THE SPANISH TOXIC OIL SYNDROME

In May 1981, disease broke out in Spain and quickly became of epidemic proportions, although the incidence of the disease was limited to a relatively small area around Madrid. The most commonly reported symptoms were fever, respiratory distress, nausea and vomiting, headaches, various skin eruptions, general discomfort, abdominal pain, and myalgias. The respiratory distress was initially the major symptom but later neuromuscular changes predominated, ranging from simple myalgia to muscular weakness and atrophy involving peripheral neuropathy, severe weight loss, scleroderma‐like skin changes, and pulmonary hypertension. The epidemic affected more than 20,000 people in Spain and claimed about 400 lives between May 1981 and October 1983. Afflicted patients are still dying, and it is feared that the eventual death toll may exceed 500.