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 The start of this millennium in the U.S. has been marked by concerns about terrorism. As that concern grows, so does the possibility of an outbreak of mass hysteria. An article in the New England Journal of Medicine examines one such case that happened in Tennessee, and Health Contributor Dr. Bernadine Healy talked about it on The Early Show.


In Tennessee, the case of mass hysteria, or mass psychogenic illness, started with nothing more dramatic than a funny smell at Warren County High School in McMinnville on Nov. 12, 1998. A teacher noticed it first in a school kitchen. She felt sick to her stomach. 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.


A second rash of cases occurred a week later, a day after the school reopened, again resulting in the closure of the facility. After the second incident, an extensive environmental and epidemiological investigation was launched.


The school of 2,000 students was closed for more than two weeks. Nearly $100,000 was spent on emergency care alone.


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.


The head researcher said it is possible the outbreak was touched off by a real chemical smell, though such a chemical was never discovered. But he said mass hysteria soon took over and brought on the vast share of illness.


"This is not all in their minds," explains Dr. Healy. "This is their minds influencing their bodies to react to what they saw was a perceived threat. It's a normal biological response, sort of 'fight or flight' when you are confronted with a concern.


"However," she adds, "the big issue here is: Is this something that we have to learn to handle better, and do doctors really know about it?"


When you are suddenly in a panicked state, your brain is responsible for triggering adrenaline and cortisone. Hormones go through your body and cause your heart to race, maybe cause you to feel sick to your stomach.


The investigators did find some classic hallmarks of contagious anxiety: Victims were about three more times more likely than others to have seen another sick person or to know that a classmate was ill. Sixty-nine percent were women, compared with 52 percent of the school population.


Women are more prone to anxiety and to panic attacks, but not because women are more psychologically disturbed than men, explains Dr. Healy. It probably is related to inherent biological features that go back through evolution. In panic situations, men are apt to stand and fight. Women ae more apt to flee, probably to protect their young, and their reactions are different.


The phenomenon has long historical roots. Hundreds of outbreaks of mass hysteria have been documented over the past century, often among schoolchildren, soldiers, and factory workers. Some historians attribute a feverish medieval mania of jerky movements, known as Saint Vitus' Dance and once blamed on demons, largely to mass hysteria. In modern times, bioterrorism is replacing demons.


In the coming century, it is likely that we will see more instances of mass hysteria, says Dr. Healy, because, in the past century, we already have seen environmental threats and the fear of industrial accidents. It is likely that, in this century, chemical warfare, a similar kind of threat, will be added to the list of concerns.
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