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Coca-Cola health scare may be mass sociogenic illness

BMJ 1999; 319 doi: (Published 17 July 1999) Cite this as: BMJ 1999;319:146
  1. Rory Watson
  1. Brussels

    Belgium witnessed an outbreak of mass sociogenic illness last month as hundreds of people contacted the country's National Poison Centre when they became ill after drinking Coca-Cola. But scientists are divided over the scale of the outbreak and whether it fully explains the many different symptoms, experienced mainly by schoolchildren, which forced the company to take all its products off the market.

    Four members or former advisers of the health council attached to the federal health and social affairs ministry have diagnosed mass sociogenic illness as the root cause. They have attributed the large number of health complaints associated with Coca-Cola to acute somatisation, with victims requiring social healing and not medical cure. In a letter published in last week's Lancet (1999;354:77), they noted that outbreaks of mass sociogenic illness are characterised by “the preponderance of illness among female preadolescents, transmission by the media, health professionals, social and family networks and the telephone, absence of illness among other groups in the same environment… presence of unusual physical or mental stress among those reporting illness.”

    The authors noted that the outbreak was triggered by exposure to non-toxic amounts of aversive chemicals and occurred against a background of stress in a population. At the time, many of the school children were involved in end of year exams and Belgium was coming to terms with the high profile scandal of the dioxin contamination of chickens.

    But research for the government at the Louis Pasteur scientific institute for public health in Brussels into the five different schools where the illnesses were reported suggests that the explanation is not so clear cut. The institute questioned the 112 pupils who were taken ill as well as a separate control group of 169 children who had experienced no health problems. In the first school in which illnesses were reported, the researchers found that the children who had drunk Coca-Cola were 22 times more likely than the other children to display many of the symptoms. Many of the pupils had neurological symptoms (92% had headaches, 81% trembling, 63% loss of balance, and 26% pains in their legs). In the four other schools, where only 53% of the children taken ill had drunk Coca-Cola, the children who had drunk Coca-Cola were only three times as likely to display symptoms.

    Dr Frank Van Loock of the Louis Pasteur institute's department of epidemiology, said: “We have a close association between the illnesses and the consumption of Coca-Cola in all the schools we looked at. In one, it was very close. In the other four, it was moderately close. There is also a very high degree of neurological signs, and we may have to look further into this.” At the same time, he acknowledged that Coca-Cola consumption could not explain all the illnesses, and he accepted that stress factors were present that could enable mass sociogenic illness to be an explanation for some of the cases of reported illnesses.

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