Mysterious "Toxin" Causes Outbreak
January 14, 2000
Can unfounded concerns about the dangers of toxic chemicals in the environment make people sick? At first, an illness that sent 170 students and teachers to the emergency room and closed a Tennessee high school for two weeks was attributed to exposure to a toxic substance. But it turned out to be something else entirely.
In November 1998, a teacher noticed a "gasoline-like" smell in her classroom, and soon 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. In an article in the New England Journal of Medicine, they report how they tracked down the real cause of the illness using tests and questionnaires.
- 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.
- 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.
The illness, attributed by those who became ill to exposure to some unknown toxic substance, was evidently "mass psychogenic illness" -- popularly called mass hysteria. In other words, people became ill because they thought they had been exposed to an environmental toxin -- even though there was no objective evidence of an environmental cause.
Source: Timothy F. Jones, et al., "Mass Psychogenic Illness Attributed to Toxic Exposure at a High School," New England Journal of Medicine, January 13, 2000.
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