On rare occasions that Medinah leaves her home, people around her will cough, sneeze and rub their eyes.
“I am the allergen,” the 23-year-old, who did not want her full name used, tells Sky News.
She is one of a group of people with a condition so rare it does not have an official medical name.
It is known simply as People Allergic To Me – often shortened to PATM.
Medinah spent a year online searching her symptoms before she found social media support groups and the name that had been coined there.
During those months, she worried she was “crazy”: “I thought, yes, I’m losing it now. But then after a year and the constant reactions with people, I just realised this cannot be in my head, I can’t be crazy, I’m seeing this in real time.”
Hay fever-type symptoms
Several of the people in those groups spoke to Sky News. They described people developing hay fever-type symptoms in their presence, saying as much as 90% of a room would start coughing, choking, or sneezing when they entered.
They detailed the immense toll of isolating themselves to avoid these reactions. Some said they had been suicidal; others talked of losing friends, giving up jobs, and spending hundreds of pounds on possible remedies.
Last year, PATM sufferers had a glimmer of hope. A researcher in Japan published the first cohort study on the condition – and it indicated there could be a physical cause.
Image: Medinah has suffered from People Allergic To Me since 2020
Speaking to Sky News from Tokyo, Professor Yoshika Sekine from Tokai University describes what he found when he compared the skin gases emitted by 20 people with PATM to a control group of 24.
He discovered the PATM group had “very specific characteristic skin gas patterns”, giving off higher levels of certain chemicals that are known to provoke respiratory symptoms in people exposed to them.
One of them, toluene, is used in the manufacture of explosives, paints and plastics and as a solvent in some types of paint thinner and glue. It can cause irritation to the eyes, nose, throat and respiratory tract, according to Public Health England – and people with PATM emitted 39 times more of it than the control group.
The other chemicals Prof Sekine identified as being particularly important are sulphur compounds, which have a “very strong, pungent odour” and hexanol, which has a hay-like smell.
These chemicals are known to trigger respiratory symptoms and skin irritation and are both linked to sick building syndrome, a condition recognised by the World Health Organisation where people are made ill by the building in which they live or work.
The study concluded: “We must carefully consider the possibility that the chemicals emitted by the PATM group may induce chemical intolerance in those around them.”
‘You feel you don’t have the right to live’
It’s been about 18 months since Fahima started noticing reactions from people around her.
“Wherever I go, if I go into a shop, if I’m out, if I walk past someone, people will sneeze and hysterically cough,” she tells Sky News.
In that time, she’s shifted to working entirely from home. She has stopped attending her nine-year-old son’s school plays because “I don’t want to impact the children”.
She shops in the early, quiet hours. The school run is the only time she regularly leaves the house.
“From the minute I wake up, the first thought is, how are people going to react to me today? I have to minimise myself so that I don’t impact other people.”
She says she also gives off an odour that developed from sweat to fish and then faeces.
There is a medically recognised condition called trimethylaminuria (TMAU) – sometimes called “fish odour syndrome” for the smell sufferers emit – that is sometimes grouped together with PATM.
However, there are PATM sufferers who say their symptoms are not accompanied by any discernible smell.
Dr Robin Lachmann, one of the country’s leading doctors specialising in TMAU, tells Sky News that unlike PATM, TMAU is a condition “which we understand well and can treat”.
A key difference is that while people around the patient may find the odour unpleasant, “these responses aren’t allergic”.
Fahima took a test for TMAU which came back negative – but even getting the test took a year of “legwork” on her part, she says.
“With PATM, doctors say even if you want to get tested, there’s no diagnosis. There’s no way to treat it.”
The reactions Fahima gets aren’t just involuntary coughs and sneezes, she says, but insults and abuse.
“You know what? I don’t blame people. Especially the people that are having allergic reactions to us, we’re physically making them sick, so I don’t expect them to have any other reaction.”
But it’s “draining”, she says, and makes her “incredibly depressed”.
“It makes you feel like you don’t have the right to live, almost. Because why should you be in a place making someone else feel uncomfortable?”
Image: Sufferers describe isolating themselves to avoid reactions from other people. Pic: iStock
Fahima says the allergic reactions vary depending on her diet. If she eats a lot of sugar, meat or carbohydrates, the following day she will notice a lot of people sneezing.
Her son mostly doesn’t react to her, she says, but when she eats meat his reactions are so severe she will give him an antihistamine.
Prof Sekine says while skin gases are typically influenced by diet, he hasn’t yet been able to find a link for PATM. But he has spoken to people who have improved their symptoms by cutting out dairy, increasing their intake of antioxidants and working on boosting good gut bacteria.
He also suggests why not everyone reacts to people with PATM. He says it could be to do with sensitivity to chemicals, with some people affected by very low doses in the air around them.
Just as not everyone suffers from hay fever when there’s a high pollen count, not everyone will be sensitive to the higher chemicals in the skin gases of PATM patients.
‘It’s all in your head’
The PATM sufferers who spoke to Sky News invariably said they had been told the condition was “all in their head”.
There is a recognised psychological condition that bears similarities to PATM called Olfactory Reference Disorder, or ORD.
People with ORD are preoccupied with the belief they are giving off a bad smell despite there being no odour, explains Professor David Veale, a consultant psychiatrist at the Nightingale Hospital.
It can have a “devastating” impact on peoples’ lives as they dedicate their energy to tackling the perceived problem and avoid social situations out of fear of being “shamed, humiliated, rejected”, he says.
“They are very stressed and very disabled by it. But no one can convince them that they can’t smell them. They think they’re just saying that to be nice.”
Prof Veale says the difference between PATM and ORD appears to be that ORD patients are preoccupied with their perceptions of what other people think about an imagined smell, while PATM sufferers perceive physical reactions in other people.
Prof Sekine also identifies this difference in his research, concluding PATM is unique “in that it affects the people around them, at least based on descriptions by people with PATM”.
Image: File pic: iStock
Sandra, who did not want to use her real name, says she seriously considered whether her condition could “be in my head” after her doctor suggested she had ORD.
“I’d had too many incidents happen for that to be true,” she says.
“I was even bullied at work about it in one job.”
Almost 60, Sandra has lived with the condition for 15 years. She says she used to have a good career, but no longer works “partly due to the stress and anxiety that this causes”.
Her first sign of PATM came when she returned to work after a bout of sickness and her boss had a “sneezing fit” every time he came into her office.
A deep clean didn’t sort what she thought was a dust issue – and then she noticed other colleagues reacting in the same way, then friends and even her husband.
“Eventually it occurred to me that it must be me causing this, which filled me with horror,” she says.
“When the reactions are at their worst, I have a similar reaction myself, that is I become allergic to myself.
“I have other symptoms like a bad taste in my mouth, itchy throat, itchy skin with a mild rash on my abdomen and spiking mild temperature.”
But making others react is the worst part: “It makes me feel dreadfully guilty to be causing all of this and I have severe anxiety and depression as a result.”
Alex’s 24-year-old brother Miguel first noticed PATM symptoms about 10 years ago, but didn’t tell his family until he was 19.
Many people with PATM say close relatives do not get symptoms, and Alex does not notice himself reacting to his brother.
He says it’s also hard to say whether more people cough and sneeze around his brother because it’s such a commonplace thing – but Miguel will notice every cough or nose scratch, and someone having a coughing fit can be enough to make him stay in his room for days.
Alex recalls being at a restaurant with their grandparents when Miguel first told them about the condition, and his grandmother agreed she could hear people “just constantly coughing in the restaurant”.
“That seemed like an increase to what’s normal. But then how do you know what normal is if you’re not paying attention to it?”
PATM is easy to write off as “just” psychological because “it sounds ridiculous”, Alex says, but his first concern when his brother opened up about the condition was to find a way to cope with the impact on his mental health.
“That’s the important thing – and then it doesn’t matter whether it’s real or not.”
What causes PATM?
The cause of PATM is a puzzle to sufferers and researchers alike. Some people say their symptoms started during a time when they were eating a lot of fast food or experiencing high stress.
Sufferers trade theories about possible triggers: a disrupted gut microbiome, fungal infections, sinus problems.
“You’re like your own doctor, your own medical team,” Medinah says. “I literally stay up all night researching.”
Sandra and another person who spoke to Sky News found their PATM flared after a course of antibiotics, while others described developing skin issues before other symptoms.
MEBO Research, a small collective of researchers investigating rare genetic metabolic diseases, has conducted exploratory studies of PATM without being able to pinpoint a cause beyond an apparent issue with the body’s “detoxification process”.
Mehmet Ali, MEBO’s director of community outreach and strategy, tells Sky News PATM needs attention and research from the medical community.
Prof Sekine’s research also did not identify a cause – although it is his goal to find it. “I would like to define the criteria for what PATM is, and what it is not. This is a very difficult point,” he says.
Without even a criteria of what PATM is, there is no formal diagnosis. NHS England told Sky News it follows NICE guidelines, and there are none for PATM.
A spokesperson for NICE said it “can only look at treatments that are licensed by the UK regulators… If they have not been licensed for PATM, we cannot recommend them for the condition”.
But finding a treatment seems a distant dream to sufferers who share remedies on Facebook and Reddit: supplements of every variety, antibiotics, digestive enzymes, probiotics, herbal treatments.
Sufferers go to extreme lengths in search of solutions. Fasts; eliminating sugar, gluten and dairy; raw veganism and its opposite, the “carnivore diet” – essentially just eating meat, eggs and dairy.
But what might grant one person temporary relief doesn’t necessarily work for someone else.
Sandra sees no end to her 15 years of misery: “We are all just waiting for a cure with our lives in effect on hold but I’m nearly 60 now and not confident it will happen in my lifetime.”
‘It crushes you like nothing has crushed you before’
Amir, who did not want to use his real name, says without family relying on him “I wouldn’t be here, that’s how bad I feel sometimes”.
He describes a life that has become “really, really unbearable”. He says he has lost all his friends “because they can’t be in the same areas as me” and even avoids the mosque.
“I do an experiment – I stay out of the room to see if anyone is coughing, then go in the room for a few minutes. The majority of people will start reacting.”
Not everyone with PATM who spoke to Sky News isolates themselves. Some hold down jobs and socialise – but none seem immune to the mental health impacts of the condition.
They describe the loneliness of not just being physically isolated, but of being misunderstood by doctors, friends and family; the guilt of feeling you’re making another person ill; the despair of there being no treatment or cure.
Medinah describes her mental health as “shattered, it’s non-existent”.
“In the beginning it crushes you, it crushes you in a way that nothing has ever crushed you before.”
She says she quit her job as a teaching assistant because she was getting “aggressive” reactions, and now life is at a “complete stop”.
She gets emotional talking about the future: “I don’t feel excited at all. I don’t even like to think about it. The reality is so sad. I can’t even go to the local park, I can’t do anything.”
Anyone feeling emotionally distressed or suicidal can call Samaritans for help on 116 123 or email jo@samaritans.org in the UK. In the US, call the Samaritans branch in your area or 1 (800) 273-TALK.
Nigel Farage has told Sky News he would allow some essential migration in areas with skill shortages but that numbers would be capped.
The Reform UK leader said he would announce the cap “in four years’ time” after he was pressed repeatedly by Sky’s deputy political editor Sam Coates about his manifesto pledge to freeze “non-essential” immigration.
It was put to Mr Farage that despite his criticism of the government’s migration crackdown, allowing essential migration in his own plans is quite a big caveat given the UK’s skills shortages.
However the Clacton MP said he would allow people to plug the gaps on “time dependent work permits” rather than on longer-term visas.
He said: “Let’s take engineering, for argument’s sake. We don’t train enough engineers, we just don’t. It’s crazy.
“We’ve been pushing young people to doing social sciences degrees or whatever it is.
“So you’re an engineering company, you need somebody to come in on skills. If they come in, on a time dependent work permit, if all the right health assurances and levies have been paid and if at the end of that period of time, you leave or you’re forced to leave, then it works.”
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28:27
‘We need to reduce immigration’
Reform’s manifesto, which they call a “contract”, says that “essential skills, mainly around healthcare, must be the only exception” to migration.
Pressed on how wide his exemption would be, Mr Farage said he hopes enough nurses and doctors will be trained “not to need anybody from overseas within the space of a few years”.
He said that work permits should be separate to immigration, adding: “If you get a job for an American TV station and you stay 48 hours longer than your work permit, they will smash your front door down, put you in handcuffs and deport you.
“We allow all of these routes, whether it’s coming into work, whether it’s coming as a student, we have allowed all of these to become routes for long-term migration.”
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1:51
Sky’s Sam Coates questions PM on migration
Asked if he would put a cap on his essential skills exemption, he said: “We will. I can’t tell you the numbers right now, I don’t have all the figures. What I can tell you is anyone that comes in will not be allowed to stay long-term. That’s the difference.”
Pressed if that was a commitment to a cap under a Reform UK government, he suggested he would set out further detail ahead of the next election, telling Coates: “Ask me in four years’ time, all right?”
Mr Farage was speaking after the government published an immigration white paper which pledged to ban overseas care workers as part of a package of measures to bring down net migration.
The former Brexit Party leader claimed the proposals were a “knee jerk reaction” to his party’s success at the local elections and accused the prime minister of not having the vigour to “follow them through”.
However he said he supports the “principle” of banning foreign care workers and conceded he might back some of the measures if they are put to a vote in parliament.
He said: “If it was stuff that did actually bind the government, there might be amendments on this that you would support. But I’m not convinced.”
The combination of full prisons and tight public finances has forced the government to urgently rethink its approach.
Top of the agenda for an overhaul are short sentences, which look set to give way to more community rehabilitation.
The cost argument is clear – prison is expensive. It’s around £60,000 per person per year compared to community sentences at roughly £4,500 a year.
But it’s not just saving money that is driving the change.
Research shows short custodial terms, especially for first-time offenders, can do more harm than good, compounding criminal behaviour rather than acting as a deterrent.
Image: Charlie describes herself as a former ‘junkie shoplifter’
This is certainly the case for Charlie, who describes herself as a former “junkie, shoplifter from Leeds” and spoke to Sky News at Preston probation centre.
She was first sent down as a teenager and has been in and out of prison ever since. She says her experience behind bars exacerbated her drug use.
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Image: Charlie in February 2023
“In prison, I would never get clean. It’s easy, to be honest, I used to take them in myself,” she says. “I was just in a cycle of getting released, homeless, and going straight back into trap houses, drug houses, and that cycle needs to be broken.”
Eventually, she turned her life around after a court offered her drug treatment at a rehab facility.
She says that after decades of addiction and criminality, one judge’s decision was the turning point.
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“That was the moment that changed my life and I just want more judges to give more people that chance.”
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0:22
How to watch Sophy Ridge’s special programme live from Preston Prison
Also at Preston probation centre, but on the other side of the process, is probation officer Bex, who is also sceptical about short sentences.
“They disrupt people’s lives,” she says. “So, people might lose housing because they’ve gone to prison… they come out homeless and may return to drug use and reoffending.”
Image: Bex works with offenders to turn their lives around
Bex has seen first-hand the value of alternative routes out of crime.
“A lot of the people we work with have had really disjointed lives. It takes a long time for them to trust someone, and there’s some really brilliant work that goes on every single day here that changes lives.”
It’s people like Bex and Charlie, and places like Preston probation centre, that are at the heart of the government’s change in direction.
“As far as I’m concerned, there’s only three ways to spend the taxpayers’ hard-earned when it comes to prisons. More walls, more bars and more guards.”
Prison reform is one of the hardest sells in government.
Hospitals, schools, defence – these are all things you would put on an election leaflet.
Even the less glamorous end of the spectrum – potholes and bin collections – are vote winners.
But prisons? Let’s face it, the governor’s quote from the Shawshank Redemption reflects public polling pretty accurately.
It’s a phrase that is frequently used so carelessly that it’s been diluted into cliche. But in this instance, it is absolutely correct.
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Without some kind of intervention, the prison system is at breaking point.
It will break.
Inside Preston Prison
Ahead of the government’s Sentencing Review, expected to recommend more non-custodial sentences, I’ve been talking to staff and inmates at Preston Prison, a Category B men’s prison originally built in 1790.
Overcrowding is at 156% here, according to the Howard League.
Image: Sophy Ridge talking outside Preston Prison
One prisoner I interviewed, in for burglary, was, until a few hours before, sharing his cell with his son.
It was his son’s first time in jail – but not his. He had been out of prison since he was a teenager. More than 30 years – in and out of prison.
His family didn’t like it, he said, and now he has, in his own words, dragged his son into it.
Sophie is a prison officer and one of those people who would be utterly brilliant doing absolutely anything, and is exactly the kind of person we should all want working in prisons.
She said the worst thing about the job is seeing young men, at 18, 19, in jail for the first time. Shellshocked. Mental health all over the place. Scared.
And then seeing them again a couple of years later.
And then again.
The same faces. The officers get to know them after a while, which in a way is nice but also terrible.
Image: Sophy Ridge talking to one of the officers who works within Preston Prison
The £18bn spectre of reoffending
We know the stats about reoffending, but it floored me how the system is failing. It’s the same people. Again and again.
The Sentencing Review, which we’re just days away from, will almost certainly recommend fewer people go to prison, introducing more non-custodial or community sentencing and scrapping short sentences that don’t rehabilitate but instead just start people off on the reoffending merry-go-round, like some kind of sick ride.
But they’ll do it on the grounds of cost (reoffending costs £18bn a year, a prison place costs £60,000 a year, community sentences around £4,500 per person).
They’ll do it because prisons are full (one of Keir Starmer’s first acts was being forced to let prisoners out early because there was no space).
If the government wants to be brave, however, it should do it on the grounds of reform, because prison is not working and because there must be a better way.
Image: Inside Preston Prison, Sky News saw first-hand a system truly at breaking point
A cold, hard look
I’ve visited prisons before, as part of my job, but this was different.
Before it felt like a PR exercise, I was taken to one room in a pristine modern prison where prisoners were learning rehabilitation skills.
This time, I felt like I really got under the skin of Preston Prison.
It’s important to say that this is a good prison, run by a thoughtful governor with staff that truly care.
But it’s still bloody hard.
“You have to be able to switch off,” one officer told me, “Because the things you see….”
Staff are stretched and many are inexperienced because of high turnover.
After a while, I understood something that had been nagging me. Why have I been given this access? Why are people being so open with me? This isn’t what usually happens with prisons and journalists.
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1:10
Probation centres answer to UK crime?
That’s when I understood.
They want people to know. They want people to know that yes, they do an incredible job and prisons aren’t perfect, but they’re not as bad as you think.
But that’s despite the government, not because of it.
Sometimes the worst thing you can do on limited resources is to work so hard you push yourself to the brink, so the system itself doesn’t break, because then people think ‘well maybe we can continue like this after all… maybe it’s okay’.
But things aren’t okay. When people say the system is at breaking point – this time it isn’t a cliche.