Una nota del Economist de esta semana pasada advierte:
“Saber que la angustia causa las mismas síntomas que el envenenamiento podrá ayudar en el caso de un ataque bioquímico.”
Archivan la nota bajo el titulo: Histeria Masiva, implicaciones, consecuencias, advertencias.
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23.5.06
Sintomas de la histeria masiva
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Mass hysteria
Telling the truth to the terrified
May 18th 2006
From The Economist print edition
Knowing that anxiety causes the same symptoms as poisoning could help in a biochemical attack
AP
LAST December a mysterious illness broke out in a school in the Shelkovsk region of Chechnya. Symptoms included convulsions, nausea and breathing difficulties. The illness spread to neighbouring schools. Local doctors suspected mass poisoning, but when a delegation of medics arrived from Moscow, they attributed it to mass hysteria.
Chechnya has been the scene of Russian military operations since 1994, so understandably those affected have little faith in the official verdict. Meanwhile, without knowing the nature of the suspected toxin, local doctors are at a loss as to how to treat their patients. The only way to break the impasse, public health experts say, is to send in an investigating team from outside the former Soviet block—one that the Chechens will trust. If mass hysteria is to blame, they say, the truth is the best medicine.
Zsuzsanna Jakab is director of the European Centre for Disease Prevention and Control in Stockholm but, in 1996, she worked for the World Health Organisation and helped to investigate an outbreak of illness in Macedonia. It affected schoolchildren in the mainly Albanian district of Tetovo. Dr Jakab received reports from Albanian representatives of mass poisoning, which were denied by the Macedonian authorities. She led a team consisting of a paediatrician, an epidemiologist, a toxicologist and a clinical expert. They spent a couple of weeks in the region, taking samples that were sent to laboratories outside the country for analysis, reviewing the hospital's case reports, interviewing affected families and searching for possible environmental contaminants.
The team found no evidence of poisoning, and concluded that the illness was probably caused by stress resulting from high political tensions in Tetovo. Its report was rejected both by the Albanians, who continued to stick to the poisoning theory, and by the Macedonians, who denied that a climate of fear existed in the region. Nevertheless, after the team returned to explain its findings to the families, reports of symptoms gradually subsided. Dr Jakab says that a region where conspiracy theories and fear abound is a prime breeding ground for mass hysteria. In a war zone, allegations that a toxic agent has been deployed cannot be dismissed—indeed they need more urgent investigation, she says.
A familiar problem
Mass hysteria, or medically unexplained epidemic illness, has been documented since medieval times. Simon Wessely, a director of the King's Centre for Military Health Research at King's College London, says such outbreaks tend to reflect a society's beliefs. In the past witchcraft or demonic possession were often blamed—they still are in some societies. In today's industrialised world, environmental contamination is more likely to be invoked. In 2001, after al-Qaeda's attacks on America, Dr Wessely predicted more of these outbreaks, because of the heightened risk of terrorism and, in particular, bioterrorism. The later anthrax attack, which killed five people, was second only to the assault on the twin towers in terms of the shock and anxiety it caused the American people.
Dr Wessely distinguishes acute episodes of mass hysteria from the chronic sort. He says that he has a huge boxful of reports of the first type, which often occur among schoolchildren and are investigated rapidly. Symptoms vanish within days, once the patients have been gently reassured that their imagined cause does not exist. When an outbreak occurs against a backdrop of social trauma, it can go on for months or longer. For an episode to become chronic, patients' beliefs that they are being poisoned must be reinforced by local physicians and media. Shelkovsk may be a case in point, he says.
Whether or not the Chechen incident turns out to be mass hysteria, the patients' symptoms are real enough. What people find hard to believe, says Dr Jakab, is that anxiety-related illness can so closely mimic illness caused by an organic cause. In 1987 thieves stole a canister containing highly radioactive caesium chloride that would have been used in radiation therapy from an abandoned hospital in Goiânia, Brazil. They sold it to a junkyard owner, exposing a number of people to high doses of radiation. Some 112,000 people were screened, and 250 of them were found to have been contaminated. Yet another 5,000 people reported vomiting, diarrhoea and rashes—all symptoms of acute radiation sickness.
Dr Jakab says medical staff need to realise that the cause of these symptoms is anxiety so that patients can be treated accordingly. The World Health Organisation now has instructions describing what to do. Being told to stop faking it is unlikely to speed patients along the road to recovery. Instead, they should be removed from the stressful environment and persuaded that nothing is poisoning them except their own worries. People also need to be educated about the real risks of bioterrorism, says Dr Wessely. Ignorance breeds fear. The danger is that medical and social services will be overwhelmed, as they were in Brazil, and so take longer to identify the real victims of the incident. That, he says, is why biochemical warfare is really psychological warfare.
http://www.economist.com/science/displaystory.cfm?story_id=6941729
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