Explainer: All you need to know about mass hysteria

Recently, Starehe Girls Centre was closed for a few days after an outbreak of a mysterious disease that left 52 students isolated.

The disease, characterised by unique multiple high-pitched coughing and sneezing pattern, had affected more than 60 students in four days.

Health ministry, which found no signs of disease from blood samples taken to the lab, termed the infection as mass psychogenic illness, also known as mass hysteria.

Here is what you need to know about this infection that sent shockwave across Starehe and beyond:

• What is mass hysteria?

It is the rapid spread of illness signs and symptoms affecting members of a cohesive group.

It usually originates from a nervous system disturbance that involves excitement, loss, or alteration of function, whereby physical complaints such as a cough are exhibited unconsciously and have no corresponding organic cause.

Clinical Psychologist and Chief Executive Thalia Psychotherapy in Nairobi Ruth Mwaura says that the condition is referred to mass hysteria because it would start with one person and spread to other individuals like the case at the Starehe Girls Centre.

“We classify it under conversion disorders, which is a chronic condition characterised by unexplained physical symptoms,” she says.

“In these you find pain that is excessive or chronic, chronic and multiple symptoms that seem to lack adequate explanations, complaints that don't improve despite treatment that helps most people.”

Specialists often describe it as a psychological illness, meaning it begins in the mind as opposed to the body.

It exhibits physiological symptoms that affect the nervous system in the absence of a physical cause of illness, and which may appear in reaction to psychological distress such as fear, sadness and anxiety.

• What are the symptoms of mass hysteria?

Mass hysteria have symptoms that have no organic basis— meaning upon conducting medical exams, no results can conclusively explain the occurrence of the ‘disease’.

This condition occurs in a segregated group with studies showing that females are often victims of the occurrence.

It also occurs in the presence of extraordinary anxiety such as the beginning of exams or change of environment.

• How does mass hysteria start?

Many outbreaks of mass psychogenic start with an environmental trigger, like a bad smell or a rumour of exposure to a poison.

When one person gets sick, others in the group also start feeling sick, for example, if one person starts coughing the others star coughing as well.

It should also be noted that the first person to get sick might have had a real illness, but it might not have been related to the trigger.

Medical specialists and researchers, however, agree that a major cause of mass hysteria is stress.

“What triggers it can vary but it is often triggered by stress that is not addressed, which is then expressed physically,” says Ms Mwaura.

“Among adolescents, it can be pressures in school and at home (to perform), relationship issues, conflict with teachers and peers, issues that come with adolescence like self-identity, conflicts at home, dysfunctional families, abuse both physical and sexual among others.”

• How do the symptoms spread?

The symptoms of mass hysteria are often temporary and are spread over sight, sound or oral communication.

They have a rapid onset with a quick recovery period.

It also spreads and moves down the age scale, beginning with older or higher-status people in the affected group.

Reports show that symptoms are further spread when there is much attention given such as a media coverage of the outbreak.

• Are the symptoms real or imagined?

Although mass hysteria starts as a psychological ailment, people who are in these outbreaks have real signs of sickness that are not imagined or faked.

Those affected exhibit real symptoms such as coughing, sneezing, headaches, dizziness among others but they are not caused by any germs or poison.

A disease is only classified as mass hysteria if physical exams and tests are normal, doctors can't find anything wrong with the group's environment, but many people get sick.

• What is the relationship of mass hysteria with females?

Research shows that instances of mass hysteria are most prominently experienced by groups of women.

Some researchers argue that women may be more exposed to collective obsessional behaviour because they are typically exposed to more stressful situations.

“The social and cultural factors in which you find women are more prone to tension and frustration and most times it will be exhibited in physical symptoms,” Ms Mwaura notes.

The occurrence is then related to the possibility of extreme stress that is then manifested through physiological symptoms and behaviour.

• Has mass hysteria happened before?

Mass hysteria has occurred several times in various countries, with a majority taking place in schools. In 1962, in Kashasha village, Tanzania, three girls in the Kashasha Mission School broke into fits of giggles.

Within weeks, the contagious laughter spread to the whole school, the village, and into neighbouring schools as well.

The laughing epidemic, which affected thousands and lasted a few months, was accompanied by reports of fainting, screaming, crying and difficulties in breathing.

In the 1980s, girls in Mityana Secondary School in Uganda had a mass hysteria, with the girls saying they were being attacked by “demons” and “spirits”.

The school had to be shut down after almost 100 students attempted to kill a teacher. The incident began with only eight students.

More recently, on February 4, 2008, more than 100 pupils went out of control in Sir Tito Winyi Primary School, located in Hoima District, Uganda.

According to the school head teacher, the pupils were totally mad, chasing everybody including teachers and fellow pupils, throwing stones, banging doors and window.

• How is mass hysteria treated?

Most of mass hysteria outbreaks stop when people get away from the place where the illness started.

The illness also tends to go away once people are examined and doctors tell them that they do not have a dangerous illness.

“Another is to ignore the behaviour because it ceases with time. In schools you will find when a person starts exhibiting the behaviours and he or she is given attention, it continues,” Ms Mwaura says.

“What needs to be done is the person is referred to the school psychologist when the physical tests have turned out negative so as to explore psychological issues and address them.”

As it affects mostly schools and is triggered by stressful environments, it is also important for counsellors to talk to students about stress and how to manage it effectively.