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© 1987 Oxford University Press

research-article

Epidemiological Enquiries into a School Outbreak of an Unusual Illness

K T GOH

Quarantine and Epidemiology Department, Ministry of the Environment 40 Scotts Road, Singapore 0922

A total of 65 students and one female teacher were afflicted with an unusual illness following alleged inhalation of a ‘gas’ in the school. The main symptoms were dizziness, chills, nausea, headache, difficulty in breathing and faintness. Initial investigations revealed elevated carboxyhaemoglobin levels (>5%) of 16 hospitalized students. However, no sources of carbon monoxide emission could be detected despite extensive environmental investigations. The out-break was characterized by the following features: most victims were adolescent girls; there was a high proportion of recurrences; the illness was self-limiting with inconsistent clinical and epidemiological findings; its mode of transmission was associated with antecedent visual observation or verbal information, and it died down immediately after confidence had been restored. A diagnosis of mass psychogenic illness was made. The high-risk students were Malay girls who were from the normal class (for slow learners), engaged in part-time employment and easily influenced by what they had heard or seen.

Received 1 September 1986


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