Mass Hysteria among Beneficiary Students of the School-Feeding Program in Addis Ababa, Ethiopia

BACKGROUND: Mass hysteria is described as the rapid spread of conversion disorder without organic basis among a group of people. Mass hysteria can occur in work place and commonly in schools. There are usually some factors attributable to the episode; however, the lack of a pathogen upon investigation is a fundamental characteristic. We are reporting an episode of mass hysteria from two schools in Addis Ababa, Ethiopia.METHODS: Clinical record, laboratory investigation, toxicology study from the food and psychiatric evaluations.RESULTS: On November 25, 2019 a total of 113 students were brought from two schools in Addis to Tikur Anbessa Specialized Hospital. Most were between the ages of 10 and 15 years and were female students. Their school breakfast of bread and marmaladewas attributed as the cause of the episode; however only 49% of the students brought in had eaten the food. The majority complained of nausea and vomiting but most had normal physical finding; and their symptoms were resolved without treatment. The laboratory investigation on samples of blood and stool were negative for bacterial growth and food culture and toxicology were non-revealing. Most were reassured and few were given symptomatic treatment.CONCLUSION: This mass hysteric episode is similar to episodic reports from other school feeding programs in some Asian and African countries. The finding of this report is important for health care practitioners to consider mass psychogenic illness in case they face similar mass presentation without objective finding; and will help to avoid unnecessary costly investigations.