Mystery Malady in Chechnya

[sarongsong]

March 10, 2006
"...12-year-old...Zareta woke up in a hospital, it took three adults to hold her down. She was thrashing and clutching her throat, unable to get a breath, screaming in terror...The outbreak began Dec. 16, and doctors and parents say the children are still suffering fits day and night. The list of victims has grown to 93...the answer to what happened to Shelkovskaya's children may never be fully known..."
Los Angeles Times (http://www.latimes.com/news/printedition/la-fg-sickness10mar10,1,6583819.story)

[Gullible Jones]

Due to stress? Riiiggghhht... Stress can do a lot of things, but I doubt that this kind of thing is one of them. Convulsions, bad smell, inability to breath, people collapsing quickly... Huh. I wonder if someone uncovered some buried chemical ordnance, or something to that effect?

[sarongsong]

Yep, sure sounds like a cover-up of some sort in this long-besieged land.

[soylentgreen]

The Ministry of Truth must have been working overtime to come up with that ludicrous cover story.
:shhh:

[Maha Vailo]

We discussed this a little bit at the Snopes.com message board, and thought it might be due to nerve gas. The symptoms sound very much alike.

- Maha Vailo

[Sammy]

We discussed this a little bit at the Snopes.com message board, and thought it might be due to nerve gas. The symptoms sound very much alike.

- Maha Vailo

The presenting symptoms are appropriate for nerve gas exposure, but not the continuing display of those symptoms. Medical treatment, or the body's natural detox processes should eliminate or greatly diminish the symptoms, or the patient dies.

http://www.emergency.com/nervgas.htm is a good summary of exposure symptoms and treatment.

[beskeptical]

First, any nerve 'gas' would have affected people in a different pattern. Second, logic then follows you'd have to find what source these kids had in common.

And third, don't jump to conclusions until more information is revealed. Mass hysteria has indeed caused such events.

My Infectious Disease Society daily bulletin will address this and I'll let you know what they find. They ask for e-mails from treating physicians and others with direct information and post the replies. I've learned from reading those daily reports over many years that the news media report this stuff as if it were fact when quite often it isn't. And, what look like obvious conclusions often turn out to be incorrect. And, weird outbreaks of bizarre diseases are reported almost daily. Sometimes they do turn out to be toxins. There have been chemically contaminated school lunches for example. Sometimes they turn out to have mundane explanations. And sometimes they turn out to be worrisome new epidemics.

[Maha Vailo]

http://www.emergency.com/nervgas.htm is a good summary of exposure symptoms and treatment.

That's a nice overview, but it doesn't say how long nerve gas poisonings are supposed to last without treatment and how long they last when they are treated.

- Maha Vailo

[beskeptical]

That's a nice overview, but it doesn't say how long nerve gas poisonings are supposed to last without treatment and how long they last when they are treated.

- Maha VailoDepends on the agent. I'm sure you could find that for us. But the epidemiology suggests not a gas. So far no word about it in the IDS site. If it was a real event, it will be commented on there. I'll e-mail them the article in case it hasn't come to the moderator's attention yet.

[beskeptical]

No wonder they haven't commented on it on the IDS site. The outbreak began Dec. 16 according to this article. I had the impression it was a new event. I only looked in this year's archive. (I just had a deja vu' feeling when I read the preview of this post, weird.)

article on non-subscription site (http://www.kentucky.com/mld/heraldleader/news/world/14078950.htm)Mystery illness hits Russian schools
SICKNESS AND SUSPICION
By Kim Murphy
LOS ANGELES TIMES

Sultan Alimkhadzhiyev, Chechnya's deputy health minister, said it was difficult to explain to parents..."In this case, what we have seen are not symptoms of poisoning ... but of psychosis. A state of panic. Children are feeling constant fear, a premonition of tragedy."

On Feb. 22, just when parents were beginning to feel confident enough to send their children back to School No. 2, three teachers fell ill with symptoms with a slight similarity to those of the original victims. The school quickly emptied again, and 11 new people showed up at a hospital with breathing difficulties. Three were admitted.

Parents are not convinced.

"It's a clear case of chemical poisoning," said Elim Nogamevzuyev, a resident who showed up for a meeting early this month with senior Chechen health officials at School No. 2. "They tested new chemical weapons on our children here."

The Independent Online Ed. (http://news.independent.co.uk/europe/article350567.ece)Yesterday, it was reported that four women and two teenage girls have been taken to hospital with the symptoms, bringing the number of people to fall ill with the condition since mid-December to almost 100.

The authorities and some, but not all, of the medical professionals who have studied the problem have concluded that the mainly female victims are suffering from "mass hysteria".

That investigation was swiftly dropped, however, along with the poison theory, when a series of specialists, some of whom had flown in from Moscow, said the disorder was psychological. The doctors blamed the media for triggering more cases of the condition with alarmist reports.

Moscow has remained silent. Anna Politkovskaya, a Russian independent journalist specialising in Chechnya, is convinced that Moscow has used the republic as a weapons laboratory.

After looking at this in more detail, I see lots of evidence it is indeed hysteria and not poisoning. But you are unlikely to convince anyone involved of that given the political climate and the proclamations by news personalities it is a cover up of purposeful poisoning.

Once a child or sometimes an adult begins this kind of behavior they paint themselves into a corner. They continue because the people around them make such a fuss. That and the possibility of a true psychotic break would explain the length of time the illness has continued.

I've seen this many times though to a milder degree. People are convinced there is some toxin in the building. Pretty soon half of the people there have symptoms. Then someone finds "toxic mold" and building owners or taxpayers shell out millions to correct it. Believe it or not, the evidence that there really is a "toxic mold" other than individual allergies is absolutely unconvincing to most medical professionals. There is a whole crowd of followers and believers but the actual evidence is almost non-existent.

Take for example an event here several years ago. A group of 911 dispatch workers became convinced their building was making them ill. This occurred over time so it wasn't that there could have been a single exposure. Yet it only affected one group of workers. Replacements had no symptoms at all. In fact no one who entered the building had any symptoms other than the one group who believed they were being affected. The city tore down the building and replaced it at taxpayers' expense.

It's very hard to convince people there is no such thing as "toxic mold". But look at the recognizable pattern you see with such complaints. They involve people convincing each other there is a problem and 'authorities' aren't taking them seriously. It almost always involves the workplace or a building like a school, rarely a home. And if it does involve the home, it is usually connected to a lawsuit or landlord tenant dispute. There are few if any 'clinical findings' to support the fact the symptoms are more than just imagined. At some point, when you see this pattern over and over, and you can predict the things I've mentioned above will be in your assessment even before you talk to the patient, it's time to recognize not everything is real even if the symptoms are.

There's an easy way to tell if those children are really having "seizures". I've seen it done on some pretty convincing seizure patients in the ER who were indeed faking. Just stick an NG tube down their throat. Any one faking a seizure will stop. Amazing how fast an NG tube will wake some 'unconscious' people. You can also drop a person's arm above their face when they are faking unconsciousness if you don't want to do the NG tube test. If you are unconscious your arm will hit your face. If you are faking it, your arm will fall to the side.

Trying to defuse a situation like the one in this report is very difficult. Buildings are needlessly torn down and replaced over just this sort of thing. Some people permanently disable themselves by convincing themselves they are really ill. I'm sure there are some reading this post who will say, how do you know? Some people do indeed have real illnesses that are missed when there are no 'clinical findings'. We later find something earlier tests missed. But many people, in fact most people, who have these types of illnesses have factors such as lawsuits and other psychological components like suspicion and anger that precede the events. You cannot discount that evidence just because some conspiracy is possible. Once yes, repeating patterns no.

[Maha Vailo]

So, if something like this is really a case of mass hysteria, how do (or should) doctors treat it? And just exactly how do you fake a seizure convincingly enough to fool people?

- Maha (the plot thickens) Vailo

[beskeptical]

So, if something like this is really a case of mass hysteria, how do (or should) doctors treat it? And just exactly how do you fake a seizure convincingly enough to fool people?

- Maha (the plot thickens) VailoYou use voluntary muscle movements instead of involuntary ones. You'd be amazed what people do. An EEG or the NG tube sorts it out real quick but we don't have that kind of information from the news reports.

As to what to do, frankly it is absurd to tear down the building but it happens for supposed toxic mold all the time here in the US. Most of these problems are very difficult to treat since nothing works except antidepressants in some cases. But even then, people and in this case parents may not like your diagnosis. So they run off from doctor to doctor until they find one that gives them a name and a cause. But they still don't get better.

I imagine in Chechnya they don't have the luxury of doctor shopping.

If the complaints of things like toxic mold are handled properly in the first place, you can actually avoid a lot of this. Peter Sandman has developed some interventions that work to lower the "outrage" as he calls it. Dr. Peter Sandman, Outrage Management, (Low Hazard, High Outrage) (http://www.psandman.com/indxoutr.htm) is his web site paper on it. I have his book and have heard him speak as well.

[Maha Vailo]

You use voluntary muscle movements instead of involuntary ones. You'd be amazed what people do. An EEG or the NG tube sorts it out real quick but we don't have that kind of information from the news reports.

Yeah, but what kind of voluntary movements? Is there any pattern to the involuntary movements of a seizure, or is it all just random thrashing?

And as for treating a psychological disease, why not just give a person a placebo and claim it'll cure them? Certianly it seems a lot easier then trying to counsel someone who might not listen.

- Maha Vailo

[beskeptical]

It isn't clear whether placebos are ethical. I don't lie to patients myself. I don't think any placebo benefit is worth losing a patient's trust.

Grand mal seizures are sort of rhythmic contractions. I'm sure you could find a good description with a Google search.

[Sammy]

Beskeptical wrote


As to what to do, frankly it is absurd to tear down the building but it happens for supposed toxic mold all the time here in the US.


Someone ought to do a study/book of the hysteria/outright scams related to "toxic molds." The "danger of toxic mold" has become part of the accepted truth to most people. It shows up on the local news when "found" in schools, on home improvement shows, and in health/homeowner advice colums in the newspaper and in magazines.

A book like Bad Science, which documented/debunked the whole Fleischman/Pons cold fusion fairy tale would make a great read (hint to Beskeptical).

[Maha Vailo]

Well, if mold isn't toxic, then what exactly does it do (good, bad, or indifferent) - besides looking and smelling bad, damaging paper and wooden goods, and aggravating asthma/allergy symptoms?

- Maha "breaking the mold, Chechen-style" Vailo

[sarongsong]

Mold in Indoor Environments (http://www.nsc.org/library.htm)
"The most recent issue of Injury Insights features a review article on research pertaining to mold and its health effects..." National Safety Council

[Gillianren]

We've got a complex down the road from where I live that allegedly had toxic mold. While I'm willing to accept that there's no such thing (what do I know?), I will definitively state that it was a slum, and the "toxic mold" scare got it completely remodelled, which it badly needed anyway.

[Sammy]

Well, if mold isn't toxic, then what exactly does it do (good, bad, or indifferent) - besides looking and smelling bad, damaging paper and wooden goods, and aggravating asthma/allergy symptoms?

- Maha "breaking the mold, Chechen-style" Vailo

From the link posted by Sarongsong


Health-based exposure standards for molds and mycotoxins do not yet exist. While there is evidence of health effects in animals and humans after high levels of inhalation exposure or direct contact with mycotoxins, current published research does not provide compelling evidence that exposure at the levels expected in most mold-contaminated indoor environments is likely to result in measurable health effects


I think that includes exacerabating allergy/asthma symptoms.

The point of my earlier post is that people are worried far too much about a relatively minor risk, and not nearly enough about other indoor health hazards, e.g., volatile organic compounds and ozone.

[sarongsong]

...I will definitively state that it was a slum, and the "toxic mold" scare got it completely remodelled, which it badly needed anyway.Same principle at work here (http://www.nctimes.com/articles/2005/04/16/military/15_22_234_15_05.txt) in nearby coastal Camp Pendleton; the housing units have been complained about for years by resident Marines and their families, most of whom simply can't afford to live off-base...."I remember what the housing was like," Donovan said in a booming voice. "It wasn't good enough to be a ghetto..."...older housing at Pendleton has mold problems...

[LurchGS]

heh - I lived in military housing in Alaska - houses (duplexes) originally designed for Guam.. it wasn't all that bad if you didn't mind the breeze. I did have some breathing problems there, but I think it was mostly dust from the attic and crawlspace.

I have more problems in my 'modern' house (carpet, carpet, carpet)

On the inclement side of the coin, right across the street from the president of my SAR group is a house where the water line broke on the upstairs floor - while the owners were away for a week. what a mess. It's now supposed to be chock-full of 'toxic mold'. The owners haven't lived there in 4 years or so, and insurance won't pay off on it (they did fix the water damaged walls/floors)...

Me.. while absense of proof does not mean the mold is not bad, I'd just as soon avoid such a place.

[sarongsong]

...houses (duplexes) originally designed for Guam...
??? (imagining igloos arriving in Guam)

[beskeptical]

Well, if mold isn't toxic, then what exactly does it do (good, bad, or indifferent) - besides looking and smelling bad, damaging paper and wooden goods, and aggravating asthma/allergy symptoms?

- Maha "breaking the mold, Chechen-style" VailoIt grows. I'm not sure what you mean by, "what does it do?"

Mold spreads itself via spores which are released into the air. So just as pollens are airborne and small enough to be inhaled so are spores. Foreign proteins in some people initiate a allergic response.

As to the toxins, one study showed there might be a relationship in newborns exposed to mold and Pediatric Idiopathic Pulmonary Hemorrhage and Hemosiderosis in a Cleveland Community (http://pediatrics.aappublications.org/cgi/content/full/99/1/e5). Trouble was, the report was very speculative and there were only 10 infants in the study. No further research, to my knowledge, has shown a clear connection between mold and any disease other than allergic diseases. But then, researchers at the mold level started discussing mycotoxins (toxic chemical produced by the mold to resist predators and clear away the competition as the mold invades territory). Next thing you know all these folks start assuming the disease connection was supported by research so they assumed these mycotoxins were now a proved hazard to humans. Anyone who imagined their headache, scratchy throat, lethargy, dizziness, skin rash or other symptom with unknown cause was occurring only in a certain building went looking for toxic mold as the cause. Also, indoor air quality "experts" opened new businesses that could detect and correct the problems. Voila! A myth is created.

[jkmccrann]

Isn't toxic mold one of the reasons so many residences in New Orleans are currently vacant even if they are still standing in one piece?

Should peeps just be going back and living in these places then?

[beskeptical]

Mold in your house is a problem. It wrecks things. The most common cause aside from direct water leaks is a poorly insulated wall. Warm inside, cold outside and you get condensation on the inner surface. You need double pane windows and better insulated walls. For houses with inner mold, often it is a circulation problem. Turning on the fan for the heater without the heat in summer is helpful. Making sure air can circulate in areas where mold is found so that moisture doesn't accumulate helps.

[snarkophilus]

Sounds like witchcraft to me. Right out of The Crucible. ;)