An epidemic of respiratory complaints exacerbated by mass psychogenic illness in a military recruit population

The authors report an episode of mass psychogenic illness exacerbating respiratory symptoms in military recruits. The epidemic occurred over a 10- to 12-hour period in September 1988, in a group initially complaining of cough and pleuritic chest pain. More than 1,800 men were evacuated from their barracks because of a suspected toxic gaseous exposure. Approximately 1,000 recruits developed at least one new symptom, 375 were evacuated by ambulance to receive further medical evaluation, and at least eight were hospitalized. Air sample testing from the area was unremarkable, and there were few abnormal physical examination or laboratory findings. The epidemiologic investigation included a questionnaire administered 2 weeks after the epidemic to 1,000 of the recruits involved. A total of 55% of those who completed the questionnaire reported the onset of at least one new symptom after supper, with at least 25% reporting the new onset of cough, light-headedness, chest pain, shortness of breath, headache, sore throat, or dizziness. A total of 18% received further medical evaluation. The development of new symptoms and the receipt of further medical evaluation were associated with evidence of physical stress, mental stress, and awareness of rumors of odors, gases, and/or smoke. This epidemic was unique because of its size and its occurrence in an all-male population.