Not a villager in Kazakhstan, but maybe someone afflicted by the same disease. Photo via Flickr user Timothy Krause.
Over the past few months, the town of Kalachi, Kazakhstan, has suffered yet another round of the mystery illness that causes its villagers to fall asleep at random for no apparent reason. The problem was first reported in 2010, and government officials—perhaps spurred on by a recent burst of international attention as well as the scale of the latest flare-up—have finally upped their efforts to get to the root of the bizarre plague. At least two other towns nearby have reported similar symptoms from their residents.
Lead doctors now claim that they may have discovered the source of the epidemic. But their findings seem weak by toxicology standards and are far from the conclusive closure locals need. So with a lack of any real cure, local authorities have just started evacuating Kalachi en masse, hoping that getting people out of the town will just eliminate the illness wholesale.
As of the last outbreak from August to September 2014, about 60 people (10 percent of Kalachi's population) had fallen asleep for days on end. A sudden wave in late December 2014 added over 30 more victims (including one non-local, a visiting Russian retiree) to the count. By the end of January, the overall number of victims had reached 126—not including one cat supposedly affected as well—doubling the affliction's toll to 20 percent of the local population. Among these latest victims was the village's administrator, Asel Sadvakasova. The scale of this outbreak led Kazakhstani Deputy Prime Minister Berdibek Saparbaev to officially call upon foreign medical institutions to help local doctors find the source of the illness and figure out exactly what the hell is going on.
By early February, Professor Leonid Rikhvanov of Tomsk Polytechnic University in Siberia, who'd been following the Kalachi story for some time, answered this call, claiming in international media outlets like the Daily Mail that he could explain the entire affair. The culprit, he said, was the unusually high level of radon gas emitting naturally from nearby uranium mines.
Yet this hypothesis had already been rejected (very early on in the disease's history). And about a week after Rikhvanov made his claim, Sergei Lukashenko, the director of Kazakhstan's National Nuclear Center's Radiation Safety and Ecology Institute, dismissed the radon idea, saying the conditions on the ground didn't match. He also noted that Rikhvanov had never even visited Kalachi, so he had very little evidence upon which to base his claims.
Lukashenko believes the illness has something to do with carbon monoxide leaks, which his agency noted in mid-January they had measured in concentrations up to ten times above nationally acceptable levels in recent regional tests. Kazakhstan's Health Ministry seems to be on board with Lukashenko's theory, declaring around the same time that they had preliminarily connected the condition's symptoms to vapor accumulations in poorly ventilated homes.
"Carbon monoxide is definitely a factor," the Siberian Times quoted Lukashenko as saying. "But I can't tell you whether this is the main and vital factor. The question is why it does not go away. We have some suspicions as the village has a peculiar location and weather patterns frequently force chimney smoke to go down instead of up."
Carbon monoxide has been a favorite culprit for amateurs following the story, so for many Lukashenko's claims will come as a moment of intense validation. Yet this conclusion still feels incomplete as it doesn't describe the conditions of the illness in Kalachi all that well. Many fall asleep suddenly, with no prior symptoms, outside of the homes where leaks occur. And when a batch of four patients were taken to the national capital of Astana for the first time for examination at some of the nation's premiere medical facilities, tests found no traces of external factors that could have influenced their health and caused their current condition.
"Carbon monoxide poisoning doesn't just make you fall down and go to sleep," Professor Andrew Stolbach, the head of Johns Hopkins Hospital's toxicology training curriculum, told VICE, explaining how the Kalachi case as he understands it doesn't fit the proposed explanation. "There's a progress of symptoms: nausea, headache, [and] eventually you can have confusion and unconsciousness. But you move slowly through that progression."
"You can have a big enough concentration at one spot [to knock someone out immediately]," Stolbach admits. "But if it's big enough to knock you out [that quickly], you'd be in a coma."
"It should be very straightforward to determine if it were carbon monoxide poisoning," concluded Stolbach. "You could measure carboxyhemoglobin in the blood. Carbon monoxide would be just the easiest thing to diagnose and exclude."
Despite statements from the Health Ministry about locating the cause of the sleeping sickness in vapors, local officials seem to at least implicitly recognize that carbon monoxide probably isn't the culprit (or at least that they're really getting no closer to a solution) as they recently started evacuating Kalachi.
As far back as late November, Kadyrkhan Otarov, the First Deputy Mayor of Akmola Oblast, the administrative district where Kalachi is located, floated the idea of allocating millions of dollars for locals' resettlement into new homes and jobs in nearby cities like Esil. Around the same time, the majority of Kalachi's residents voted in favor of relocation in a local poll. Then after the latest outbreak further pledges emerged promising to begin relocations by the end of January.
By January 14, 2015, at least one family had a new apartment and plans were to have at least 40 others evacuated by the end of the month. The political head of the Akmola Oblast then promised that every citizen would be relocated by May at the latest. As of mid-February, several families have now dispersed to Atbasar, Bulandy, Ereymentau, and Esil, although their exodus is hampered by the fact that fearful taxi drivers often refuse to come to Kalachi to pick people up lest they be struck with the sleeping sickness themselves.
Yet around the same time that relocation came on the docket in November, residents in the small oilfield town of Beryozovka started to claim they were suffering sudden fainting spells. And the next month the town of Krasnogorsky, a bit closer to the uranium mines than Kalachi, started reporting their own cases of the infamous sleeping sickness and requesting relocation themselves.
To date the government has refused requests for new jobs and accommodation in Beryozovka, although they did offer new homes to the 130 people in Krasnogorsky. But those new homes were, for some unfathomable reason, in Kalachi.
If these other villages are legitimately dealing with the same disease and not just faking symptoms to get a free move out of their hometown, then this combined with the continuing lack of any reasonable explanation for Kalachi's affliction makes the idea of explaining this as a case of Mass Psychological Illness seem a bit more likely. I was previously skeptical of this theory because, even if the community were suffering from the collective stresses of poverty and grim uncertainty, outsiders had also suffered from sleeping sickness without being a part of the cultural milieu. Yet Professor Regina Santella, a toxicologist at Columbia University's Mailman School of Public Health, doesn't think that this rules out a psychological phenomenon.
"I would vote for mass hysteria," Santella wrote to VICE, cautioning that this is not her specialty and that she doesn't know everything about the case. But, she explained, collective psychological conditions can have a profound effect, even sporadically and on outsiders exposed to them.
Stolbach, for his part, isn't ready to back a mass hysteria diagnosis, mainly because it's not just hard to diagnose, but it's also the last thing he'd feel the need to worry about or try to prove.
"We have to exclude other things first," he says. "We'd always consider something like mass hysteria at the end because it's not going to kill you [like an environmental factor might]."
The frustrating thing for anyone in search of a definite diagnosis in this case being, if Kalachi's residents recover when they move, it could be taken as proof of either an undetected environmental factor or of a mass psychological illness. Right now all we have is the timing of the disease's spread and our absolute befuddlement to go on, which is just a weak case for hysteria. If the residents stay ill after they move, we'll have more reason to swing back toward an environmental or biological explanation—but no one's pulling for that. On the other hand, if all goes well for them, the rest of us out here scratching our heads will be left with one more infuriating mystery in the world. If that's the case, at least we might be able to make a decent movie out of all of this.
Follow Mark Hay on Twitter.