Students Ill? Mass Hysteria

It started with nothing more dramatic than a funny smell. A teacher noticed it first in a school kitchen. She felt sick. Several of her students felt strange. Soon, by the dozens, students throughout the school complained of nausea, dizziness, headaches and drowsiness.

Before it was over, more than 170 students, teachers and others sought emergency treatment during the November 1998 outbreak at Warren County High School in McMinnville, Tenn., southeast of Nashville. The school of 2,000 students was closed for more than two weeks.

A raft of government investigators studied the school grounds and analyzed blood samples. They examined puddles and grease traps and even checked an air space above the foundation. They looked for viruses, germs, pesticides, herbicides, poisons, anything that could conceivably make so many people ill so quickly.

They found . . . nothing.

In an article published in today's New England Journal of Medicine, they blame the outbreak on mass hysteria, real symptoms set off by spreading anxiety.

The investigators say such outbreaks are much more common than recognized at schools and in other close-knit communities. And they say cases of mass hysteria--now called "psychogenic illness"--will probably become more frequent and severe with rising worry over biological terrorism.

New technology may be promoting new forms of hysteria. Ron House, a University of Toronto researcher, said Internet messages about real or imagined symptoms of conditions such as chemical sensitivity now appear to be touching off such outbreaks in people at great distances from each other.

Sickle Cell Disease Signals

Early complications of sickle cell disease can allow physicians to predict which infants most likely will die or suffer a stroke later in life and could therefore benefit most from risky transplants, researchers report in today's New England Journal of Medicine.

According to the National Heart, Lung and Blood Institute, more than 70,000 people in the United States--predominantly African Americans--suffer from sickle cell disease, which affects the red blood cells' ability to carry oxygen around the body.

Sickle cell disease carries the risk of debilitating fatigue, blindness, infections, organ damage, stroke and a shortened life.

There are various treatments, including penicillin, pain-killing drugs and, in more serious cases, bone marrow and stem cell transplants.

Researchers from the Cooperative Study of Sickle Cell Disease concentrated on the most severe cases and whether they could determine if such transplants, which are high-risk procedures, should be considered.

After studying the records of 392 children from infancy to about 10 years of age, they found that three early complications--painful swelling of hands and feet before the age of 1, early severe anemia, and the elevation of white blood cell counts--were associated with more dire complications later such as stroke and death.