Outbreak of a Psychogenic Illness in an Elementary School - Tainan County

Tainan County Health Bureau

1987 Vol.3 NO.3

Correspondence Author:


On January 22. 1987, one day after final examinations, an outbreak of gastrointestinal symptoms occurred among students at Jen-Ai Elementary School (enrollment 2.030) in Ja-Li Township, Tainan County. The outbreak began shortly after 8:00 am when a female third grade student complained of abdominal pain and dizziness to her teacher. Within one hour. 12 (26%) of 47 students in this classroom (classroom A) developed similar symptoms (Figure 1). Since all students had been given milk from a local dairy at 8:00 am, school officials were concerned that milk might have caused the illness. Around 8:50 am, the school principal made an announcement over the loud-speaker to inform students that the milk might he spoiled, and that any students who had not already drunk milk should not do so. By this time, however, students in all but two classrooms had already drunk the milk. Within minutes of this announcement. 10 (2 1%) of 48 students in another classroom (classroom B) became ill with similar symptoms. Six more cases occurred later in the day (one in classroom B, and five in other classrooms). The clustering of illness in two of 40 classrooms was highly significant (chi-square goodness-of-fit=3l3; p< 10-4 with 39 degrees-of-freedom). Among classrooms A and B, the attack rate among females was significantly higher than among males: 18 (46%) of 39 compared to 4 (7%) of 56 were ill, respectively (chi-square= 17.53: