Publicatie datum

Social epidemics in the aftermath of disasters.

IJzermans, C.J. Social epidemics in the aftermath of disasters. European Journal of Public Health: 2002, 12(4 suppl.) 8. Abstract. 10th Annual Eupha Meeting 'Bridging the gap between research and policy in public health: information, promotion and training' in Dresden, Germany 28 - 30 November 2002.
Issue/problem: After disasters, terrorist attacks and wars social epidemics of medically unexplained physical symptoms/syndromes (ups) are often seen. In modern times people feel more vulnerable and especially under pressure of those incidents, everyday symptoms are interpreted as disease and causally attributed to the event(s). How are these symptoms and syndromes linked to each other? What is the role of the media in emerging 'new diseases'?
Description: In the aftermath of the Bijlmermeer plane crash (Amsterdam, 1992) we studied, six years later, symptoms attributed to the crash by 850 persons who were invited to present their symptoms to a call center. Then, Symptom Checklist-90 was sent to their homes to measure their distress. The symptoms were compared in the medical files of their general practitioners (GP). On average 4.3 symptoms were presented to the call center and the majority (74%) was presented to the GP. One out of four symptoms were either reported to the GP before the disaster took place, or six or more years after (at the time of immense media attention). There appeared to be a lot of distress more than 2 SDs from normal). Most of the symptoms belong to the ups-group (fatigue, headache, dyspnea). At the moment we monitor all symptoms presented to GPs, company doctors and mental health carers by 11,000 victims of the firework disaster in Enschede, the Netherlands (May, 2000) in an attempt of the Dutch government to prevent or to minimalize social (and psychological) epidemics by means of a proactive public health response. In both studies we carried out a search in literature, especially on ups. Conclusions: Unexplained physical symptoms are a major public health problem, especially in the aftermath of stressfull events. They are closely related to each other and belong to a rather small repertoire of complaints and illness independent of exposure, but the dependent of labeling by physicians and media. (aut. ref.)