The authorities are scrambling to find the source of the mysterious illness that has so far afflicted more than 500 people in rural India, with two possible culprits identified: heavy metals such as nickel and lead, or pesticides.

Some 555 residents of Eluru – a town with a population of 200,000, in Andhra Pradesh state in southern India – have been struck by the unexplained illness.

The sinister sickness, which causes spontaneous collapse, first appeared on Saturday. Many patients presented to emergency rooms with injuries that were sustained as they fell.

“Some people are saying that it is mass hysteria, but it is not,” said A.S. Ram, a senior doctor at Eluru Government Hospital. “Most of the patients are coming in with minor head injuries or a black eye, as they collapsed suddenly with the seizure.”

A 45-year-old man is so far the only confirmed fatality from the illness. He had experienced a series of convulsions, as well as nausea and chronic pain. An autopsy failed to yield any conclusive evidence of the cause of death. 

 Of the 555 people who have been treated since Saturday, about 80 presented with symptoms on Tuesday alone, Eluru Government Hospital chief Dr. A.V. Mohan said. At least 70 children have been afflicted by the illness.

On Tuesday, a team of doctors from New Delhi’s All India Institute of Medical Sciences reported the presence of heavy metals in blood samples, though they caution that the sample size is too small yet to definitively state that heavy metal poisoning is the cause. 

Chemical additives in pesticides are also suspected of playing a role in the mysterious illness, and an official inquiry has been launched. Tests on water supply and milk have been carried out, while cooking oil, rice, and urine samples have also been sent for analysis. Adding to the intrigue is the fact that there are no major chemical factories in the region.

After consultation with local medical authorities, federal lawmaker G.V.L. Narasimha Rao claimed the “most likely cause is poisonous organochlorine substances.”

Organochlorines have been banned in many countries, due to their links to various cancers. Symptoms of exposure to these chemicals include convulsions, headache, dizziness, nausea, vomiting, tremors, confusion, muscle weakness, slurred speech, salivation, and sweating.

India currently has the second-highest number of coronavirus cases in the world, expected to surpass 10 million soon, though all patients in Eluru have tested negative for Covid-19, as well as dengue fever, chikungunya, and herpes.

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