Al-Arabia – Iran’s government has arrested more than 100 people who it believes are responsible for a mystery illness that has affected potentially thousands of the country’s schoolgirls, with many attributing the sickness to poisoning.
As videos continue to emerge online of distressed young people being taken to clinics and hospitals, toxicologists, chemical-weapons researchers, epidemiologists, and political scientists have explored possible explanations, in an investigation by the Nature journal.
Human-rights activists say one of the earliest cases reported in the media was at a school in the northern city of Qom in November 2022, and since then, hundreds of videos have been posted on social media of girls and young women reporting symptoms including fatigue, burning throats, nausea, headaches, and numbness.
According to a toxicologist, the government and researchers are collecting data, but initial analyses are not robust enough to draw conclusions. Iran has yet to publish official data other than the number of people who have fallen ill. Clinicians who have treated them are not providing public statements. This means any external interpretation of events is mostly reliant on secondary sources.
Alastair Hay, a toxicologist and chemical-weapons researcher at the University of Leeds, UK, says he has seen the results of blood tests from young people who have been hospitalized. However, it is not always possible to detect poisoning in this way because blood tests do not screen for different kinds of poison. A comprehensive toxicological screen and a representative number of cases are needed, he adds.
‘Potentially caused by Chloramine’
Keith Ward, a chemist at George Mason University in Fairfax, Virginia, who has advised human-rights organizations in cases where chemical and biological weapons have been used in conflicts, says that if a chemical was involved, a potential candidate would be chloramine.
Chloramine is produced by combining a cleaning product containing bleach with another containing ammonia. Its presence creates some (but not all) of the odors and symptoms being reported. Ward says other candidates, such as nerve gases and mustard gas, are less likely. Signs that nerve agents have been used would include an eye condition called pinpoint pupil, which is not being reported. Mustard gas has delayed effects after exposure and not the immediate reactions being reported, Ward adds.
‘Mass psychogenic illness’
Both Hay and Dan Kaszeta, a toxicologist at the Royal United Services Institute, a think tank in London working on military issues, are not ruling out the possibility of an episode of mass psychogenic illness.
This arises from anxiety in response to fears of a threat or knowledge that a threat could be imminent. In Iran, this threat is real, as the government has been arresting and imprisoning young people following nationwide protests after the death of Mahsa Amini, a student, while in custody in 2022.
Girls and women have died as a result, according to Human Rights Watch and Amnesty International. There have been previous cases in which fears of poisonings “have led to stress reactions such as fainting, nausea and hyperventilation,” John Drury, a psychologist at the University of Sussex in Brighton, UK, who studies collective behavior, told the Nature journal.
The phenomenon is thought to affect schoolchildren, often girls in countries where there is conflict.
However, Drury says it is hard to distinguish between psychogenic effects and exposure to actual hazards, and that tests to determine the causes of physical symptoms should still be carried out.
Other researchers say it is too soon to be searching for psychogenic causes.
Ali Arab, a statistician and epidemiologist at Georgetown University in Washington DC, says that a psychological phenomenon is “an absurd argument in this particular case,” given the abundance of video and photographic evidence showing physical symptoms.
Orkideh Behrouzan, a physician and medical anthropologist at the School of Oriental and African Studies (SOAS) in London, agrees. “Bringing in a mass psychogenic hypothesis before having ruled out all physical causes is dangerous and misleading,” she says.
According to Behrouzan, researchers, human-rights groups, and some governments are calling for an independent investigation into recent events in Iran. Such an investigation would require access to health data that are typically heavily guarded in the country.
The Organization for the Prohibition of Chemical Weapons (OPCW), a United Nations agency based in The Hague and of which Iran is a member, could carry out the investigation if a member state makes a formal request, which has yet to occur. However, the agency is monitoring developments in Iran closely.
Researchers interviewed by Nature suggest that a thorough investigation would involve toxicological tests, analyses of clinical histories, an epidemiological study, interviews with victims, and environmental sampling. Ward and Hay emphasize the importance of community involvement to ensure the credibility of the findings.
Hay believes that Iran has the expertise and equipment necessary to carry out toxicological investigations, which were developed during and after the country’s war with Iraq.
While the interior ministry has announced the arrest of more than 100 people for using “smelly and harmless” substances to shut down classrooms, some researchers cannot rule out the possibility of government involvement in the poisoning events.
The military and security apparatus may have used poisoning as a means of punishing protesters, according to Saeid Golkar, a political scientist who studies Iran.
Encieh Erfani, a physicist formerly at the Institute for Advanced Studies in Basic Science in Zanjan, resigned in protest at the state’s violent repression of girls and women and believes that the government’s approval would be necessary for such events to occur.
Ali Ansari, a historian of Iran at the University of St Andrews, suggests that there are those in the regime who believe that girls should not be educated and may be taking matters into their own hands