When the first episode if what would be called the Tanganyika Laughter Epidemic occurred on January 30, 1962 at boarding school in Kashasha, Tanganyika (now Tanzania), no one suspected that what they were seeing would eventually affect over one thousand people. The first three victims were teenage girls though the laughing quickly spread to the rest of the school with 95 of the nearly 200 students at the school being affected. None of the teachers were affected. Symptoms usually faded after a few hours though some of the affected students were prone to relapses. While the school was shut down for two months as a reaction to the outbreak, new cases developed almost immediately after the school was reopened. From Kashasha, new cases soon broke out in other villages in the area as news of the strange outbreak got out. In one memorable episode, over two hundred people from the same village fell ill within a matter of days which completely overwhelmed local health agencies. Medical doctors admitted to being stymied by the strange epidemic which locals dubbed "endwara yokusheka" (the laughing sickness) as well as "Akujanja" (madness).
Reporters covering the story seemed as mystified as everybody else about what was happening. All they could do was report on the progress of the outbreak as it continued to spread. According to one story published in Newsweek in August, 1963:
"In the steamy, East African bush town of Kashasha, Tanganyika [now known as Tanzania] , a 13-year old girl suddenly began giggling for no reason. Soon her giggles turned to spasms of violent, uncontrolled laughter. Within an hour, her laughter had dissolved into equally intense sobs. By nightfall, 100 of her schoolmates at the Swedish Evangelical Mission school were all laughing and sobbing uncontrollably. The school was closed, but the girls carried their strange behavior home to their villages. Some coffee-bean farms lay untended as convulsed - and exhausted - villagers lay sprawled in their thatch-roofed huts."
In a 1963 report published in the Central African Medical Journal, Dr. A.M. Rankin of Uganda's Makerere College and Dr. P.J. Phillip, a Tanganyika medical officer pointed out that virtually all of the reported cases involved schoolchildren and young adults living in villages relatively close to one another. Though no trace of fever was found in any of the reported cases, medical doctors found that dilated pupils and impaired concentration seemed to be common symptoms. Some patients even reported "strange things moving around in their heads" though no physical cause could be found. All that health officials could say for certain was that the disease apparently spread by physical contact as people traveled between villages. Perhaps more significantly, none of the medical doctors and nurses treating the affected villagers ever developed symptoms.
Still, while there was no medical explanation for what was happening, other people had no problem finding things to blame the outbreak on. Along with the usual supernatural explanations, some villagers suggested that the epidemic was caused by atmospheric contamination resulting from nuclear testing (why it would be affecting western Africa in particular was left to the imagination). The original school where the epidemic began was later sued for allowing children and their parents to spread the disease. Though the symptoms themselves seemed fairly mild, the prospect of a disease that could strike without warning contributed to the sense of panic many people expedrienced.
Almost from the beginning, doctors raised the possibility that all of the cases were due to mass hysteria though the symptoms seemed very real to the people involved. With no cure in sight, new cases would continue to crop up for as long as eighteen months after the first episode. Eventually however, the epidemic ran its course and everyone breathed a sigh of relief as everything got back to normal. Despite lingering questions over why the epidemic had happened, local health officials declared the entire matter closed.
While episodes of mass hysteria (now known as mass psychogenic illness) that simulate disease epidemics are fairly common, there are some unique aspects to the Tanganyika case that highlight that set it apart from other outbreaks. In 2002, forty years after the Tanganyika outbreak began, Christian F. Hemplemann, then a graduate student at Purdue University, presented a paper on the epidemic at the International Society for Humor Studies Conference at Northeastern Illinois University. In his paper, he a comprehensive overview of the epidemic as well as other cases of mass psychogenic illness that have occurred over the past few decades. Despite the laughter that was the most commonly reported symptom, Hemplemann argued that it was stress, not humour, that kept the epidemic going.
Now at Texas A&M University, Hemplemann has continued his research on the Tanganyika epidemic and on different mass psychogenic illness outbreaks that have occurred since. As he pointed out in a 2003 media interview, "One person laughs, then another person laughs, then it spreads like an avalanche. So when parents picked up their children from school, they started laughing. Then it spread to other villages, and so on. And depending on where you read about it, the laughing epidemic lasted for anywhere from six months to a year-and-a-half....Now we call it Mass Psychogenic Illness (MPI). It’s psychogenic, meaning it is all in the minds of the people who showed the symptoms. It’s not caused by an element in the environment, like food poisoning or a toxin. There is an underlying shared stress factor in the population. It usually occurs in a group of people who don’t have a lot of power. MPI is a last resort for people of a low status. It’s an easy way for them to express that something is wrong. That may be why it has come to be associated more often with women.”
While there is no clear answer for why the epidemic struck when it did, Hemplemann suggests that the political turmoil resulting from Tanganyika's recent independence from Great Britain may have been a factor. "The young people involved reported that they were feeling stressed by the higher expectations of their teachers and parents. It is a common occurrence and a costly occurrence if it occurs at your workplace because it may have to be closed down. This happened in Lafayette, Ind., a couple of years ago. They'll get someone to spray the area to comfort people who were involved. People will say that there were a bunch of bugs and we were all stung by it. They won't admit that it was hysteria."
Despite its unique features, what happened in Tanganyika in 1963 shares many of the common factors identified in similar outbreaks. These factors include:
- Symptoms with no known organic basis
- Symptoms with rapid onset and recovery
- Symptoms that are typically transient in nature
- Occurring in a specific group
- Extreme anxiety
- Symptoms are spread by word of mouth or through popular media
- Spreading down the age scale from older to younger victims
- Predominantly female victims
Symptoms linked to mass psychogenic illness can include nausea, headaches, abdominal cramps or pain, fainting, chest pain, vomiting, diarrhea, and anxiety attacks. According to British psychologist, Simon Wessely, MPI can manifest itself as either “mass anxiety hysteria” with episodes of acute anxiety (primarily in schoolchildren), or as “mass motor hysteria” involving abnormal motor behaviour.
Still, the infectious laughter manifested by its victims has given the Tanganyika outbreak a place in medical history along with the dancing epidemic seen in the 13th century, possessed nuns in France, demonic possessions, and even the Salem witch hysteria of the 17th century. Only time will tell what new bizarre symptoms will appear next.