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Communication Considerations in a Pandemic

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  • sharon sanders
    Re: mass events of multiple unexplained symptoms

    Thank you JT.

    This is a very important post. I am copying it to the Pandemic Communication forum.

    We have attemped to incorporate some of the ideas expressed above at FT since we are a mass communication vehicle.

    Clearly we need to define our communication role in a detailed plan.

    Thanks, as usual.


    Leave a comment:

  • Thornton
    started a topic Communication Considerations in a Pandemic

    Communication Considerations in a Pandemic

    Some background abstracts on the events termed "mass psychogenic illness." The bottom line is that as the acute event unfolds it is necessary to provide a full medical response, evaluation and monitoring.

    Pastel RH.
    Collective behaviors: mass panic and outbreaks of multiple unexplained symptoms. Mil Med. 2001 Dec;166(12 Suppl):44-6. The general public, the mass media, and many government officials believe that the use of weapons of mass destruction (WMD) will inevitably lead to mass panic and/or mass hysteria. However, studies of disasters and wars show that disorganized flight in the presence of a real or perceived danger (i.e., mass panic) is rare. On the other hand, in a real or perceived WMD scenario, outbreaks of multiple unexplained symptoms (i.e., mass psychogenic illness, mass sociogenic illness, mass hysteria, or epidemic hysteria) may be prevalent. Many of the symptoms (fatigue, nausea, vomiting, headache, dizziness/lightheadedness, and anorexia) are common in combat and after toxic chemical exposure, chemical weapon exposure, prodromal infectious illness, and acute radiation sickness.

    Jones TF, Craig AS, Hoy D, Gunter EW, Ashley DL, Barr DB, Brock JW, Schaffner W. Mass psychogenic illness attributed to toxic exposure at a high school. N Engl J Med. 2000 Jan 13;342(2):96-100.

    Comment in:
    N Engl J Med. 2000 Jan 13;342(2):129-30.
    N Engl J Med. 2000 Jun 1;342(22):1673-4; author reply 1675.
    N Engl J Med. 2000 Jun 1;342(22):1673; author reply 1675.
    N Engl J Med. 2000 Jun 1;342(22):1674-5.
    N Engl J Med. 2000 Jun 1;342(22):1674; author reply 1675.
    N Engl J Med. 2000 Jun 1;342(22):1674; author reply 1675.

    Epidemic Intelligence Service, Epidemiology Program Office, Centers for Disease Control and Prevention, Atlanta, USA.

    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.

    Mass psychogenic illness attributed to toxic exposure at a high school. [N Engl J Med. 2000] PMID:10836878

    Epidemiological enquiries into a school outbreak of an unusual illness. [Int J Epidemiol. 1987] PMID:3610454

    Mass psychogenic illness attributed to toxic exposure at a high school. [N Engl J Med. 2000] PMID:10836877

    An epidemic of respiratory complaints exacerbated by mass psychogenic illness in a military recruit population. [Am J Epidemiol. 1990] PMID:2260544

    Mass sociogenic illness by proxy: parentally reported epidemic in an elementary school. [Lancet. 1989] PMID:2574312

    Jones TF. Mass psychogenic illness: role of the individual physician.
    Am Fam Physician. 2000 Dec 15;62(12):2649-53, 2655-6.

    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.

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