When fear spreads

Just yesterday, after watching a human biology film, an entire class of school children in Barnsley, South Yorkshire, one after another, became faint and nauseated. Thirty-two children and their teacher were taken by ambulance to the hospital and the entire school was evacuated as a precaution, while environmental and public health officials combed the building to determine the cause. Meanwhile, doctors did careful examinations and tests on the children. They could find nothing physically wrong with the kids and the building checked out okay, too. It turned out to be another case of mass hysteria. The Times reported on it today.

This episode occurred just weeks after another case in Monrocia, Liberia West Africa on November 20th. Sixty girls and a teacher at St. Teresa’s Convent, “amidst wailing and screaming with inexpressible grief,” were reported to have been struck by seizures “that left them fainting, with foam in the mouth.” The intense alarm and fear that swept through the community led Dr. Benjamin Harris, MD to write an article last week explaining mass sociogenic illness in the Liberian Observer.

If these sensational stories sound like the antics of mischievous, easily-impressionable or disturbed children, you may be surprised to learn that mass hysteria is a very real phenomenon and that more than 200 cases have been documented in the medical literature. Countless examples have also occurred throughout history. But most people have probably never heard of them.

Last week I wrote about how the placebo and nocebo effects were at work in most of today’s popular beliefs surrounding good-bad foods and alternative modalities. “Collective delusions” is the term that sociologists and psychologists give to the phenomenon of false or exaggerated beliefs and fears consuming a group of people. But for those emersed in it, it is not a delusion. Their personal experiences are very real.

Even when we’re told, or know, there is no scientific basis for what we’re experiencing, it’s still hard to believe that our minds can be that powerful.

“Mass hysteria,” also called “mass psychosomatic reaction” or “mass sociogenic illness,” is an epidemic of physical symptoms without biological basis that spread through a group of people, often young women, who share certain beliefs about their fears and symptoms. The physical symptoms of illness in an outbreak can be extremely varied and frightening. They come on quickly after exposure to a believed threat and spread fast merely by suggestion: watching or hearing about it. And the symptoms can disappear just as quickly. With the internet, mass hysteria spreads far more quickly and far beyond the regional clusters of the past. Mass hysteria can take hold of anyone. Even 300 nurses at a London hospital were once overcome by mass hysteria, experiencing paralysis!

The U.S. Centers for Disease Control and Prevention investigated and described an outbreak of mass sociogenic illness that occurred among 150 children, mostly girls, at a summer program in Florida. The symptoms began shortly after lunch and included stomach aches, nausea, headaches, dizziness, sore throat and vomiting. The children were rushed to the emergency room and underwent thorough physical exams and tests. The lunch foods were tested for any possible contaminant, the food preparation and storage was checked, and the facility was scrutinized by public health officials for any exposure. Nothing physical could be found. The CDC notes that the rapid onset and disappearance of symptoms, the lack of physical findings, the preponderance of cases in females, and the absence of a laboratory-confirmed etiologic agent are consistent with mass sociogenic illness.

There was a mass hysteria episode in 1998 where 800 children in Jordan believed they had been poisoned by their tetanus-diphtheria vaccinations and 122 ended up requiring hospitalization. Kids here have been victims after being prompted by the suggestion of fumes. In fact, none of these children had actually had an exposure.

At the core of these traumatic episodes is fear and anxiety of unseen dangers. And goodness knows, fear is the marketing tactic of today and a favorite among junk scientists. Doctors at Children’s Hospital of Pittsburgh recently cautioned that as fears increase, such as those concerning bioterrorism, the frequency of these episodes will increase, which in turn will create and build more anxiety.

Because the illness symptoms of these extreme cases initially mimic bioterrorism, infection or acute toxic exposure, it can be challenging for medical professionals and the community to recognize what is going on. However, mass hysteria is exacerbated when people over-react — such as teachers, parents, media, doctors and public health officials — making it especially important to quickly identify and explain what is happening, inform everyone of the negative laboratory and environmental tests (which sadly, aren’t always believed), and try to prevent it from spreading.

The Canadian Medical Association Journal noted that these events are far more common than is believed. Besides disrupting lives and communties, they place enormous burdens on emergency and public health services.

A good overview is a physician’s guide written by Dr. Tomothy Jones, MD with the Tennessee Department of Health in Nashville and published by the American Academy of Family Physicians. They also offer a printable, consumer-friendly handout on Mass Psychogenic Illness to help families understand it and learn what they can do.