Chemical Agents of Opportunity for Terrorism: TICs & TIMs

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Chemical Agents of Opportunity for Terrorism Training Support Package Participant Guide Chemical Agents of Opportunity for Terrorism: TICs & TIMs Features Suggestive of “Mass Psychogenic Illness ” • Rapid onset and recovery • Contagious, spreads via: – Sight (particularly “line of sight ”) – Smell • Diversity of symptoms w/o physical signs or abnormal labs • Benign morbidity with no sequelae – Though remember the “Toxic Lady ” • Often recurs when returning to environment • No reasonable organic basis – Environmental investigation is negative Module One – Observed Behaviors during Mass Chemical Exposures 28 When we evaluate cases of potential toxic mass exposure, there are certain features suggestive of mass psychogenic illness that we should recognize: Onset is generally immediate or rapid, often precipitated by sensing an odor or viewing another person getting “sick”. The clinical complaints are often variable between patients, and clinical evaluation proves negative. Most people recover quickly and have no long term morbidity, though patients can suffer self-harm unintentionally. Symptoms may recur due to lingering anxiety on re-entry, while concentrations of any noxious (unpleasant) agent or toxic compound is generally less due to ventilation and the passage of time. No toxic exposure is identified, or a potential exposure inconsistent with the toxidrome, is found. December 2008 Version 2.0 Page 454
Chemical Agents of Opportunity for Terrorism Training Support Package Participant Guide Slide 29 In the high school case just described, these are the varied symptoms identified among the 91 people initially evaluated at the hospital. All are protean or nonspecific symptoms, and the findings varied among the patients, suggesting it is not due to an exposure to any given toxic substance. December 2008 Version 2.0 Page 455
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Chemical Agents of Opportunity for Terrorism: TICs & TIMs

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