Regarding the gender ratios in epidemics, I was a bit surprised to see that Goudsmit paper reported that 292 members of Royal Free Hospital staff were affected, 265 of whom were women (so only 27 men). 12 patients were affected (sex ratio not given). So, the Royal Free isn't an example of an epidemic with a 1:1 sex ratio. It isn't clear from that paper how many men and women were still sick in the long term though, which is what we really need to know. That many female nurses were affected may well be a result of them living together in the same hostel.
But further to my comment above about a combination of gender based prejudice and a conflation of MECFS with psychosomatic illness possibly affecting the sex ratios in diagnosed MECFS patients:
The paper mentions a number of other similar epidemics and notes that those with either equal numbers of men and women or a majority of men were not seen as psychosomatic.
In the same year, there were three similar outbreaks. The first outbreak occurred in Addington Hospital, Durban, at the same time as a poliomyelitis epidemic (Hill et al., 1959). Ninety-eight nurses were affected, of whom 11 were still unfit for duty three years later and 10 had to seek other occupations because of the residual effects of the illness. Like the outbreak at the Royal Free Hospital, this epidemic followed a number of cases in the general population living in the vicinity, and the reason for the increased virulence of the infecting organism was probably the semi-isolated nature of the hospital community and the close physical contact between the members of staff.
The second commenced in Dalston, Cumbria in February 1955 and lasted until July, affecting 233 members of the general population. The ratio of female to male sufferers in this outbreak was 1:1 (Wallis 1955).
The third outbreak occurred in a very large area of North West London, extending from East Ham in the North to Shepherds Bush in the South. It is not known exactly how many numbers were affected but one hospital alone admitted 53 cases between May 1955 and March 1958 (Ramsay 1957, 1986). It preceded the epidemic at the Royal Free Hospital, which served part of this area.
The two hospital outbreaks, but not the epidemic in Dalston, were regarded by McEvedy and Beard as examples of mass hysteria despite the fact that the symptoms in all four outbreaks were remarkably similar (McEvedy and Beard 1970b).
....
That the susceptibility of women in hospital outbreaks of M.E. may be linked to factors other than the psychological make-up of women is supported by data from outbreaks amongst the general population. Many of these outbreaks, such as the ones in Dalston (Wallis 1955) and Adelaide (Ramsay 1986, Pellew 1951) affected an equal number of men and women and several, including ones in Switzerland (Gsell 1949) and Berlin (Sumner 1956) only involved men. Interestingly enough, McEvedy and Beard (1970b) did not regard the latter, a relatively mild outbreak which affected only 7 soldiers, as mass hysteria.
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McEvedy and Beard (1970a, 1973) based their <<mass hysteria>> hypothesis on the following arguments:
1. The vast majority of those affected were young women.
2. These women were socially segregated.
3. No organic cause could be found and the results of the laboratory tests were not significant.
4. Some of the symptoms could be explained in terms of anxiety and hyperventilation.
5. The illness failed to “propagate beyond the institutional population.”
6. The mean Neuroticism score of a small number of affected nurses was higher than that of a control group of unaffected nurses.
7. Those nurses who became ill had suffered from more illnesses requiring hospital admissions and had borne fewer children than the unaffected nurses.
....
Yes, all this was back in the 1970's and 80's. Hopefully things have changed a bit.
