Not residents of Kalachi, but very sleepy people nonetheless. Photo via Flickr user Tinou Bao
Classified as an encephalopathy of unclear origin—the highfalutin term for a weird brain disorder we can't figure out—villagers who do not simply keel over while moving or working report feeling weakness, dizziness, and memory and motor control loss. At least two children have reported hallucinations as well: Misha Plyukhin saw flying horses and light bulbs, his mother with eight eyes and a trunk, and snakes and worms in his bed, trying to eat his arms; Rudolf Boyarinos cannot remember his visions, but four people had to calm and subdue him as he screamed "monsters!" The sleep is so deep that some locals fear an old man they assumed was dead could have been buried alive.
As the Kazakhstani government and outside consultants fail on repeated pledges to figure out the cause of the epidemic, many locals are turning to conspiracy theories—like alien viruses and government experimentation. More disturbing than a cover-up, though, is the prospect that we could be dealing with a new disease or contaminant that we don't know how to test for.
The first outbreak of the illness occurred from March to May 2013, when around ten villagers ranging from 14 to 70 years old went to the hospital with similar symptoms. Subsequent outbreaks followed from January to March 2014, in May (when the international press picked up on a story originally published in the Siberian Times on the issue), and from August to September. Usually patients wake up after a few days, sometimes falling back to sleep soon after. It is not yet clear whether those afflicted can fully recover or will continue to fall asleep at inopportune moments in the future.
Similar sleeping sicknesses offer no help in diagnosing the Kazakhstani case.
The best known, trypanosomiasis, can't be blamed because it's caused by a parasitic infection transmitted by the bite of the tsetse fly, endemic to Africa. A lesser-known disease, nodding syndrome, which has infected over 3,000 children in South Sudan and Uganda since the 1990s, could have been linked to the Kazakhstani outbreak despite its geographic origin. But cases outside of children are rare, and just this fall scientists released evidence suggesting the disease traces back to another insect-bite-transmitted parasite local to Africa.
Global afflictions, like Kleine-Levin syndrome, only cause sleepiness in distinct populations (here, adolescents), and cannot explain the wider symptoms and demographics in Kazakhstan. Encephalitis lethargica, a plague that infected around a million people from 1915 to 1926, killing almost one-third of patients and locking many others into a catatonic state (the subject of Oliver Sachs' 1973 Awakenings), seemed a likely candidate given its murky causes and sporadic modern infections. But research over the last decade has tied the condition to a reaction to a unique form of streptococcal bacteria, which has not been detected in the Kazakhstani patients—nor do any demonstrate the Parkinsonian symptoms described in post-encephalitic patients.
Local and national medical teams at first suspected some other bacterial infection, like meningitis, might be responsible. However after over 7,000 tests on patients and the town's air, food, water, and general environment, no signs of bacterial, viral, chemical, radiological, or any other contamination have been identified. The greatest lead right now is the local observation that outbreaks tend to accord with shifts from cold to warm weather.
Most reports have attempted to link the illness to the proximity of a Soviet-era uranium mine, closed in the 1990s. In March 2014 and during RT's recent investigations, reporters did detect slightly elevated levels of radon gas in the environment possibly linked to the mine—perhaps the periodic evaporation of gas during thaws. But Krasnogorsk, a town closer to the mines, has reported no cases of sleeping sickness, nor do any of the patients have any connections to the mines. And the symptoms of uranium poisoning—and most other heavy metal and gas contaminations, which tend to destroy people's internal organs, especially the kidneys—haven't been seen in any of the patients.
The only disease whose symptoms match those on display and which has not been conclusively ruled out may be narcolepsy, a neurological affliction leading to sudden and prolonged sleep and occasionally difficulty moving and speaking or hallucinations while awake. Usually present in less than 0.03 percent of the population, there is some indication that the disease, which tends to manifest in adolescence, can be triggered at any point in life by the exposure to toxins, stress, or injuries that alter the brain's production of hypocretin, a neurotransmitter linked to sleep. But the lack of any smoking-gun toxin in Kalachi makes this explanation unlikely.
Without any clear biological or environmental cause, many assume the contained affliction must be the result of a Mass Psychological Illness, also known as mass hysteria. Sharing symptoms with some toxic exposures and triggered by feelings of intense communal stress, these incidents cause physical and behavioral symptoms in one individual that our remarkably suggestive bodies pick up on and mimic. Famous cases include the 1374 and 1518 German and 1840s Madagascaran outbreak of choreomania, or the dancing plague. Famines and natural disasters preceding these incidents caused one individual to snap and, influenced by cultural tropes, start dancing ecstatically, whipping others into a frenzy lasting days and endangering their health. A more recent example around 9/11 in America, the Bin Laden Itch, involved the threat of a biological attack on the nation triggering nationwide, psychosomatic rashes.
These psychological epidemics either play themselves out, with some damage to those involved, or can be cured with a placebo, convincing people that their legitimate affliction has been addressed. In modern times, this involves sugar pills, but historically the ritual of exorcisms has helped to close the psychological rift of victims and restore them to everyday life. However the fact that the residents of Kalachi believe they have a modern medical condition that cannot be pinned down by any doctors almost precludes the possible use of a placebo if this is hysteria.
One troubling case reported in May 2014 by the Siberian Times also confounds the whole idea that this is just a communal reaction to common stresses. Alexey Gom, a resident of another village a ways away, came to visit his mother-in-law and quickly and unexpectedly found himself suffering from the condition. Yet as an outsider he would not suffer from the same stresses of those living in Kalachi. And no stress or cultural trope of sleep-as-illness has been isolated in the village to explain a potential Mass Psychological Illness either.
This leaves the residents of Kalachi, after one-and-a-half years of suffering, at ground zero. They could wait for more tests or see if it all plays out naturally. Or perhaps, since science has failed them, it's time to embrace the fact that this tableau feels like the gritty reboot of a fairytale and seek alternative treatments a la the Brother's Grimm. True love's kiss isn't sanctioned by the medical community, but if nothing else is working and there's no logic to this disease, they might as well move it into clinical trials, or fortify and stock the village for their Rip Van Winkle future.
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