Tag: disease

  • Havana syndrome fits the pattern of psychosomatic illness – but that doesn’t mean the symptoms aren’t real

    Mass psychogenic illness is a condition whereby people in a group feel sick because they think they have been exposed to something dangerous – even though there has been no actual exposure.

    In early September 2021, a CIA agent was evacuated from Serbia in the latest case of what the world now knows as “Havana syndrome.”

    Like most people, I first heard about Havana syndrome in the summer of 2017. Cuba was allegedly attacking employees of the U.S. Embassy in Havana in their homes and hotel rooms using a mysterious weapon. The victims reported a variety of symptoms, including headaches, dizziness, hearing loss, fatigue, mental fog and difficulty concentrating after hearing an eerie sound.

    Over the next year and a half, many theories were put forward regarding the symptoms and how a weapon may have caused them. Despite the lack of hard evidence, many experts suggested that a weapon of some sort was causing the symptoms.

    I am an emeritus professor of neurology who studies the inner ear, and my clinical focus is on dizziness and hearing loss. When news of these events broke, I was baffled. But after reading descriptions of the patients’ symptoms and test results, I began to doubt that some mysterious weapon was the cause.

    I have seen patients with the same symptoms as the embassy employees on a regular basis in my Dizziness Clinic at the University of California, Los Angeles. Most have psychosomatic symptoms – meaning the symptoms are real but arise from stress or emotional causes, not external ones. With a little reassurance and some treatments to lessen their symptoms, they get better.

    The available data on Havana syndrome matches closely with mass psychogenic illness – more commonly known as mass hysteria. So what is really happening with so–called Havana syndrome?

    A mysterious illness

    In late December 2016, an otherwise healthy undercover agent in his 30s arrived at the clinic of the U.S. Embassy in Cuba complaining of headaches, difficulty hearing and acute pain in his ear. The symptoms themselves were not alarming, but the agent reported that they developed after he heard “a beam of sound” that “seemed to have been directed at his home”.

    As word of the presumed attack spread, other people in the embassy community reported similar experiences. A former CIA officer who was in Cuba at the time later noted that the first patient “was lobbying, if not coercing, people to report symptoms and to connect the dots.”

    Patients from the U.S. Embassy were first sent to ear, nose and throat doctors at the University of Miami and then to brain specialists in Philadelphia. Physicians examined the embassy patients using a range of tests to measure hearing, balance and cognition. They also took MRIs of the patients’ brains. In the 21 patients examined, 15 to 18 experienced sleep disturbances and headaches as well as cognitive, auditory, balance and visual dysfunction. Despite these symptoms, brain MRIs and hearing tests were normal.

    A flurry of articles appeared in the media, many accepting the notion of an attack.

    From Cuba, Havana syndrome began to spread around the globe to embassies in China, Russia, Germany and Austria, and even to the streets of Washington.

    The Associated Press released a recording of the sound in Cuba, and biologists identified it as the call of a species of Cuban cricket.

    A sonic or microwave weapon?

    Initially, many experts and some of the physicians suggested that some sort of sonic weapon was to blame. The Miami team’s study in 2018 reported that 19 patients had dizziness caused by damage to the inner ear from some type of sonic weapon.

    This hypothesis has for the most part been discredited due to flaws in the studies, the fact there is no evidence that any sonic weapon could selectively damage the brain and nothing else, and because biologists identified the sounds in recordings of the supposed weapon to be a Cuban species of cricket.

    Some people have also proposed an alternative idea: a microwave radiation weapon.

    This hypothesis gained credibility when in December 2020, the National Academy of Science released a report concluding that “pulsed radiofrequency energy” was a likely cause for symptoms in at least some of the patients.

    If someone is exposed to high energy microwaves, they may sometimes briefly hear sounds. There is no actual sound, but in what is called the Frey effect, neurons in a person’s ear or brain are directly stimulated by microwaves and the person may “hear” a noise. These effects, though, are nothing like the sounds the victims described, and the simple fact that the sounds were recorded by several victims eliminates microwaves as the source. While directed energy weapons do exist, none that I know of could explain the symptoms or sounds reported by the embassy patients.

    Despite all these stories and theories, there is a problem: No physician has found a medical cause for the symptoms. And after five years of extensive searching, no evidence of a weapon has been found.

    Havana syndrome fits the pattern of psychosomatic illness – but that doesn’t mean the symptoms aren’t real
    Mass psychogenic illness – more commonly known as mass hysteria – is a well-documented phenomenon throughout history, as seen in this painting of an outbreak of dancing mania in the Middle Ages. Pieter Brueghel the Younger/WikimediaCommons

    Mass psychogenic illness

    Mass psychogenic illness is a condition whereby people in a group feel sick because they think they have been exposed to something dangerous – even though there has been no actual exposure. For example, as telephones became widely available at the turn of the 20th century, numerous telephone operators became sick with concussion-like symptoms attributed to “acoustic shock.” But despite decades of reports, no research has ever confirmed the existence of acoustic shock.

    I believe it is much more likely that mass psychogenic illness – not an energy weapon – is behind Havana syndrome.

    Mass psychogenic illness typically begins in a stressful environment. Sometimes it starts when an individual with an unrelated illness believes something mysterious caused their symptoms. This person then spreads the idea to the people around them and even to other groups, and it is often amplified by overzealous health workers and the mass media. Well-documented cases of mass psychogenic illness – like the dancing plagues of the Middle Ages – have occurred for centuries and continue to occur on a regular basis around the world. The symptoms are real, the result of changes in brain connections and chemistry. They can also last for years.

    The story of Havana syndrome looks to me like a textbook case of mass psychogenic illness. It started from a single undercover agent in Cuba – a person in what I imagine is a very stressful situation. This person had real symptoms, but blamed them on something mysterious – the strange sound he heard. He then told his colleagues at the embassy, and the idea spread. With the help of the media and medical community, the idea solidified and spread around the world. It checks all the boxes.

    Interestingly, the December 2020 National Academy of Science report concluded that mass psychogenic illness was a reasonable explanation for the patients’ symptoms, particularly the chronic symptoms, but that it lacked “patient-level data” to make such a diagnosis.

    The Cuban government itself has been investigating the supposed attacks over the years as well. The most detailed report, released on Sept. 13, 2021, concludes that there is no evidence of directed energy weapons and says that psychological causes are the only ones that cannot be dismissed.

    While not as sensational as the idea of a new secret weapon, mass psychogenic illness has historical precedents and can explain the wide variety of symptoms, lack of brain or ear damage and the subsequent spread around the world.

    [Understand new developments in science, health and technology, each week.Subscribe to The Conversation’s science newsletter.]The Conversation

    Robert Baloh, Professor of Neurology, University of California, Los Angeles

    This article is republished from The Conversation under a Creative Commons license. Read the original article.

  • When Purell is Contraband, How Do You Contain Coronavirus?

    Handwashing and sanitizers may make people on the outside safer. But in prison it can be impossible to follow public health advice.

    This article was originally published on March 6th by The Marshall Project, a nonprofit news organization covering the U.S. criminal justice system. Sign up for their newsletter, or follow The Marshall Project on Facebook or Twitter.

    When Lauren Johnson reached for a squirt of hand sanitizer on her way out of the doctor’s office, she regretted it immediately.

    In the Central Texas prison where she was housed, alcohol-based hand sanitizer was against the rules—and the on-duty officer was quick to let her know it.

    “He screamed at me,” she said.

    Then, she said, he wrote her up and she lost her recreation and phone privileges for 10 days.

    The incident was a minor blip in Johnson’s last prison stay a decade ago, but the rules hold true today and underscore a potential problem for combating coronavirus: Behind bars, some of the most basic disease prevention measures are against the rules or simply impossible.

    “Jails and prisons are often dirty and have really very little in the way of infection control,” said Homer Venters, former chief medical officer at New York City’s notorious Rikers Island jail complex. “There are lots of people using a small number of bathrooms. Many of the sinks are broken or not in use. You may have access to water, but nothing to wipe your hands off with, or no access to soap.”

    So far, the respiratory virus has sickened more than 97,000 people worldwide and at least 200 in the U.S. More than 3,300 people have died. As of late Thursday there were no reported cases in American prisons, though experts say it’s just a matter of time. (Ed Note: These were the numbers as of March 6th, 2020. At time of this publication, they have increased. See current stats here.)

    To minimize further spread, the Centers for Disease Control and Prevention suggests things like avoiding close contact with people who are sick, covering your mouth with a tissue when you cough or sneeze, disinfecting frequently-used surfaces and washing your hands or using alcohol-based hand sanitizer.

    But these recommendations run up against the reality of life in jails and prisons. Behind bars, access to toilet paper or tissues is often limited and covering your mouth can be impossible if you’re handcuffed, either because of security status or during transport to another facility.

    Typically, facilities provide some access to cleaning products for common areas and individual cells, but sometimes those products aren’t effective, and Johnson recalled women stealing bleach and supplies so they could clean adequately.

    Hand sanitizer is often contraband because of the high alcohol content and the possibility for abuse (the alcohol can be separated out from the gel). A spokesman clarified Thursday that the Texas prison system now sells sanitizer on commissary, though it is a non-alcohol-based alternative, which is not what the CDC recommends.

    Even something as basic as hand-washing can be difficult in facilities with spotty water access or ongoing concerns about contamination, such as in the recent Legionnaires’ outbreak at one federal prison complex in Florida. (Legionnaires is caused by contaminated water, though the source of that water is not clear in Florida).

    Aside from all that, prisons and jails are large communities where a sicker-than-average population is crammed into close quarters where healthcare is often shoddy, and medical providers are often understaffed. In an infectious disease outbreak, health experts recommend separating sick people from well people to prevent the disease from spreading, but in prison that can be nearly impossible, since prisoners are already grouped according to security and other logistical considerations.

    Given all that, correctional facilities often respond to outbreaks with the same set of tools: lockdowns, solitary confinement and visitation restrictions. That’s what some prisons and jails did during the 2009 swine flu pandemic, and it’s what happened more recently in the Florida federal prison complex struck by Legionnaires’. In Texas and other states, prison officials regularly shut down visitation or institute partial lockdowns during mumps and flu outbreaks.

    This time, though, some public health officials—including former Rikers health official Venters—are proposing a different solution: large-scale releases, like those already underway in Iran. There, officials approved the temporary release of more than 54,000 prisoners in an effort to combat the spread of the new virus.

    “That’s a gauntlet for the U.S.,” said Jody Rich, a professor of Medicine and Epidemiology at Brown University. “ Really? Iran’s going to do it better than we are?”

    Advocates in Indiana on Thursday called on the governor to consider releasing large numbers of elderly and sick prisoners, who are at highest risk of complications from coronavirusPeople with chronic illnesses are vastly overrepresented in U.S. prisons and jails, and elderly inmates are the fastest-growing share of prisoners.

    Some in law enforcement immediately criticized the proposal.

    “I don’t think a viable solution for the safety of our community is to have mass releases from jails,” said Joe Gamaldi, president of the Houston police union. “As much as we have to balance the dangers that coronavirus poses to the community, we also have to balance that against the danger of letting violent criminals back out on the streets.”

    It’s not yet clear whether any prisons or jails are seriously considering widespread releases. A spokeswoman for the federal prison system did not respond to questions about the idea, instead saying that the isolating nature of prisons could be an asset in handling any potential outbreak.

    “The controlled environment of a prison allows the Bureau of Prisons to isolate, contain and address any potential medical concern quickly and appropriately,” said Nancy Ayers, the spokeswoman. “Every facility has contingency plans in place to address a large range of concerns.”

    View the original article at thefix.com