparent visual transmission, may be aggravated by a prominent emergency or media response, and frequently resolve after patients are separated from each other and removed from the environment in which the outbreak began. Physicians should consider this diagnosis when faced with a cluster of unexplained acute illness. (+info)
Mass psychogenic illness following tetanus-diphtheria toxoid vaccination in Jordan.
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In September 1998, more than 800 young people in Jordan believed they had suffered from the side-effects of tetanus-diphtheria toxoid vaccine administered at school; 122 of them were admitted to hospital. For the vast majority, their symptoms did not result from the vaccine but arose from mass psychogenic illness. The role played by the media, the children's parents, and the medical profession in the escalation of this mass reaction appeared, at first sight, to be unusual and even unique to the circumstances in Jordan at the time. A review of the literature showed, however, that this mass reaction was similar in many ways to previous outbreaks, even though the underlying causes varied. There are about 200 published accounts of mass responses to situations involving suspected poisoning or other events. Because such mass reactions are relatively rare and the triggers so diverse, individuals faced with responding to them are unlikely to have prior experience in how to handle them and are unlikely to take bold steps to prevent their escalation. Indeed they may be unaware that such events have been recorded before. The lessons learned from this incident in Jordan may help other immunization programme managers to handle crisis situations elsewhere. (+info)
Protean nature of mass sociogenic illness: from possessed nuns to chemical and biological terrorism fears.
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BACKGROUND: Episodes of mass sociogenic illness are becoming increasingly recognised as a significant health and social problem that is more common than is presently reported. AIMS: To provide historical continuity with contemporary episodes of mass sociogenic illness in order to gain a broader transcultural and transhistorical understanding of this complex, protean phenomenon. METHOD: Literature survey to identify historical trends. RESULTS: Mass sociogenic illness mirrors prominent social concerns, changing in relation to context and circumstance. Prior to 1900, reports are dominated by episodes of motor symptoms typified by dissociation, histrionics and psychomotor agitation incubated in an environment of preexisting tension. Twentieth-century reports feature anxiety symptoms that are triggered by sudden exposure to an anxiety-generating agent, most commonly an innocuous odour or food poisoning rumours. From the early 1980s to the present there has been an increasing presence of chemical and biological terrorism themes, climaxing in a sudden shift since the 11 September 2001 terrorist attacks in the USA. CONCLUSIONS: A broad understanding of the history of mass sociogenic illness and a knowledge of episode characteristics are useful in the more rapid recognition and treatment of outbreaks. (+info)
A study on mass hysteria (monkey men?) victims in East Delhi.
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During the summer month of May 2001 East Delhi came in grip of an outbreak of mass hysteria. Initial reports alleged that some monkey like creature attacked and caused injuries among number of persons. A medical board was set up to examine and find out the cause of injuries in the victims of the outbreak as a part exercise to apprehend the culprit. The study describes the sociodemographic pattern and injuries observed in these cases. Majority of victims were adult males, belonging to low socioeconomic strata and having low educational level. The incidents occurred mainly during night at the time of power failure. The type, distribution and characteristic of the injuries suggested of their accidental nature. The paper also discusses the role of forensic experts and press in such outbreak. (+info)
Emotional and behavioral consequences of bioterrorism: planning a public health response.
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Millions of dollars have been spent improving the public health system's bioterrorism response capabilities. Yet relatively little attention has been paid to precisely how the public will respond to bioterrorism and how emotional and behavioral responses might complicate an otherwise successful response. This article synthesizes the available evidence about the likely emotional and behavioral consequences of bioterrorism to suggest what decision makers can do now to improve that response. It examines the emotional and behavioral impact of previous "bioterrorism-like" events and summarizes interviews with experts who have responded to such events or conducted research on the effects of community-wide disasters. The article concludes by reflecting on the evidence and experts' perspectives to suggest actions to be taken now and future policy and research priorities. (+info)
Mob justice in Tanzania: a medico-social problem.
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OBJECTIVE: To investigate the magnitude of mob justice and associated factors. BACKGROUND: Mob justice is a social and public health problem that has grown in Tanzania in recent decades that has negative effects on social and health of the country, communities, and families. MATERIALS AND METHODS: A four-year autopsy study was conducted at the Department of Pathology, MUCHS. Information on the cases was obtained from police, the relatives, friends and other witnesses if available. RESULTS: 1,249 persons were killed by mobs in Dar es Salaam during the period of 5 years (2000-2004). The alleged offense ranged from a serious crime like theft or murder to a mere violation of local customs or religious beliefs. The mode of the killings were mostly burning (48.11%) and stoning (49.96%). Other modes accounted for only 3.0% of the cases. The pattern of injuries ranged from skull and other skeletal fractures to viscera rupture. CONCLUSION: MJ is a social, legal and public health problem in Tanzania that needs immediate attention. Unemployment of youth and perceived economic inequalities should be addressed. As long as the judicial system doesn't work and corruption is not punished, people will continue to organize their own trials and judge their suspects in the street. These must be tackled in order to reduce the growing incidences of mob justice, hence saving life. It must be ensured that criminals do not violate the freedom, dignity and respect of each and every human or member of the society. (+info)