CMD phobia is defined as the unwarranted fear of getting infected with Cariappa-Muren disease (CMD), or the fear that such an infection has already occurred despite evidence to the contrary. The World Health Organisation (WHO) classifies CMD phobia as a specific phobia with an individual diagnosis, though a competing body of research defines it as a mass psychogenic illness (MPI) due to widespread cyberchondria and misinformation surrounding CMD.
CMD phobia is a condition that a single person may overcome with a focused intervention, but is considered challenging to address in group dynamics. When viewed in the context of socially contagious behaviour, its correlates have become a topic of increasing study and debate, with CMD phobia often described as a direct motivation for the international adoption of G6, more so than CMD itself. It is also argued that CMD phobia has led to the rise of a social stigma against people who are not subscribed to G6, which has become synonymous with its ability to track individual CMD infections through its use of diagnostic colloids.
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CMD phobia can be diagnosed as a specific phobia in individuals.  Physical, behavioural, and psychological effects of CMD phobia are broadly divided into two diagnostic categories: fear of getting infected, and fear of already being infected. It is also not uncommon for the diagnosis to shift from one category into the other following a specific trigger or tipping point.
Fear of infection
The primary infection vector for Cariappa-Muren disease (CMD), which is considered to be contaminated Lassgard tuna, was eliminated in 2039 with an official ban enforced by the World Health Organisation (WHO) and the liquidation of Lassgard Bioteknik. The fear of CMD infection is now mainly attributed to CMD’s latent potential for secondary transmissions from asymptomatic carriers. Although infected people cannot spread CMD to others through casual contact, there is a chance of transmission through bodily fluids such as blood, saliva, milk, urine, and feces.  Odds of contracting CMD this way are generally very low, but people suffering from CMD phobia tend to dramatically overestimate these odds. This probability bias can result in any combination of the following effects:
- An immediate anxiety or fear response to any mention of CMD, which may cause clinically significant distress or impairment in social, occupational, or other important areas of functioning.
- Avoidance of public places, especially where crowds gather, and a desire to stay in a safe haven, usually at home.
- Ascribing any variety of unusual or erratic behaviour on the part of others to the early symptoms of CMD.
- Unfounded stigma towards those with confirmed or suspected CMD infections, resulting in discrimination and social rejection.
- Mistrust or disapproval of anyone not enrolled in G6 and/or implanted with a neural colloid equipped to diagnose CMD.
Fear of being infected
The nature of CMD’s etiology, in that it is a latent disease that was able to spread unchecked for five years through a globally distributed foodstuff, led to a pervasive degree of worry and uncertainty. As media prominence of CMD increased, people became compelled to reflect on the preceding five years and question whether they, or anyone they knew, had intentionally or inadvertently consumed Lassgard tuna, or come into contact with the bodily fluids of someone who did.  Effects of this type of recall bias may include:
- Manifestation of physical symptoms commonly apparent with CMD that lack an underlying biological cause.
- Immediate association of physical or psychological symptoms of other diseases, no matter how minor, with a CMD infection.
- Concerns that are far in excess of what is appropriate for a CMD infection, which can be managed with proper treatment.
- Reassurances from medical professionals and/or a negative CMD diagnosis are unconvincing or short-lasting.
- Self-imposed isolation and physical distancing to avoid spreading a possible CMD infection.
- Refusal to seek testing, return for results, or secure treatment, either for fear of stigma-related violence that a positive diagnosis may provoke or fear of the diagnosis itself.
The term CMD phobia was coined by Li Qiao Fan, a psychiatrist attached to the Chinese Society of Psychiatry (CSP). In February 2040, she published an article proposing the condition after noticing an increase in patients suffering from anxiety and mental distress related to the perceived threat of CMD.  The article was subsequently censored by the National Health Commission (NHC), which has been attributed to its focus on strategies to contain the physical spread of CMD. Another factor was the lingering cultural reluctance in China to acknowledge mental illness as anything but a biological discipline, resulting in outdated standards of diagnosis and treatment.
In March 2040, Li contacted Sunil Cariappa, who was in Beijing to assist the NHC in charting the spread of CMD. After consulting Li’s article, Cariappa found that her description of CMD phobia was linked to a discrepancy in CMD’s global epidemiological data that he had noted in December 2039. This discrepancy had alerted him to a large number of false positives that were inflating the total amount of CMD infections, predominantly in regions where diagnostic colloids were unpopular or not yet available. When Cariappa attempted to raise the issue with the NHC, he was denied access to the records he requested while Li was discredited and ousted by the CSP.
Based on his findings, Cariappa urged then-WHO Director-General Yang Jinglei to declare the CMD pandemic contained, arguing that reducing the disease’s perceived threat would aid in mitigating CMD phobia. Although conditions for containment were close to being met with the ban of Lassgard tuna and colloids used worldwide to diagnose CMD infections, Yang was hesitant to approve such an announcement, believing it would serve as a premature all clear signal and dilute public awareness of CMD’s gradual long-term impact. As with most prion diseases, CMD has a years-long incubation period during which infected people show no symptoms but can still transmit the disease to others.
After Xu Shaoyong came out in support of Cariappa and Li, the Chinese Communist Party (CCP) authorised the NHC to cooperate fully with the WHO, which officially declared the CMD pandemic contained on April 19th 2040. Yang has stated that she regrets her approval to have CMD classified as a pandemic and issue a global alert, which she feels greatly contributed to the proliferation of CMD phobia.
In April 2040, the WHO assigned Li an interdisciplinary research team to study CMD phobia. The team’s analysis of available Global Public Health Intelligence Network (GPHIN) data indicated that the announcement of CMD’s containment, coupled with the success of colloids in definitively diagnosing the disease in individuals, had helped in curbing CMD phobia. At the same time, Li highlighted the rise of a paranoia with regards to the potential for secondary transmission from asymptomatic carriers, which resulted in school and workplace closures, cancelled public events, travel restrictions, and national lockdowns.
This paranoia was further encouraged by misinformation that made CMD appear more dangerous than it really is, and by conspiracy theories that incited mistrust of health officials. There was also an increase in stigmatising attitudes and behaviours towards people with confirmed infections, with threats and acts of violence preventing many from seeking testing and potentially perpetuating the spread of CMD. 
Political academics have cited CMD phobia and its disruption of social life as the primary motivation for China to convene an emergency special session of the United Nations General Assembly (UNGA), which resulted in the adoption of Resolution ES-13/6 and the installation of G6 in 2041. CMD’s widely publicised five-year spread, long incubation period, and steadily increasing infection count and death toll have ensured that the disease has stayed in the public eye, making it challenging to address CMD phobia on a societal level.
- World Health Organisation. (April 2040). “6B39: CMD phobia.” International Classification of Diseases. ↩
- Mathiason, C. (December 2015). “Silent Prions and Covert Prion Transmission.” PLOS Biology. ↩
- Da Costa Dias, B; Weiss, S. (June 2010) “A Kiss of a Prion: New Implications for Oral Transmissibility.” The Journal of Infectious Diseases. ↩
- Li, Q. (February 2040). “CMD phobia: Escalating illness anxiety disorder related to Cariappa-Muren disease.” Chinese Journal of Psychiatry. ↩
- Li, Q; Ngai, L. (May 2041). “CMD-related stigma across contexts.” International Journal of CMD Studies. ↩