De aanpak van een peracute epidemie: wat kunnen we leren van ‘het mysterie van Hoogeveen’

Samenvatting

In Hoogeveen was sprake van een incident met onbekende oorzaak. De ervaring bij soortgelijke incidenten leert dat speculaties over de oorzaak blijven bestaan. Elke nieuwe ziekte van iemand die betrokken is geweest bij het incident, wordt mede in dat licht bezien: komt het alsnog door de vergiftiging tijdens het incident? Onder andere de Bijlmerramp in 1992 en de ATF-brand te Drachten in 2000 hebben zo een lange nasleep gekregen. Daarom is het van belang een incident niet overhaast af te sluiten.

Abstract

How to handle a peracute epidemic: lessons from the Hoogeveen incident

On 5 November 2007 employees of an animal wholesaler in Hoogeveen (the Netherlands) became ill. On site, the cause of the complaints could not be determined. After being admitted to the UMCG hospital for observation overnight, the patients were discharged predominantly healthy. It remains unclear what has caused their illness. The collective clinical image as it was at the time of the incident was reconstructed through a study. The obtained data was compared to the limited number of possible causes of a peracute epidemic, i.e. chemical toxidromes, acute infectious diseases and mass sociogenic illness. The data showed no evidence of the health effects being caused by biological toxins, micro-organisms or chemical substances. The pattern of these health problems, in combination with the symptoms and complaints, was in many respects similar to a typically stress-related sociogenic epidemic. It is difficult to distinguish a sociogenic epidemic from chemical poisoning or an infectious disease. Nevertheless, we recommend considering the possibility of a sociogenic epidemic at an early stage of an incident, since the approach rather diverges from the chemical or biological routines. Mass sociogenic illness deserves a place in the differential diagnosis when dealing with incidents involving an unclear cause.

Keywords: Mass sociogenic illness, unknown cause, peracute epidemic, toxidrome