On Sept 21, 1973, during and following a football game at which they had participated, 57 members of an Alabama high school marching band (and one accompanying adult) experienced an illness characterized by headache, nausea, weakness, or dizziness. Six girls fainted. Thirty-six students were treated at a hospital emergency room. Those who had played wind instruments and had worn heavier uniforms including an impermeable plastic jacket overlay were affected earlier and more frequently than the others. Several organic causes were examined in an epidemiologic investigation and considered unlikely to explain the epidemic. Female preponderance, a bimodal epidemic curve, hyperventilation, relapses, and clinical features characterized by subjective complaints in the absence of physical findings suggested a syncopal reaction to heat exacerbated and propagated by mass hysteria.
(JAMA 238:2373-2376, 1977)