Ciguatera fish poisoning with elevated muscle enzymes and abnormal spinal MRI.

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Wasay, Mohammad; Sarangzai, Amanullah; Siddiqi, Ather; Nizami, Qamaruddin

2008-03-01

We report three cases of ciguatera fish poisoning. One patient died secondary to respiratory failure. Two patients showed elevated muscle enzymes and one patients had an abnormal cervical spinal MRI. MRI findings have not been previously described. MRI findings explain the mechanism of the L'hermitte phenomenon (a common complaint) among these patients. Respiratory failure is rare in ciguatera fish poisoning. Our findings suggest this could be related to respiratory muscles involvement.

The effects of natural disturbances, reef state, and herbivorous fish densities on ciguatera poisoning in Rarotonga, southern Cook Islands.

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Rongo, Teina; van Woesik, Robert

2013-03-15

Ciguatera poisoning is a critical public-health issue among Pacific island nations. Accurately predicting ciguatera outbreaks has become a priority, particularly in Rarotonga in the southern Cook Islands, which has reported the highest incidence of ciguatera poisoning globally. Since 2006, however, cases of ciguatera poisoning have declined, and in 2011 ciguatera cases were the lowest in nearly 20 years. Here we examined the relationships between cases of ciguatera poisoning, from 1994 to 2011, and: (i) coral cover, used as a proxy of reef state, (ii) the densities of herbivorous fishes, and (iii) reef disturbances. We found that coral cover was not a good predictor of cases of ciguatera poisoning, but high densities of the herbivorous fish Ctenochaetus striatus and reef disturbances were both strong predictors of ciguatera poisoning. Yet these two predictors were correlated, because the densities of C. striatus increased only after major cyclones had disturbed the reefs. Since 2006, the number of cyclones has decreased considerably in Rarotonga, because of the climatic shift toward the negative phase of the Pacific Decadal Oscillation. We suggest that fewer cyclones have led to decreases in both the densities of C. striatus and of the number of reported cases of ciguatera poisoning in Rarotonga. Copyright © 2013 Elsevier Ltd. All rights reserved.

Ciguatera poisoning in Vanuatu.

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Goodman, Anna; Williams, Thomas N; Maitland, Kathryn

2003-02-01

Ciguatera poisoning is endemic in many tropical and subtropical countries. We conducted a retrospective study of admissions to two hospitals on the islands of Vanuatu in the southwestern Pacific region. We estimated the annual hospital admission rate for fish poisoning to be 65 (95% confidence interval [CI] = 55-75)/100,000 population on the island of Santo and 29 (95% CI = 19-43)/100,000 population on the island of Ambae. Hospital admission was more common in males 20-29 years old. Death was a rare complication. In the face of increases in both tourism and in the global trade in tropical and exotic fish, physicians in both endemic and non-endemic areas should be familiar with the epidemiology and clinical features of this important condition.

Ciguatera poisoning.

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Achaibar, Kira C; Moore, Simon; Bain, Peter G

2007-10-01

Ciguatera is a form of poisoning that occurs after eating tropical and subtropical ciguatoxic fish. The ciguatoxins are a family of heat stable, lipid soluble cyclic polyether compounds that bind to and open voltage-sensitive Na(+) channels at resting membrane potential, resulting in neural hyperexcitability, as well as swelling of the nodes of Ranvier. The authors describe a 45-year-old man who developed acute gastrointestinal symptoms in Antigua soon after eating red snapper and grouper, potentially "ciguatoxic fish". This was followed by neurological symptoms 24-48 hours later, including temperature reversal (paradoxical dysaesthesia), intense pruritus and increased nociception as a result of a small fibre peripheral neuropathy. The patient's symptoms and small fibre neuropathy improved over a period of 10 months.

Reversible cerebellar dysfunction associated with ciguatera fish poisoning.

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Oh, Sun-Young; Kim, Do-Hyung; Seo, Man-Wook; Shin, Byoung-Soo

2012-10-01

Ciguatera-fish poisoning (or ciguatera) is a common but underdiagnosed food-borne illness related to fish consumption that is characterized by nausea, vomiting and neurologic symptoms such as tingling in the fingers or toes. We describe the case of a young man who suffered from diarrhea and abdominal pain after eating raw fish and who also developed severe ataxia with spontaneous downbeat and perverted head-shaking nystagmus. The patient experienced visual fixation suppression failure during the bithermal caloric test and bilateral smooth-pursuit impairment. Oculomotor findings suggested dysfunction of the vestibulocerebellum, especially the flocculus. These findings suggest that both the peripheral and the central nervous systems can be involved in ciguatera. Copyright © 2012 Elsevier Inc. All rights reserved.

Outbreak bias in illness reporting and case confirmation in ciguatera fish poisoning surveillance in south Florida.

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Begier, Elizabeth M; Backer, Lorraine C; Weisman, Richard S; Hammond, Roberta M; Fleming, Lora E; Blythe, Donna

2006-01-01

Ciguatera fish poisoning is a potentially life-threatening disease caused by eating coral reef fish contaminated with ciguatoxins and is the most common marine poisoning. However, existing surveillance systems capture few cases. To improve regional ciguatera surveillance in South Florida, this study compared ciguatera illnesses in the Florida Poison Information Center-Miami (FPICM) call database to ciguatera cases in the Florida Department of Health (FDOH) disease surveillance systems. Univariate and multivariate logistic regression were used to identify predictors of when FPICM reported ciguatera illnesses to FDOH and whether FDOH confirmed reported ciguatera cases. FPICM staff preferentially reported ciguatera illnesses that were of shorter duration (adjusted odds ratio [AOR] = 0.84 per additional illness day; 95% confidence interval [CI] 0.74, 0.97); outbreak-associated (AOR = 7.0; 95% CI 2.5, 19.5); and clinically more severe (AOR = 21.6; 95% CI 2.3, 198.5). Among ciguatera illnesses reported to FDOH, outbreak-associated illnesses were more likely than single, sporadic illnesses to become confirmed surveillance cases (crude OR = 11.1; 95% CI 2.0, 62.5). The over-representation of outbreak-associated ciguatera cases underestimates the true contribution of sporadic illnesses to ciguatera disease burden. This bias should be considered when evaluating surveillance systems that include both outbreak-associated and sporadic illness reports.

Characteristic Features and Contributory Factors in Fatal Ciguatera Fish Poisoning--Implications for Prevention and Public Education.

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Chan, Thomas Y K

2016-04-01

In this review, the main objective was to describe the characteristic features of fatal ciguatera fish poisoning and identify contributory factors, with a view to promote prevention and public education. Ciguatera-related deaths, although rare, have been reported from the Pacific, Caribbean, and Indian Ocean regions. The clinical features were generally dominated by convulsions and coma, with various focal neurological signs. Several contributory factors could be identified, including consumption of ciguatoxin (CTX)-rich fish parts (viscera and head) in larger amounts, the most ciguatoxic fish species (e.g.,Gymnothorax flavimarginatus) and reef fish collected after storms and individuals' susceptibility. Mass ciguatera fish poisoning with mortalities also occurred when G. flavimarginatus and other ciguatoxic fish species were shared in gatherings and parties. The characteristic features of fatal ciguatera fish poisoning must be recognized early. The public should be repeatedly reminded to avoid eating the most ciguatoxic fish species and the CTX-rich parts of reef fish. To prevent mass poisoning in gatherings and parties, the most ciguatoxic fish species and potentially toxic fish species must be avoided. Particularly after hits by disastrous storms, it is important to monitor the toxicity of reef fish and the incidence rates of ciguatera. © The American Society of Tropical Medicine and Hygiene.

Use of monoclonal antibodies as an effective strategy for treatment of ciguatera poisoning.

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Inoue, Masayuki; Lee, Nayoung; Tsumuraya, Takeshi; Fujii, Ikuo; Hirama, Masahiro

2009-06-01

Ciguatera is a global food poisoning caused by the consumption of fish that have accumulated sodium channel activator toxins, ciguatoxins. At present, most diagnosed cases of ciguatera are treated with symptomatic and supportive remedies, and no specific therapy has been devised. Here we report that ciguatoxin CTX3C can be effectively neutralized in vitro and in vivo by simultaneous use of two anti-ciguatoxin monoclonal antibodies, providing the first rational approach toward directly preventing and treating ciguatera.

Cardiovascular Complications in Ciguatera Fish Poisoning: A Wake-up Call

OpenAIRE

Senthilkumaran, Subramanian; Meenakshisundaram, Ramachandran; Michaels, Andrew D.; Suresh, Ponnuswamy; Thirumalaikolundusubramanian, Ponniah

2011-01-01

Ciguatera fish poisoning occurs with ingestion of fish containing ciguatoxin. It causes a clinical syndrome that comprises classic gastrointestinal, neurological and cardiovascular symptoms. Ciguatoxin is a sodium channel agonist with cholinergic and adrenergic activity. Although cardiovascular symptoms are rare with ciguatoxin, we report two cases with bradycardia and hypotension. Fatality and long-term sequelae are not uncommon with ciguatoxin poisoning and educating the general population ...

A case of ciguatera fish poisoning in a French traveler.

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Develoux, M; Le Loup, G; Pialoux, G

2008-11-06

Ciguatera is a toxic poisoning due to ingestion of fish and is rarely reported in France. Little is known about this imported tropical disease. We present a case observed in Paris in a traveller returning from the Dominican Republic.

Ciguatera Fish Poisoning: Treatment, Prevention and Management

Directory of Open Access Journals (Sweden)

Andrew Reich

2008-08-01

Full Text Available Ciguatera Fish Poisoning (CFP is the most frequently reported seafood-toxin illness in the world, and it causes substantial physical and functional impact. It produces a myriad of gastrointestinal, neurologic and/or cardiovascular symptoms which last days to weeks, or even months. Although there are reports of symptom amelioration with some interventions (e.g. IV mannitol, the appropriate treatment for CFP remains unclear to many physicians. We review the literature on the treatments for CFP, including randomized controlled studies and anecdotal reports. The article is intended to clarify treatment options, and provide information about management and prevention of CFP, for emergency room physicians, poison control information providers, other health care providers, and patients.

Ciguatera fish poisoning: treatment, prevention and management.

Science.gov (United States)

Friedman, Melissa A; Fleming, Lora E; Fernandez, Mercedes; Bienfang, Paul; Schrank, Kathleen; Dickey, Robert; Bottein, Marie-Yasmine; Backer, Lorraine; Ayyar, Ram; Weisman, Richard; Watkins, Sharon; Granade, Ray; Reich, Andrew

2008-01-01

Ciguatera Fish Poisoning (CFP) is the most frequently reported seafood-toxin illness in the world, and it causes substantial physical and functional impact. It produces a myriad of gastrointestinal, neurologic and/or cardiovascular symptoms which last days to weeks, or even months. Although there are reports of symptom amelioration with some interventions (e.g. IV mannitol), the appropriate treatment for CFP remains unclear to many physicians. We review the literature on the treatments for CFP, including randomized controlled studies and anecdotal reports. The article is intended to clarify treatment options, and provide information about management and prevention of CFP, for emergency room physicians, poison control information providers, other health care providers, and patients.

Ciguatera Fish Poisoning: Treatment, Prevention and Management

Science.gov (United States)

Friedman, Melissa A.; Fleming, Lora E.; Fernandez, Mercedes; Bienfang, Paul; Schrank, Kathleen; Dickey, Robert; Bottein, Marie-Yasmine; Backer, Lorraine; Ayyar, Ram; Weisman, Richard; Watkins, Sharon; Granade, Ray; Reich, Andrew

2008-01-01

Ciguatera Fish Poisoning (CFP) is the most frequently reported seafood-toxin illness in the world, and it causes substantial physical and functional impact. It produces a myriad of gastrointestinal, neurologic and/or cardiovascular symptoms which last days to weeks, or even months. Although there are reports of symptom amelioration with some interventions (e.g. IV mannitol), the appropriate treatment for CFP remains unclear to many physicians. We review the literature on the treatments for CFP, including randomized controlled studies and anecdotal reports. The article is intended to clarify treatment options, and provide information about management and prevention of CFP, for emergency room physicians, poison control information providers, other health care providers, and patients. PMID:19005579

CIGUATERA POISONING: PACIFIC DISEASE, FOODBORNE POISONING FROM FISH IN WARM SEAS AND OCEANS. Review

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Snezha Zlateva

2017-02-01

Full Text Available Purpose: The review is provoked because of lack of awareness of the medical practitioners in Bulgaria concerning of the ethnology, pathogenesis, clinical symptoms and treatment of the ciguatera fish poisoning (CFP. This can be a source of prolonged diagnostic delays, as some cases reporting in another country in Europe, for example Germany, Spain and UK. Varna is the sea town with many sailor crews returning from tropical and subtropical regions, or CFP can affect people who travel to the Pacific and Caribbean or ate exotic fish from supermarket. The information of this fish food-borne poisoning is part of student’s education in discipline “Marine medicine” in Medical University, Varna. Materials and methods: To present better information from different authors and last scientific data, we made review of published materials of 58 issues to construct definition, history, etiology, pathogenesis (toxins and mechanisms of action, clinical symptoms, treatment and prevention of the Ciguatera or ichtyosarcotoxicosis, a wide spread food-born poisoning. Results: Ciguatera poisoning is ichtyosarcotoxicosis, a wide-spread foodborne poisoning in people after consumption of flesh of different kinds of fishes in which toxins produced by poisonous microorganisms (Dinoflagellates have accumulated. The poisoning develops by accumulating toxins higher up the food chain starting with toxin producing dinoflagellates (species: Gambierdiscus toxicus, Prorocentrum concavum, Pr. lima, Ostreoposis lenticularis, Ostr. Siamensis and others, continuing with the poisoned algae (species: Portieria, Halymenia, Turbinaria, Sargassum, and after that involving small crustacea and small fishes to greater fishes (vector fishes, genus Herbivores and Carnivores, in which the toxins have been stored in amount, great enough to cause foodborne poisoning in humans. This poisoning is widespread in tropical and subtropical regions, but because of its delayed toxic effects, lasting

Ciguatera fish poisoning in the Pacific Islands (1998 to 2008).

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Skinner, Mark P; Brewer, Tom D; Johnstone, Ron; Fleming, Lora E; Lewis, Richard J

2011-12-01

Ciguatera is a type of fish poisoning that occurs throughout the tropics, particularly in vulnerable island communities such as the developing Pacific Island Countries and Territories (PICTs). After consuming ciguatoxin-contaminated fish, people report a range of acute neurologic, gastrointestinal, and cardiac symptoms, with some experiencing chronic neurologic symptoms lasting weeks to months. Unfortunately, the true extent of illness and its impact on human communities and ecosystem health are still poorly understood. A questionnaire was emailed to the Health and Fisheries Authorities of the PICTs to quantify the extent of ciguatera. The data were analyzed using t-test, incidence rate ratios, ranked correlation, and regression analysis. There were 39,677 reported cases from 17 PICTs, with a mean annual incidence of 194 cases per 100,000 people across the region from 1998-2008 compared to the reported annual incidence of 104/100,000 from 1973-1983. There has been a 60% increase in the annual incidence of ciguatera between the two time periods based on PICTs that reported for both time periods. Taking into account under-reporting, in the last 35 years an estimated 500,000 Pacific islanders might have suffered from ciguatera. This level of incidence exceeds prior ciguatera estimates locally and globally, and raises the status of ciguatera to an acute and chronic illness with major public health significance. To address this significant public health problem, which is expected to increase in parallel with environmental change, well-funded multidisciplinary research teams are needed to translate research advances into practical management solutions.

Ciguatera fish poisoning in the Pacific Islands (1998 to 2008.

Directory of Open Access Journals (Sweden)

Mark P Skinner

2011-12-01

Full Text Available BACKGROUND: Ciguatera is a type of fish poisoning that occurs throughout the tropics, particularly in vulnerable island communities such as the developing Pacific Island Countries and Territories (PICTs. After consuming ciguatoxin-contaminated fish, people report a range of acute neurologic, gastrointestinal, and cardiac symptoms, with some experiencing chronic neurologic symptoms lasting weeks to months. Unfortunately, the true extent of illness and its impact on human communities and ecosystem health are still poorly understood. METHODS: A questionnaire was emailed to the Health and Fisheries Authorities of the PICTs to quantify the extent of ciguatera. The data were analyzed using t-test, incidence rate ratios, ranked correlation, and regression analysis. RESULTS: There were 39,677 reported cases from 17 PICTs, with a mean annual incidence of 194 cases per 100,000 people across the region from 1998-2008 compared to the reported annual incidence of 104/100,000 from 1973-1983. There has been a 60% increase in the annual incidence of ciguatera between the two time periods based on PICTs that reported for both time periods. Taking into account under-reporting, in the last 35 years an estimated 500,000 Pacific islanders might have suffered from ciguatera. CONCLUSIONS: This level of incidence exceeds prior ciguatera estimates locally and globally, and raises the status of ciguatera to an acute and chronic illness with major public health significance. To address this significant public health problem, which is expected to increase in parallel with environmental change, well-funded multidisciplinary research teams are needed to translate research advances into practical management solutions.

Proceedings of the International Conference on Ciguatera Fish Poisoning (3rd), Held in La Parguera, Puerto Rico on April 30-May 5, 1990.

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Ciguatera fish poisoning is a human health problem that affects all persons living in tropical seas for whom marine fish represent a significant...source of food. Ciguatera traditionally was limited to tropical regions, however, modern improvements in refrigeration and transport have augmented...reports of this poisoning in the tropical Pacific in the 17th century, ciguatera has come to have an impact of global proportions. A broad and detailed

Tectus niloticus (Tegulidae, Gastropod as a Novel Vector of Ciguatera Poisoning: Clinical Characterization and Follow-Up of a Mass Poisoning Event in Nuku Hiva Island (French Polynesia

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Clémence Mahana iti Gatti

2018-02-01

Full Text Available Ciguatera fish poisoning (CFP is the most prevalent non-bacterial food-borne form of poisoning in French Polynesia, which results from the consumption of coral reef fish naturally contaminated with ciguatoxins produced by dinoflagellates in the genus Gambierdiscus. Since the early 2000s, this French territory has also witnessed the emergence of atypical forms of ciguatera, known as ciguatera shellfish poisoning (CSP, associated with the consumption of marine invertebrates. In June 2014, nine tourists simultaneously developed a major and persistent poisoning syndrome following the consumption of the gastropod Tectus niloticus collected in Anaho, a secluded bay of Nuku Hiva Island (Marquesas Archipelago, French Polynesia. The unusual nature and severity of this event prompted a multidisciplinary investigation in order to characterize the etiology and document the short/long-term health consequences of this mass-poisoning event. This paper presents the results of clinical investigations based on hospital medical records, medical follow-up conducted six and 20 months post-poisoning, including a case description. This study is the first to describe the medical signature of T. niloticus poisoning in French Polynesia and contributed to alerting local authorities about the potential health hazards associated with the consumption of this gastropod, which is highly prized by local communities in Pacific island countries and territories.

Tectus niloticus (Tegulidae, Gastropod) as a Novel Vector of Ciguatera Poisoning: Clinical Characterization and Follow-Up of a Mass Poisoning Event in Nuku Hiva Island (French Polynesia).

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Gatti, Clémence Mahana Iti; Lonati, Davide; Darius, Hélène Taiana; Zancan, Arturo; Roué, Mélanie; Schicchi, Azzurra; Locatelli, Carlo Alessandro; Chinain, Mireille

2018-02-28

Ciguatera fish poisoning (CFP) is the most prevalent non-bacterial food-borne form of poisoning in French Polynesia, which results from the consumption of coral reef fish naturally contaminated with ciguatoxins produced by dinoflagellates in the genus Gambierdiscus . Since the early 2000s, this French territory has also witnessed the emergence of atypical forms of ciguatera, known as ciguatera shellfish poisoning (CSP), associated with the consumption of marine invertebrates. In June 2014, nine tourists simultaneously developed a major and persistent poisoning syndrome following the consumption of the gastropod Tectus niloticus collected in Anaho, a secluded bay of Nuku Hiva Island (Marquesas Archipelago, French Polynesia). The unusual nature and severity of this event prompted a multidisciplinary investigation in order to characterize the etiology and document the short/long-term health consequences of this mass-poisoning event. This paper presents the results of clinical investigations based on hospital medical records, medical follow-up conducted six and 20 months post-poisoning, including a case description. This study is the first to describe the medical signature of T. niloticus poisoning in French Polynesia and contributed to alerting local authorities about the potential health hazards associated with the consumption of this gastropod, which is highly prized by local communities in Pacific island countries and territories.

Tectus niloticus (Tegulidae, Gastropod) as a Novel Vector of Ciguatera Poisoning: Clinical Characterization and Follow-Up of a Mass Poisoning Event in Nuku Hiva Island (French Polynesia)

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Lonati, Davide; Zancan, Arturo; Schicchi, Azzurra; Locatelli, Carlo Alessandro; Chinain, Mireille

2018-01-01

Ciguatera fish poisoning (CFP) is the most prevalent non-bacterial food-borne form of poisoning in French Polynesia, which results from the consumption of coral reef fish naturally contaminated with ciguatoxins produced by dinoflagellates in the genus Gambierdiscus. Since the early 2000s, this French territory has also witnessed the emergence of atypical forms of ciguatera, known as ciguatera shellfish poisoning (CSP), associated with the consumption of marine invertebrates. In June 2014, nine tourists simultaneously developed a major and persistent poisoning syndrome following the consumption of the gastropod Tectus niloticus collected in Anaho, a secluded bay of Nuku Hiva Island (Marquesas Archipelago, French Polynesia). The unusual nature and severity of this event prompted a multidisciplinary investigation in order to characterize the etiology and document the short/long-term health consequences of this mass-poisoning event. This paper presents the results of clinical investigations based on hospital medical records, medical follow-up conducted six and 20 months post-poisoning, including a case description. This study is the first to describe the medical signature of T. niloticus poisoning in French Polynesia and contributed to alerting local authorities about the potential health hazards associated with the consumption of this gastropod, which is highly prized by local communities in Pacific island countries and territories. PMID:29495579

Treatment of a mild chronic case of ciguatera fish poisoning with intravenous mannitol, a case study.

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Mitchell, Gary

2005-03-01

This article describes a recent case of ciguatera poisoning treated with intravenous mannitol. Mannitol has been used with good effect in non-controlled studies in acutely severely poisoned patients, but is not described in the treatment of chronic or milder poisoning. Our patient was a 35-year-old Niuean man who had eaten a ciguatoxic fish two weeks previously. His symptoms were not severe but were very unpleasant and restricted his ability to work. He was given a single dose of mannitol (0.66g/kg) as an intravenous infusion over two hours. His symptoms dramatically improved within 24 hours, and within a few days he felt virtually back to his former self. He experienced no side effects to the mannitol. It is suggested that intravenous mannitol may prove to be a useful treatment for mild to moderate ciguatera poisoning, and for patients who present late for treatment.

Gene Expression Patterns in Peripheral Blood Leukocytes in Patients with Recurrent Ciguatera Fish Poisoning: Preliminary Studies.

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Lopez, Maria-Cecilia; Ungaro, Ricardo F; Baker, Henry V; Moldawer, Lyle L; Robertson, Alison; Abbott, Margaret; Roberts, Sparkle M; Grattan, Lynn M; Morris, J Glenn

2016-07-01

Ciguatera fish poisoning (ciguatera) is a common clinical syndrome in areas where there is dependence on tropical reef fish for food. A subset of patients develops recurrent and, in some instances, chronic symptoms, which may result in substantial disability. To identify possible biomarkers for recurrent/chronic disease, and to explore correlations with immune gene expression, peripheral blood leukocyte gene expression in 10 ciguatera patients (7 recurrent, 3 acute) from the U.S. Virgin Islands, and 5 unexposed Florida controls were evaluated. Significant differences in gene expression were noted when comparing ciguatera patients and controls; however, it was not possible to differentiate between patients with acute and recurrent disease, possibly due to the small sample sizes involved.

Outbreak of ciguatera fish poisoning on a cargo ship in the port of hamburg.

Science.gov (United States)

Schlaich, Clara; Hagelstein, Jan-Gerd; Burchard, Gerd-Dieter; Schmiedel, Stefan

2012-07-01

Ciguatera fish poisoning is a travel-related illness characterized by a combination of gastrointestinal and neurological symptoms in persons who eat ciguatoxic seafood in endemic areas. In 2009, an outbreak of the disease on a refrigerator vessel in the port of Hamburg was investigated. The ship's crew fell ill after they ate fish from a catch in the Caribbean 2 weeks earlier. All 15 sailors on board were examined by port medical officers. Samples of blood and stool specimens were taken from symptomatic sailors. The frozen fish was secured for the prevention of further disease spreading and additional diagnostic tests. All but one sailor ate the fish. The intoxication resulted in gastrointestinal or neurological symptoms in all 14 sailors who consumed the fish and persisted in varying degrees in 93% of sailors over at least 14 days. No fatality occurred, but two seamen were "unfit for duty" on the ship due to severity of symptoms. The diagnosis was supported by the fact that all seafarers who consumed the same reef fish, experienced typical signs, symptoms, and time course consistent with ciguatera fish poisoning. The fish from the catch in the Caribbean was identified as Caranx sexfasciatus (Bigeye Trevally) and Cephalopholis miniata (Red Grouper). An experimental assay later confirmed presence of the ciguatoxin in the fish. Sailors are an occupational group at risk for ciguatera fish poisoning due to potentially unsafe food sources during international travel. Even if no fatality occurred, the disease affected marine operations due to high attack rates and chronicity of symptoms. Medical doctors must be aware that ciguatera fish poisoning is a risk for seafarers traveling in tropical and subtropical areas. Stocking of food in affected ports from safe sources, adequate training of ship cooks, and informing sailors about the risk of fishing are needed to prevent disease occurrence in seafarers in international trade and traffic. © 2012 International Society of

Incidence and clinical characteristics of ciguatera fish poisoning in Guadeloupe (French West Indies) between 2013 and 2016: a retrospective cases-series.

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Boucaud-Maitre, Denis; Vernoux, Jean-Paul; Pelczar, Stéphane; Daudens-Vaysse, Elise; Aubert, Lyderic; Boa, Sylvie; Ferracci, Serge; Garnier, Robert

2018-02-15

This retrospective case study analysed the incidence and symptoms of ciguatera fish poisoning (ciguatera) in Guadeloupe (French West Indies) between 2013 and 2016. Cases attending the emergency departments of the two public hospitals and the reports received by the regional health authority in charge of monitoring (ARS) were compiled. Two hundred and thirty-four cases of poisoning were observed, with a mean annual incidence of 1.47/10,000 (95% CI): 1.29-1.66), i.e 5 times higher than the previously reported incidence (1996-2006). The main species described as being responsible for poisoning were fish from the Carangidae family (n = 47) (jack), followed by fish from the Lutjanidae family (n = 27) (snapper), Serranidae family (n = 15) (grouper), Sphyraenidae family (n = 12) (barracuda), and Mullidae family (n = 12) (goatfish). One case of lionfish ciguatera was observed. 93.9% of patients experienced gastrointestinal symptoms, 76.0% presented neurological signs (mainly paresthesia, dysesthesia and pruritus) and 40.3% presented cardiovascular symptoms (bradycardia and/or hypotension). A high frequency (61.4%) of hypothermia (body temperature ciguatera poisoning throughout the Caribbean region must be improved, notably after reef disturbance due to Irma and Maria major cyclones.

Ciguatera fish poisoning in industrial ship crewmembers: a retrospective study in a seaport general practice in Trinidad and Tobago.

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Poon-King, C M; Chen, A; Poon-King, T

2004-09-01

The objective of this study was to outline the epidemiology of Ciguatera fish poisoning as seen in a general practice serving two industrial seaports in Trinidad and Tobago, in order to highlight the potential public health implications. A retrospective study was undertaken of all the cases of Ciguatera fish poisoning identified between November 1, 1992 and October 31, 1998 in a seaport general practice to identify signs, symptoms and treatment. An investigation of one outbreak was undertaken. Four outbreaks affecting 42 male ship crewmembers were identified. The suspect fish were caught in northern Caribbean waters en route to Trinidad and Tobago. The most common early symptoms were diarrhoea, vomiting, abdominal cramps, pruritus and tiredness. In the third outbreak, dysaesthesia was common. Progression to muscular weakness, ataxic gait, unsteadiness and other neurotoxic signs were seen in moderate to severe disease. Hypotension was an important prognostic sign in the initial case. Treatment was symptomatic and supportive and included vitamins B12 and BCO, folic acid, prostigmine, steroids and antihistamines as indicated. In the investigation of the second outbreak, the relative risk of 'eating fish meat' was 5 (95% CI 1.45, 17.27, p ciguatera fish poisoning.' All cases were industrial ship crewmembers. It is suggested that increased clinician awareness with early and appropriate treatment, and focussed public health intervention may help limit the potential public health impact of ciguatera poisoning in industrial ship crewmembers and other fish-consuming communities in the future.

Ciguatera fish poisoning: a review

NARCIS (Netherlands)

Fouw JC de; Egmond HP van; Speijers GJA; CSR

2001-01-01

Het overzicht van ciguatera visvergiftiging bevat informatie over de ciguatera vergiftigingen en de veroorzakers (CTXs) en gambiertoxine-4b (GTX-4 B), van welke CTX-1 de belangrijkste component is aan het eind van de voedsel keten (roofvissen). Gegevens over chemische structuren, detectie

CONDUCT AN INVESTIGATION OF CIGUATERA POISON

Science.gov (United States)

Research on ciguatera toxin resulted in a satisfactory method for extracting the toxin from fish muscle. Partial purification was also accomplished...by precipitation and silicic acid adsorption. The most precise fractionation of ciguatera toxin is accomplished on a silicic acid column developed...WILL LEAD TO HIGHLY PURIFIED SAMPLES OF CIGUATERA TOXIN. Paper chromatography was examined using fourteen different solvent systems, but none proved

Neurotoxicity and reactive astrogliosis in the anterior cingulate cortex in acute ciguatera poisoning.

Science.gov (United States)

Zhang, Xu; Cao, Bing; Wang, Jun; Liu, Jin; Tung, Vivian Oi Vian; Lam, Paul Kwan Sing; Chan, Leo Lai; Li, Ying

2013-06-01

Ciguatoxins (CTXs) cause long-term disturbance of cerebral functions. The primary mechanism of neurotoxicity is related to their interaction with voltage-gated sodium channels. However, until now, the neurological targets for CTXs in the brain of intact animals have not been described. In our study, 1 day following oral exposure to 0.26 ng/g of Pacific ciguatoxin 1 (P-CTX-1), we performed in vivo electrophysiological recordings in the rat anterior cingulate cortex (ACC) and identified the increase in spontaneous firings and enhanced responses to visceral noxious stimulation. Local field recordings characterized the P-CTX-1-induced synaptic potentiation and blockage of the induction of electrical stimulation-induced long-term potentiation in the medial thalamus (MT)-ACC pathway. Furthermore, intracerebroventricular administration of P-CTX-1 at doses of 1.0, 5.0, and 10 nM produced a dose-dependent increase in ACC neuronal firings and MT-ACC synaptic transmission. Further studies showed upregulated Na(+) channel expression in astrocytes under pathological conditions. We hypothesized that the astrocytes might have been activated in the ciguatera poisoning in vivo. Increases in glial fibrillary acid protein expression were detected in reactive astrocytes in the rat ACC. The activation of astroglia was further indicated by activation of the gap junction protein connexin 43 and upregulation of excitatory amino acid transporter 2 expression suggesting that glutamate was normally rapidly cleared from the synaptic cleft during acute ciguatera poisoning. However, neurotoxicity and reactive astrogliosis were not detected in the ACC after 7 days of P-CTX-1 exposure. The present results are the first characterization of P-CTX-1-invoked brain cortex neuronal excitotoxicity in vivo and supported the theme that neuron and astroglia signals might play roles in acute ciguatera poisoning.

Cluster of ciguatera fish poisoning--North Carolina, 2007.

Science.gov (United States)

2009-03-27

Ciguatera fish poisoning (CFP) is a distinctive type of foodborne disease that results from eating predatory ocean fish contaminated with ciguatoxins. As many as 50,000 cases are reported worldwide annually, and the condition is endemic in tropical and subtropical regions of the Pacific basin, Indian Ocean, and Caribbean. In the United States, 5--70 cases per 10,000 persons are estimated to occur yearly in ciguatera-endemic states and territories. CFP can cause gastrointestinal symptoms (nausea, vomiting, abdominal cramps, or diarrhea) within a few hours of eating contaminated fish. Neurologic symptoms, with or without gastrointestinal disturbance, can include fatigue, muscle pain, itching, tingling, and (most characteristically) reversal of hot and cold sensation. This report describes a cluster of nine cases of CFP that occurred in North Carolina in June 2007. Among the nine patients, six experienced reversal of hot and cold sensations, five had neurologic symptoms only, and overall symptoms persisted for more than 6 months in three patients. Among seven patients who were sexually active, six patients also complained of painful intercourse. This report highlights the potential risks of eating contaminated ocean fish. Local and state health departments can train emergency and urgent care physicians in the recognition of CFP and make them aware that symptoms can persist for months to years.

TRPV1 as a key determinant in ciguatera and neurotoxic shellfish poisoning

Science.gov (United States)

Cuypers, Eva; Yanagihara, Angel; Rainier, Jon D.; Tytgat, Jan

2007-01-01

Ciguatera fish poisoning and neurotoxic shellfish poisoning are distinct clinical entities characterized by gastrointestinal and neurological disturbances, following the consumption of certain reef fish and shellfish containing toxic polyether compounds sporadically present in certain toxic marine dinoflagellates. The biotransformation and bioaccumulation of gambierol and brevetoxin, and their congeners, are believed to be involved in the pathogenesis of these “food-chain diseases”, for which no effective treatments are available. Here, we describe for the first time the potent effect of gambierol and brevetoxin on TRPV1 channels, a key player in thermal and pain sensation. Our findings may lead to promising new therapeutic interventions. PMID:17659256

Ciguatera fish poisoning on the West Africa Coast: An emerging risk in the Canary Islands (Spain).

Science.gov (United States)

Boada, Luis D; Zumbado, Manuel; Luzardo, Octavio P; Almeida-González, Maira; Plakas, Steven M; Granade, Hudson R; Abraham, Ann; Jester, Edward L E; Dickey, Robert W

2010-12-01

Ciguatera fish poisoning (CFP) is endemic in certain tropical and subtropical regions of the world. CFP had not been described on the West Africa Coast until a 2004 outbreak in the Canary Islands. In 2008-2009, two additional outbreaks of ciguatera occurred. Individuals afflicted had consumed lesser amberjack (Seriola rivoliana) captured from nearby waters. Caribbean ciguatoxin-1 (C-CTX-1) was confirmed in fish samples by LC-MS/MS. Ciguatoxic fish in this region may pose a new health risk for the seafood consumer. Copyright © 2010 Elsevier Ltd. All rights reserved.

Ciguatera fish poisoning in an international ship crew in Saint John Canada: 2015.

Science.gov (United States)

Muecke, C; Hamper, L; Skinner, A L; Osborne, C

2015-11-05

An international ship crew presented for medical care in Saint John, New Brunswick, following rapid onset of gastrointestinal and in some cases neurological and cardiac symptoms after a common fish meal. Ciguatera poisoning was identified as the cause of illness. This report describes the public health investigation and management of this incident, including collaboration between the implicated provincial and federal authorities.

[Study of three ciguatera fish poisoning cases in Xiamen city, in 2005].

Science.gov (United States)

Luo, He-dong; Bai, Yan-yan; Zhou, Na

2011-06-01

To find out the reason of three ciguatera fish poisoning cases in Xiamen in 2005 and identify the fish species. The grouper implicated in food poisoning and seven other coral reef fishes collected from market were tested by mice bioassay and ciguatoxin-test kit. The mtDNA was extracted from toxic grouper meat, and Cty b gene segment was amplified and the PCR products were sequenced. The sequences were compared with those in the GenBank. The result turned out to be positive by the ciguatoxin-test kit, while the toxicity of the toxic grouper implicated in food poisoning was 0.11 mouse unit (MU)/g by mice bioassay. A 475 bp segments of Cty b gene was amplified by PCR and the sequence was 99% homologous with Epinephelus fuscoguttatus (GenBank: AY950695).No ciguatoxin in six grouper species collected from market was detected. All three food poisoning cases were caused by consumption of ciguatoxin-carrying groupers.

Ciguatera Fish Poisoning and Climate Change: Analysis of National Poison Center Data in the United States, 2001–2011

Science.gov (United States)

Strickland, Matthew J.; Hess, Jeremy J.

2014-01-01

Background: Warm sea surface temperatures (SSTs) are positively related to incidence of ciguatera fish poisoning (CFP). Increased severe storm frequency may create more habitat for ciguatoxic organisms. Although climate change could expand the endemic range of CFP, the relationship between CFP incidence and specific environmental conditions is unknown. Objectives: We estimated associations between monthly CFP incidence in the contiguous United States and SST and storm frequency in the Caribbean basin. Methods: We obtained information on 1,102 CFP-related calls to U.S. poison control centers during 2001–2011 from the National Poison Data System. We performed a time-series analysis using Poisson regression to relate monthly CFP call incidence to SST and tropical storms. We investigated associations across a range of plausible lag structures. Results: Results showed associations between monthly CFP calls and both warmer SSTs and increased tropical storm frequency. The SST variable with the strongest association linked current monthly CFP calls to the peak August SST of the previous year. The lag period with the strongest association for storms was 18 months. If climate change increases SST in the Caribbean 2.5–3.5°C over the coming century as projected, this model implies that CFP incidence in the United States is likely to increase 200–400%. Conclusions: Using CFP calls as a marker of CFP incidence, these results clarify associations between climate variability and CFP incidence and suggest that, all other things equal, climate change could increase the burden of CFP. These findings have implications for disease prediction, surveillance, and public health preparedness for climate change. Citation: Gingold DB, Strickland MJ, Hess JJ. 2014. Ciguatera fish poisoning and climate change: analysis of National Poison Center data in the United States, 2001–2011. Environ Health Perspect 122:580–586; http://dx.doi.org/10.1289/ehp.1307196 PMID:24618280

Are cyanobacteria involved in Ciguatera Fish Poisoning-like outbreaks in New Caledonia ?

OpenAIRE

Laurent, Dominique; Kerbrat, Anne-Sophie; Darius, H. T.; Girard, E.; Golubic, S.; Benoit, E.; Sauviat, M. P.; Chinain, M.; Molgo, J.; Pauillac, S.

2008-01-01

From 2001 to 2005, numerous cases of seafood poisonings were reported in a tribe from Lifou (Loyalty Islands Province, New Caledonia) of which 35 were thoroughly examined. Observations outlined by the epidemiological and clinical data (including severity and rapid onset of certain symptoms following consumption of either giant clams (Tridacna spp.) or grazing and molluscivorous fish together with the apparent inefficacy of traditional remedies, were not in favour of a classical Ciguatera Fish...

A phylogenetic re-analysis of groupers with applications for ciguatera fish poisoning.

Science.gov (United States)

Schoelinck, Charlotte; Hinsinger, Damien D; Dettaï, Agnès; Cruaud, Corinne; Justine, Jean-Lou

2014-01-01

Ciguatera fish poisoning (CFP) is a significant public health problem due to dinoflagellates. It is responsible for one of the highest reported incidence of seafood-borne illness and Groupers are commonly reported as a source of CFP due to their position in the food chain. With the role of recent climate change on harmful algal blooms, CFP cases might become more frequent and more geographically widespread. Since there is no appropriate treatment for CFP, the most efficient solution is to regulate fish consumption. Such a strategy can only work if the fish sold are correctly identified, and it has been repeatedly shown that misidentifications and species substitutions occur in fish markets. We provide here both a DNA-barcoding reference for groupers, and a new phylogenetic reconstruction based on five genes and a comprehensive taxonomical sampling. We analyse the correlation between geographic range of species and their susceptibility to ciguatera accumulation, and the co-occurrence of ciguatoxins in closely related species, using both character mapping and statistical methods. Misidentifications were encountered in public databases, precluding accurate species identifications. Epinephelinae now includes only twelve genera (vs. 15 previously). Comparisons with the ciguatera incidences show that in some genera most species are ciguateric, but statistical tests display only a moderate correlation with the phylogeny. Atlantic species were rarely contaminated, with ciguatera occurrences being restricted to the South Pacific. The recent changes in classification based on the reanalyses of the relationships within Epinephelidae have an impact on the interpretation of the ciguatera distribution in the genera. In this context and to improve the monitoring of fish trade and safety, we need to obtain extensive data on contamination at the species level. Accurate species identifications through DNA barcoding are thus an essential tool in controlling CFP since meal remnants in

A phylogenetic re-analysis of groupers with applications for ciguatera fish poisoning.

Directory of Open Access Journals (Sweden)

Charlotte Schoelinck

Full Text Available Ciguatera fish poisoning (CFP is a significant public health problem due to dinoflagellates. It is responsible for one of the highest reported incidence of seafood-borne illness and Groupers are commonly reported as a source of CFP due to their position in the food chain. With the role of recent climate change on harmful algal blooms, CFP cases might become more frequent and more geographically widespread. Since there is no appropriate treatment for CFP, the most efficient solution is to regulate fish consumption. Such a strategy can only work if the fish sold are correctly identified, and it has been repeatedly shown that misidentifications and species substitutions occur in fish markets.We provide here both a DNA-barcoding reference for groupers, and a new phylogenetic reconstruction based on five genes and a comprehensive taxonomical sampling. We analyse the correlation between geographic range of species and their susceptibility to ciguatera accumulation, and the co-occurrence of ciguatoxins in closely related species, using both character mapping and statistical methods.Misidentifications were encountered in public databases, precluding accurate species identifications. Epinephelinae now includes only twelve genera (vs. 15 previously. Comparisons with the ciguatera incidences show that in some genera most species are ciguateric, but statistical tests display only a moderate correlation with the phylogeny. Atlantic species were rarely contaminated, with ciguatera occurrences being restricted to the South Pacific.The recent changes in classification based on the reanalyses of the relationships within Epinephelidae have an impact on the interpretation of the ciguatera distribution in the genera. In this context and to improve the monitoring of fish trade and safety, we need to obtain extensive data on contamination at the species level. Accurate species identifications through DNA barcoding are thus an essential tool in controlling CFP since

Ciguatera fish poisoning: a first epidemic in Germany highlights an increasing risk for European countries.

Science.gov (United States)

Mattei, César; Vetter, Irina; Eisenblätter, Anneka; Krock, Bernd; Ebbecke, Martin; Desel, Herbert; Zimmermann, Katharina

2014-12-01

Toxin-producing microalgae are thriving worldwide due to coral reef destruction and global warming with major consequences on ecosystems, international trade and human health. Microalgae belonging to the family of flagellate protists, in particular dinoflagellates, secrete a variety of high-molecular-weight polyether toxins that accumulate through the marine food chain to cause disease in humans by acting as sodium channel activator toxins; ciguatera is the most frequent seafood-borne illness worldwide with 50,000 to 500,000 global incidences per annum and is usually limited to endemic areas located between 35° northern and 35° southern latitude. The rising global incidence frequency renders it a major human health problem, because no curative treatment is available yet and reliable detection assays are lacking. During the last decade ciguatera has increasingly become endemic in previously unaffected areas for two reasons: first global warming has contributed to the emergence of dinoflagellate species in subtropical and even temperate regions that previously had been constrained to tropical areas and second: in Europe globalization of fishing industry and tourism has led to a progressive increase in the number of ciguatera cases and a lack of awareness among medical personnel contributes to under-reporting. We review, through a recent ciguatera outbreak in Germany, the risk for ciguatera poisoning in Europe and highlight characteristic symptoms, current knowledge about disease pathomechanisms and treatment options.

Ciguatera fish poisoning in East Asia and southeast Asia.

Science.gov (United States)

Chan, Thomas Y K

2015-06-02

In the coastal countries of East Asia and Southeast Asia, ciguatera should be common because of the extensive tropical and subtropical coral reefs along the coasts and in the neighboring seas with ciguatoxic fishes. An extensive search of journal databases, the Internet and the government websites was performed to identify all reports of ciguatera from the regions. Based on the official data and large published case series, the incidence of ciguatera was higher in the coastal cities (Hong Kong, Foshan, Zhongshan) of southern China than in Japan (Okinawa Prefecture). In Singapore, ciguatera appeared to be almost unknown. In other countries, only isolated cases or small case series were reported, but under-reporting was assumed to be common. Ciguatera may cause severe acute illness and prolonged neurological symptoms. Ciguatera represents an important public health issue for endemic regions, with significant socio-economic impact. Coordinated strategies to improve risk assessment, risk management and risk communication are required. The systematic collection of accurate data on the incidence and epidemiology of ciguatera should enable better assessment and management of its risk. Much more work needs to be done to define the size threshold for important coral reef fish species from different regions, above which the risk of ciguatera significantly increases.

Ciguatera Fish Poisoning in East Asia and Southeast Asia

Directory of Open Access Journals (Sweden)

Thomas Y. K. Chan

2015-06-01

Full Text Available In the coastal countries of East Asia and Southeast Asia, ciguatera should be common because of the extensive tropical and subtropical coral reefs along the coasts and in the neighboring seas with ciguatoxic fishes. An extensive search of journal databases, the Internet and the government websites was performed to identify all reports of ciguatera from the regions. Based on the official data and large published case series, the incidence of ciguatera was higher in the coastal cities (Hong Kong, Foshan, Zhongshan of southern China than in Japan (Okinawa Prefecture. In Singapore, ciguatera appeared to be almost unknown. In other countries, only isolated cases or small case series were reported, but under-reporting was assumed to be common. Ciguatera may cause severe acute illness and prolonged neurological symptoms. Ciguatera represents an important public health issue for endemic regions, with significant socio-economic impact. Coordinated strategies to improve risk assessment, risk management and risk communication are required. The systematic collection of accurate data on the incidence and epidemiology of ciguatera should enable better assessment and management of its risk. Much more work needs to be done to define the size threshold for important coral reef fish species from different regions, above which the risk of ciguatera significantly increases.

Ciguatera Fish Poisoning in East Asia and Southeast Asia

Science.gov (United States)

Chan, Thomas Y. K.

2015-01-01

In the coastal countries of East Asia and Southeast Asia, ciguatera should be common because of the extensive tropical and subtropical coral reefs along the coasts and in the neighboring seas with ciguatoxic fishes. An extensive search of journal databases, the Internet and the government websites was performed to identify all reports of ciguatera from the regions. Based on the official data and large published case series, the incidence of ciguatera was higher in the coastal cities (Hong Kong, Foshan, Zhongshan) of southern China than in Japan (Okinawa Prefecture). In Singapore, ciguatera appeared to be almost unknown. In other countries, only isolated cases or small case series were reported, but under-reporting was assumed to be common. Ciguatera may cause severe acute illness and prolonged neurological symptoms. Ciguatera represents an important public health issue for endemic regions, with significant socio-economic impact. Coordinated strategies to improve risk assessment, risk management and risk communication are required. The systematic collection of accurate data on the incidence and epidemiology of ciguatera should enable better assessment and management of its risk. Much more work needs to be done to define the size threshold for important coral reef fish species from different regions, above which the risk of ciguatera significantly increases. PMID:26042615

An Updated Review of Ciguatera Fish Poisoning: Clinical, Epidemiological, Environmental, and Public Health Management

OpenAIRE

Friedman, Melissa A.; Fernández, Mercedes; Backer, Lorraine C.; Dickey, Robert W.; Bernstein, Jeffrey; Schrank, Kathleen; Kibler, Steven; Stephan, Wendy; Gribble, Matthew O.; Bienfang, Paul; Bowen, Robert E.; Degrasse, Stacey; Flores Quintana, Harold A.; Loeffler, Christopher R.; Weisman, Richard

2017-01-01

Ciguatera Fish Poisoning (CFP) is the most frequently reported seafood-toxin illness in the world. It causes substantial human health, social, and economic impacts. The illness produces a complex array of gastrointestinal, neurological and neuropsychological, and cardiovascular symptoms, which may last days, weeks, or months. This paper is a general review of CFP including the human health effects of exposure to ciguatoxins (CTXs), diagnosis, human pathophysiology of CFP, treatment, detection...

[Imported tropical fish causes ciguatera fish poisoning in Germany].

Science.gov (United States)

Zimmermann, Katharina; Eisenblätter, Anneka; Vetter, Irina; Ebbecke, Martin; Friedemann, Miriam; Desel, Herbert

2015-01-01

Ciguatera is a seafood-borne illness caused by consumption of tropical fish contaminated with ciguatoxins, lipophilic polyethers that are produced in benthic dinoflagellates and accumulate through the marine food chain. Ciguatera cases in Europe usually occur in travellers returning from tropical and subtropical regions of the Pacific and Carribean, where ciguatera is endemic. In 2012, several cases of ciguatera occurred in Germany due to sale of contaminated fish products originating from the Indian Ocean. Although the symptomatology in these cases were typical of ciguatera, with patients reporting gastrointestinal discomfort including nausea, vomiting and diarrhea as well as neurological effects including widespread intense pruritus, paresthesias, hypothermia or altered temperature sensation and diffuse pain, correct diagnosis was delayed in all cases due to lack of awareness of the treating medical practitioners. In light of increasing global mobility, trade, and occurrence of ciguatoxic fish in previously non-endemic areas, ciguatera should be considered as a possible diagnosis if gastrointestinal and neurological symptoms occur shortly after consumption of fish. Georg Thieme Verlag Stuttgart.

Two patients with ciguatera toxicity: a seafood poisoning in travellers to (sub) tropical areas.

Science.gov (United States)

Slobbe, L; van Genderen, P J J; Wismans, P J

2008-10-01

Ciguatera toxicity is a type of seafood poisoning caused by the consumption of ciguatoxic reef fish. We describe two patients with characteristic gastrointestinal and neurological symptoms, both of whom had eaten local seafood. Although mortality is low, morbidity can be considerable due to debilitating symptoms. Most cases originate in the (sub)tropics but due to expanding tourism and fish exportation, it may be encountered in more temperate regions. Treatment is supportive, but some benefit from intravenous mannitol has been reported.

Temporal trends and epidemiological aspects of ciguatera in French Polynesia: a 10-year analysis.

Science.gov (United States)

Chateau-Degat, Marie-Ludivine; Dewailly, Eric; Cerf, Nicole; Nguyen, Ngoc Lam; Huin-Blondey, Marie-Odile; Hubert, Bruno; Laudon, François; Chansin, René

2007-04-01

The purpose of this study was to report the temporal trends of the incidence of ciguatera poisoning from 1992 to 2001 in French Polynesia. This retrospective study analysed 7842 cases of ciguatera disease recorded over a period of 10 years. The annual incidence varied from 26.3 to 41.9 per 10,000 person-years. An analysis of cases grouped by archipelago revealed differences in incidences (P ciguatera poisoning appeared relatively stable during the 10 years of the study period. However, the gradient of remoteness observed suggests an adaptation of management of ciguatera disease to each archipelago.

Poisoning - fish and shellfish

Science.gov (United States)

Fish poisoning; Dinoflagellate poisoning; Seafood contamination; Paralytic shellfish poisoning; Ciguatera poisoning ... algae and algae-like organisms called dinoflagellates. Small fish that eat the algae become contaminated. If larger ...

Revisiting the association between sea surface temperature and the epidemiology of fish poisoning in the South Pacific: reassessing the link between ciguatera and climate change.

Science.gov (United States)

Llewellyn, Lyndon E

2010-10-01

The most detailed dataset of ciguatera intensity is that produced by the South Pacific Epidemiological and Health Information Service (SPEHIS) of the Secretariat of the Pacific Community. The SPEHIS fish poisoning database has been previously analysed yielding statistically significant correlations between the Southern Oscillation Index (SOI) and ciguatera case numbers in several countries raising concerns this affliction will increase as oceans warm. Mapping of the SPEHIS records and other data hints at ciguatera not only being restricted to warm waters but that the Indo-Pacific Warm Pool, a body of water that remains hot throughout much of the year, may inhibit ciguatera prevalence. A qualitative assessment of ciguatera intensity and sea surface temperature (SST) behaviour within the EEZ of selected South Pacific nations supported the notion that ciguatera intensity was highest when SST was between an upper and lower limit. Many more climate and SST indices beyond the SOI are now available, including some that measure the abovementioned phenomenon of oceanic warm pools. Statistically significant, positive and negative cross-correlations were obtained between time series of annual ciguatera case rates from the SPEHIS dataset and the Pacific Warm Pool Index and several ENSO related indices which had been lagged for up to 2 years before the ciguatera time series. This further supports the possibility that when considering the impact of climate change on ciguatera, one has to consider two thresholds, namely waters that remain warm enough for a long enough period can lead to ciguatera and that extended periods where the water remains too hot may depress ciguatera case rates. Such a model would complicate projections of the effects of climate change upon ciguatera beyond that of a simple relationship where increased SST may cause more ciguatera. Crown Copyright 2009. Published by Elsevier Ltd. All rights reserved.

Normal axonal ion channel function in large peripheral nerve fibers following chronic ciguatera sensitization.

Science.gov (United States)

Vucic, Steve; Kiernan, Matthew C

2008-03-01

Although the acute clinical effects of ciguatera poisoning, due to ingestion of ciguatoxin, are mediated by activation of transient Na+ channels, the mechanisms underlying ciguatera sensitization remain undefined. Axonal excitability studies were performed by stimulating the median motor and sensory nerves in two patients with ciguatera sensitization. Excitability parameters were all within normal limits, thereby arguing against dysfunction of axonal membrane ion channels in large-diameter fibers in ciguatera sensitization.

Characteristic Features and Contributory Factors in Fatal Ciguatera Fish Poisoning—Implications for Prevention and Public Education

Science.gov (United States)

Chan, Thomas Y. K.

2016-01-01

In this review, the main objective was to describe the characteristic features of fatal ciguatera fish poisoning and identify contributory factors, with a view to promote prevention and public education. Ciguatera-related deaths, although rare, have been reported from the Pacific, Caribbean, and Indian Ocean regions. The clinical features were generally dominated by convulsions and coma, with various focal neurological signs. Several contributory factors could be identified, including consumption of ciguatoxin (CTX)-rich fish parts (viscera and head) in larger amounts, the most ciguatoxic fish species (e.g., Gymnothorax flavimarginatus) and reef fish collected after storms and individuals' susceptibility. Mass ciguatera fish poisoning with mortalities also occurred when G. flavimarginatus and other ciguatoxic fish species were shared in gatherings and parties. The characteristic features of fatal ciguatera fish poisoning must be recognized early. The public should be repeatedly reminded to avoid eating the most ciguatoxic fish species and the CTX-rich parts of reef fish. To prevent mass poisoning in gatherings and parties, the most ciguatoxic fish species and potentially toxic fish species must be avoided. Particularly after hits by disastrous storms, it is important to monitor the toxicity of reef fish and the incidence rates of ciguatera. PMID:26787145

Neurology of ciguatera

Science.gov (United States)

Pearn, J

2001-01-01

Ciguatera is a widespread ichthyosarcotoxaemia with dramatic and clinically important neurological features. This severe form of fish poisoning may present with either acute or chronic intoxication syndromes and constitutes a global health problem. Ciguatera poisoning is little known in temperate countries as a potentially global problem associated with human ingestion of large carnivorous fish that harbour the bioaccumulated ciguatoxins of the photosynthetic dinoflagellate Gambierdiscus toxicus. This neurotoxin is stored in the viscera of fish that have eaten the dinoflagellate and concentrated it upwards throughout the food chain towards progressively larger species, including humans. Ciguatoxin accumulates in all fish tissues, especially the liver and viscera, of "at risk" species. Both Pacific (P-CTX-1) and Caribbean (C-CTX-1) ciguatoxins are heat stable polyether toxins and pose a health risk at concentrations above 0.1 ppb. The presenting signs of ciguatera are primarily neurotoxic in more than 80% of cases. Such include the pathognomonic features of postingestion paraesthesiae, dysaesthesiae, and heightened nociperception. Other sensory abnormalities include the subjective features of metallic taste, pruritis, arthralgia, myalgia, and dental pain. Cerebellar dysfunction, sometimes diphasic, and weakness due to both neuropathy and polymyositis may be encountered. Autonomic dysfunction leads to hypotension, bradycardia, and hypersalivation in severe cases. Ciguatoxins are potent, lipophilic sodium channel activator toxins which bind to the voltage sensitive (site 5) sodium channel on the cell membranes of all excitable tissues. Treatment depends on early diagnosis and the early administration of intravenous mannitol. The early identification of the neurological features in sentinel patients has the potential to reduce the number of secondary cases in cluster outbreaks.

 PMID:11118239

Ciguatera fish poisoning and climate change: analysis of National Poison Center Data in the United States, 2001-2011.

Science.gov (United States)

Gingold, Daniel B; Strickland, Matthew J; Hess, Jeremy J

2014-06-01

Warm sea surface temperatures (SSTs) are positively related to incidence of ciguatera fish poisoning (CFP). Increased severe storm frequency may create more habitat for ciguatoxic organisms. Although climate change could expand the endemic range of CFP, the relationship between CFP incidence and specific environmental conditions is unknown. We estimated associations between monthly CFP incidence in the contiguous United States and SST and storm frequency in the Caribbean basin. We obtained information on 1,102 CFP-related calls to U.S. poison control centers during 2001-2011 from the National Poison Data System. We performed a time-series analysis using Poisson regression to relate monthly CFP call incidence to SST and tropical storms. We investigated associations across a range of plausible lag structures. Results showed associations between monthly CFP calls and both warmer SSTs and increased tropical storm frequency. The SST variable with the strongest association linked current monthly CFP calls to the peak August SST of the previous year. The lag period with the strongest association for storms was 18 months. If climate change increases SST in the Caribbean 2.5-3.5 °C over the coming century as projected, this model implies that CFP incidence in the United States is likely to increase 200-400%. Using CFP calls as a marker of CFP incidence, these results clarify associations between climate variability and CFP incidence and suggest that, all other things equal, climate change could increase the burden of CFP. These findings have implications for disease prediction, surveillance, and public health preparedness for climate change.

Ciguatera fish poisoning in Hong Kong--a 10-year perspective on the class of ciguatoxins.

Science.gov (United States)

Wong, Chun-Kwan; Hung, Patricia; Lo, Janice Y C

2014-08-01

The present study used liquid chromatography-tandem mass spectrometry (LC-MS/MS) to investigate retrospectively ciguatoxin (CTX)-positive samples as determined by mouse bioassay (MBA) in the past 10 years in Hong Kong. The results showed that Pacific CTXs (P-CTX-1, -2 and -3) were the most commonly observed toxins found in the samples, indicating Pacific Ocean areas as the most important origin of ciguatera fish poisoning. Clinical diagnosis from ciguatera patients also revealed the predominance of neurological illnesses in most cases, supporting intoxication of Pacific origin. This study demonstrated the ability of laboratory analysis to identify and quantify Pacific CTXs in suspected fish samples, so as to support the clinical diagnosis of ciguatera. Comparative analysis (Student's t-test and Spearman's rank correlation analysis) on the two CTX detection methods showed approximate linearity for overall P-CTXs (P-CTX-1, -2 and -3)/P-CTX-1 alone as derived by LC-MS/MS and total toxicity levels (P-CTX-1 equivalent) as determined by MBA. The LC-MS/MS method coupled with the rapid extraction method could allow the detection of trace amount of CTXs at levels below the clinically relevant limit, 0.1 ppb P-CTX-1 in fish flesh. For practical application, the adoption of a two-tiered approach for testing, chemical analysis by LC-MS/MS for toxic fish screening, coupled with biological assay by MBA for final toxicity confirmation, was proposed for first-line screening of CTX in potentially contaminated fish samples in the market, with an aim to minimizing the use of laboratory mice and at the same time providing reasonably effective means for routine analysis. Copyright © 2014 Elsevier Ltd. All rights reserved.

Determination of toxins involved in ciguatera fish poisoning in the Pacific by LC/MS.

Science.gov (United States)

Yogi, Kentaro; Sakugawa, Satsuki; Oshiro, Naomasa; Ikehara, Tsuyoshi; Sugiyama, Kiminori; Yasumoto, Takeshi

2014-01-01

Ciguatera fish poisoning is the most extensive and difficult to control of the seafood poisonings. To facilitate monitoring of fish toxicity, toxin profiles were investigated by an LC/MS/MS method using 14 reference toxins on eight representative species of fish collected in four different areas of the Pacific. Snappers and groupers from Okinawa contained ciguatoxin-1B (CTX1B) and two deoxy congeners at variable but species-specific ratios, while red snapper, Lutjanus bohar, from Minamitorishima, and amberjack, Seriola dumerili, from Hawaii, contained both CTX1B-type and CTX3C-type toxins. Spotted knifejaw, Oplegnathus punctatus, from Okinawan waters, contained mainly CTX4A and CTX4B, but the same species caught at Miyazaki was contaminated primarily with the CTX3C-type toxins. Otherwise, the toxin profiles were consistently species-specific in fish collected from various locations around Okinawa over 20 years. The LC/MS/MS and mouse bioassay results agreed well, indicating the LC/MS/MS method is a promising alternative to the mouse bioassay. Pure CTX1B and CTX3C were prepared for use in future LC/MS/MS analysis.

A review of traditional remedies of ciguatera fish poisoning in the Pacific.

Science.gov (United States)

Kumar-Roiné, Shilpa; Taiana Darius, H; Matsui, Mariko; Fabre, Nicolas; Haddad, Mohamed; Chinain, Mireille; Pauillac, Serge; Laurent, Dominique

2011-07-01

Ciguatera fish poisoning (CFP) is an illness caused by eating tropical coral fish contaminated with ciguatoxins (CTXs). The clinical management of patients with CFP is generally supportive and symptomatic in nature as no antidote exists. Of the many drugs prescribed, several have been claimed to be efficient in small, uncontrolled studies, but the outcomes of treatments with these medicines are often contradictory. In New Caledonia, traditional remedies are commonly employed in the treatment of CFP and of the 90 plant species catalogued as useful in CFP, the most popular herbal remedy by far is a decoction prepared from the leaves of Heliotropium foertherianum Diane & Hilger (Boraginaceae). Other important plants used in the treatment of CFP include Euphorbia hirta L. (Euphorbiaceae) and Vitex L. sp. (Lamiaceae). This review focuses on the evidence for efficacy of these species and pharmacological studies which support their use. Other plants used in CFP and the conventional treatment of CFP are also discussed briefly. Copyright © 2011 John Wiley & Sons, Ltd.

Ciguatera fish poisoning in la Habana, Cuba: a study of local social-ecological resilience.

Science.gov (United States)

Morrison, Karen; Aguiar Prieto, Pablo; Castro Domínguez, Arnaldo; Waltner-Toews, David; Fitzgibbon, John

2008-09-01

Following the collapse of the Cuban economy in the early 1990s, epidemiologists in the Cuban Ministry of Health noticed dramatic increases in reported outbreaks of ciguatera fish poisoning (CFP) in some coastal communities. This article summarizes the results of a comparative case study which applied an ecosystem approach to human health to investigate this issue. Situated learning and complexity theories were used to interpret the results of the investigation. CFP outbreaks are influenced by a complex set of interactions between ecological and socioeconomic processes. This study found that the level of organization of the local sports fishing community and the degree of degradation of the local nearshore marine ecosystem appear to be key factors influencing the diverging levels of CFP outbreaks recorded in the 1990s in the communities studied.

Invasive lionfish (Pterois volitans): a potential human health threat for ciguatera fish poisoning in tropical waters.

Science.gov (United States)

Robertson, Alison; Garcia, Ana C; Quintana, Harold A Flores; Smith, Tyler B; Castillo, Bernard F; Reale-Munroe, Kynoch; Gulli, Joseph A; Olsen, David A; Hooe-Rollman, Jennifer I; Jester, Edward L E; Klimek, Brian J; Plakas, Steven M

2013-12-27

Invasive Indo-Pacific lionfish (Pterois volitans) have rapidly expanded in the Western Atlantic over the past decade and have had a significant negative impact on reef fish biodiversity, habitat, and community structure, with lionfish out-competing native predators for resources. In an effort to reduce this population explosion, lionfish have been promoted for human consumption in the greater Caribbean region. This study examined whether the geographical expansion of the lionfish into a known ciguatera-endemic region can pose a human health threat for ciguatera fish poisoning (CFP). More than 180 lionfish were collected from waters surrounding the US Virgin Islands throughout 2010 and 2011. Ciguatoxin testing included an in vitro neuroblastoma cytotoxicity assay for composite toxicity assessment of sodium-channel toxins combined with confirmatory liquid chromatography tandem mass spectrometry. A 12% prevalence rate of ciguatoxic lionfish exceeding the FDA guidance level of 0.1 µg/kg C-CTX-1 equivalents was identified in fish from the U.S. Virgin Islands, highlighting a potential consumption risk in this region. This study presents the first evidence that the invasive lionfish, pose a direct human health risk for CFP and highlights the need for awareness and research on this food safety hazard in known endemic areas.

Invasive Lionfish (Pterois volitans: A Potential Human Health Threat for Ciguatera Fish Poisoning in Tropical Waters

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Alison Robertson

2013-12-01

Full Text Available Invasive Indo-Pacific lionfish (Pterois volitans have rapidly expanded in the Western Atlantic over the past decade and have had a significant negative impact on reef fish biodiversity, habitat, and community structure, with lionfish out-competing native predators for resources. In an effort to reduce this population explosion, lionfish have been promoted for human consumption in the greater Caribbean region. This study examined whether the geographical expansion of the lionfish into a known ciguatera-endemic region can pose a human health threat for ciguatera fish poisoning (CFP. More than 180 lionfish were collected from waters surrounding the US Virgin Islands throughout 2010 and 2011. Ciguatoxin testing included an in vitro neuroblastoma cytotoxicity assay for composite toxicity assessment of sodium-channel toxins combined with confirmatory liquid chromatography tandem mass spectrometry. A 12% prevalence rate of ciguatoxic lionfish exceeding the FDA guidance level of 0.1 µg/kg C-CTX-1 equivalents was identified in fish from the U.S. Virgin Islands, highlighting a potential consumption risk in this region. This study presents the first evidence that the invasive lionfish, pose a direct human health risk for CFP and highlights the need for awareness and research on this food safety hazard in known endemic areas.

Invasive Lionfish (Pterois volitans): A Potential Human Health Threat for Ciguatera Fish Poisoning in Tropical Waters

Science.gov (United States)

Robertson, Alison; Garcia, Ana C.; Flores Quintana, Harold A.; Smith, Tyler B.; Castillo, Bernard F.; Reale-Munroe, Kynoch; Gulli, Joseph A.; Olsen, David A.; Hooe-Rollman, Jennifer I.; Jester, Edward L. E.; Klimek, Brian J.; Plakas, Steven M.

2013-01-01

Invasive Indo-Pacific lionfish (Pterois volitans) have rapidly expanded in the Western Atlantic over the past decade and have had a significant negative impact on reef fish biodiversity, habitat, and community structure, with lionfish out-competing native predators for resources. In an effort to reduce this population explosion, lionfish have been promoted for human consumption in the greater Caribbean region. This study examined whether the geographical expansion of the lionfish into a known ciguatera-endemic region can pose a human health threat for ciguatera fish poisoning (CFP). More than 180 lionfish were collected from waters surrounding the US Virgin Islands throughout 2010 and 2011. Ciguatoxin testing included an in vitro neuroblastoma cytotoxicity assay for composite toxicity assessment of sodium-channel toxins combined with confirmatory liquid chromatography tandem mass spectrometry. A 12% prevalence rate of ciguatoxic lionfish exceeding the FDA guidance level of 0.1 µg/kg C-CTX-1 equivalents was identified in fish from the U.S. Virgin Islands, highlighting a potential consumption risk in this region. This study presents the first evidence that the invasive lionfish, pose a direct human health risk for CFP and highlights the need for awareness and research on this food safety hazard in known endemic areas. PMID:24378919

Update on methodologies available for ciguatoxin determination: perspectives to confront the onset of ciguatera fish poisoning in Europe.

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Caillaud, Amandine; de la Iglesia, Pablo; Darius, H Taiana; Pauillac, Serge; Aligizaki, Katerina; Fraga, Santiago; Chinain, Mireille; Diogène, Jorge

2010-06-14

Ciguatera fish poisoning (CFP) occurs mainly when humans ingest finfish contaminated with ciguatoxins (CTXs). The complexity and variability of such toxins have made it difficult to develop reliable methods to routinely monitor CFP with specificity and sensitivity. This review aims to describe the methodologies available for CTX detection, including those based on the toxicological, biochemical, chemical, and pharmaceutical properties of CTXs. Selecting any of these methodological approaches for routine monitoring of ciguatera may be dependent upon the applicability of the method. However, identifying a reference validation method for CTXs is a critical and urgent issue, and is dependent upon the availability of certified CTX standards and the coordinated action of laboratories. Reports of CFP cases in European hospitals have been described in several countries, and are mostly due to travel to CFP endemic areas. Additionally, the recent detection of the CTX-producing tropical genus Gambierdiscus in the eastern Atlantic Ocean of the northern hemisphere and in the Mediterranean Sea, as well as the confirmation of CFP in the Canary Islands and possibly in Madeira, constitute other reasons to study the onset of CFP in Europe [1]. The question of the possible contribution of climate change to the distribution of toxin-producing microalgae and ciguateric fish is raised. The impact of ciguatera onset on European Union (EU) policies will be discussed with respect to EU regulations on marine toxins in seafood. Critical analysis and availability of methodologies for CTX determination is required for a rapid response to suspected CFP cases and to conduct sound CFP risk analysis.

Update on Methodologies Available for Ciguatoxin Determination: Perspectives to Confront the Onset of Ciguatera Fish Poisoning in Europe

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Amandine Caillaud

2010-06-01

Full Text Available Ciguatera fish poisoning (CFP occurs mainly when humans ingest finfish contaminated with ciguatoxins (CTXs. The complexity and variability of such toxins have made it difficult to develop reliable methods to routinely monitor CFP with specificity and sensitivity. This review aims to describe the methodologies available for CTX detection, including those based on the toxicological, biochemical, chemical, and pharmaceutical properties of CTXs. Selecting any of these methodological approaches for routine monitoring of ciguatera may be dependent upon the applicability of the method. However, identifying a reference validation method for CTXs is a critical and urgent issue, and is dependent upon the availability of certified CTX standards and the coordinated action of laboratories. Reports of CFP cases in European hospitals have been described in several countries, and are mostly due to travel to CFP endemic areas. Additionally, the recent detection of the CTX-producing tropical genus Gambierdiscus in the eastern Atlantic Ocean of the northern hemisphere and in the Mediterranean Sea, as well as the confirmation of CFP in the Canary Islands and possibly in Madeira, constitute other reasons to study the onset of CFP in Europe [1]. The question of the possible contribution of climate change to the distribution of toxin-producing microalgae and ciguateric fish is raised. The impact of ciguatera onset on European Union (EU policies will be discussed with respect to EU regulations on marine toxins in seafood. Critical analysis and availability of methodologies for CTX determination is required for a rapid response to suspected CFP cases and to conduct sound CFP risk analysis.

[Ciguatera and acute polyradiculoneuritis. Description of two cases in French Polynesia: immunoallergic hypothesis?].

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Oehler, E; Gatti, C; Legrand, A M; Ghawche, F

2009-02-01

Ciguatera is a foodborne poisoning caused by eating seafood from tropical and subtropical reef areas. According to official data from the local health department, cases of ciguatera in French Polynesia are estimated to involve 240 to 400 persons per 100 000 inhabitants. Associated with a wide spectrum of gastrointestinal, cardiovascular, nervous, and general signs, ciguatera is usually benign although some forms can lead to hospitalization. The purpose of this report is to describe two unusual cases involving patients who developed acute polyradiculoneuritis with Guillain-Barré-syndrome-like peripheral nervous system deficits on the seventh day of ciguatera after ingestion of moray eel. The hypothesis of an immune-allergic reaction is raised especially in the light of rapid improvement of the patient who received polyvalent immunoglobulin treatment.

Total synthesis of ciguatoxin CTX3C: a venture into the problems of ciguatera seafood poisoning.

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Hirama, Masahiro

2005-01-01

After a twelve-year struggle, the total synthesis of ciguatoxin CTX3C has been achieved. Annually, more than 20,000 people worldwide suffer from ciguatera seafood poisoning. The extremely small amounts of the causative neurotoxin, ciguatoxin, in fish hampered the isolation, structural elucidation, detailed biological study, and preparation of anti-ciguatoxin antibodies for detecting these toxins. The large (3 nanometers long) and complicated molecular structure of ciguatoxins hindered chemists from completing a total synthesis. The chemical synthesis of CTX3C, determination of the absolute configuration, and synthesis-based preparation of the monoclonal antibodies as well as the effect of synthetic CTX3C on voltage-sensitive sodium channels are outlined. (c) 2005 The Japan Chemical Journal Forum and Wiley Periodicals, Inc.

Regional Variations in the Risk and Severity of Ciguatera Caused by Eating Moray Eels.

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Chan, Thomas Y K

2017-06-26

Moray eels ( Gymnothorax species) from tropical waters have long been known to be high-risk species, and the consumption of particularly the viscera or ungutted eels can result in severe ciguatera (known as Gymnothorax or moray eel poisoning), characterized by prominent neurological features. In this review, the main objective was to describe the risk and severity of ciguatera caused by eating moray eels in different parts of the world. Moray eels can accumulate very high ciguatoxin (CTX) levels in the flesh and particularly the liver. Therefore, even the smaller ones can be toxic and the consumption of an average portion (particularly liver) can result in severe or fatal ciguatera. Moray eels (particularly when ungutted) must never be served in gatherings since they can cause mass poisoning because of their large sizes and high CTX levels. Apart from regulatory measures restricting or excluding access, the public should be repeatedly warned to avoid eating moray eels.

Regional Variations in the Risk and Severity of Ciguatera Caused by Eating Moray Eels

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Thomas Y. K. Chan

2017-06-01

Full Text Available Moray eels (Gymnothorax species from tropical waters have long been known to be high-risk species, and the consumption of particularly the viscera or ungutted eels can result in severe ciguatera (known as Gymnothorax or moray eel poisoning, characterized by prominent neurological features. In this review, the main objective was to describe the risk and severity of ciguatera caused by eating moray eels in different parts of the world. Moray eels can accumulate very high ciguatoxin (CTX levels in the flesh and particularly the liver. Therefore, even the smaller ones can be toxic and the consumption of an average portion (particularly liver can result in severe or fatal ciguatera. Moray eels (particularly when ungutted must never be served in gatherings since they can cause mass poisoning because of their large sizes and high CTX levels. Apart from regulatory measures restricting or excluding access, the public should be repeatedly warned to avoid eating moray eels.

Regional Variations in the Risk and Severity of Ciguatera Caused by Eating Moray Eels

Science.gov (United States)

Chan, Thomas Y. K.

2017-01-01

Moray eels (Gymnothorax species) from tropical waters have long been known to be high-risk species, and the consumption of particularly the viscera or ungutted eels can result in severe ciguatera (known as Gymnothorax or moray eel poisoning), characterized by prominent neurological features. In this review, the main objective was to describe the risk and severity of ciguatera caused by eating moray eels in different parts of the world. Moray eels can accumulate very high ciguatoxin (CTX) levels in the flesh and particularly the liver. Therefore, even the smaller ones can be toxic and the consumption of an average portion (particularly liver) can result in severe or fatal ciguatera. Moray eels (particularly when ungutted) must never be served in gatherings since they can cause mass poisoning because of their large sizes and high CTX levels. Apart from regulatory measures restricting or excluding access, the public should be repeatedly warned to avoid eating moray eels. PMID:28672845

Update on Methodologies Available for Ciguatoxin Determination: Perspectives to Confront the Onset of Ciguatera Fish Poisoning in Europe [1

Science.gov (United States)

Caillaud, Amandine; de la Iglesia, Pablo; Darius, H. Taiana; Pauillac, Serge; Aligizaki, Katerina; Fraga, Santiago; Chinain, Mireille; Diogène, Jorge

2010-01-01

Ciguatera fish poisoning (CFP) occurs mainly when humans ingest finfish contaminated with ciguatoxins (CTXs). The complexity and variability of such toxins have made it difficult to develop reliable methods to routinely monitor CFP with specificity and sensitivity. This review aims to describe the methodologies available for CTX detection, including those based on the toxicological, biochemical, chemical, and pharmaceutical properties of CTXs. Selecting any of these methodological approaches for routine monitoring of ciguatera may be dependent upon the applicability of the method. However, identifying a reference validation method for CTXs is a critical and urgent issue, and is dependent upon the availability of certified CTX standards and the coordinated action of laboratories. Reports of CFP cases in European hospitals have been described in several countries, and are mostly due to travel to CFP endemic areas. Additionally, the recent detection of the CTX-producing tropical genus Gambierdiscus in the eastern Atlantic Ocean of the northern hemisphere and in the Mediterranean Sea, as well as the confirmation of CFP in the Canary Islands and possibly in Madeira, constitute other reasons to study the onset of CFP in Europe [1]. The question of the possible contribution of climate change to the distribution of toxin-producing microalgae and ciguateric fish is raised. The impact of ciguatera onset on European Union (EU) policies will be discussed with respect to EU regulations on marine toxins in seafood. Critical analysis and availability of methodologies for CTX determination is required for a rapid response to suspected CFP cases and to conduct sound CFP risk analysis. PMID:20631873

Ciguatera fish poisoning: Incidence, health costs and risk perception on Moorea Island (Society archipelago, French Polynesia).

Science.gov (United States)

Morin, Ewen; Gatti, Clémence; Bambridge, Tamatoa; Chinain, Mireille

2016-12-01

Ciguatera Fish Poisoning (CFP) is a non-bacterial seafood poisoning well characterized in the remote archipelagos of French Polynesia, yet poorly documented in the Society archipelago, most notably on Moorea, the second most populated island in French Polynesia, which counts a high proportion of fishermen fishing on a regular basis. To address this knowledge gap, a holistic study of the ciguatera issue was conducted on Moorea. First, ciguatera risk was analysed in terms of incidence rate, fish species most commonly involved and risk stratification in Moorea lagoon based on 2007-2013 epidemiological data. A mean incidence rate of 8 cases per 10,000 inhabitants for the study period and an average under-reporting rate of 54% were found. Taking into account hospitalization and medication fees, and loss of productive days, the health-related costs due to CFP were estimated to be USD $1613 and $749 for each reported and unreported case, respectively, with an overall cost of USD $241,847 for the study period. Comparison of the present status of CFP on Moorea with a risk map established in the late 1970's showed that the spatial distribution of the risk has stayed relatively stable in time, with the north shore of the island remaining the most prone to ciguatera. Evaluation of the current knowledge on CFP among different populations groups, i.e. fishermen, residents and visitors, was also conducted through direct and indirect interviews. About half of the fishermen interviewed were actually able to identify risky fishing areas. While, overall, the CFP risk perception in the fishing community of Moorea seemed accurate, although not scientifically complete, it was sufficient for the safe practice of their fishing activities. This may be due in part to adaptive responses adopted by 36% of the fishermen interviewed, such as the avoidance of either high-risk fishing sites or toxic species. At the residents and visitors' level, the study points out a striking lack of awareness

Ciguatera incidence in the US Virgin Islands has not increased over a 30-year time period despite rising seawater temperatures.

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Radke, Elizabeth G; Grattan, Lynn M; Cook, Robert L; Smith, Tyler B; Anderson, Donald M; Morris, J Glenn

2013-05-01

Ciguatera fish poisoning is the most common marine food poisoning worldwide. It has been hypothesized that increasing seawater temperature will result in increasing ciguatera incidence. In St. Thomas, US Virgin Islands, we performed an island-wide telephone survey (N = 807) and a medical record review of diagnosed ciguatera cases at the emergency department of the sole hospital and compared these data with comparable data sources collected in 1980. Annual incidence from both recent data sources remained high (12 per 1,000 among adults in the telephone survey). However, the combined data sources suggest that incidence has declined by 20% or more or remained stable over 30 years, whereas seawater temperatures were increasing. Illness was associated with lower education levels, higher levels of fish consumption, and having previous episodes of ciguatera; population shifts from 1980 to 2010 in these factors could explain an incidence decline of approximately 3 per 1,000, obscuring effects from rising seawater temperature.

Ciguatera fish poisoning in Hawai'i and the Pacific.

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Copeland, Nathanial K; Palmer, Wyatt R; Bienfang, Paul K

2014-11-01

Ciguatera fish poisoning (CFP) is a foodborne illness caused by fish containing ciguatoxin (CTX). The toxin is produced by the microalgae Gambierdiscus spp. which are then eaten by reef fish; humans contract the illness when eating either fish that have eaten the algae, or carnivorous fish that have eaten those fish. CTX is an odorless, tasteless, and colorless neurotoxin that blocks voltage-sensitive Na(+) channels and accumulates in many tissues of the fish, especially the viscera. The illness is typically mild to moderate in severity with gastrointestinal (diarrhea, cramping, nausea, vomiting) and neurological (paraesthesias, cold allodynia, fatigue, pruritis) manifestations. Rarely, the disease can be more severe with significant neuropathic or cardiac effects such as bradycardia and hypotension. Endemic to Hawai'i and islands throughout the Caribbean and Pacific, CFP incidence rates range from several to thousands of cases per 100,000 per year. Since fishing is important for local food supply, exportation, and recreation throughout the Pacific, CFP is medically and economically significant in these areas. We present a case of CFP from Hawai'i to illustrate the disease, demonstrating that the diagnosis is primarily clinical, with confirmatory tests from fish samples available in some cases. Treatment is supportive and symptomatic with no disease specific remedy. The prognosis for most cases is good with a short duration of self-limited symptoms, but for some cases neurological sequelae can become chronic. With no effective treatment, education on which species of reef fish and which body parts to avoid eating is essential in the prevention of CFP.

Ciguatera Fish Poisoning in Hawai‘i and the Pacific

Science.gov (United States)

Palmer, Wyatt R; Bienfang, Paul K

2014-01-01

Ciguatera fish poisoning (CFP) is a foodborne illness caused by fish containing ciguatoxin (CTX). The toxin is produced by the microalgae Gambierdiscus spp. which are then eaten by reef fish; humans contract the illness when eating either fish that have eaten the algae, or carnivorous fish that have eaten those fish. CTX is an odorless, tasteless, and colorless neurotoxin that blocks voltage-sensitive Na+ channels and accumulates in many tissues of the fish, especially the viscera. The illness is typically mild to moderate in severity with gastrointestinal (diarrhea, cramping, nausea, vomiting) and neurological (paraesthesias, cold allodynia, fatigue, pruritis) manifestations. Rarely, the disease can be more severe with significant neuropathic or cardiac effects such as bradycardia and hypotension. Endemic to Hawai‘i and islands throughout the Caribbean and Pacific, CFP incidence rates range from several to thousands of cases per 100,000 per year. Since fishing is important for local food supply, exportation, and recreation throughout the Pacific, CFP is medically and economically significant in these areas. We present a case of CFP from Hawai‘i to illustrate the disease, demonstrating that the diagnosis is primarily clinical, with confirmatory tests from fish samples available in some cases. Treatment is supportive and symptomatic with no disease specific remedy. The prognosis for most cases is good with a short duration of self-limited symptoms, but for some cases neurological sequelae can become chronic. With no effective treatment, education on which species of reef fish and which body parts to avoid eating is essential in the prevention of CFP. PMID:25478299

Ciguatera fish poisoning - New York City, 2010-2011.

Science.gov (United States)

2013-02-01

During August 2010-July 2011, the New York City Department of Health and Mental Hygiene (DOHMH) received reports of six outbreaks and one single case of ciguatera fish poisoning (CFP), involving a total of 28 persons. CFP results from consumption of certain large, predatory, tropical reef fish that have bioaccumulated ciguatoxins (CTX). CFP is characterized by various gastrointestinal, cardiovascular, and neurologic symptoms. A prolonged period of acute illness can result, and the neurologic symptoms can last months, with variable asymptomatic and symptomatic periods. The first two outbreaks and the single case, involving 13 persons, were reported during August 6-September 13, 2010. DOHMH distributed a health alert in November 2010 requesting health-care providers be alert for CFP signs and symptoms. The health alert resulted in identification of 11 more cases that month and an additional two outbreaks involving four persons in July 2011. In comparison, only four CFP outbreaks, involving 21 persons total, had been reported in New York City (NYC) during the preceding 10 years (2000-2009). DOHMH's investigation revealed that 13 persons became ill after eating barracuda, and 15 became ill after eating grouper. Although specific and highly sensitive laboratory analyses can detect and confirm CTX in fish, no practical field tests are available for fish monitoring programs. CFP prevention depends on educating the public, seafood suppliers, and distributors about known CFP endemic areas and high-risk fish species. Traceback investigations of fish associated with outbreaks provide valuable information regarding fishing areas associated with CFP. Not all fish from CFP endemic areas are ciguatoxic, but persons who eat fish from endemic regions are at higher risk for CFP. If an illness is suspected to be CFP, public health authorities should be notified and informed of the case history for possible investigation and intervention measures.

Ciguatera: a public health perspective.

Science.gov (United States)

Dickey, Robert W; Plakas, Steven M

2010-08-15

Ciguatera fish poisoning is a seafood-borne illness caused by consumption of fish that have accumulated lipid-soluble ciguatoxins. In the United States, ciguatera is responsible for the highest reported incidence of food-borne illness outbreaks attributed to finfish, and it is reported to hold this distinction globally. Ciguatoxins traverse the marine food web from primary producers, Gambierdiscus spp., to commonly consumed fish in tropical and subtropical regions of the world. Ciguatoxins comprise 12 known congeners among Caribbean and tropical Atlantic fish and 29 reported congeners among Pacific fish. Expanding trade in fisheries from ciguatera-endemic regions contributes to wider distribution and increasing frequency of disease among seafood consumers in non-endemic regions. Ciguatoxins produce a complex array of gastrointestinal, neurological and cardiological symptoms. Treatment options are very limited and supportive in nature. Information derived from the study of ciguatera outbreaks has improved clinical recognition, confirmation, and timely treatment. Such studies are equally important for the differentiation of ciguatoxin profiles in fish from one region to the next, the determination of toxicity thresholds in humans, and the formulation of safety limits. Analytical information from case and outbreak investigations was used to derive Pacific and Caribbean ciguatoxin threshold contamination rates for adverse effects in seafood consumers. To these threshold estimates 10-fold safety factors were applied to address individual human risk factors; uncertainty in the amount of fish consumed; and analytical accuracy. The studies may serve as the basis for industry and consumer advisory levels of 0.10ppb C-CTX-1 equivalent toxicity in fish from the tropical Atlantic, Gulf of Mexico, Caribbean, and 0.01ppb P-CTX-1 equivalent toxicity in fish from Pacific regions. Published by Elsevier Ltd.

Neurotoxic Syndromes in Marine Poisonings a Review

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Gholam Hossein Mohebbi

2014-08-01

Full Text Available Background: Marine neurotoxins as of Marine biotoxins are natural toxins that produced mainly by dinoflagellates, diatoms and several species of invertebrates and fish. Marine poisoning results from the ingestion of marine animals contain these toxins and causes considerable adverse effects. Materials and methods: This review provides some facts about the structures of marine neurotoxins, their molecular target and pharmacology, analytical methods for their detection and quantitation, diagnosis and laboratory testing, clinical manifestations, as well as prevention and treatment, if were obtainable. Furthermore, we focus on marine poisoning and various associated neurological syndromes like ciguatera, tetrodotoxin poisoning, and paralytic shellfish poisoning, after ingestion of the common marine toxins. Results: A number of neurotoxins that prescribed according to their potency (LD50 are: Maitotoxin, Ciguatoxins and Palytoxin, Tetrodotoxin and Saxitoxin, Brevetoxins, Azaspiracid, Yessotoxin, Cooliatoxin, Domoic acid and Conotoxins, Respectively. The primary target of most marine neurotoxins is voltage gated sodium channels and the resulting block of ion conductance through these channels. Moreover, these compounds interact with voltage-gated potassium and calcium channels and modulate the flux of stated ions into many cell types. As well, the target recognized for palytoxin is the Na+- K+ /ATPase. Conclusion: Results of reviewed studies revealed that, the Ciguatera is the commonest syndrome of marine poisoning, but is rarely lethal. Puffer fish poisoning results from the ingestion of fish containing tetrodotoxin and paralytic shellfish poisoning are less common, but have a higher fatality rate than ciguatera. Despite their high toxicity, no much research has been done on some of the toxins, like maitotoxin. In addition, there have remained unknown the pharmacological effects, mechanism of action and molecular target of some toxins such as

[First ciguatera outbreak in Germany in 2012].

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Friedemann, Miriam

2016-12-01

In November 2012, 23 cases of ciguatera with typical combinations of gastrointestinal and neurological symptoms occurred in Germany after consumption of imported tropical fish (Lutjanus spp.). A questionnaire was used to gather information on the disease course and fish consumption. All patients suffered from pathognomonic cold allodynia. Aside from two severe courses of illness, all other cases showed symptoms of moderate intensity. During a three-year follow-up, seven patients reported prolonged paresthesia for more than one year. Two of them reported further neuropathies over almost three years. This is the first time that long-term persistence of symptoms has been documented in detail. Outbreak cases were allocated to eight clusters in seven German cities. A further cluster was prevented by the successful recall of ciguatoxic fish. Three clusters were confirmed by the detection of ciguatoxin in samples of suspicious and recalled fish. An extrapolation on the basis of ciguatoxic samples revealed twenty prevented cases of ciguatera. Further officially unknown cases should be assumed. During the outbreak investigations, inadvertently falsely labelled fish species and fishing capture areas on import and retail level documents were observed. The ascertainment of cases and the outbreak investigations proved to be difficult due to inconsistent case reports to poisons centers, local health and veterinary authorities. In Germany, many physicians are unaware of the disease pattern of ciguatera and the risks caused by tropical fish. The occurrence of further outbreaks during the following years emphasizes the increasing significance of ciguatera in Germany.

An Updated Review of Ciguatera Fish Poisoning: Clinical, Epidemiological, Environmental, and Public Health Management

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Melissa A. Friedman

2017-03-01

Full Text Available Ciguatera Fish Poisoning (CFP is the most frequently reported seafood-toxin illness in the world. It causes substantial human health, social, and economic impacts. The illness produces a complex array of gastrointestinal, neurological and neuropsychological, and cardiovascular symptoms, which may last days, weeks, or months. This paper is a general review of CFP including the human health effects of exposure to ciguatoxins (CTXs, diagnosis, human pathophysiology of CFP, treatment, detection of CTXs in fish, epidemiology of the illness, global dimensions, prevention, future directions, and recommendations for clinicians and patients. It updates and expands upon the previous review of CFP published by Friedman et al. (2008 and addresses new insights and relevant emerging global themes such as climate and environmental change, international market issues, and socioeconomic impacts of CFP. It also provides a proposed universal case definition for CFP designed to account for the variability in symptom presentation across different geographic regions. Information that is important but unchanged since the previous review has been reiterated. This article is intended for a broad audience, including resource and fishery managers, commercial and recreational fishers, public health officials, medical professionals, and other interested parties.

An Updated Review of Ciguatera Fish Poisoning: Clinical, Epidemiological, Environmental, and Public Health Management.

Science.gov (United States)

Friedman, Melissa A; Fernandez, Mercedes; Backer, Lorraine C; Dickey, Robert W; Bernstein, Jeffrey; Schrank, Kathleen; Kibler, Steven; Stephan, Wendy; Gribble, Matthew O; Bienfang, Paul; Bowen, Robert E; Degrasse, Stacey; Flores Quintana, Harold A; Loeffler, Christopher R; Weisman, Richard; Blythe, Donna; Berdalet, Elisa; Ayyar, Ram; Clarkson-Townsend, Danielle; Swajian, Karen; Benner, Ronald; Brewer, Tom; Fleming, Lora E

2017-03-14

Ciguatera Fish Poisoning (CFP) is the most frequently reported seafood-toxin illness in the world. It causes substantial human health, social, and economic impacts. The illness produces a complex array of gastrointestinal, neurological and neuropsychological, and cardiovascular symptoms, which may last days, weeks, or months. This paper is a general review of CFP including the human health effects of exposure to ciguatoxins (CTXs), diagnosis, human pathophysiology of CFP, treatment, detection of CTXs in fish, epidemiology of the illness, global dimensions, prevention, future directions, and recommendations for clinicians and patients. It updates and expands upon the previous review of CFP published by Friedman et al. (2008) and addresses new insights and relevant emerging global themes such as climate and environmental change, international market issues, and socioeconomic impacts of CFP. It also provides a proposed universal case definition for CFP designed to account for the variability in symptom presentation across different geographic regions. Information that is important but unchanged since the previous review has been reiterated. This article is intended for a broad audience, including resource and fishery managers, commercial and recreational fishers, public health officials, medical professionals, and other interested parties.

An Updated Review of Ciguatera Fish Poisoning: Clinical, Epidemiological, Environmental, and Public Health Management

Science.gov (United States)

Friedman, Melissa A.; Fernandez, Mercedes; Backer, Lorraine C.; Dickey, Robert W.; Bernstein, Jeffrey; Schrank, Kathleen; Kibler, Steven; Stephan, Wendy; Gribble, Matthew O.; Bienfang, Paul; Bowen, Robert E.; Degrasse, Stacey; Flores Quintana, Harold A.; Loeffler, Christopher R.; Weisman, Richard; Blythe, Donna; Berdalet, Elisa; Ayyar, Ram; Clarkson-Townsend, Danielle; Swajian, Karen; Benner, Ronald; Brewer, Tom; Fleming, Lora E.

2017-01-01

Ciguatera Fish Poisoning (CFP) is the most frequently reported seafood-toxin illness in the world. It causes substantial human health, social, and economic impacts. The illness produces a complex array of gastrointestinal, neurological and neuropsychological, and cardiovascular symptoms, which may last days, weeks, or months. This paper is a general review of CFP including the human health effects of exposure to ciguatoxins (CTXs), diagnosis, human pathophysiology of CFP, treatment, detection of CTXs in fish, epidemiology of the illness, global dimensions, prevention, future directions, and recommendations for clinicians and patients. It updates and expands upon the previous review of CFP published by Friedman et al. (2008) and addresses new insights and relevant emerging global themes such as climate and environmental change, international market issues, and socioeconomic impacts of CFP. It also provides a proposed universal case definition for CFP designed to account for the variability in symptom presentation across different geographic regions. Information that is important but unchanged since the previous review has been reiterated. This article is intended for a broad audience, including resource and fishery managers, commercial and recreational fishers, public health officials, medical professionals, and other interested parties. PMID:28335428

[Toxin profiles in fish implicated in ciguatera fish poisoning in Amami and Kakeroma Islands, Kagoshima Prefecture, Japan].

Science.gov (United States)

Yogi, Kentaro; Oshiro, Naomasa; Matsuda, Seiko; Sakugawa, Satsuki; Matsuo, Toshiaki; Yasumoto, Takeshi

2013-01-01

Ciguatoxins (CTXs) responsible for ciguatera fish poisoning (CFP) in Amami Islands, Kagoshima, Japan in 2008 were determined by LC-MS/MS analysis. Ciguatoxin-1B (CTX1B), 54-deoxyCTX1B, and 52-epi-54-deoxyCTX1B were detected in Variola louti and Lutjanus monostigma. The toxin profile distinctly differed from that of a CFP-related fish from Miyazaki, which mainly contained ciguatoxin-3C type toxins. Toxin profiles were species-specific, as observed in fish from Okinawa. The LC-MS/MS and mouse bioassay (MBA) methods produced comparable data, though 54-deoxyCTX1B was not taken into consideration owing to the lack of toxicity data. To improve assessment, toxicity data for this compound are needed. A reef fish caught on the same occasion and judged nontoxic by MBA (<0.025 MU/g) was found to contain low levels of CTX, indicating a potential risk for CFP.

Ciguatera fish poisoning and environmental change: a case for strengthening health surveillance in the Pacific?

Science.gov (United States)

Derne, Bonnie; Fearnley, Emily; Goater, Sarah; Carter, Karen; Weinstein, Philip

2010-09-01

Ciguatera Fish Poisoning (CFP), a significant public health problem in the Pacific, is intrinsically linked to the health of coral reef ecosystems. Incidence data on CFP could therefore be used, in theory, as indicators of disruption to coral reefs. Some disruptions, such as increasing sea surface temperatures, result from global environmental change--therefore suggesting that CFP is likely to become an increasing public health problem in the region. The proactive management of increasing numbers of cases will depend on an understanding of the ecology of the disease, sound health surveillance systems to report cases of CFP including appropriate case definitions, and quantifiable correlations between case numbers and environmental variables. Here, we briefly review the knowledge about these components in Pacific Island Countries and Territories (PICTs), including summarising regional variation in symptoms of CFP cases, investigating media as an enhanced surveillance tool, and summarising regional environmental drivers of CFP cases. We conclude that CFP could be an important indicator of the health of reef ecosystems in the face of global climate change and more novel approaches such as combining environmental and health data, need to be implemented to improve surveillance of CFP.

Hypnosis to alleviate the symptoms of ciguatera toxicity: a case study.

Science.gov (United States)

Laser, Eleanor D; Shenefelt, Philip D

2012-01-01

Ciguatera toxicity is a poisoning from consuming reef fish that had fed on dinoflagellates such as Gambierdiscus toxicus found along coral reefs. The toxin is oil soluble, odorless, colorless, tasteless, heat stable, and is concentrated in larger carnivorous fish such as amberjack, barracuda, eel, grouper, red snapper, sea bass, and Spanish mackerel. Onset of symptoms is usually within 6-12 hours after ingestion. Gastrointestinal symptoms lasting 1-2 days include abdominal pain, nausea, vomiting, and diarrhea. Neurological symptoms may persist for weeks or several months or--rarely--years and include circumoral and extremity paresthesias, temperature sensation reversal, itching, weakness, ataxia, and others. A patient with burning hands and feet who had not found relief using other methods had diagnosis of ciguatera toxicity assisted by hypnotically refreshed memory followed by rapid relief with hypnotic suggestions in 1 session and remained free of symptoms.

Ciguatera fish poisoning and sea surface temperatures in the Caribbean Sea and the West Indies.

Science.gov (United States)

Tester, Patricia A; Feldman, Rebecca L; Nau, Amy W; Kibler, Steven R; Wayne Litaker, R

2010-10-01

Ciguatera fish poisoning (CFP) is a circumtropical disease caused by ingestion of a variety of reef fish that bioaccumulate algal toxins. Distribution and abundance of the organisms that produce these toxins, chiefly dinoflagellates of the genus Gambierdiscus, are reported to correlate positively with water temperature. Consequently, there is growing concern that increasing temperatures associated with climate change could increase the incidence of CFP. This concern prompted experiments on the growth rates of six Gambierdiscus species at temperatures between 18 degrees C and 33 degrees C and the examination of sea surface temperatures in the Caribbean and West Indies for areas that could sustain rapid Gambierdiscus growth rates year-round. The thermal optimum for five of six Gambierdiscus species tested was >/=29 degrees C. Long-term SST data from the southern Gulf of Mexico indicate the number of days with sea surface temperatures >/=29 degrees C has nearly doubled (44 to 86) in the last three decades. To determine how the sea surface temperatures and Gambierdiscus growth data correlate with CFP incidences in the Caribbean, a literature review and a uniform, region-wide survey (1996-2006) of CFP cases were conducted. The highest CFP incidence rates were in the eastern Caribbean where water temperatures are warmest and least variable. Published by Elsevier Ltd.

Linking ciguatera poisoning to spatial ecology of fish: a novel approach to examining the distribution of biotoxin levels in the great barracuda by combining non-lethal blood sampling and biotelemetry.

Science.gov (United States)

O'Toole, Amanda C; Dechraoui Bottein, Marie-Yasmine; Danylchuk, Andy J; Ramsdell, John S; Cooke, Steven J

2012-06-15

Ciguatera in humans is typically caused by the consumption of reef fish that have accumulated Ciguatoxins (CTXs) in their flesh. Over a six month period, we captured 38 wild adult great barracuda (Sphyraena barracuda), a species commonly associated with ciguatera in The Bahamas. We sampled three tissues (i.e., muscle, liver, and blood) and analysed them for the presence of ciguatoxins using a functional in vitro N2A bioassay. Detectable concentrations of ciguatoxins found in the three tissue types ranged from 2.51 to 211.74pg C-CTX-1 equivalents/g. Blood and liver toxin concentrations were positively correlated (ρ=0.86, P=0.003), indicating that, for the first time, blood sampling provides a non-lethal method of detecting ciguatoxin in wild fish. Non-lethal blood sampling also presents opportunities to couple this approach with biotelemetry and biologging techniques that enable the study of fish distribution and movement. To demonstrate the potential for linking ciguatoxin occurrence with barracuda spatial ecology, we also present a proof-of-concept case study where blood samples were obtained from 20 fish before releasing them with acoustic transmitters and tracking them in the coastal waters using a fixed acoustic telemetry array covering 44km(2). Fish that tested positive for CTX may have smaller home ranges than non-toxic fish (median distance travelled, U=2.21, P=0.03). Results presented from this study may help identify high risk areas and source-sink dynamics of toxins, potentially reducing the incidence and human health risk of ciguatera fish poisoning. Moreover, development of the non-lethal sampling approach and measurement of ciguatera from blood provide future opportunities to understand the mechanistic relationship between toxins and the spatial ecology of a broad range of marine fish species. Copyright © 2012 Elsevier B.V. All rights reserved.

Tectus niloticus (Tegulidae, Gastropod) as a Novel Vector of Ciguatera Poisoning: Detection of Pacific Ciguatoxins in Toxic Samples from Nuku Hiva Island (French Polynesia).

Science.gov (United States)

Darius, Hélène Taiana; Roué, Mélanie; Sibat, Manoella; Viallon, Jérôme; Gatti, Clémence Mahana Iti; Vandersea, Mark W; Tester, Patricia A; Litaker, R Wayne; Amzil, Zouher; Hess, Philipp; Chinain, Mireille

2017-12-21

Ciguatera fish poisoning (CFP) is a foodborne disease caused by the consumption of seafood (fish and marine invertebrates) contaminated with ciguatoxins (CTXs) produced by dinoflagellates in the genus Gambierdiscus . The report of a CFP-like mass-poisoning outbreak following the consumption of Tectus niloticus (Tegulidae, Gastropod) from Anaho Bay on Nuku Hiva Island (Marquesas archipelago, French Polynesia) prompted field investigations to assess the presence of CTXs in T. niloticus . Samples were collected from Anaho Bay, 1, 6 and 28 months after this poisoning outbreak, as well as in Taiohae and Taipivai bays. Toxicity analysis using the neuroblastoma cell-based assay (CBA-N2a) detected the presence of CTXs only in Anaho Bay T. niloticus samples. This is consistent with qPCR results on window screen samples indicating the presence of Gambierdiscus communities dominated by the species G. polynesiensis in Anaho Bay. Liquid chromatography-tandem mass spectrometry (LC-MS/MS) analyses revealed that P-CTX-3B was the major congener, followed by P-CTX-3C, P-CTX-4A and P-CTX-4B in toxic samples. Between July 2014 and November 2016, toxin content in T. niloticus progressively decreased, but was consistently above the safety limit recommended for human consumption. This study confirms for the first time T. niloticus as a novel vector of CFP in French Polynesia.

Tectus niloticus (Tegulidae, Gastropod as a Novel Vector of Ciguatera Poisoning: Detection of Pacific Ciguatoxins in Toxic Samples from Nuku Hiva Island (French Polynesia

Directory of Open Access Journals (Sweden)

Hélène Taiana Darius

2017-12-01

Full Text Available Ciguatera fish poisoning (CFP is a foodborne disease caused by the consumption of seafood (fish and marine invertebrates contaminated with ciguatoxins (CTXs produced by dinoflagellates in the genus Gambierdiscus. The report of a CFP-like mass-poisoning outbreak following the consumption of Tectus niloticus (Tegulidae, Gastropod from Anaho Bay on Nuku Hiva Island (Marquesas archipelago, French Polynesia prompted field investigations to assess the presence of CTXs in T. niloticus. Samples were collected from Anaho Bay, 1, 6 and 28 months after this poisoning outbreak, as well as in Taiohae and Taipivai bays. Toxicity analysis using the neuroblastoma cell-based assay (CBA-N2a detected the presence of CTXs only in Anaho Bay T. niloticus samples. This is consistent with qPCR results on window screen samples indicating the presence of Gambierdiscus communities dominated by the species G. polynesiensis in Anaho Bay. Liquid chromatography-tandem mass spectrometry (LC-MS/MS analyses revealed that P-CTX-3B was the major congener, followed by P-CTX-3C, P-CTX-4A and P-CTX-4B in toxic samples. Between July 2014 and November 2016, toxin content in T. niloticus progressively decreased, but was consistently above the safety limit recommended for human consumption. This study confirms for the first time T. niloticus as a novel vector of CFP in French Polynesia.

Prevalence, symptoms and chronicity of ciguatera in New Caledonia: results from an adult population survey conducted in Noumea during 2005.

Science.gov (United States)

Baumann, Francine; Bourrat, Marie-Blanche; Pauillac, Serge

2010-10-01

Ciguatera is a widespread ichthyosarcotoxism which causes gastrointestinal, neurological and cardiovascular disturbances. Investigations conducted by ORSTOM in 1992 highlighted a prevalence of 25% in the adult population of Noumea, New Caledonia. The main objective of our study was to estimate the prevalence of ciguatera and the persistence of symptoms by sex and by ethnicity among adult patients of a nurse clinic in Noumea in 2005. Investigations were conducted from 1st January to 15th June 2005. During this period, 559 patients were included: 165 males and 394 females. Among them, 37.8% were poisoned at least once in their life. This rate was independent of gender and ethnicity, but was significantly higher in age groups above 40 years. Neurological signs were more frequent (>80%) than gastrointestinal (ciguatera prevalence, and its chronicity for 1/5 of European cases. Copyright 2009 Elsevier Ltd. All rights reserved.

Use of Surveillance Systems in Detection of a Ciguatera Fish Poisoning Outbreak - Orange County, Florida, 2014.

Science.gov (United States)

Klekamp, Benjamin G; Bodager, Dean; Matthews, Sarah D

2015-10-16

What is already known on this topic? Ciguatera fish poisoning (CFP), caused by the ingestion of predatory reef-dwelling fish harboring ciguatoxins is one of the most commonly reported fish-associated marine intoxications. Ciguatoxin retains toxicity regardless of freezing or cooking. Prompt treatment can reduce debilitating neurologic symptoms that are associated with CFP.What is added by this report? Syndromic surveillance systems in Florida identified six adults with CFP following consumption of black grouper. Five patients sought medical attention; health care providers did not make a diagnosis of CFP or report the cases to public health authorities, and none of the patients received treatment. Close collaboration among several investigating agencies allowed traceback efforts to link black grouper consumed by all patients to a common international distributor.What are the implications for public health practice? Syndromic surveillance systems capable of detecting CFP are essential public health tools to identify outbreaks and enhance investigations. Medical and public health practitioners should be educated to inquire about recent fish consumption when evaluating patients with clinically compatible signs and symptoms to allow for prompt treatment, and report suspected CFP cases to public health authorities to facilitate source-food traceback efforts. Public education on avoidance of consumption of relatively large predatory reef fish species known to be from ciguatoxic-endemic areas might reduce the risk for CFP.

Critical issues in the development of health information systems in supporting environmental health: a case study of ciguatera.

Science.gov (United States)

Goater, Sarah; Derne, Bonnie; Weinstein, Philip

2011-05-01

Emerging environmental pressures resulting from climate change and globalization challenge the capacity of health information systems (HIS) in the Pacific to inform future policy and public health interventions. Ciguatera, a globally common marine food-borne illness, is used here to illustrate specific HIS challenges in the Pacific and how these might be overcome proactively to meet the changing surveillance needs resulting from environmental change. We review and highlight inefficiencies in the reactive nature of existing HIS in the Pacific to collect, collate, and communicate ciguatera fish poisoning data currently used to inform public health intervention. Further, we review the capacity of existing HIS to respond to new data needs associated with shifts in ciguatera disease burden likely to result from coral reef habitat disruption. Improved knowledge on the ecological drivers of ciguatera prevalence at local and regional levels is needed, combined with enhanced surveillance techniques and data management systems, to capture environmental drivers as well as health outcomes data. The capacity of public HIS to detect and prevent future outbreaks is largely dependent on the future development of governance strategies that promote proactive surveillance and health action. Accordingly, we present an innovative framework from which to stimulate scientific debate on how this might be achieved by using existing larger scale data sets and multidisciplinary collaborations.

Epidemiology of Ciguatera in Florida.

Science.gov (United States)

Radke, Elizabeth G; Reich, Andrew; Morris, John Glenn

2015-08-01

Ciguatera is the most commonly reported marine food-borne illness worldwide. Because there is a biological plausibility that ciguatera may be impacted by long-term climate variability and Florida is on the northern border of the geographic distribution of ciguatera, it is important to update our understanding of its epidemiology in Florida. We performed an analysis of 291 reports in Florida from 2000 to 2011 and an e-mail survey of 5,352 recreational fishers to estimate incidence and underreporting and identify high risk demographic groups, fish types, and catch locations. Incidence was 5.6 per 100,000 adjusted for underreporting. Hispanics had the highest incidence rate (relative risk [RR] = 3.4) and were more likely to eat barracuda than non-Hispanics. The most common catch locations for ciguatera-causing fish were the Bahamas and Florida Keys. Cases caused by fish from northern Florida were infrequent. These results indicate that ciguatera incidence is higher than estimated from public health reports alone. There is little evidence that incidence or geographic range has increased because of increased seawater temperatures since earlier studies. © The American Society of Tropical Medicine and Hygiene.

Socioeconomic impacts and management ciguatera in the Pacific.

Science.gov (United States)

Lewis, R J

1992-01-01

The inshore fisheries resource is important to the health and culture of many of the inhabitants of Pacific Island countries (PIC). Ciguateric fishes (mainly demersal reef fishes) cause a range of distressing and often debilitating gastrointestinal neurological and cardiovascular disturbances. Consequently, ciguatera limits the utilisation of this otherwise over-exploited resource. For many victims, the symptoms suffered during the chronic phase of ciguatera (lasting weeks, months and occasionally years) are exacerbated upon consumption of certain foods, particularly non-toxic fishes. After each outbreak, victims and members of their social-network experience a transient increase in perception of the risk of eating reef fish. The impact of ciguatera is greatest in atoll island countries where fish is the primary source of protein (it also has a major impact and to facilitate the management of ciguatera in PIC, regular information is required that quantifies: (i) the true incidence of ciguatera; (ii) the extent and way in which different communities avoid ciguatera; and (iii) the adverse impact ciguatera has on health, the workforce, trade and tourism. Over the last 15 years (based on SPEHIS data to 1990), some countries recorded a decrease in the ciguatera problem (New Caledonia, Marshall Is.), other countries an increase (Kirbati, Tuvalu, French Polynesia), while still other countries recorded an increase followed by a decrease in ciguatera (Tokelau, American Samoa, Western Samoa, Fiji and Vanuatu). There may also be seasonal trends in the incidence of ciguatera in some countries e.g. Fiji. Management options presently implementable in PIC include: (i) treatment with i.v. mannitol; (ii) provision of timely advise on the location and status of ciguatera "hot spots" in each country that would allow affected communities to react objectively to the risk posed by ciguatera; and (iii) modification of human behaviour and aspirations to reduce the impact of increasing

Contribution to the risk characterization of ciguatoxins: LOAEL estimated from eight ciguatera fish poisoning events in Guadeloupe (French West Indies)

International Nuclear Information System (INIS)

Hossen, Virginie; Soliño, Lucia; Leroy, Patricia; David, Eric; Velge, Pierre; Dragacci, Sylviane; Krys, Sophie; Flores Quintana, Harold; Diogène, Jorge

2015-01-01

From 2010 to 2012, 35 ciguatera fish poisoning (CFP) events involving 87 individuals who consumed locally-caught fish were reported in Guadeloupe (French West Indies). For 12 of these events, the presence of ciguatoxins (CTXs) was indicated in meal remnants and in uncooked fish by the mouse bioassay (MBA). Caribbean ciguatoxins (C-CTXs) were confirmed by liquid chromatography–tandem mass spectrometry (LC–MS/MS) analysis. Using a cell-based assay (CBA), and the only available standard Pacific ciguatoxin-1 (P-CTX-1), the lowest toxins level detected in fish samples causing CFP was 0.022 µg P-CTX-1 equivalent (eq.)·kg −1 fish. Epidemiological and consumption data were compiled for most of the individuals afflicted, and complete data for establishing the lowest observable adverse effects level (LOAEL) were obtained from 8 CFP events involving 21 individuals. Based on toxin intakes, the LOAEL was estimated at 4.2 ng P-CTX-1 eq./individual corresponding to 48.4 pg P-CTX-1 eq. kg −1 body weight (bw). Although based on limited data, these results are consistent with the conclusions of the European Food Safety Authority (EFSA) opinion which indicates that a level of 0.01 µg P-CTX-1 eq. kg −1 fish, regardless of source, should not exert effects in sensitive individuals when consuming a single meal. The calculated LOAEL is also consistent with the U.S. Food and Drug Administration guidance levels for CTXs (0.1 µg C-CTX-1 eq. kg −1 and 0.01 µg P-CTX-1 eq. kg −1 fish). - Highlights: • We report on an epidemiological study on Ciguatera events in the French West Indies. • The collection of consumption data allows for the first time the LOAEL determination. • The LOAEL for ciguatoxins was established at 48.4 pg P-CTX-1 eq. kg −1 bw. • LC–MS/MS provided structural confirmation of C-CTX1 in two suspected samples • Neuro-2A CBA is suitable for assessing composite toxicity levels in fish samples.

Two clusters of ciguatera fish poisoning in Paris, France, related to tropical fish imported from the French Caribbean by travelers.

Science.gov (United States)

Epelboin, Loïc; Pérignon, Alice; Hossen, Virginie; Vincent, Renaud; Krys, Sophie; Caumes, Eric

2014-01-01

Ciguatera fish poisoning (CFP) is a food-borne illness due to the consumption of reef fish containing pathogenic toxins. CFP is endemic to tropical areas and may be described in travelers in non-endemic areas. We describe two clusters of autochthonous cases of CFP in Paris, France. They were related to two fish caught in Guadeloupe (French West Indies) and consumed in Paris after being air-transported in a cooler. In both cases, fish flesh was analyzed and the presence of ciguatoxins by mouse bioassay (MBA) was confirmed. The first cluster involved eight individuals among whom five presented gastrointestinal symptoms and four presented neurological symptoms after consuming barracuda flesh (Sphyraena barracuda). The second cluster involved a couple who consumed a grey snapper (Lutjanus griseus). Most of them consulted at different emergency departments in the region of Paris. CFP may be seen in non-traveler patients outside endemic countries resulting from imported species of fish. Thus, CFP may be undiagnosed as physicians are not aware of this tropical disease outside endemic countries. The detection of ciguatoxins by MBA in the French National Reference Laboratory is useful in the confirmation of the diagnosis. © 2014 International Society of Travel Medicine.

Ciguatera fish poisoning: A first epidemic in Germany highlights an increasing risk for European countries

OpenAIRE

Mattei, César; Vetter, Irina; Eisenblätter, Anneka; Krock, Bernd; Ebbecke, Martin; Desel, Herbert; Zimmermann, Katharina

2014-01-01

Toxin-producing microalgae are thriving worldwide due to coral reef destruction and global warming with major consequences on ecosystems, international trade and human health. Microalgae belonging to the family of flagellate protists, in particular dinoflagellates, secrete a variety of high-molecular-weight polyether toxins that accumulate through the marine food chain to cause disease in humans by acting as sodium channel activator toxins; ciguatera is the most frequent seafood-borne illness...

Contribution to the risk characterization of ciguatoxins: LOAEL estimated from eight ciguatera fish poisoning events in Guadeloupe (French West Indies)

Energy Technology Data Exchange (ETDEWEB)

Hossen, Virginie [Université Paris-Est, ANSES-Laboratory for Food Safety, National Reference Laboratory for the Control of Marine biotoxins, 14 rue Pierre et Marie Curie, 94701 Maisons-Alfort (France); Soliño, Lucia [Institut de Recerca i Tecnologia Agroalimentàries (IRTA), Ctra. Poble Nou km 5.5, Sant Carles de la Rapita (Spain); Leroy, Patricia [Université Paris-Est, ANSES-Laboratory for Food Safety, National Reference Laboratory for the Control of Marine biotoxins, 14 rue Pierre et Marie Curie, 94701 Maisons-Alfort (France); David, Eric [Ministry of Agriculture, Direction de l’Alimentation de l’Agriculture et de la Forêt de Guadeloupe, Abymes (France); Velge, Pierre [Ministry of Agriculture, General Directorate for Food, Paris (France); Dragacci, Sylviane, E-mail: Sylviane.dragacci@anses.fr [Université Paris-Est, ANSES-Laboratory for Food Safety, National Reference Laboratory for the Control of Marine biotoxins, 14 rue Pierre et Marie Curie, 94701 Maisons-Alfort (France); Krys, Sophie [Université Paris-Est, ANSES-Laboratory for Food Safety, National Reference Laboratory for the Control of Marine biotoxins, 14 rue Pierre et Marie Curie, 94701 Maisons-Alfort (France); Flores Quintana, Harold [U.S. Food and Drug Administration (FDA), Division of Seafood Science and Technology, Gulf Coast Seafood Laboratory, 1 Iberville Drive, Dauphin Island, AL 36528 (United States); Diogène, Jorge [Institut de Recerca i Tecnologia Agroalimentàries (IRTA), Ctra. Poble Nou km 5.5, Sant Carles de la Rapita (Spain)

2015-11-15

From 2010 to 2012, 35 ciguatera fish poisoning (CFP) events involving 87 individuals who consumed locally-caught fish were reported in Guadeloupe (French West Indies). For 12 of these events, the presence of ciguatoxins (CTXs) was indicated in meal remnants and in uncooked fish by the mouse bioassay (MBA). Caribbean ciguatoxins (C-CTXs) were confirmed by liquid chromatography–tandem mass spectrometry (LC–MS/MS) analysis. Using a cell-based assay (CBA), and the only available standard Pacific ciguatoxin-1 (P-CTX-1), the lowest toxins level detected in fish samples causing CFP was 0.022 µg P-CTX-1 equivalent (eq.)·kg{sup −1} fish. Epidemiological and consumption data were compiled for most of the individuals afflicted, and complete data for establishing the lowest observable adverse effects level (LOAEL) were obtained from 8 CFP events involving 21 individuals. Based on toxin intakes, the LOAEL was estimated at 4.2 ng P-CTX-1 eq./individual corresponding to 48.4 pg P-CTX-1 eq. kg{sup −1} body weight (bw). Although based on limited data, these results are consistent with the conclusions of the European Food Safety Authority (EFSA) opinion which indicates that a level of 0.01 µg P-CTX-1 eq. kg{sup −1} fish, regardless of source, should not exert effects in sensitive individuals when consuming a single meal. The calculated LOAEL is also consistent with the U.S. Food and Drug Administration guidance levels for CTXs (0.1 µg C-CTX-1 eq. kg{sup −1} and 0.01 µg P-CTX-1 eq. kg{sup −1} fish). - Highlights: • We report on an epidemiological study on Ciguatera events in the French West Indies. • The collection of consumption data allows for the first time the LOAEL determination. • The LOAEL for ciguatoxins was established at 48.4 pg P-CTX-1 eq. kg{sup −1} bw. • LC–MS/MS provided structural confirmation of C-CTX1 in two suspected samples • Neuro-2A CBA is suitable for assessing composite toxicity levels in fish samples.

The prevalence of benthic dinoflagellates associated with ciguatera fish poisoning in the central Red Sea.

Science.gov (United States)

Catania, Daniela; Richlen, Mindy L; Mak, Yim Ling; Morton, Steve L; Laban, Elizabeth H; Xu, Yixiao; Anderson, Donald M; Chan, Leo Lai; Berumen, Michael L

2017-09-01

This study confirms the presence of the toxigenic benthic dinoflagellates Gambierdiscus belizeanus and Ostreopsis spp. in the central Red Sea. To our knowledge, this is also the first report of these taxa in coastal waters of Saudi Arabia, indicating the potential occurrence of ciguatera fish poisoning (CFP) in that region. During field investigations carried out in 2012 and 2013, a total of 100 Turbinaria and Halimeda macroalgae samples were collected from coral reefs off the Saudi Arabian coast and examined for the presence of Gambierdiscus and Ostreopsis, two toxigenic dinoflagellate genera commonly observed in coral reef communities around the world. Both Gambierdiscus and Ostreopsis spp. were observed at low densities (weight algae). Cell densities of Ostreopsis spp. were significantly higher than Gambierdiscus spp. at most of the sampling sites, and abundances of both genera were negatively correlated with seawater salinity. To assess the potential for ciguatoxicity in this region, several Gambierdiscus isolates were established in culture and examined for species identity and toxicity. All isolates were morphologically and molecularly identified as Gambierdiscus belizeanus. Toxicity analysis of two isolates using the mouse neuroblastoma cell-based assay for ciguatoxins (CTX) confirmed G. belizeanus as a CTX producer, with a maximum toxin content of 6.50±1.14×10 -5 pg P-CTX-1 eq. cell -1 . Compared to Gambierdiscus isolates from other locations, these were low toxicity strains. The low Gambierdiscus densities observed along with their comparatively low toxin contents may explain why CFP is unidentified and unreported in this region. Nevertheless, the presence of these potentially toxigenic dinoflagellate species at multiple sites in the central Red Sea warrants future study on their possible effects on marine food webs and human health in this region. Copyright © 2017 Elsevier B.V. All rights reserved.

The prevalence of benthic dinoflagellates associated with ciguatera fish poisoning in the central Red Sea

KAUST Repository

Catania, Daniela

2017-09-09

This study confirms the presence of the toxigenic benthic dinoflagellates Gambierdiscus belizeanus and Ostreopsis spp. in the central Red Sea. To our knowledge, this is also the first report of these taxa in coastal waters of Saudi Arabia, indicating the potential occurrence of ciguatera fish poisoning (CFP) in that region. During field investigations carried out in 2012 and 2013, a total of 100 Turbinaria and Halimeda macroalgae samples were collected from coral reefs off the Saudi Arabian coast and examined for the presence of Gambierdiscus and Ostreopsis, two toxigenic dinoflagellate genera commonly observed in coral reef communities around the world. Both Gambierdiscus and Ostreopsis spp. were observed at low densities (<200 cells g−1 wet weight algae). Cell densities of Ostreopsis spp. were significantly higher than Gambierdiscus spp. at most of the sampling sites, and abundances of both genera were negatively correlated with seawater salinity. To assess the potential for ciguatoxicity in this region, several Gambierdiscus isolates were established in culture and examined for species identity and toxicity. All isolates were morphologically and molecularly identified as Gambierdiscus belizeanus. Toxicity analysis of two isolates using the mouse neuroblastoma cell-based assay for ciguatoxins (CTX) confirmed G. belizeanus as a CTX producer, with a maximum toxin content of 6.50±1.14×10−5pg P-CTX-1 eq. cell−1. Compared to Gambierdiscus isolates from other locations, these were low toxicity strains. The low Gambierdiscus densities observed along with their comparatively low toxin contents may explain why CFP is unidentified and unreported in this region. Nevertheless, the presence of these potentially toxigenic dinoflagellate species at multiple sites in the central Red Sea warrants future study on their possible effects on marine food webs and human health in this region.

Ciguatera caused by consumption of humphead wrasse.

Science.gov (United States)

Chan, Thomas Y K

2013-12-15

Humphead wrasse (Cheilinus undulatus) is an apex predator from coral reefs of the Indo-Pacific region. A food surveillance project using a validated mouse bioassay revealed the presence of ciguatoxins in significantly greater amounts in its flesh than in groupers and other coral reef fishes commonly available in Hong Kong wholesale market. Humphead wrasse has long been known to cause ciguatera, but there was a lack of clinical reports. A 45-year-old woman developed ciguatera after eating humphead wrasse. She required ICU care and infusions of intravenous fluids and dopamine for management of severe hypotension. All 5 published case series are also reviewed to characterise the types, severity and chronicity of ciguatera symptoms after its consumption. In addition to the gastrointestinal, neurological and other features that were typical of ciguatera, some subjects developed sinus bradycardia, hypotension, shock, neuropsychiatric features (e.g. mental exhaustion, depression, insomnia and memory loss), other central nervous system symptoms (e.g. coma, convulsions and ataxia) and myocardial ischaemia. Other subjects still experienced residual symptoms 6 months later; these were mainly neurological or neuropsychiatric complaints and skin pruritus. To prevent ciguatera, the public should avoid eating humphead wrasse and other large coral reef fishes. They should realise that consumption of the high-risk fish may result in more severe and chronic illness, including life-threatening complications and neuropsychiatric features. Copyright © 2013 Elsevier Ltd. All rights reserved.

Ability of certain plant extracts traditionally used to treat ciguatera fish poisoning to inhibit nitric oxide production in RAW 264.7 macrophages.

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Kumar-Roiné, Shilpa; Matsui, Mariko; Reybier, Karine; Darius, Hélène Taiana; Chinain, Mireille; Pauillac, Serge; Laurent, Dominique

2009-06-25

Ciguatera fish poisoning (CFP) is an intertropical ichthyosarcotoxism that manifests in complex assortment of symptoms in humans. Ciguatoxins (CTXs), issued from Gambierdicus spp., are causative agents of this intoxication. We have recently demonstrated that a Pacific CTX (P-CTX-1B) strongly modulated iNOS expression, leading to overproduction of nitric oxide (NO) in RAW 264.7 murine macrophage cells. NO produced in large amounts is involved in a wide range of pathophysiological processes. Many traditional remedies are commonly used in the Pacific against CFP. In this context, bioassay-guided screening was carried out to study NO inhibiting capacity of 28 selected plant extracts. We prepared aqueous extracts of plants used in New Caledonia in the treatment of CFP and screened their NO inhibitory activity in lipopolysaccharide (LPS)-activated RAW 264.7 macrophages. Among 28 plants tested, Euphorbia hirta (Euphorbiaceae), Syzygium malaccense (Myrtaceae), Schinus terebenthifolius (Anacardiaceae), Punica granatum (Punicaceae), Cerbera manghas (Apocynaceae), Vitex trifolia (Labiateae) and Ximenia americana (Olacaceae) showed inhibitory activity, validating their use as traditional remedies in CFP, and the potential for use in the treatment of conditions accompanied by NO overproduction. These plants are promising candidates for further screening of their active compounds through activity-guided fractionation.

The Epiphytic Genus Gambierdiscus (Dinophyceae) in the Kermadec Islands and Zealandia Regions of the Southwestern Pacific and the Associated Risk of Ciguatera Fish Poisoning.

Science.gov (United States)

Rhodes, Lesley L; Smith, Kirsty F; Murray, Sam; Harwood, D Tim; Trnski, Tom; Munday, Rex

2017-07-11

Species in the genus Gambierdiscus produce ciguatoxins (CTXs) and/or maitotoxins (MTXs), which may cause ciguatera fish poisoning (CFP) in humans if contaminated fish are consumed. Species of Gambierdiscus have previously been isolated from macroalgae at Rangitahua (Raoul Island and North Meyer Islands, northern Kermadec Islands), and the opportunity was taken to sample for Gambierdiscus at the more southerly Macauley Island during an expedition in 2016. Gambierdiscus cells were isolated, cultured, and DNA extracted and sequenced to determine the species present. Bulk cultures were tested for CTXs and MTXs by liquid chromatography-mass spectrometry (LC-MS/MS). The species isolated were G. australes , which produced MTX-1 (ranging from 3 to 36 pg/cell), and G. polynesiensis , which produced neither MTX-1 nor, unusually, any known CTXs. Isolates of both species produced putative MTX-3. The risk of fish, particularly herbivorous fish, causing CFP in the Zealandia and Kermadec Islands region is real, although in mainland New Zealand the risk is currently low. Both Gambierdiscus and Fukuyoa have been recorded in the sub-tropical northern region of New Zealand, and so the risk may increase with warming seas and shift in the distribution of Gambierdiscus species.

The Epiphytic Genus Gambierdiscus (Dinophyceae in the Kermadec Islands and Zealandia Regions of the Southwestern Pacific and the Associated Risk of Ciguatera Fish Poisoning

Directory of Open Access Journals (Sweden)

Lesley L. Rhodes

2017-07-01

Full Text Available Species in the genus Gambierdiscus produce ciguatoxins (CTXs and/or maitotoxins (MTXs, which may cause ciguatera fish poisoning (CFP in humans if contaminated fish are consumed. Species of Gambierdiscus have previously been isolated from macroalgae at Rangitahua (Raoul Island and North Meyer Islands, northern Kermadec Islands, and the opportunity was taken to sample for Gambierdiscus at the more southerly Macauley Island during an expedition in 2016. Gambierdiscus cells were isolated, cultured, and DNA extracted and sequenced to determine the species present. Bulk cultures were tested for CTXs and MTXs by liquid chromatography-mass spectrometry (LC-MS/MS. The species isolated were G. australes, which produced MTX-1 (ranging from 3 to 36 pg/cell, and G. polynesiensis, which produced neither MTX-1 nor, unusually, any known CTXs. Isolates of both species produced putative MTX-3. The risk of fish, particularly herbivorous fish, causing CFP in the Zealandia and Kermadec Islands region is real, although in mainland New Zealand the risk is currently low. Both Gambierdiscus and Fukuyoa have been recorded in the sub-tropical northern region of New Zealand, and so the risk may increase with warming seas and shift in the distribution of Gambierdiscus species.

Severe bradycardia and prolonged hypotension in ciguatera.

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Chan, Thomas Yan Keung

2013-06-01

Ciguatera results when ciguatoxin-contaminated coral reef fish from tropical or subtropical waters are consumed. The clinical features that present in affected persons are mainly gastrointestinal, neurological, general, and much less commonly, cardiovascular. We report the case of a 50-year-old man who developed the characteristic combination of acute gastrointestinal and neurological symptoms after the consumption of an unidentified coral reef fish head. In addition to those symptoms, he developed dizziness, severe bradycardia (46 bpm) and prolonged hypotension, which required the administration of intravenous atropine and over three days of intravenous fluid replacement with dopamine infusion. Patients with ciguatera can develop severe bradycardia and prolonged hypotension. Physicians should recognise the possible cardiovascular complications of ciguatera and promptly initiate treatment with intravenous atropine, intravenous fluid replacement and inotropic therapy if such complications are observed.

Assessing the incidence of ciguatera fish poisoning with two surveys conducted in Culebra, Puerto Rico, during 2005 and 2006.

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Azziz-Baumgartner, Eduardo; Luber, George; Conklin, Laura; Tosteson, Thomas R; Granade, Hudson R; Dickey, Robert W; Backer, Lorraine C

2012-04-01

Although ciguatera fish poisoning (CFP) is the most common seafood intoxication worldwide, its burden has been difficult to establish because there are no biomarkers to diagnose human exposure. We explored the incidence of CFP, percentage of CFP case-patients with laboratory-confirmed ciguatoxic meal remnants, cost of CFP illness, and potential risk factors for CFP. During 2005 and again during 2006, we conducted a census of all occupied households on the island of Culebra, Puerto Rico, where locally caught fish are a staple food. We defined CFP case-patients as persons with gastrointestinal symptoms (abdominal pain, vomiting, diarrhea, or nausea) and neurological symptoms (extremity paresthesia, arthralgia, myalgia, malaise, pruritus, headache, dizziness, metallic taste, visual disturbance, circumoral paresthesia, temperature reversal, or toothache) or systemic symptoms (e.g., bradycardia) within 72 hr of eating fish during the previous year. Participants were asked to save fish remnants eaten by case-patients for ciguatoxin analysis at the Food and Drug Administration laboratory in Dauphin Island, Alabama (USA). We surveyed 340 households during 2005 and 335 households during 2006. The estimated annual incidence of possible CFP was 4.0 per 1,000 person-years, and that of probable CFP was 7.5 per 1,000 person-years. One of three fish samples submitted by probable case-patients was positive for ciguatoxins. None of the case-patients required respiratory support. Households that typically consumed barracuda were more likely to report CFP (p = 0.02). Our estimates, which are consistent with previous studies using similar case findings, contribute to the overall information available to support public health decision making about CFP prevention.

Association of cardiac disease and alcohol use with the development of severe ciguatera.

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Radke, Elizabeth G; Grattan, Lynn M; Morris, John Glenn

2013-12-01

Ciguatera is a foodborne illness that causes severe gastrointestinal and neurologic symptoms, but the risk factors for illness are not well established. In St Thomas, US Virgin Islands, we performed a case-control study for ciguatera, enrolling 47 patients primarily through the emergency department and 141 age- and sex-matched controls identified through an island-wide survey. We used conditional logistic regression to assess health-related risk factors for ciguatera, including comorbidities and alcohol and tobacco use. Cases were more likely than controls to report alcohol consumption at least weekly (odds ratio 5.7, 95% confidence interval 2.7-24.8). Cases also more frequently had a history of heart disease (odds ratio 6.3, 95% confidence interval 1.2-32.7). Previous ciguatera episodes, lower levels of education, and frequent fish consumption also were associated with illness. This study provides preliminary evidence that preexisting health status influences an individual's risk of developing severe ciguatera. There may be a benefit to educating high-risk individuals about preventing ciguatera.

Emergence and epidemiology of ciguatera in the coastal cities of southern China.

Science.gov (United States)

Chan, Thomas Y K

2015-03-02

In the present review of 23 published case studies, the main objective is to report the emergence and epidemiology of ciguatera in the coastal cities of southern China. There was a sudden surge in ciguatera outbreaks in 2004. Ciguatera mostly occurred in the Guangdong Province. In Shenzhen, the incidence of ciguatera in 2004 was estimated to be over 7.5 per million people. In Foshan and Zhongshan, three large outbreaks each affecting over 100-200 subjects (caused by tiger grouper served at banquets) accounted for the much higher incidence of ciguatera in 2004 (>48.7 and >129.9 per million people). Humphead wrasse and areolated coral grouper were the other important ciguatoxic fish. In some subjects, risk factors for increased likelihood of (severe) ciguatera were present, namely concomitant alcohol consumption and ingestion of large reef fishes and CTX-rich fish parts. To prevent large outbreaks and severe illness, large apex predators from coral reefs should never be served at banquets and the public should realize the increased risk of severe symptoms due to ingestion of CTX-rich fish parts with alcohol. The systematic collection of accurate details, implementation of risk assessment process and continuing education for the public on prevention are of obvious importance.

Emergence and Epidemiology of Ciguatera in the Coastal Cities of Southern China

Directory of Open Access Journals (Sweden)

Thomas Y. K. Chan

2015-03-01

Full Text Available In the present review of 23 published case studies, the main objective is to report the emergence and epidemiology of ciguatera in the coastal cities of southern China. There was a sudden surge in ciguatera outbreaks in 2004. Ciguatera mostly occurred in the Guangdong Province. In Shenzhen, the incidence of ciguatera in 2004 was estimated to be over 7.5 per million people. In Foshan and Zhongshan, three large outbreaks each affecting over 100–200 subjects (caused by tiger grouper served at banquets accounted for the much higher incidence of ciguatera in 2004 (>48.7 and >129.9 per million people. Humphead wrasse and areolated coral grouper were the other important ciguatoxic fish. In some subjects, risk factors for increased likelihood of (severe ciguatera were present, namely concomitant alcohol consumption and ingestion of large reef fishes and CTX-rich fish parts. To prevent large outbreaks and severe illness, large apex predators from coral reefs should never be served at banquets and the public should realize the increased risk of severe symptoms due to ingestion of CTX-rich fish parts with alcohol. The systematic collection of accurate details, implementation of risk assessment process and continuing education for the public on prevention are of obvious importance.

Contribution to the risk characterization of ciguatoxins: LOAEL estimated from eight ciguatera fish poisoning events in Guadeloupe (French West Indies).

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Hossen, Virginie; Soliño, Lucia; Leroy, Patricia; David, Eric; Velge, Pierre; Dragacci, Sylviane; Krys, Sophie; Flores Quintana, Harold; Diogène, Jorge

2015-11-01

From 2010 to 2012, 35 ciguatera fish poisoning (CFP) events involving 87 individuals who consumed locally-caught fish were reported in Guadeloupe (French West Indies). For 12 of these events, the presence of ciguatoxins (CTXs) was indicated in meal remnants and in uncooked fish by the mouse bioassay (MBA). Caribbean ciguatoxins (C-CTXs) were confirmed by liquid chromatography-tandem mass spectrometry (LC-MS/MS) analysis. Using a cell-based assay (CBA), and the only available standard Pacific ciguatoxin-1 (P-CTX-1), the lowest toxins level detected in fish samples causing CFP was 0.022 µg P-CTX-1 equivalent (eq.)·kg(-1) fish. Epidemiological and consumption data were compiled for most of the individuals afflicted, and complete data for establishing the lowest observable adverse effects level (LOAEL) were obtained from 8 CFP events involving 21 individuals. Based on toxin intakes, the LOAEL was estimated at 4.2 ng P-CTX-1 eq./individual corresponding to 48. 4 pg P-CTX-1 eq.kg(-1) body weight (bw). Although based on limited data, these results are consistent with the conclusions of the European Food Safety Authority (EFSA) opinion which indicates that a level of 0.01 µg P-CTX-1 eq.kg(-1) fish, regardless of source, should not exert effects in sensitive individuals when consuming a single meal. The calculated LOAEL is also consistent with the U.S. Food and Drug Administration guidance levels for CTXs (0.1 µg C-CTX-1 eq.kg(-1) and 0.01 µg P-CTX-1 eq.kg(-1) fish). Copyright © 2015 Elsevier Inc. All rights reserved.

[Advance on study development of detection of ciguatoxins].

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Yuan, Jianhui; Zhao, Kunshan; Zhuang, Zhixiong

2007-11-01

Ciguatoxin may be a terrible coral fish toxin that can result in poisoning in people who eat fish containing ciguatoxin. Being lack of a convenient and accurate detection method for ciguatoxin, Ciguatera fish poisoning have occurred from time to time. To provide references for detection and prevention of ciguatera fish poisoning, in this paper, the current detection methods of ciguatoxin were reviewed.

The Prevalence of Benthic Dinoflagellates Associated with Ciguatera in the Central Red Sea

KAUST Repository

Catania, Daniela

2012-12-01

This study confirms the presence of Gambierdiscus sp., Ostreopsis sp. as well as other epiphytic benthic dinoflagellates associated with Ciguatera Fish Poisoning (CFP) in the Central Red Sea, highlighting the potential occurrence of CFP in this region. These species are reported for the first time in Saudi Arabian coastal waters. A total of 80 Turbinaria and Halimeda macroalgae samples were collected from coral reefs off the Saudi Arabian coast. Sample analyses indicated low average cell abundances (< 40 cells g-1 wet weight algae) of Gambierdiscus sp. and Ostreopsis sp. Subsequent statistical analyses indicated a significant difference in the cell abundances of both genera between sampling sites, between species and between inshore and offshore reefs. The presence of several potentially toxigenic dinoflagellate species in the Red Sea and the statistical differences in abundances between different sampling sites merits future study on possible impacts of these dinoflagellates on marine food webs and human health.

Bomb tests attack the food chain

Energy Technology Data Exchange (ETDEWEB)

Ruff, T. (Monash Medical School, Melbourne (Australia))

1990-03-01

Ciguatera poisoning, the most common type of fish poisoning in the world, has become a major public health problem in some parts of the South Pacific. This area has always been the site of periodic outbreaks, especially after severe storms or natural disasters that damage core reefs. But since World War II it has become evident that military activities and major construction projects that wreak havoc on corals also lead to ciguatera outbreaks. Extraordinarily high rates of ciguatera poisoning have occurred on the small Pacific islands that have been used for nuclear tests and on the islands that host the military infrastructures and activities that accompany the tests. This is true for both the Marshall Islands near Bikini and Eniwetok, where U.S. tests took place, and in French Polynesia, in the area around Moruroa Atoll where the French government continues to test. Ciguatera poisoning has a disastrous effect on people who depend on fishing as a way of life and on fish as the major source of protein. 10 refs.

Defining the neurotoxin derived illness chronic ciguatera using markers of chronic systemic inflammatory disturbances: a case/control study.

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Shoemaker, Ritchie C; House, Dennis; Ryan, James C

2010-01-01

Ciguatoxins are extremely potent neurotoxins, produced by tropical marine dinoflagellates, that persistently enter into our food web. Over 100,000 people annually experience acute ciguatera poisoning from consuming toxic fish. Roughly 5% of these victims will develop chronic ciguatera (CC), a widespread, multisymptom, multisystem, chronic illness that can last tens of years. CC is marked by disproportionate disability and non-specific refractory symptoms such as fatigue, cognitive deficits and pain, and is suggestive of other illnesses. Its unknown pathophysiology makes both diagnosis and treatment difficult. We wanted to compare objective parameters of visual contrast sensitivity testing, measures of innate immune response and genetic markers in cases to controls to assess the potential for the presence of persistent inflammatory parameters that are demonstrated in other biotoxin associated illnesses at a single specialty clinic. Using 59 CC cases and 59 controls we present in retrospective review, in all cases, abnormalities in immune responses paralleling the chronic systemic inflammatory response syndrome seen in several other chronic diseases. This study defines a preliminary case definition using medical history, total symptoms, visual contrast sensitivity, HLA DR genotype analysis, reduction of regulatory neuropeptides VIP and MSH, and multiple measures of inflammatory immune response, especially C4a and TGFβ1, thereby providing a basis for identification and targeted therapy. CC provides a model for chronic human illness associated with initiation of inflammatory responses by biologically produced neurotoxins. Copyright © 2010 Elsevier Inc. All rights reserved.

Draft Environmental Impact Statement. Proposed Actions at U.S. Army Kwajalein Atoll

Science.gov (United States)

1989-06-01

activities have been implicated as causes for in- creased incidence and outbreaks of ciguatera fish poisoning that have occurred at some of the same... ciguatera is more toxic to mammals, including man (Withers, 1982). Con- siderable research has been done by the Japanese and French on the causes...symptoms, and distribution of ciguatera , especially in French Polynesia, where it is particularly prevalent. Cases of ciguatera have been reported among

Ciguatera risk management in French Polynesia: the case study of Raivavae Island (Australes Archipelago).

Science.gov (United States)

Chinain, Mireille; Darius, H Taiana; Ung, André; Fouc, Mote Tchou; Revel, Taina; Cruchet, Philippe; Pauillac, Serge; Laurent, Dominique

2010-10-01

Based on epidemiological data available through long-term monitoring surveys conducted by both the Public Health Directorate and the Louis Malardé Institute, ciguatera is highly endemic in French Polynesia, most notably in Raivavae (Australes) which appears as a hot spot of ciguatera with an average incidence rate of 140 cases/10,000 population for the period 2007-2008. In order to document the ciguatera risk associated with Raivavae lagoon, algal and toxin-based field monitoring programs were conducted in this island from April 2007 to May 2008. Practically, the distribution, abundance and toxicity of Gambierdiscus populations, along with the toxicity levels in 160 fish distributed within 25 distinct species, were assessed in various sampling locations. Herbivores such as Scarids (parrotfish) and Acanthurids (unicornfish) were rated as high-risk species based on receptor-binding assay toxicity data. A map of the risk stratification within the Raivavae lagoon was also produced, which indicates that locations where both natural and man-made disturbances have occurred remained the most susceptible to CFP incidents. Our findings also suggest that, locally, the traditional knowledge about ciguatera may not be scientifically complete but is functionally correct. Community education resulted in self-regulating behaviour towards avoidance of high-risk fish species and fishing locations. Copyright 2009 Elsevier Ltd. All rights reserved.

Effect of ciguatoxin 3C on voltage-gated Na+ and K+ currents in mouse taste cells.

Science.gov (United States)

Ghiaroni, Valeria; Fuwa, Haruhiko; Inoue, Masayuki; Sasaki, Makoto; Miyazaki, Keisuke; Hirama, Masahiro; Yasumoto, Takeshi; Rossini, Gian Paolo; Scalera, Giuseppe; Bigiani, Albertino

2006-09-01

The marine dinoflagellate Gambierdiscus toxicus produces highly lipophilic, polycyclic ether toxins that cause a seafood poisoning called ciguatera. Ciguatoxins (CTXs) and gambierol represent the two major causative agents of ciguatera intoxication, which include taste alterations (dysgeusiae). However, information on the mode of action of ciguatera toxins in taste cells is scarce. Here, we have studied the effect of synthetic CTX3C (a CTX congener) on mouse taste cells. By using the patch-clamp technique to monitor membrane ion currents, we found that CTX3C markedly affected the operation of voltage-gated Na(+) channels but was ineffective on voltage-gated K(+) channels. This result was the exact opposite of what we obtained earlier with gambierol, which inhibits K(+) channels but not Na(+) channels. Thus, CTXs and gambierol affect with high potency the operation of separate classes of voltage-gated ion channels in taste cells. Our data suggest that taste disturbances reported in ciguatera poisoning might be due to the ability of ciguatera toxins to interfere with ion channels in taste buds.

Ciguatera Fish Poisoning

Science.gov (United States)

... monotis , Thecadinium spp. and Amphidinium carterae Toxins implicated: Ciguatoxins; possibly maitotoxin, okadaic acid, palytoxin analogs, and others. ... in approximately 20% of those acutely exposed to ciguatoxins and lasts for several years, which may be ...

Ecology of the ciguatera causing dinoflagellates from the Northern Great Barrier Reef: changes in community distribution and coastal eutrophication.

Science.gov (United States)

Skinner, Mark P; Lewis, Richard J; Morton, Steve

2013-12-15

Ciguatera fish poisoning (CFP) is known to be caused by the ciguatoxins from the dinoflagellate genus Gambierdiscus, however, there is the potential for other toxins such as okadaic acid and dinophysistoxins from the genus Prorocentrum, and palytoxin from the genus Ostreopsis, to contaminate seafood. These genera may also be indicators of ecosystem health and potentially impact on coral reef ecosystems and the role they may play in the succession of coral to macroalgae dominated reefs has not been researched. Sixteen GBR field sites spanning inshore, mid-lagoon and outer lagoon (offshore) regions were studied. Samples were collected from September 2006 to December 2007 and abundance of benthic dinoflagellates on different host macroalgae and concentration of nutrients present in the water column were determined. The maximum abundance of Prorocentrum, Ostreopsis and Gambierdiscus found was 112, 793 and 50 cells per gram wet weight of host macroalgae, respectively. The average level of Dissolved Inorganic Nitrogen (DIN) in the water column across all sites (0.03 mg/L) was found to be more than double the threshold critical value (0.013 mg/L) for healthy coral reefs. Compared to a previous study 1984, there is evidence of a major shift in the distribution and abundance of these dinoflagellates. Inshore reefs have either of Prorocentrum (as at Green Island) or Ostreopsis (as at Magnetic Island) dominating the macroalgal surface niche which was once dominated by Gambierdiscus, whilst at offshore regions Gambierdiscus is still dominant. This succession may be linked to the ongoing eutrophication of the GBR lagoon and have consequences for the sources of toxins for ongoing cases of ciguatera. Published by Elsevier Ltd.

Collaborative Research Program on Seafood Toxins

Science.gov (United States)

1988-08-14

Crystallographic Structures of Saxitoxins Cl and C2 Appendix C: Collaborative Research Program an Seafcod Toxins Progress Report on Ciguatera and Related...radioimmunoassay for PSP were also evalumted. The Hokama stick test for ciguatera toxin was also evaluated. 4. initiate Studies on the Accumulation...tco•d which caie a form of b-mnn poisoning referred to as ciguatera . The respcnsible toxins originate from ll1ular rine algae of the division

Prevalence and proposal for cost-effective management of the ciguatera risk in the Noumea fish market, New Caledonia (South Pacific).

Science.gov (United States)

Clua, Eric; Brena, Pierpaolo F; Lecasble, Côme; Ghnassia, Reine; Chauvet, Claude

2011-11-01

Ciguatera fish poisoning (CFP) is a common intoxication associated with the consumption of reef fish, which constitutes a critical issue for public health in many countries. The complexity of its epidemiology is responsible for the poor management of the risk in tropical fish markets. We used the example of the Noumea fish market in New Caledonia to develop a cost-effective methodology of assessing the CFP risk. We first used published reports and the knowledge of local experts to define a list of potentially poisonous local species, ranked by their ciguatoxic potential. Based on two 1-month surveys in the market, conducted in winters 2008 and 2009, we then calculated the consolidated ratio of biomass of potentially poisonous species vs. total biomass of fish sold on the market. The prevalence of high CFP-risk species in the market was 16.1% and 18.9% in 2008 and 2009, respectively. The most common high CFP risk species were groupers (serranids), king mackerels (scombrids), snappers (lutjanids), barracudas (sphyaraenids), emperors (lethrinids) and wrasses (labrids). The size (age) of the fish also plays a critical role in the potential ciguatoxic risk. According to proposals of average size thresholds provided by experts for high-risk species, we were also able to assess the additional risk induced by the sale of some large fish on the market. The data collected both from experts and from the market allowed us to develop a cost-effective proposal for improving the management of the CFP risk in this market. However, the successful implementation of any regulation aiming to ban some specific species and sizes from the market, with an acceptable economical impact, will require the improvement of the expertise in fish identification by public health officers and, ideally, the commitment of retailers. Copyright © 2011 Elsevier Ltd. All rights reserved.

Caribbean ciguatera: a changing paradigm

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T.R Tosteson

2004-09-01

Full Text Available Analyses of ciguatoxicity in the great barracuda Sphyraena barracuda and quantity of toxic benthic dinoflagellates on coastal reefs (correlated with the number of cases of human ciguatera intoxications in Puerto Rico were used to construct a model formulated on data obtained during the period of 1985-1988. The validity of the proposed model has been questioned by recent data obtained during the period of 1990-2000. Barracuda ciguatoxicity no longer showed a prominent seasonality while the fraction of randomly caught barracuda that were ciguatoxic significantly increased during this period. These two changes, accompanied by the discovery that ciguatoxic fish contained a variety of multiple toxins, appear to be correlated with the steadily increasing periods of elevated sea surface temperatures in this regionPruebas de ciguatoxicidad en la gran barracuda, Sphyraena barracuda y la cantidad de dinoflagelados bentónicos tóxicos en los arrecifes de la costa están correlacionados con el número de casos de intoxicaciones por ciguatera en humanos, en Puerto Rico. Estos hechos fueron utilizados para construir un modelo que fue formulado con la información recopilada durante el período de 1985- 1988. La validez de este modelo propuesto ha sido cuestionada debido a la información recientemente obtenida durante el período 1990-2000. La ciguatoxicidad en la barracuda ya no demostraba una marcada asociación con las temporadas mientras que la cantidad de barracuda ciguatóxica capturada al azar tuvo un aumento significativo durante este período. Estos dos cambios estuvieron acompañados por el descubrimiento de que peces ciguatóxicos contienen una gran variedad de toxinas que parecen estar relacionadas con los períodos de elevadas temperaturas en la superficie del mar. Estas temperaturas continúan aumentando de manera que a su vez continúan en un aumento estable en esta región

Ionic mechanisms of spinal neuronal cold hypersensitivity in ciguatera.

Science.gov (United States)

Patel, Ryan; Brice, Nicola L; Lewis, Richard J; Dickenson, Anthony H

2015-12-01

Cold hypersensitivity is evident in a range of neuropathies and can evoke sensations of paradoxical burning cold pain. Ciguatoxin poisoning is known to induce a pain syndrome caused by consumption of contaminated tropical fish that can persist for months and include pruritus and cold allodynia; at present no suitable treatment is available. This study examined, for the first time, the neural substrates and molecular components of Pacific ciguatoxin-2-induced cold hypersensitivity. Electrophysiological recordings of dorsal horn lamina V/VI wide dynamic range neurones were made in non-sentient rats. Subcutaneous injection of 10 nm ciguatoxin-2 into the receptive field increased neuronal responses to innocuous and noxious cooling. In addition, neuronal responses to low-threshold but not noxious punctate mechanical stimuli were also elevated. The resultant cold hypersensitivity was not reversed by 6-({2-[2-fluoro-6-(trifluoromethyl)phenoxy]-2-methylpropyl}carbamoyl)pyridine-3-carboxylic acid, an antagonist of transient receptor potential melastatin 8 (TRPM8). Both mechanical and cold hypersensitivity were completely prevented by co-injection with the Nav 1.8 antagonist A803467, whereas the transient receptor potential ankyrin 1 (TRPA1) antagonist A967079 only prevented hypersensitivity to innocuous cooling and partially prevented hypersensitivity to noxious cooling. In naive rats, neither innocuous nor noxious cold-evoked neuronal responses were inhibited by antagonists of Nav 1.8, TRPA1 or TRPM8 alone. Ciguatoxins may confer cold sensitivity to a subpopulation of cold-insensitive Nav 1.8/TRPA1-positive primary afferents, which could underlie the cold allodynia reported in ciguatera. These data expand the understanding of central spinal cold sensitivity under normal conditions and the role of these ion channels in this translational rat model of ciguatoxin-induced hypersensitivity. © 2015 The Authors. European Journal of Neuroscience published by Federation of

Large outbreaks of ciguatera after consumption of brown marbled grouper.

Science.gov (United States)

Chan, Thomas Y K

2014-07-11

Brown marbled grouper (Epinephelus fuscoguttatus) is an apex predator from coral reefs of the Indo-Pacific region. All five published case series of ciguatera after consumption of brown marbled grouper were reviewed to characterize the types, severity and chronicity of ciguatera symptoms associated with its consumption. Three of these case series were from large outbreaks affecting over 100-200 subjects who had eaten this reef fish served at banquets. Affected subjects generally developed a combination of gastrointestinal, neurological and, less commonly, cardiovascular symptoms. Gastrointestinal symptoms occurred early and generally subsided in 1-2 days. Some neurological symptoms (e.g., paresthesia of four limbs) could last for weeks or months. Sinus bradycardia and hypotension occurred early, but could be severe and prolonged, necessitating the timely use of intravenous fluids, atropine and dopamine. Other cardiovascular and neurological features included atrial ectopics, ventricular ectopics, dyspnea, chest tightness, PR interval >0.2 s, ST segment changes, polymyositis and coma. Concomitant alcohol consumption was associated with a much higher risk of developing bradycardia, hypotension and altered skin sensation. The public should realize that consumption of the high-risk fish (especially the ciguatoxin-rich parts and together with alcohol use) and repeated ciguatoxin exposures will result in more severe and chronic illness.

Large Outbreaks of Ciguatera after Consumption of Brown Marbled Grouper

Directory of Open Access Journals (Sweden)

Thomas Y. K. Chan

2014-07-01

Full Text Available Brown marbled grouper (Epinephelus fuscoguttatus is an apex predator from coral reefs of the Indo-Pacific region. All five published case series of ciguatera after consumption of brown marbled grouper were reviewed to characterize the types, severity and chronicity of ciguatera symptoms associated with its consumption. Three of these case series were from large outbreaks affecting over 100–200 subjects who had eaten this reef fish served at banquets. Affected subjects generally developed a combination of gastrointestinal, neurological and, less commonly, cardiovascular symptoms. Gastrointestinal symptoms occurred early and generally subsided in 1–2 days. Some neurological symptoms (e.g., paresthesia of four limbs could last for weeks or months. Sinus bradycardia and hypotension occurred early, but could be severe and prolonged, necessitating the timely use of intravenous fluids, atropine and dopamine. Other cardiovascular and neurological features included atrial ectopics, ventricular ectopics, dyspnea, chest tightness, PR interval >0.2 s, ST segment changes, polymyositis and coma. Concomitant alcohol consumption was associated with a much higher risk of developing bradycardia, hypotension and altered skin sensation. The public should realize that consumption of the high-risk fish (especially the ciguatoxin-rich parts and together with alcohol use and repeated ciguatoxin exposures will result in more severe and chronic illness.

Large Outbreaks of Ciguatera after Consumption of Brown Marbled Grouper

Science.gov (United States)

Chan, Thomas Y. K.

2014-01-01

Brown marbled grouper (Epinephelus fuscoguttatus) is an apex predator from coral reefs of the Indo-Pacific region. All five published case series of ciguatera after consumption of brown marbled grouper were reviewed to characterize the types, severity and chronicity of ciguatera symptoms associated with its consumption. Three of these case series were from large outbreaks affecting over 100–200 subjects who had eaten this reef fish served at banquets. Affected subjects generally developed a combination of gastrointestinal, neurological and, less commonly, cardiovascular symptoms. Gastrointestinal symptoms occurred early and generally subsided in 1–2 days. Some neurological symptoms (e.g., paresthesia of four limbs) could last for weeks or months. Sinus bradycardia and hypotension occurred early, but could be severe and prolonged, necessitating the timely use of intravenous fluids, atropine and dopamine. Other cardiovascular and neurological features included atrial ectopics, ventricular ectopics, dyspnea, chest tightness, PR interval >0.2 s, ST segment changes, polymyositis and coma. Concomitant alcohol consumption was associated with a much higher risk of developing bradycardia, hypotension and altered skin sensation. The public should realize that consumption of the high-risk fish (especially the ciguatoxin-rich parts and together with alcohol use) and repeated ciguatoxin exposures will result in more severe and chronic illness. PMID:25019942

Epiphytic dinoflagellates associated with ciguatera in the northwestern coast of Cuba

Directory of Open Access Journals (Sweden)

Gilma Delgado

2006-06-01

Full Text Available The spatial and temporal abundance of epiphytic dinoflagellates associated with ciguatera was studied over two annual cycles (March 1999 to March 2000 and March 2001 to March 2002 in the northwestern coast of Cuba. From 14 species of macroalgae (Phaeophyta, Chlorophyta, and Rhodophyta, 1340 samples were obtained identifying seven species as potentially noxious; five of them are new reports for Cuba’s phytobenthos: Prorocentrum belizeanum Faust, P. concavum Fukuyo, P. mexicanum Tafall, Coolia monotis Meunier, and Ostreopsis lenticularis Fukuyo. ANOVA/MANOVA analysis showed significant spatial differences: lower cell abundance near the shoreline adjacent to a river inlet and higher cell abundance in the deepest area. Prorocentrum lima (Ehrenberg Dodge 1975 was found mainly on Phaeophyta followed by Chlorophyta and Rhodophyta. Gambierdiscus toxicus was found mainly on Phaeophyta followed by Rhodophyta and Chlorophyta. All the species reported in the study area were mainly on Padina spp. (Phaeophyta. Acanthophora spicifera (Rhodophyta did not host dinoflagellate species. Environmental conditions in summer (higher temperature, more nutrients, greater water transparency, and low wind intensity are suitable for macroalgae development, which serves as a substrate for potentially harmful dinoflagellates, and possibly the main vector for spreading ciguatera along the coast of Cuba. Rev. Biol. Trop. 54(2: 299-310. Epub 2006 Jun 01.Se estudió la abundancia espacial y temporal de dinoflagelados epífitos asociados a la ciguatera durante dos ciclos anuales (marzo 1999 a marzo 2000, y marzo 2001 a marzo 2002 en la costa del noroeste de Cuba. Recolectamos 14 especies de macroalgas (Phaeophyta, Chlorophyta y Rhodophyta y obtuvimos 1340 muestras. Identificamos siete especies de dinoflagelados potencialmente nocivas, cinco de ellas nuevos registros para el fitobentos cubano: Prorocentrum belizeanum Faust, P. concavum Fukuyo, P. mexicanum Tafall, Coolia monotis

Marine biotoxins

National Research Council Canada - National Science Library

2004-01-01

... (ciguatera fish poisoning). It discusses in detail the causative toxins produced by marine organisms, chemical structures and analytical methods, habitat and occurrence of the toxin-producing organisms, case studies and existing regulations...

Toxicological Investigations on the Sea Urchin Tripneustes gratilla (Toxopneustidae, Echinoid from Anaho Bay (Nuku Hiva, French Polynesia: Evidence for the Presence of Pacific Ciguatoxins

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Hélène Taiana Darius

2018-04-01

Full Text Available The sea urchin Tripneustes gratilla (Toxopneustidae, Echinoids is a source of protein for many islanders in the Indo-West Pacific. It was previously reported to occasionally cause ciguatera-like poisoning; however, the exact nature of the causative agent was not confirmed. In April and July 2015, ciguatera poisonings were reported following the consumption of T. gratilla in Anaho Bay (Nuku Hiva Island, Marquesas archipelago, French Polynesia. Patient symptomatology was recorded and sea urchin samples were collected from Anaho Bay in July 2015 and November 2016. Toxicity analysis using the neuroblastoma cell–based assay (CBA-N2a detected the presence of ciguatoxins (CTXs in T. gratilla samples. Gambierdiscus species were predominant in the benthic assemblages of Anaho Bay, and G. polynesiensis was highly prevalent in in vitro cultures according to qPCR results. Liquid chromatography–tandem mass spectrometry (LC-MS/MS analyses revealed that P-CTX-3B was the major ciguatoxin congener in toxic sea urchin samples, followed by 51-OH-P-CTX-3C, P-CTX-3C, P-CTX-4A, and P-CTX-4B. Between July 2015 and November 2016, the toxin content in T. gratilla decreased, but was consistently above the safety limit allowed for human consumption. This study provides evidence of CTX bioaccumulation in T. gratilla as a cause of ciguatera-like poisoning associated with a documented symptomatology.

Toxicological Investigations on the Sea Urchin Tripneustes gratilla (Toxopneustidae, Echinoid) from Anaho Bay (Nuku Hiva, French Polynesia): Evidence for the Presence of Pacific Ciguatoxins.

Science.gov (United States)

Darius, Hélène Taiana; Roué, Mélanie; Sibat, Manoella; Viallon, Jérôme; Gatti, Clémence Mahana Iti Iti; Vandersea, Mark W; Tester, Patricia A; Litaker, R Wayne; Amzil, Zouher; Hess, Philipp; Chinain, Mireille

2018-04-06

The sea urchin Tripneustes gratilla ( Toxopneustidae , Echinoids) is a source of protein for many islanders in the Indo-West Pacific. It was previously reported to occasionally cause ciguatera-like poisoning; however, the exact nature of the causative agent was not confirmed. In April and July 2015, ciguatera poisonings were reported following the consumption of T. gratilla in Anaho Bay (Nuku Hiva Island, Marquesas archipelago, French Polynesia). Patient symptomatology was recorded and sea urchin samples were collected from Anaho Bay in July 2015 and November 2016. Toxicity analysis using the neuroblastoma cell-based assay (CBA-N2a) detected the presence of ciguatoxins (CTXs) in T. gratilla samples. Gambierdiscus species were predominant in the benthic assemblages of Anaho Bay, and G. polynesiensis was highly prevalent in in vitro cultures according to qPCR results. Liquid chromatography-tandem mass spectrometry (LC-MS/MS) analyses revealed that P-CTX-3B was the major ciguatoxin congener in toxic sea urchin samples, followed by 51-OH-P-CTX-3C, P-CTX-3C, P-CTX-4A, and P-CTX-4B. Between July 2015 and November 2016, the toxin content in T. gratilla decreased, but was consistently above the safety limit allowed for human consumption. This study provides evidence of CTX bioaccumulation in T. gratilla as a cause of ciguatera-like poisoning associated with a documented symptomatology.

Release of neuropeptides from a neuro-cutaneous co-culture model: A novel in vitro model for studying sensory effects of ciguatoxins.

Science.gov (United States)

Le Garrec, Raphaele; L'herondelle, Killian; Le Gall-Ianotto, Christelle; Lebonvallet, Nicolas; Leschiera, Raphael; Buhe, Virginie; Talagas, Matthieu; Vetter, Irina; Lewis, Richard J; Misery, Laurent

2016-06-15

Ciguatoxins are the major toxins responsible for ciguatera fish poisoning, a disease dominated by muco-cutaneous sensory disorders including paresthesiae, cold dysesthesia and pruritus. While the ciguatoxins are well known to target voltage-gated sodium channels (VGSCs), the ensuing molecular mechanisms underlying these sensory disorders remain poorly understood. In this study, we propose a primary sensory neuron-keratinocyte co-culture as an appropriate model to study the neuro-cutaneous effects of ciguatoxins. Using this model, we show for the first time that nanomolar concentrations of Pacific ciguatoxin-2 (P-CTX-2) induced a VGSC-dependent release of substance P (SP) and calcitonin gene-related peptide (CGRP). As these neuropeptides are known mediators of pain and itch sensations, the ciguatoxin-induced sensory disturbances in ciguatera fish poisoning may involve the release of these neuropeptides. We further determined time- and P-CTX-2 concentration-dependence of the release of SP and CGRP from the co-culture model. Moreover, we highlighted the influence of extracellular calcium on the release of neuropeptides elicited by P-CTX-2. These findings underline the usefulness of this novel in vitro model for studying the cellular and molecular mechanisms of the neuro-cutaneous effects of ciguatoxins, which may assist with identifying potential therapeutics for ciguatera fish poisoning. Copyright © 2015 Elsevier Ltd. All rights reserved.

TRP channel blamed for burning cold after a tropical fish meal

Science.gov (United States)

Voets, Thomas

2012-01-01

EMBO J (2012) 31 19, 3795–3808 doi:10.1038/emboj.2012.207; published online 07312012 Ciguatera is one of the most common forms of food poisoning, occurring after consumption of fish contaminated with ciguatoxins. New work by Vetter et al (2012) reveals the key molecular players that underlie the altered temperature sensation associated with ciguatera. In particular, they show that ciguatoxins act on sensory neurons that express TRPA1, an ion channel implicated in the detection of noxious cold. PMID:22960637

Primer informe del género Gambierdiscus (Dinophyceae y otros dinoflagelados bentónicos en el Parque Nacional Isla del Coco, Costa Rica, Pacífico Tropical Oriental First report of the genus Gambierdiscus (Dinophyceae and other benthic dinoflagellates from Isla del Coco National Park, Costa Rica, Eastern Tropical Pacific

Directory of Open Access Journals (Sweden)

Maribelle Vargas-Montero

2012-11-01

conocer la incidencia de dinoflagelados bentónicos implicados en ciguatera para el Pacífico Tropical Oriental.The Eastern Tropical Pacific is a region reported as free of ciguatera poisoning that causes serious gastrointestinal, neural and cardiovascular problems, even death. But with this study we found a high incidence of benthic microalgae involved in ciguatera poisoning in Isla del Coco National Park (PNIC, from its name in Spanish, Costa Rica. Between 2006 and 2011, during expeditions to PNIC, 420 phytoplankton samples with the interest of finding benthic dinoflagellates involved in the ciguatera poisoning were collected and analyzed. Samples were taken with phytoplankton nets, towed vertically and horizontally or carried by diving, between 5 to 30 m depth, over reef areas, and by direct extraction from benthic macroalgae. We found the dinoflagellates Gambierdiscus spp., Coolia tropicalis, Coolia cf. areolota, Prorocentrum concavum, Prorocentrum compressum, Amphidinium carterae and Ostreopsis siamensis. The quantity of dinoflagellates by macroalgae weight was high, mainly for Gambierdiscus. Ostreopsis and Prorocentrum, the most widely distributed genera throughout the collection sites. Gambierdiscus is a ciguatera producing genus. Two different sizes of Gambierdiscus were found, and comparing our samples with other studies, we conclude that they are different to any previously reported. They possibly represent two new species. Coco Island is an oceanic island and because of its protection status, it is an ideal site for studying the evolution of marine phytoplankton. Also, long-term monitoring is important due to the variety of potentially toxic dinoflagellates living in this marine ecosystem. This is the first study to report benthic dinoflagellates implicated in ciguatera poisoning in other areas of the Eastern Tropical Pacific.

Total synthesis of ciguatoxin.

Science.gov (United States)

Hamajima, Akinari; Isobe, Minoru

2009-01-01

Something fishy: Ciguatoxin (see structure) is one of the principal toxins involved in ciguatera poisoning and the target of a total synthesis involving the coupling of three segments. The key transformations in this synthesis feature acetylene-dicobalthexacarbonyl complexation.

House of Poison: Poisons in the Home.

Science.gov (United States)

Keller, Rosanne

One of a series of instructional materials produced by the Literacy Council of Alaska, this booklet provides information about common household poisons. Using a simplified vocabulary and shorter sentences, it provides statistics concerning accidental poisonings; a list of the places poisons are usually found in the home; steps to make the home…

Poison Ivy Rash

Science.gov (United States)

Poison ivy rash Overview Poison ivy rash is caused by an allergic reaction to an oily resin called urushiol (u-ROO-she-ol). This oil is in the leaves, stems and roots of poison ivy, poison oak and poison sumac. Wash your ...

Dieffenbachia poisoning

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Dumbcane poisoning; Leopard lily poisoning; Tuft root poisoning ... Get the following information: Person's age, weight, and condition Parts of the plant that were eaten, if known Time swallowed Amount swallowed

Mistletoe poisoning

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... if known Time it was swallowed Amount swallowed Poison Control Your local poison center can be reached directly by calling the national toll-free Poison Help hotline (1-800-222-1222) from anywhere ...

Detergent poisoning

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... if known) Time it was swallowed Amount swallowed Poison Control Your local poison center can be reached directly by calling the national toll-free Poison Help hotline (1-800-222-1222) from anywhere ...

Kerosene poisoning

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... if known) Time it was swallowed Amount swallowed Poison Control Your local poison center can be reached directly by calling the national toll-free Poison Help hotline (1-800-222-1222) from anywhere ...

Zinc poisoning

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... help if this information is not immediately available. Poison Control Your local poison center can be reached directly by calling the national toll-free Poison Help hotline (1-800-222-1222) from anywhere ...

Foxglove poisoning

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... if known Time it was swallowed Amount swallowed Poison Control Your local poison center can be reached directly by calling the national toll-free Poison Help hotline (1-800-222-1222) from anywhere ...

Cologne poisoning

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... the product Time it was swallowed Amount swallowed Poison Control Your local poison center can be reached directly by calling the national toll-free Poison Help hotline (1-800-222-1222) from anywhere ...

Oleander poisoning

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... if known Time it was swallowed Amount swallowed Poison Control Your local poison center can be reached directly by calling the national toll-free Poison Help hotline (1-800-222-1222) from anywhere ...

Ammonia poisoning

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... if known) Time it was swallowed Amount swallowed Poison Control Your local poison center can be reached directly by calling the national toll-free Poison Help hotline (1-800-222-1222) from anywhere ...

Yew poisoning

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... if known Time it was swallowed Amount swallowed Poison Control Your local poison center can be reached directly by calling the national toll-free Poison Help hotline (1-800-222-1222) from anywhere ...

Philodendron poisoning

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... if known Time it was swallowed Amount swallowed Poison Control Your local poison center can be reached directly by calling the national toll-free Poison Help hotline (1-800-222-1222) from anywhere ...

Bee poison

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... page: //medlineplus.gov/ency/article/002847.htm Bee poison To use the sharing features on this page, ... Time of the sting Location of the sting Poison Control Your local poison center can be reached ...

Insecticide poisoning

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... if known) Time it was swallowed Amount swallowed Poison Control Your local poison control center can be reached directly by calling the national toll-free Poison Help hotline (1-800-222-1222) from anywhere ...

Ciguatera fish toxicity in French Polynesia: size does not always matter.

Science.gov (United States)

Gaboriau, Matthias; Ponton, Dominique; Darius, H Taiana; Chinain, Mireille

2014-06-01

Accumulation of ciguatoxins (CTXs) in tropical reef fish tissues during their life is responsible of the most prevalent human seafood intoxication in the South Pacific called Ciguatera Fish Poisoning (CFP). It has been assumed for a long time that CTXs are transferred and accumulated along the trophic food chain, and consequently that smaller individuals within a given fish species are safer to eat than larger ones. However, the relationship between toxicity and fish size has been studied for a limited number of species only and the conclusions are often contradictory. The toxicity of 856 fishes from 59 different species sampled in six islands in French Polynesia between 2003 and 2011 was assessed by Receptor Binding Assay. Among them, 45 species × island and 32 families × island for which the number of individuals was ≥6 allowed testing the relationship between toxicity and size. Except for six specimens of Lutjanus bohar caught in Fakarava (P < 0.01; R(2) = 0.854), the 44 remaining species × island showed no significant increase of CTXs concentration with fish total length (TL). Moreover, the proportion of toxic individuals decreased significantly for Epinephelus polyphekadion from Fakarava (n = 24; P < 0.05) and Kyphosus cinerascens from Raivavae (n = 29; P < 0.05), while no significant variation was detected for the other 43 species × island. At the family level, only three positive and three negative relationships between size and CTXs concentration were observed among the 32 family × island analyzed. No relationship between the proportion of toxic fish within a family and the relative total length of individuals were observed. The lack of relationship between toxicity and size observed for most of the species and families from the six islands suggests that fish size cannot be used as an efficient predictor of fish toxicity in French Polynesia. These results highlight the need for improving our knowledge about metabolic processes

Burnable poison rod

International Nuclear Information System (INIS)

Natsume, Tomohiro.

1988-01-01

Purpose: To decrease the effect of water elimination and the effect of burn-up residue boron, thereby reduce the effect of burnable poison rods as the neutron poisons at the final stage of reactor core lifetime. Constitution: In a burnable poison rod according to the present invention, a hollow burnable poison material is filled in an external fuel can, an inner fuel can mounted with a carbon rod is inserted to the hollow portion of the burnable poison material and helium gases are charged in the outer fuel can. In such a burnable poison rod, the reactivity worths after the burning are reduced to one-half as compared with the conventional case. Accordingly, since the effect of the burnable poison as the neutron poisons is reduced at the final stage of the reactor core of lifetime, the excess reactivity of the reactor core is increased. (Horiuchi, T.)

Scombroid fish poisoning: an overlooked marine food poisoning.

Science.gov (United States)

Wu, M L; Yang, C C; Yang, G Y; Ger, J; Deng, J F

1997-08-01

Scombroid fish poisoning is a food-borne chemical intoxication caused by certain spoiled fish that contain a large amount of histamine and some biogenic diamines. It has gradually become a world-wide medical problem and probably is the most common cause of fish poisoning. As the data on the incidents of scombroid fish poisoning in Taiwan remains scarce, we report 2 incidents of scombroid fish poisoning in Northern Taiwan. We collected data of the 2 outbreaks of suspected fish poisoning which were reported to us in 1996. An epidemiological investigation was undertaken. Questionnaire interviews were given to persons who ate lunch in the same cafeteria in outbreak 2. The leftover fish were sent for species identification and toxin analysis. The first incident involving 4 women occurred in March 1996. All cases experienced flush, dizziness, blurred vision and skin rashes after eating lunch. A non-scombroid fish of Makaira with histamine levels as high as 84.13 mg/100 g flesh was implicated in this incident. In August 1996, another incident involving some cases who ate lunch at the same cafeteria were investigated. A total of 146 questionnaires were distributed with a return of 132 questionnaires (90.4%). Fifty-five employees reported positive signs or symptoms; 48 persons who ate fish and 7 women who did not eat fish were ill. Fish was the only food associated with the illness with an attack rate of 73.8% (p < 0.001). The incriminated fish was later identified as a scombroid fish of Euthynnus with a histamine content of 271.9 mg/100 g flesh in 1 leftover piece and 118.5 mg/100 g flesh in another piece. Most cases in these 2 outbreaks received treatment with antihistamines and had rapid and complete recovery. The diagnosis of scombroid fish poisoning could be misdiagnosed as food allergy or bacterial food poisoning if physicians are not aware of such poisoning. The nonspecific but characteristic symptomatology of histamine food poisoning and previous consumption of fish

HARMFUL ALGAL BLOOMS IN THE MEDITERRANEAN SEA: EFFECTS ON HUMAN HEALTH.

Directory of Open Access Journals (Sweden)

Margherita Ferrante

2013-01-01

Full Text Available A harmful algal bloom (HAB is defined as a bloom that has deleterious effects on plants, animals or humans. Marine algal toxins are responsible for an array of human illnesses associated with consumption of seafood or exposure to aerosolized toxins. The effects of algal toxins are generally observed as acute intoxications, whereas the environmental health effects of chronic exposure to low levels of algal toxins are, to date, only poorly documented and an emerging issue. Consumption of seafood contaminated with algal toxins can result in five types of seafood poisoning syndromes: paralytic shellfish poisoning, neurotoxic shellfish poisoning, amnesic shellfish poisoning, diarrhetic shellfish poisoning and ciguatera fish poisoning. The aim of this paper is to provide an overview on HAB-related issues in the Mediterranean Sea.

Poisoning

Science.gov (United States)

... your home. Regularly test and replace the batteries. Poisoning treatment Treatment depends on the person and the type ... Injury Prevention, Prevention and Wellness, Staying HealthyTags: chemical ... poison treatments, snakebite, syrup of ipecac July 12, 2017 Featured ...

78 FR 18273 - Draft Guidance for Industry on Purchasing Reef Fish Species Associated With the Hazard of...

Science.gov (United States)

2013-03-26

.... FDA-2013-D-0269] Draft Guidance for Industry on Purchasing Reef Fish Species Associated With the... availability of a draft guidance entitled ``Guidance for Industry: Purchasing Reef Fish Species Associated With... seafood processors who purchase reef fish how to minimize the risk of ciguatera fish poisoning (CFP) from...

The power of poison: pesticide poisoning of Africa's wildlife.

Science.gov (United States)

Ogada, Darcy L

2014-08-01

Poisons have long been used to kill wildlife throughout the world. An evolution has occurred from the use of plant- and animal-based toxins to synthetic pesticides to kill wildlife, a method that is silent, cheap, easy, and effective. The use of pesticides to poison wildlife began in southern Africa, and predator populations were widely targeted and eliminated. A steep increase has recently been observed in the intensity of wildlife poisonings, with corresponding population declines. However, the majority of poisonings go unreported. Under national laws, it is illegal to hunt wildlife using poisons in 83% of African countries. Pesticide regulations are inadequate, and enforcement of existing legislation is poor. Few countries have forensic field protocols, and most lack storage and testing facilities. Methods used to poison wildlife include baiting carcasses, soaking grains in pesticide solution, mixing pesticides to form salt licks, and tainting waterholes. Carbofuran is the most widely abused pesticide in Africa. Common reasons for poisoning are control of damage-causing animals, harvesting fish and bushmeat, harvesting animals for traditional medicine, poaching for wildlife products, and killing wildlife sentinels (e.g., vultures because their aerial circling alerts authorities to poachers' activities). Populations of scavengers, particularly vultures, have been decimated by poisoning. Recommendations include banning pesticides, improving pesticide regulations and controlling distribution, better enforcement and stiffer penalties for offenders, increasing international support and awareness, and developing regional pesticide centers. © 2014 New York Academy of Sciences.

Ciguatoxins: Cyclic Polyether Modulators of Voltage-gated Iion Channel Function

Science.gov (United States)

Nicholson, Graham M.; Lewis, Richard J.

2006-01-01

Ciguatoxins are cyclic polyether toxins, derived from marine dinoflagellates, which are responsible for the symptoms of ciguatera poisoning. Ingestion of tropical and subtropical fin fish contaminated by ciguatoxins results in an illness characterised by neurological, cardiovascular and gastrointestinal disorders. The pharmacology of ciguatoxins is characterised by their ability to cause persistent activation of voltage-gated sodium channels, to increase neuronal excitability and neurotransmitter release, to impair synaptic vesicle recycling, and to cause cell swelling. It is these effects, in combination with an action to block voltage-gated potassium channels at high doses, which are believed to underlie the complex of symptoms associated with ciguatera. This review examines the sources, structures and pharmacology of ciguatoxins. In particular, attention is placed on their cellular modes of actions to modulate voltage-gated ion channels and other Na+-dependent mechanisms in numerous cell types and to current approaches for detection and treatment of ciguatera.

Establishing a public health analytical service based on chemical methods for detecting and quantifying Pacific ciguatoxin in fish samples.

Science.gov (United States)

Stewart, Ian; Eaglesham, Geoffrey K; Poole, Sue; Graham, Glenn; Paulo, Carl; Wickramasinghe, Wasantha; Sadler, Ross; Shaw, Glen R

2010-10-01

A referee analysis method for the detection and quantification of Pacific ciguatoxins in fish flesh has recently been established by the public health analytical laboratory for the State of Queensland, Australia. Fifty-six fish samples were analysed, which included 10 fillets purchased as negative controls. P-CTX-1 was identified in 27 samples, and P-CTX-2 and P-CTX-3 were found in 26 of those samples. The range of P-CTX-1 concentrations was 0.04-11.4 microg/kg fish flesh; coefficient of variation from 90 replicate analyses was 7.4%. A liquid chromatography/tandem mass spectrometry (HPLC-MS/MS) method utilising a rapid methanol extraction and clean-up is reliable and reproducible, with the detection limit at 0.03 microg/kg fish flesh. Some matrix effects are evident, with fish oil content a likely signal suppression factor. Species identification of samples by DNA sequence analysis revealed some evidence of fish substitution or inadvertent misidentification, which may have implications for the management and prevention of ciguatera poisoning. Blinded inspection of case notes from suspect ciguatera poisoning cases showed that reporting of ciguatera-related paraesthesias was highly predictable for the presence of ciguatoxins in analysed fish, with 13 of 14 expected cases having consumed fish that contained P-CTX-1 (p<0.001, Fishers Exact Test). Crown Copyright 2009. Published by Elsevier Ltd. All rights reserved.

Bug spray poisoning

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... was swallowed or inhaled Amount swallowed or inhaled Poison Control Your local poison center can be reached directly by calling the national toll-free Poison Help hotline (1-800-222-1222) from anywhere ...

Poison Control Centers

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... 1222 immediately. Name State American Association of Poison Control Centers Address AAPCC Central Office NOT A POISON ... not for emergency use. Arkansas ASPCA Animal Poison Control Center Address 1717 S. Philo Road, Suite 36 Urbana, ...

Harmful Algal Blooms and Public Health

Science.gov (United States)

Grattan, Lynn M.; Holobaugh, Sailor; Morris, J. Glenn

2015-01-01

The five most commonly recognized Harmful Algal Bloom related illnesses include Ciguatera poisoning, Paralytic Shellfish poisoning, Neurotoxin Shellfish poisoning, Diarrheic Shellfish Poisoning and Amnesic Shellfish poisoning. Although they are each the product of different toxins, toxin assemblages or HAB precursors these clinical syndromes have much in common. Exposure occurs through the consumption of fish or shellfish; routine clinical tests are not available for diagnosis; there is no known antidote for exposure; and the risk of these illnesses can negatively impact local fishing and tourism industries. Thus, illness prevention is of paramount importance to minimize human and public health risks. To accomplish this, close communication and collaboration is needed among HAB scientists, public health researchers and local, state and tribal health departments at academic, community outreach, and policy levels. PMID:27616971

Harmful Algal Blooms and Public Health.

Science.gov (United States)

Grattan, Lynn M; Holobaugh, Sailor; Morris, J Glenn

2016-07-01

The five most commonly recognized Harmful Algal Bloom related illnesses include Ciguatera poisoning, Paralytic Shellfish poisoning, Neurotoxin Shellfish poisoning, Diarrheic Shellfish Poisoning and Amnesic Shellfish poisoning. Although they are each the product of different toxins, toxin assemblages or HAB precursors these clinical syndromes have much in common. Exposure occurs through the consumption of fish or shellfish; routine clinical tests are not available for diagnosis; there is no known antidote for exposure; and the risk of these illnesses can negatively impact local fishing and tourism industries. Thus, illness prevention is of paramount importance to minimize human and public health risks. To accomplish this, close communication and collaboration is needed among HAB scientists, public health researchers and local, state and tribal health departments at academic, community outreach, and policy levels.

Genetic diversity and distribution of the ciguatera-causing dinoflagellate Gambierdiscus spp. (Dinophyceae in coastal areas of Japan.

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Tomohiro Nishimura

Full Text Available The marine epiphytic dinoflagellate genus Gambierdiscus produce toxins that cause ciguatera fish poisoning (CFP: one of the most significant seafood-borne illnesses associated with fish consumption worldwide. So far, occurrences of CFP incidents in Japan have been mainly reported in subtropical areas. A previous phylogeographic study of Japanese Gambierdiscus revealed the existence of two distinct phylotypes: Gambierdiscus sp. type 1 from subtropical and Gambierdiscus sp. type 2 from temperate areas. However, details of the genetic diversity and distribution for Japanese Gambierdiscus are still unclear, because a comprehensive investigation has not been conducted yet.A total of 248 strains were examined from samples mainly collected from western and southern coastal areas of Japan during 2006-2011. The SSU rDNA, the LSU rDNA D8-D10 and the ITS region were selected as genetic markers and phylogenetic analyses were conducted. The genetic diversity of Japanese Gambierdiscus was high since five species/phylotypes were detected: including two reported phylotypes (Gambierdiscus sp. type 1 and Gambierdiscus sp. type 2, two species of Gambierdiscus (G. australes and G. cf. yasumotoi and a hitherto unreported phylotype Gambierdiscus sp. type 3. The distributions of type 3 and G. cf. yasumotoi were restricted to the temperate and the subtropical area, respectively. On the other hand, type 1, type 2 and G. australes occurred from the subtropical to the temperate area, with a tendency that type 1 and G. australes were dominant in the subtropical area, whereas type 2 was dominant in the temperate area. By using mouse bioassay, type 1, type 3 and G. australes exhibited mouse toxicities.This study revealed a surprising diversity of Japanese Gambierdiscus and the distribution of five species/phylotypes displayed clear geographical patterns in Japanese coastal areas. The SSU rDNA and the LSU rDNA D8-D10 as genetic markers are recommended for further use.

Analysis of intentional drug poisonings using Ohio Poison Control Center Data, 2002-2014.

Science.gov (United States)

Pringle, Kelsey; Caupp, Sarah; Shi, Junxin; Wheeler, Krista K; Spiller, Henry A; Casavant, Marcel J; Xiang, Henry

2017-08-01

Pharmaceutical drug poisonings, especially those that are intentional, are a serious problem for adolescents and young adults. Poison control center data is a viable tool to track intentional drug poisonings in near real-time. To determine intentional drug poisoning rates among adolescents and young adults in Ohio using poison control center data. We analyzed data from 2002 to 2014 obtained by Ohio's three poison control centers. Inclusion variables were calls made to the centers that had appropriate subject age (10-29 years old), subject sex, involved substance (all drug classes), and medical outcome (no effect, minor effect, moderate effect, major effect, and death). Intentional drug poisoning reports were also separated into subgroups to compare suspected suicide reports to misuse and abuse reports. Finally, resident population estimates were used to generate 2014 intentional drug poisoning rates for each county in Ohio. The most common age group for intentional drug poisonings was 18-24. Females reported more suspected suicide drug poisonings while males reported more misuse/abuse drug poisonings. The most reported drug class across all ages was analgesics. Of the 88 counties in Ohio, Hamilton, Williams, Washington, and Guernsey counties had the highest rates of intentional drug poisonings. The high report rate of suspected suicides and analgesic class drugs demonstrates the need for preventative measures for adolescents and young adults in Ohio. Any interventions, along with legislative changes, will need to take place in our local communities.

Ciguatoxins: Cyclic Polyether Modulators of Voltage-gated Iion Channel Function

Directory of Open Access Journals (Sweden)

Richard J. Lewis

2006-04-01

Full Text Available Ciguatoxins are cyclic polyether toxins, derived from marine dinoflagellates, which are responsible for the symptoms of ciguatera poisoning. Ingestion of tropical and subtropical fin fish contaminated by ciguatoxins results in an illness characterised by neurological, cardiovascular and gastrointestinal disorders. The pharmacology of ciguatoxins is characterised by their ability to cause persistent activation of voltage-gated sodium channels, to increase neuronal excitability and neurotransmitter release, to impair synaptic vesicle recycling, and to cause cell swelling. It is these effects, in combination with an action to block voltage-gated potassium channels at high doses, which are believed to underlie the complex of symptoms associated with ciguatera. This review examines the sources, structures and pharmacology of ciguatoxins. In particular, attention is placed on their cellular modes of actions to modulate voltage-gated ion channels and other Na+-dependent mechanisms in numerous cell types and to current approaches for detection and treatment of ciguatera.

Benzene poisoning

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... may be admitted to the hospital if the poisoning is severe. ... benzene they swallowed and how quickly they receive treatment. The ... Poisoning can cause rapid death. However, deaths have occurred ...

Malathion poisoning

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... Prolonged treatment often is needed to reverse the poisoning. This may include staying in the hospital intensive care unit and getting long-term therapy. Some effects of the poison may last for ...

Diazinon poisoning

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... Prolonged treatment often is needed to reverse the poisoning. This may include staying in the hospital intensive care unit and getting long-term therapy. Some effects of the poison may last for ...

The first F-ring modified ciguatoxin analogue showing significant toxicity.

Science.gov (United States)

Ishihara, Yuuki; Lee, Nayoung; Oshiro, Naomasa; Matsuoka, Shigeru; Yamashita, Shuji; Inoue, Masayuki; Hirama, Masahiro

2010-05-07

Ciguatoxins, the principal causative toxins of ciguatera seafood poisoning, are potent neurotoxic polycyclic ethers. We report herein the total synthesis of a 10-membered F-ring analogue of 51-hydroxyCTX3C, which constitutes the first example of an F-ring modified ciguatoxin that exhibits potent cytotoxicity as well as mouse acute toxicity.

Two convergent routes to the left-wing fragment of ciguatoxin CTX3C using O,S-acetals as key intermediates.

Science.gov (United States)

Inoue, Masayuki; Yamashita, Shuji; Ishihara, Yuuki; Hirama, Masahiro

2006-12-07

Ciguatoxins, principal causative toxins of ciguatera seafood poisoning, are large ladderlike polycyclic ethers. Here, we report two convergent routes to synthesis of the multiolefinic left half of ciguatoxins based on a newly developed acyl radical strategy. Remarkably, only 13 steps from the monocyclic E-ring were required to construct the left wing. [reaction: see text

Using poison center exposure calls to predict methadone poisoning deaths.

Directory of Open Access Journals (Sweden)

Nabarun Dasgupta

Full Text Available PURPOSE: There are more drug overdose deaths in the Untied States than motor vehicle fatalities. Yet the US vital statistics reporting system is of limited value because the data are delayed by four years. Poison centers report data within an hour of the event, but previous studies suggested a small proportion of poisoning deaths are reported to poison centers (PC. In an era of improved electronic surveillance capabilities, exposure calls to PCs may be an alternate indicator of trends in overdose mortality. METHODS: We used PC call counts for methadone that were reported to the Researched Abuse, Diversion and Addiction-Related Surveillance (RADARS® System in 2006 and 2007. US death certificate data were used to identify deaths due to methadone. Linear regression was used to quantify the relationship of deaths and poison center calls. RESULTS: Compared to decedents, poison center callers tended to be younger, more often female, at home and less likely to require medical attention. A strong association was found with PC calls and methadone mortality (b=0.88, se=0.42, t=9.5, df=1, p<0.0001, R(2 =0.77. These findings were robust to large changes in a sensitivity analysis assessing the impact of underreporting of methadone overdose deaths. CONCLUSIONS: Our results suggest that calls to poison centers for methadone are correlated with poisoning mortality as identified on death certificates. Calls received by poison centers may be used for timely surveillance of mortality due to methadone. In the midst of the prescription opioid overdose epidemic, electronic surveillance tools that report in real-time are powerful public health tools.

Protective effect of Heliotropium foertherianum (Boraginaceae) folk remedy and its active compound, rosmarinic acid, against a Pacific ciguatoxin.

Science.gov (United States)

Rossi, Fanny; Jullian, Valérie; Pawlowiez, Ralph; Kumar-Roiné, Shilpa; Haddad, Mohamed; Darius, H Taiana; Gaertner-Mazouni, Nabila; Chinain, Mireille; Laurent, Dominique

2012-08-30

Senescent leaves of Heliotropium foertherianum Diane & Hilger (Boraginaceae) are traditionally used in the Pacific region to treat Ciguatera Fish Poisoning. This plant contains rosmarinic acid that is known for its multiple biological activities. In the present study, H. foertherianum aqueous extract, rosmarinic acid and its derivatives were evaluated for their capacity to reduce the effect of ciguatoxins. Aqueous extract of H. foertherianum leaves was prepared and studied for its effects against a Pacific ciguatoxin (P-CTX-1B) in the neuroblastoma cell assay and the receptor binding assay. Rosmarinic acid and six derivatives were also evaluated by means of these bioassays. For this purpose, we have developed an improved synthetic route for caffeic acid 3,4-dihydroxy-phenethyl ester (CADPE). Both the aqueous extract of H. foertherianum leaves and rosmarinic acid showed inhibitory activities against a Pacific ciguatoxin in the above bioassays. Among all the molecules that were evaluated, rosmarinic acid was the most active compound. These results confirm further the potential of H. foertherianum in the treatment of Ciguatera Fish Poisoning. Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.

Dinoflagellate Toxins Responsible for Ciguatera Food Poisoning

Science.gov (United States)

1991-03-30

and labeled for shipment. The vial is then encased ip a plastic container with absorbant material. The plastic container is then packed into a metal ...and Pesado , D., (1985) Production and toxicity of Gambierdiscus tcxicas, Adacbh and Fukuyo (Dinophyceae), Phycologia, 24, 2 17-223. 96. Durand, M

Poisoning in Israel: annual report of the Israel Poison Information Center, 2012.

Science.gov (United States)

Bentur, Yedidia; Lurie, Yael; Cahana, Alfred; Kovler, Nona; Bloom-Krasik, Anna; Gurevych, Bella; Klein-Schwartz, Wendy

2014-11-01

The Israel National Poison Information Center (IPIC), Rambam Health Care Campus, provides 24 hour telephone consultations in clinical toxicology as well as drug and teratogen information. It participates in research, teaching and regulatory activities, and also provides laboratory services. To report data on the epidemiology of poisonings and poison exposures in Israel. We made computerized queries and descriptive analyses of the medical records database of the IPIC during 2012. A total of 31,519 poison exposure cases were recorded, a 157.6% increase compared with 1995. Children snake venom. Four fatalities were recorded; all were intentional exposures in adults (corrosive, medications, energy drink). Poison exposures and poisonings have increased significantly and have contributed substantially to morbidity and mortality in Israel. The IPIC database is a valuable national resource for the collection and monitoring of poisoning exposure cases. It can be used as a real-time surveillance system for the benefit of public health. It is recommended that reporting to the IPIC become mandatory and its activities be adequately supported by national resources.

Survey of benthic dinoflagellates associated to beds of Thalassia testudinumin San Andres Island, Seaflower biosphere reserve, Caribbean Colombia

International Nuclear Information System (INIS)

Rodriguez E, Angelica; Mancera Pineda, J Ernesto; Gavio, Brigitte

2010-01-01

In order to determine the occurrence of epiphytic toxic dinoflagellates in the coastal waters of San Andres Island, Caribbean Colombia, we analyzed the sea grass beds on the northern and eastern sides of the island. We found seven species of toxicogenic dinoflagellates, belonging to the genera Prorocentrum and Ostreopsis. The cell densities were generally low if compared with previous studies in other Caribbean sites, ranging from 0 to 836 cells/dry weights. The species encountered are known to produce toxins causing the diarrheic shellfish poisoning and ciguatera, poisonings which have been documented in the island.

Merthiolate poisoning

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Merthiolate poisoning is difficult to treat. How well a person does depends on the amount of poison swallowed and how quickly treatment was received. The faster a person gets medical help, the better the chance for recovery. Kidney dialysis ( ...

Diagnosis of acute poisoning | Tygerberg Poison Information Centre ...

African Journals Online (AJOL)

Continuing Medical Education. Journal Home · ABOUT THIS JOURNAL · Advanced Search · Current Issue · Archives · Journal Home > Vol 21, No 8 (2003) >. Log in or Register to get access to full text downloads. Username, Password, Remember me, or Register. Diagnosis of acute poisoning. - Tygerberg Poison ...

Beryllium poisonings

International Nuclear Information System (INIS)

Alibert, S.

1959-03-01

This note reports a bibliographical study of beryllium toxicity. Thus, this bibliographical review addresses and outlines aspects and issues like aetiology, cases of acute poisoning (cutaneous manifestations, pulmonary manifestations), chronic poisoning (cutaneous, pulmonary and bone manifestations), excretion and localisation, and prognosis

Evaluation of poison information services provided by a new poison information center.

Science.gov (United States)

Churi, Shobha; Abraham, Lovin; Ramesh, M; Narahari, M G

2013-01-01

The aim of this study is to assess the nature and quality of services provided by poison information center established at a tertiary-care teaching hospital, Mysore. This was a prospective observational study. The poison information center was officially established in September 2010 and began its functioning thereafter. The center is equipped with required resources and facility (e.g., text books, Poisindex, Drugdex, toll free telephone service, internet and online services) to provide poison information services. The poison information services provided by the center were recorded in documentation forms. The documentation form consists of numerous sections to collect information on: (a) Type of population (children, adult, elderly or pregnant) (b) poisoning agents (c) route of exposure (d) type of poisoning (intentional, accidental or environmental) (e) demographic details of patient (age, gender and bodyweight) (f) enquirer details (background, place of call and mode of request) (g) category and purpose of query and (h) details of provided service (information provided, mode of provision, time taken to provide information and references consulted). The nature and quality of poison information services provided was assessed using a quality assessment checklist developed in accordance with DSE/World Health Organization guidelines. Chi-Square test (χ(2)). A total of 419 queries were received by the center. A majority (n = 333; 79.5%) of the queries were asked by the doctors to provide optimal care (n = 400; 95.5%). Most of the queries were received during ward rounds (n = 201; 48.0%), followed by direct access (n = 147; 35.1%). The poison information services were predominantly provided through verbal communication (n = 352; 84.0%). Upon receipt of queries, the required service was provided immediately (n = 103; 24.6%) or within 10-20 min (n = 296; 70.6%). The queries were mainly related to intentional poisoning (n = 258; 64.5%), followed by accidental poisoning

Brevenal inhibits pacific ciguatoxin-1B-induced neurosecretion from bovine chromaffin cells.

Directory of Open Access Journals (Sweden)

César Mattei

Full Text Available Ciguatoxins and brevetoxins are neurotoxic cyclic polyether compounds produced by dinoflagellates, which are responsible for ciguatera and neurotoxic shellfish poisoning (NSP respectively. Recently, brevenal, a natural compound was found to specifically inhibit brevetoxin action and to have a beneficial effect in NSP. Considering that brevetoxin and ciguatoxin specifically activate voltage-sensitive Na+ channels through the same binding site, brevenal has therefore a good potential for the treatment of ciguatera. Pacific ciguatoxin-1B (P-CTX-1B activates voltage-sensitive Na+ channels and promotes an increase in neurotransmitter release believed to underpin the symptoms associated with ciguatera. However, the mechanism through which slow Na+ influx promotes neurosecretion is not fully understood. In the present study, we used chromaffin cells as a model to reconstitute the sequence of events culminating in ciguatoxin-evoked neurosecretion. We show that P-CTX-1B induces a tetrodotoxin-sensitive rise in intracellular Na+, closely followed by an increase in cytosolic Ca2+ responsible for promoting SNARE-dependent catecholamine secretion. Our results reveal that brevenal and beta-naphtoyl-brevetoxin prevent P-CTX-1B secretagogue activity without affecting nicotine or barium-induced catecholamine secretion. Brevenal is therefore a potent inhibitor of ciguatoxin-induced neurotoxic effect and a potential treatment for ciguatera.

Brevenal inhibits pacific ciguatoxin-1B-induced neurosecretion from bovine chromaffin cells.

Science.gov (United States)

Mattei, César; Wen, Peter J; Nguyen-Huu, Truong D; Alvarez, Martha; Benoit, Evelyne; Bourdelais, Andrea J; Lewis, Richard J; Baden, Daniel G; Molgó, Jordi; Meunier, Frédéric A

2008-01-01

Ciguatoxins and brevetoxins are neurotoxic cyclic polyether compounds produced by dinoflagellates, which are responsible for ciguatera and neurotoxic shellfish poisoning (NSP) respectively. Recently, brevenal, a natural compound was found to specifically inhibit brevetoxin action and to have a beneficial effect in NSP. Considering that brevetoxin and ciguatoxin specifically activate voltage-sensitive Na+ channels through the same binding site, brevenal has therefore a good potential for the treatment of ciguatera. Pacific ciguatoxin-1B (P-CTX-1B) activates voltage-sensitive Na+ channels and promotes an increase in neurotransmitter release believed to underpin the symptoms associated with ciguatera. However, the mechanism through which slow Na+ influx promotes neurosecretion is not fully understood. In the present study, we used chromaffin cells as a model to reconstitute the sequence of events culminating in ciguatoxin-evoked neurosecretion. We show that P-CTX-1B induces a tetrodotoxin-sensitive rise in intracellular Na+, closely followed by an increase in cytosolic Ca2+ responsible for promoting SNARE-dependent catecholamine secretion. Our results reveal that brevenal and beta-naphtoyl-brevetoxin prevent P-CTX-1B secretagogue activity without affecting nicotine or barium-induced catecholamine secretion. Brevenal is therefore a potent inhibitor of ciguatoxin-induced neurotoxic effect and a potential treatment for ciguatera.

Lead Poisoning (For Parents)

Science.gov (United States)

... Staying Safe Videos for Educators Search English Español Lead Poisoning KidsHealth / For Parents / Lead Poisoning What's in ... Print en español La intoxicación por plomo About Lead Poisoning If you have young kids, it's important ...

Extracorporeal Treatment for Lithium Poisoning

DEFF Research Database (Denmark)

Decker, Brian S; Goldfarb, David S; Dargan, Paul I

2015-01-01

The Extracorporeal Treatments in Poisoning Workgroup was created to provide evidence-based recommendations on the use of extracorporeal treatments in poisoning. Here, the EXTRIP workgroup presents its recommendations for lithium poisoning. After a systematic literature search, clinical and toxico......The Extracorporeal Treatments in Poisoning Workgroup was created to provide evidence-based recommendations on the use of extracorporeal treatments in poisoning. Here, the EXTRIP workgroup presents its recommendations for lithium poisoning. After a systematic literature search, clinical...... extraction of patient-level data. The workgroup concluded that lithium is dialyzable (Level of evidence=A) and made the following recommendations: Extracorporeal treatment is recommended in severe lithium poisoning (1D). Extracorporeal treatment is recommended if kidney function is impaired and the [Li...... treatment (1D), but continuous RRT is an acceptable alternative (1D). The workgroup supported the use of extracorporeal treatment in severe lithium poisoning. Clinical decisions on when to use extracorporeal treatment should take into account the [Li(+)], kidney function, pattern of lithium toxicity...

Pick your poison: what's new in poison control for the preschooler.

Science.gov (United States)

Glenn, Lauren

2015-01-01

Accidental childhood poisonings are a major public health concern despite many efforts to alleviate this problem. While the rate of pediatric fatalities due to poisonings have decreased over the last two decades, poison control centers around the US have collectively fielded over one million calls with regard to toxic exposures in the preschool age group. According to the American Association of Poison Control Centers nearly half of all human exposures reported last year involved children under six. By focusing poison prevention efforts on the preschooler, we can attempt to decrease morbidity and mortality in the most vulnerable age group affected. Although the subject is still prevalent, current discussion on this topic is limited. Newer literature discusses past initiatives such as child resistant packaging and sticker deterrent programs and addresses their efficacy. This article revisits older mechanisms of prevention as well as the science behind the human motivation to change one's own practice and behavior. Copyright © 2015 Elsevier Inc. All rights reserved.

Comparison of poisonings managed at military and Veterans Administration hospitals reported to Texas poison centers.

Science.gov (United States)

Forrester, M B

2017-01-01

There is little information on poisonings managed at military and Veterans Administration (VA) hospitals. This investigation described and compared poisonings reported to Texas poison centers that were managed at military and VA hospitals. Retrospective analysis of poison centre data. Cases were poisonings among patients aged 18 years or more reported to Texas poison centers during 2000-2015 where management occurred at a military or VA hospital. The distribution of exposures for various demographic and clinical factors was determined for military and veterans hospitals and comparisons were made between the two groups. There were 4353 and 1676 poisonings managed at military and VA hospitals, resepctively. Males accounted for 50.5% of the military hospital patients and 84.9% of the VA hospital patients. The mean age for military hospital patients was 31 years and for VA hospital patients was 50 years. The proportion of poisonings managed at military hospitals and VA hospitals, respectively, were intentional (70.0% vs 64.1%), particularly suspected attempted suicide (57.3% vs 47.7%), and unintentional (25.0% vs 30.5%). More than one substance was reported in 37.7% of military and 33.2% of VA hospital poisonings. The most commonly reported substance categories for poisonings managed at military and VA hospitals, respectively, were analgesics (28.4% vs 19.7%), sedatives/hypnotics/antipsychotics (24.7% vs 23.4%), antidepressants (18.7% vs 19.7%) and alcohol (11.3% vs 10.6%). A number of differences were observed between poisonings managed at military and VA hospitals. These differing patterns of poisonings may need to be taken into account in the education, prevention and treatment of poisonings at these hospitals and among the populations they serve. Copyright © 2016 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved.

Poison control services in China

International Nuclear Information System (INIS)

Wu Yiqun; Sun Chengye

2004-01-01

The following aspects are discussed: the public health problems of acute poisoning in China in recent years; the characteristics of acute poisoning; the negative effects of poison cases on the society and economy. The four stages of development of a poison control system in China are: (1) clinical hospital as the only facility used for detoxification; (2) institutes and hospitals of occupational medicine got involved in the program; (3) the traditional model of poison control changed to the modern National Poison Control Center (NPCC), and its network got established and it began to play a key role; (4) establishment of a multi-disciplinary network for dealing with emergencies in which chemical poison control is an important component. Introduction of the operations of the NPCC: the functions of the center are a 24 h hotline service, clinical consultants service, poison identification and diagnosis, laboratory analysis, education for public, training for physicians, coordination of anti-dotes, and the development of a network of poison control centers for dealing with chemical emergencies. The work practice and achievement of NPCC and its network in the field of poison control during the last 3 years is discussed. Lessons from SARS infection: to extend the network, to strengthen multi-disciplinary cooperation, enhance communication between centers, to pay attention to capacity building, to improve reporting systems, and to share resources

[Plant poisoning cases in Turkey].

Science.gov (United States)

Oztekin-Mat, A

1994-01-01

In Turkey, the majority of the population live in rural areas where they use wild plants as food and medicine. The confusion of an edible plant with a poisonous one give rise to serious poisoning which may even result in death. The incidence of plant poisoning in Turkey is about 6% and especially high among children between ages of 2 and 11 living in rural areas. The number of species that cause poisoning is around twenty and Hyoscyamus niger (Solanaceae), Colchicum species (Liliaceae), Conium maculatum (Umbelliferae) and Prunus species (Rosaceae) are the most important. Mushroom poisoning is more frequent in spring and fall. The main reasons are their widespread usage as food and the inexperience of the gatherers in distinguishing the edibles from the poisonous. Amanita phalloides, A. verna, A. muscaria, A. pantherina are responsible for severe cases of poisoning.

Mercuric chloride poisoning

Science.gov (United States)

... page: //medlineplus.gov/ency/article/002474.htm Mercuric chloride poisoning To use the sharing features on this page, please enable JavaScript. Mercuric chloride is a very poisonous form of mercury. It ...

Hair straightener poisoning

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... this page: //medlineplus.gov/ency/article/002706.htm Hair straightener poisoning To use the sharing features on this page, please enable JavaScript. Hair straightener poisoning occurs when someone swallows products that ...

Hair spray poisoning

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... this page: //medlineplus.gov/ency/article/002705.htm Hair spray poisoning To use the sharing features on this page, please enable JavaScript. Hair spray poisoning occurs when someone breathes in (inhales) ...

Determinants of U.S. poison center utilization.

Science.gov (United States)

Litovitz, Toby; Benson, Blaine E; Youniss, Jessica; Metz, Edward

2010-06-01

High poison center utilization has been associated with decreased emergency department usage and hospitalization rates. However, utilization requires awareness of the poison center. Penetrance, defined as the number of human poison exposures reported to a poison center per 1,000 population, has been used as a marker of poison center awareness. To identify factors that influence poison center penetrance to optimize the life- and cost-saving benefits of poison control centers. Human poison exposures that were reported to the National Poison Data System in 2001 were analyzed to identify and rank factors affecting poison center penetrance. Overall penetrance correlated with pediatric penetrance (R(2) = 0.75, p poison center that were already in or en route to a healthcare facility at the time of the call to the poison center (R(2) = 0.41, p poison center service populations were associated with lower penetrance (R(2) = 0.23, p poison center (multiple regression). Positive predictors included the percentage of the population younger than 5 years, the percentage of the adult population with a bachelor's degree, poison center certification, poison center educator FTEs (full time equivalents), Asian population percentage, and population density. The inverse correlation between pediatric penetrance and healthcare facility utilization supports prior observations of excessive healthcare utilization when a poison center is not called. Since race, language and distance are barriers to poison center utilization, and since healthcare utilization increases when poison center penetrance declines, low penetrance suggests a lack of awareness of the poison center rather than a low incidence of poisonings. Strategies to raise penetrance should be informed by an understanding of the barriers to utilization - language, Black/African American race, distance from the poison center, poverty, and lower education levels.

Synthesis of the EF-ring of ciguatoxin 3C based on the [2,3]-Wittig rearrangement and ring-closing olefin metathesis.

Science.gov (United States)

Goto, Akiyoshi; Fujiwara, Kenshu; Kawai, Ayako; Kawai, Hidetoshi; Suzuki, Takanori

2007-12-20

The EF-ring segment of ciguatoxin 3C, a causative toxin of ciguatera fish poisoning, was synthesized in three major steps: 1,4-addition for the C20O-C27 bond connection, chirality transferring anti selective [2,3]-Wittig rearrangement for the construction of the anti-2-hydroxyalkyl ether part, and ring-closing olefin metathesis for the F-ring formation.

Monitoreo de Dinoflagelados Causantes de Ciguatera en las Aguas de Punta Galeta, Colón, Panamá

OpenAIRE

González, Alexander; Fábrega, José; Broce, Kathia

2018-01-01

Los océanos son la clave para la conservación de la vida y son la conexión para los ecosistemas y el mercado mundial. Los seres humanos somos atraídos a las zonas costeras por los múltiples beneficios que nos brinda, siendo el principal la pesca. A través de los productos del mar que consumimos, podemos resultar contaminados con toxinas que producen unos microorganismos acuáticos llamados  dinoflagelados que a su vez pueden causar la enfermedad ciguatera. En Panamá dentro el Paisaje Protegido...

Black-spot poison ivy.

Science.gov (United States)

Schram, Sarah E; Willey, Andrea; Lee, Peter K; Bohjanen, Kimberly A; Warshaw, Erin M

2008-01-01

In black-spot poison ivy dermatitis, a black lacquerlike substance forms on the skin when poison ivy resin is exposed to air. Although the Toxicodendron group of plants is estimated to be the most common cause of allergic contact dermatitis in the United States, black-spot poison ivy dermatitis is relatively rare.

SURVEY OF BENTHIC DINOFLAGELLATES ASSOCIATED TO BEDS OF Thalassia testudinum IN SAN ANDRÉS ISLAND, SEAFLOWER BIOSPHERE RESERVE, CARIBBEAN COLOMBIA

Directory of Open Access Journals (Sweden)

Brigitte Gavio

2010-05-01

Full Text Available In order to determine the occurrence of epiphytic toxic dinoflagellates in the coastal waters of San Andrés Island, Caribbean Colombia, we analyzed the seagrass beds on the northern and eastern sides of the island. We found seven species of toxicogenic dinoflagellates, belonging to the genera Prorocentrum and Ostreopsis. The cell densities were generally low if compared with previous studies in other Caribbean sites, ranging from 0 to 836 cells/dry weight. The species encountered are known to produce toxins causing the Diarrehic Shellfish Poisoning and Ciguatera, poisonings which have been documented in the island.

Poisoning first aid

Science.gov (United States)

... page: //medlineplus.gov/ency/article/007579.htm Poisoning first aid To use the sharing features on this page, ... burns Stupor Unconsciousness (coma) Unusual breath odor Weakness First Aid Seek immediate medical help. For poisoning by swallowing ...

Isopropanol alcohol poisoning

Science.gov (United States)

Rubbing alcohol poisoning; Isopropyl alcohol poisoning ... Isopropyl alcohol can be harmful if it is swallowed or gets in the eyes. ... These products contain isopropanol: Alcohol swabs Cleaning supplies ... Rubbing alcohol Other products may also contain isopropanol.

Hydrochloric acid poisoning

Science.gov (United States)

Hydrochloric acid is a clear, poisonous liquid. It is highly corrosive, which means it immediately causes severe damage, such ... poisoning due to swallowing or breathing in hydrochloric acid. This article is for information only. Do NOT ...

Mercurial poisoning

Energy Technology Data Exchange (ETDEWEB)

Gorton, B

1924-01-01

Cats which had been kept in a thermometer factory to catch rats were afflicted with mercury poisoning. So were the rats they were supposed to eat. The symptoms of mercury poisoning were the same in both species. The source of mercury for these animals is a fine film of the metal which coats floors, a result of accidental spills during the manufacturing process.

Gaseous poison injection device

International Nuclear Information System (INIS)

Kubota, Ryuji; Sugisaki, Toshihiko; Inada, Ikuo.

1983-01-01

Purpose: To rapidly control the chain reaction due to thermal neutrons in a reactor core by using gaseous poisons as back-up means for control rod drives. Constitution: Gaseous poisons having a large neutron absorption cross section are used as back-up means for control rod drives. Upon failure of control rod insertion, the gaseous poisons are injected into the lower portion of the reactor core to control the reactor power. As the gaseous poisons, vapors at a high temperature and a higher pressure than that of the coolants in the reactor core are injected to control the reactor power due to the void effects. Since the gaseous poisons thus employed rapidly reach the reactor core and form gas bubbles therein, the deccelerating effect of the thermal neutrons is decreased to reduce the chain reaction. (Moriyama, K.)

Chelation Therapy for Mercury Poisoning

Directory of Open Access Journals (Sweden)

Rong Guan

2009-01-01

Full Text Available Chelation therapy has been the major treatment for heavy metal poisoning. Various chelating agents have been developed and tested for treatment of heavy metal intoxications, including mercury poisoning. It has been clearly shown that chelating agents could rescue the toxicity caused by heavy metal intoxication, but the potential preventive role of chelating agents against heavy metal poisoning has not been explored much. Recent paper by Siddiqi and colleagues has suggested a protective role of chelating agents against mercury poisoning, which provides a promising research direction for broader application of chelation therapy in prevention and treatment of mercury poisoning.

Extracorporeal treatment for thallium poisoning

DEFF Research Database (Denmark)

Ghannoum, Marc; Nolin, Thomas D; Goldfarb, David S

2012-01-01

The EXtracorporeal TReatments In Poisoning (EXTRIP) workgroup was formed to provide recommendations on the use of extracorporeal treatment (ECTR) in poisoning. To test and validate its methods, the workgroup reviewed data for thallium (Tl).......The EXtracorporeal TReatments In Poisoning (EXTRIP) workgroup was formed to provide recommendations on the use of extracorporeal treatment (ECTR) in poisoning. To test and validate its methods, the workgroup reviewed data for thallium (Tl)....

[Electronic poison information management system].

Science.gov (United States)

Kabata, Piotr; Waldman, Wojciech; Kaletha, Krystian; Sein Anand, Jacek

2013-01-01

We describe deployment of electronic toxicological information database in poison control center of Pomeranian Center of Toxicology. System was based on Google Apps technology, by Google Inc., using electronic, web-based forms and data tables. During first 6 months from system deployment, we used it to archive 1471 poisoning cases, prepare monthly poisoning reports and facilitate statistical analysis of data. Electronic database usage made Poison Center work much easier.

Carbon Monoxide Poisoning

Directory of Open Access Journals (Sweden)

Kamal Mishra

2016-01-01

Full Text Available Introduction: Carbon monoxide is known as the silent killer, being colorless, odourless, and tasteless. Initially non-irritating, it is very difficult for people to detect Carbon monoxide is a product of incomplete combustion of organic matter due to insufficient oxygen supply that prevents complete oxidation of carbon to C02. During World War II, Nazis used gas vans to kill an estimated over 700,000 prisoners by carbon monoxide poisoning. This method was also used in the gas chambers ofseveral death camps. The true number of incidents of carbon monoxide poisoning is unknown, since many non-lethal exposures go undetected From the available data, carbon monoxide poisoning is the most common cause of injury and death due to poisoning worldwide. Clinical features and management: The signs of carbon monoxide poisoning vary with concentration and length of exposure. Subtle cardiovascular or neurobehavioural effects occur at low concentration. The onset of chronic poisoning is usually insidious and easily mistaken for viral prodrome, depression, or gastroenteritis in children. The classic sign of carbon monoxide poisoning which is actually more often seen in the dead than the living is appearing red-cheeked and healthy. Cherry pink colour develops in nails, skin and mucosa. In acute poisoning, common abnormalities of posture and tone are cogwheel rigidity, opisthotonus, spasticity or flaccidity and seizures. Retinal haemorrhages and the classic cherry red skin colour are seldom seen. Different people andpopulations may have different carbon monoxide tolerance levels. On average, exposures at 100ppm or greater is dangerous to human health. Treatment and prevention: The mainstay of treatment is 100% oxygen administration until the COHb level is normal When the patient is stable enough to be transported, hyperbaric oxygen (HBOT should be considered This treatment is safe and well tolerated Public education about the danger of carbon monoxide, with

Amnesic Shellfish Poisoning

Science.gov (United States)

... Since then, the death or stranding of other marine animals, including whales, has been suspected or confirmed to ... sickened or die due to domoic acid poisoning. Animals poisoned by domoic acid include seabirds and marine mammals, including sea lions, sea otters, whales. Domoic- ...

Burnable poison rod

International Nuclear Information System (INIS)

Natsume, Tomohiro.

1988-01-01

Purpose: To increase the reactor core lifetime by decreasing the effect of neutron absorption of burnable poison rods by using material with less neutron absorbing effect. Constitution: Stainless steels used so far as the coating material for burnable poison rods have relatively great absorption in the thermal neutral region and are not preferred in view of the neutron economy. Burnable poison rods having fuel can made of zirconium alloy shows absorption the thermal neutron region lower by one digit than that of stainless steels but they shows absorption in the resonance region and the cost is higher. In view of the above, the fuel can of the burnable poison material is made of aluminum or aluminu alloy. This can reduce the neutron absorbing effect by stainless steel fuel can and effectively utilize neutrons that have been wastefully absorbed and consumed in stainless steels. (Takahashi, M.)

Lithium Poisoning

DEFF Research Database (Denmark)

Baird-Gunning, Jonathan; Lea-Henry, Tom; Hoegberg, Lotte C G

2017-01-01

Lithium is a commonly prescribed treatment for bipolar affective disorder. However, treatment is complicated by lithium's narrow therapeutic index and the influence of kidney function, both of which increase the risk of toxicity. Therefore, careful attention to dosing, monitoring, and titration...... is required. The cause of lithium poisoning influences treatment and 3 patterns are described: acute, acute-on-chronic, and chronic. Chronic poisoning is the most common etiology, is usually unintentional, and results from lithium intake exceeding elimination. This is most commonly due to impaired kidney...... function caused by volume depletion from lithium-induced nephrogenic diabetes insipidus or intercurrent illnesses and is also drug-induced. Lithium poisoning can affect multiple organs; however, the primary site of toxicity is the central nervous system and clinical manifestations vary from asymptomatic...

Phosphorus poisoning in waterfowl

Science.gov (United States)

Coburn, D.R.; DeWitt, J.B.; Derby, J.V.; Ediger, E.

1950-01-01

Black ducks and mallards were found to be highly susceptible to phosphorus poisoning. 3 mg. of white phosphorus per kg. of body weight given in a single dose resulted in death of a black duck in 6 hours. Pathologic changes in both acute and chronic poisoning were studied. Data are presented showing that diagnosis can be made accurately by chemical analysis of stored tissues in cases of phosphorus poisoning.

Carbon Monoxide (CO) Poisoning Prevention

Science.gov (United States)

... family by acting wisely in case of a power outage and learning the symptoms of CO poisoning. How to Recognize CO Poisoning The most common symptoms of CO poisoning are headache, dizziness, weakness, nausea, vomiting, chest pain, and confusion. People who are sleeping or who ...

Copper sulphate poisoning in horses

Energy Technology Data Exchange (ETDEWEB)

Bauer, M

1975-01-01

In the archives of the Clinic for Internal Diseases of Domestic Animals at the Veterinary Faculty of Zagreb University some thirty cases of horse disease diagnosed as copper sulphate poisoning were noted. The data correspond in many respects to the clinical findings of copper sulphate poisoning in other domestic animals. A series of experimental horse poisonings were undertaken in order to determine the toxicity of copper sulphate. The research results are as follows: Horses are sensitive to copper sulphate. Even a single application of 0.125 g/kg body weight in 1% concentration by means of incubation into the stomach causes stomach and gut disturbances and other poisoning symptoms. Poisoning occurs in two types: acute and chronic. The former appears after one to three applications of copper sulphate solution and is characterized by gastroenteritis, haemolysis, jaundice and haemoglobinuria with signs of consecutive damage of kidney, liver and other organs. The disease, from the first application to death lasts for two weeks. Chronic poisoning is caused by ingestion of dry copper sulphate in food (1% solution dried on hay or clover) for two or more months. There are chronic disturbances of stomach and gut and loss of weight, and consecutive (three to four) haemolytic crises similar to those of acute poisoning. From the beginning of poisoning to death six or more months can elapse.

What is the definition of a poisoning?

Science.gov (United States)

Uges, D R

2001-03-01

New insights in medicine and acceptable treatments necessitates an adjustment of the existing definition of clinical or forensic poisoning to: 'An individual's medical or social unacceptable condition as a consequence of being under influence of an exogenous substance in a dose too high for the person concerned'. For medical and legal purposes it is important to know how the victim became poisoned. In general, there are three ways of causing medical poisoning: accidental poisoning, including iatrogenic poisoning, experimental and intentional poisoning. Nowadays iatrogenic intoxication, poisoning caused by the Münchhausen's syndrome (by proxy) and experimental poisoning (designer drugs) have a major place in contemporary toxicology. Although some toxicologists use the word 'intoxication' only overdoses with central effects, in this article 'intoxication' and 'poisoning' are considered to be synonymous.

Ciguatoxin-induced catecholamine secretion in bovine chromaffin cells: mechanism of action and reversible inhibition by brevenal.

Science.gov (United States)

Nguyen-Huu, Truong D; Mattei, César; Wen, Peter J; Bourdelais, Andrea J; Lewis, Richard J; Benoit, Evelyne; Baden, Daniel G; Molgó, Jordi; Meunier, Frédéric A

2010-10-01

Ciguatoxin (P-CTX-1B) from the dinoflagellate Gambierdiscus toxicus, belongs to the family of polyether neurotoxins responsible for the neurological poisoning disorder ciguatera. Although it is the most widespread marine-borne disease affecting humans, there is no current FDA-approved treatment available except for symptomatic therapies. In this paper, we report that P-CTX-1B promotes catecholamine secretion from bovine chromaffin cells, an effect that is insensitive to concomitant activation of capacitative Ca(2+) entry. Moreover, we confirm that brevenal, a polyether from the dinoflagellate Karenia brevis, blocks P-CTX-1B-induced catecholamine secretion. This effect is partially reversible. Our results therefore raise the prospect of finding functional antagonists for P-CTX-1B that could be useful for the treatment of ciguatera. Copyright 2009 Elsevier Ltd. All rights reserved.

A Rare but Potentially Fatal Poisoning; Aluminum Phosphide Poisoning

Directory of Open Access Journals (Sweden)

Orkun Tolunay

2017-04-01

Full Text Available Phosphide, a very toxic gas, is used in our country as aluminium phosphide tablets impregnated in clay. It is widely used since it has a very high diffusion capacity, whereby it can eradicate all living creatures in any form of their life cycle and does not leave any remnants in agricultural products. Aluminum phosphide poisoning is among intoxications for which there are still no true antidotes. Mortality rate varies between 30% and 100%. This paper presents a case of aluminum phosphide poisoning caused by the uncompleted suicide attempt. A 14-year-old girl, who swallowed aluminum phosphate tablets, was brought to the emergency department with the complaints of nausea and vomiting. The patient was treated with gastric lavage and activated charcoal. Since the patient ingested a lethal amount of aluminum phosphide, she was referred to the pediatric intensive care unit. The patient was discharged in stable condition after supportive care and monitoring. Specific antidotes are life-saving in poisonings. However, this case was presented to show how general treatment principles and quick access to health services affect the result of treatment. Also, we aimed to highlight the uncontrolled selling of aluminum phosphate, which results in high mortality rates in case of poisoning.

Poisoning - Multiple Languages

Science.gov (United States)

... Well-Being 6 - Poison Safety - Amarɨñña / አማርኛ (Amharic) MP3 Siloam Family Health Center Arabic (العربية) Expand Section ... Well-Being 6 - Poison Safety - myanma bhasa (Burmese) MP3 Siloam Family Health Center Dari (دری) Expand Section ...

49 CFR 172.430 - POISON label.

Science.gov (United States)

2010-10-01

... 49 Transportation 2 2010-10-01 2010-10-01 false POISON label. 172.430 Section 172.430... SECURITY PLANS Labeling § 172.430 POISON label. (a) Except for size and color, the POISON label must be as follows: EC02MR91.029 (b) In addition to complying with § 172.407, the background on the POISON label must...

49 CFR 172.554 - POISON placard.

Science.gov (United States)

2010-10-01

... 49 Transportation 2 2010-10-01 2010-10-01 false POISON placard. 172.554 Section 172.554... SECURITY PLANS Placarding § 172.554 POISON placard. (a) Except for size and color, the POISON placard must be as follows: EC02MR91.057 (b) In addition to complying with § 172.519, the background on the POISON...

Neurotoxins from Marine Dinoflagellates: A Brief Review

Directory of Open Access Journals (Sweden)

Da-Zhi Wang

2008-06-01

Full Text Available Dinoflagellates are not only important marine primary producers and grazers, but also the major causative agents of harmful algal blooms. It has been reported that many dinoflagellate species can produce various natural toxins. These toxins can be extremely toxic and many of them are effective at far lower dosages than conventional chemical agents. Consumption of seafood contaminated by algal toxins results in various seafood poisoning syndromes: paralytic shellfish poisoning (PSP, neurotoxic shellfish poisoning (NSP, amnesic shellfish poisoning (ASP, diarrheic shellfish poisoning (DSP, ciguatera fish poisoning (CFP and azaspiracid shellfish poisoning (ASP. Most of these poisonings are caused by neurotoxins which present themselves with highly specific effects on the nervous system of animals, including humans, by interfering with nerve impulse transmission. Neurotoxins are a varied group of compounds, both chemically and pharmacologically. They vary in both chemical structure and mechanism of action, and produce very distinct biological effects, which provides a potential application of these toxins in pharmacology and toxicology. This review summarizes the origin, structure and clinical symptoms of PSP, NSP, CFP, AZP, yessotoxin and palytoxin produced by marine dinoflagellates, as well as their molecular mechanisms of action on voltage-gated ion channels.

Extracorporeal treatment for barbiturate poisoning

DEFF Research Database (Denmark)

Mactier, Robert; Laliberté, Martin; Mardini, Joelle

2014-01-01

The EXTRIP (Extracorporeal Treatments in Poisoning) Workgroup conducted a systematic review of barbiturate poisoning using a standardized evidence-based process to provide recommendations on the use of extracorporeal treatment (ECTR) in patients with barbiturate poisoning. The authors reviewed all...... treatment should be continued during ECTR. (4) Cessation of ECTR is indicated when clinical improvement is apparent. This report provides detailed descriptions of the rationale for all recommendations. In summary, patients with long-acting barbiturate poisoning should be treated with ECTR provided at least......-acting barbiturates are dialyzable and short-acting barbiturates are moderately dialyzable. Four key recommendations were made. (1) The use of ECTR should be restricted to cases of severe long-acting barbiturate poisoning. (2) The indications for ECTR in this setting are the presence of prolonged coma, respiratory...

Bubble bath soap poisoning

Science.gov (United States)

... medlineplus.gov/ency/article/002762.htm Bubble bath soap poisoning To use the sharing features on this page, please enable JavaScript. Bubble bath soap poisoning occurs when someone swallows bubble bath soap. ...

[Suicidal poisoning with benzodiazepines].

Science.gov (United States)

Chodorowski, Z; Sein Anand, J

1997-01-01

In the period from 1987 to 1996, 103 patients with suicidal benzodiazepines poisoning were treated, including 62 women and 41 men from 16 to 79 (mean 34) years old. 23 persons were poisoned only by benzodiazepines, in 80 remaining cases intoxications were mixed eg. including benzodiazepines and alcohol, tricyclic antidepressants, barbiturates, opioids, phenothiazines. The main causes of suicides were mainly depression, drug addiction and alcoholism. Nobody died in the benzodiazepines group, while mortality rate in the group of mixed poisoning was 4%. Prescribing benzodiazepines by physicians was quite often not justified and facilitated, among others, accumulation of the dose sufficient for suicide attempt. Flumazenil was efficient for leading out from coma in 86% of cases with poisoning only by benzodiazepines and 13% of cases with mixed intoxications mainly containing benzodiazepines and alcohol or carbamazepine.

Poison 1 - a programme for calculation of reactivity transients due to fission product poisoning and its application in continuous determination of xenon and samarium poisoning in reactor KS-150

International Nuclear Information System (INIS)

Rana, S.B.

1973-12-01

The report contains a user's description of the 3-dimensional programme POISON 1 for calculating reactivity transients due to fission-product poisoning during changes of reactor power. The chapter dealing with Xe poisoning contains a description of Xe tables, the method of operational determination of Xe poisoning, use of Xe transients for calibrating control rods and means of shutting down the reactor without being overriden by Xe poisoning. Sm poisoning is determined continuously on the basis of the power diagram of reactor operation. In conclusion a possibility of using the programme in a process computer in combination with self-powered detectors as local power sensors is indicated. (author)

Oil-based paint poisoning

Science.gov (United States)

Paint - oil-based - poisoning ... Hydrocarbons are the primary poisonous ingredient in oil paints. Some oil paints have heavy metals such as lead, mercury, cobalt, and barium added as pigment. These heavy metals can cause additional ...

Poison exposures in young Israeli military personnel: a National Poison Center Data analysis.

Science.gov (United States)

Lavon, Ophir; Bentur, Yedidia

2017-06-01

To characterize poison exposures in young Israeli military personnel as reported to the national poison center. Retrospective poison center chart review over a 14-year period. Cases included were Israeli soldiers aged 18-21 years, the compulsory military service age required by the Israeli law. 1770 records of poison exposures in young military personnel were identified. Most exposed individuals involved males (n = 1268, 71.6%). Main routes of exposure were ingestion (n = 854, 48.3%), inhalation (n = 328, 18.6%) and ocular (n = 211, 11.9%). Accidents or misuse (n = 712, 40.2%) were the most frequently reported circumstances, followed by suicide attempts (370, 20.9%), and bites and stings (161, 9.1%). More than half of the cases involved chemicals (n = 939, 53.1%); hydrocarbons, gases and corrosives were the main causative agents. Pharmaceuticals (mainly analgesics) were involved in 519 (29.3%) cases, venomous animals (mainly scorpions, centipedes, and snakes) in 79 (4.5%). Clinical manifestations were reported in 666 (37.6%) cases, mostly gastrointestinal, neurologic, and respiratory. The vast majority of cases (1634, 92.3%) were asymptomatic or mildly affected; no fatalities were recorded. In 831 (46.9%) cases the clinical toxicologist recommended referral to an emergency department; ambulatory observation was recommended in 563 (31.8%) cases, and hospitalization in 86 (4.9%). Our data show that poison exposures among young soldiers involve mainly males, accidents, misuse and suicides, oral route and chemicals; most exposures were asymptomatic or with mild severity. Repeated evaluations of poison center data pertaining to military personnel is advised for identifying trends in poison exposure and characteristics in this particular population.

Lead poisoning in dogs

Energy Technology Data Exchange (ETDEWEB)

Wilson, M R; Lewis, G

1963-08-03

Within a short period, 14 cases of lead poisoning in the dogs have been encountered. A detailed record appears justified as no published reference can be found to this condition occurring in Britain and because reports from other countries stress the similarity of the clinical manifestations of lead poisoning to those of the common infections of the dog. Five of the 14 clinical cases of lead poisoning are described. The available literature is reviewed and the diagnosis and significance of the condition discussed. 19 references, 2 tables.

Spatial distribution of ciguateric fish in the Republic of Kiribati.

Science.gov (United States)

Chan, Wing Hei; Mak, Yim Ling; Wu, Jia Jun; Jin, Ling; Sit, Wai Hung; Lam, James Chung Wah; Sadovy de Mitcheson, Yvonne; Chan, Leo Lai; Lam, Paul Kwan Sing; Murphy, Margaret B

2011-06-01

Ciguatera is food poisoning caused by human consumption of reef fish contaminated with ciguatoxins (CTXs). The expanding international trade of tropical fish species from ciguatera-endemic regions has resulted in increased global incidence of ciguatera, and more than 50000 people are estimated to suffer from ciguatera each year worldwide. The Republic of Kiribati is located in the Pacific Ocean; two of its islands, Marakei and Tarawa, have been suggested as high-risk areas for ciguatera. The toxicities of coral reef fish collected from these islands, including herbivorous, omnivorous and carnivorous fish (24% [n=41], 8% [n=13] and 68% [n=117], respectively), were analyzed using the mouse neuroblastoma assay (MNA) after CTX extraction. The MNA results indicated that 156 fish specimens, or 91% of the fish samples, were ciguatoxic (CTX levels >0.01 ng g(-1)). Groupers and moray eels were generally more toxic by an order of magnitude than other fish species. All of the collected individuals of eight species (n=3-19) were toxic. Toxicity varied within species and among locations by up to 10000-fold. Cephalapholis argus and Gymnothorax spp. collected from Tarawa Island were significantly less toxic than those from Marakei Island, although all individuals were toxic based on the 0.01 ng g(-1) threshold. CTX concentrations in the livers of individuals of two moray eel species (Gymnothorax spp., n=6) were nine times greater than those in muscle, and toxicity in liver and muscle showed a strong positive correlation with body weight. The present study provides quantitative information on the ciguatoxicity and distribution of toxicity in fish for use in fisheries management and public health. Copyright © 2011 Elsevier Ltd. All rights reserved.

First- and second-generation total synthesis of ciguatoxin CTX3C

OpenAIRE

Inoue, Masayuki; Miyazaki, Keisuke; Uehara, Hisatoshi; Maruyama, Megumi; Hirama, Masahiro

2004-01-01

More than 20,000 people suffer annually from ciguatera seafood poisoning in subtropical and tropical regions. The extremely low content of the causative neurotoxins, designated as ciguatoxins, in fish has hampered isolation, detailed biological studies, and preparation of anti-ciguatoxin antibodies for detecting these toxins. Furthermore, the large (3 nm in length) and complex molecular structure of ciguatoxins has impeded chemists from completing their total synthesis. In this article, the f...

Diagnosis of acute poisoning

African Journals Online (AJOL)

Chantel

functional tissue damage in ... cury or alcohol) .... †The degree of poisoning, together with drug or poison levels, usually determines the .... monoxide, caffeine and the sym- .... the brain. It usually occurs when two or more drugs, which increase.

Cardiological aspects of carbon monoxide poisoning.

Science.gov (United States)

Marchewka, Jakub; Gawlik, Iwona; Dębski, Grzegorz; Popiołek, Lech; Marchewka, Wojciech; Hydzik, Piotr

2017-01-01

The aim of this study was to assess cardiological manifestations of carbon monoxide (CO) poisoning. Background/introduction: Carbon monoxide intoxication is one of the most important toxicological causes of morbidity and mortality worldwide. Early clinical manifestation of CO poisoning is cardiotoxicity. We enrolled 75 patients (34 males and 41 females, mean age 37.6 ± 17.7 y/o) hospitalized due to CO poisoning. Laboratory tests including troponin I, blood pressure measurements, HR and electrocardiograms (ECG) were collected. Pach's scale scoring and grading system was used to establish severity of poisoning. Grade of poisoning is positively correlated with troponin I levels and systolic blood pressure. Moreover, troponin levels are significantly correlated with exposition time, lactates and are higher in tachycardiac, hypertensive and positive ECG subpopulations. COHb levels are indicative of exposure but do not correlate with grade of poisoning. The main cause of CO poisoning were bathroom heaters - 83%, only 11% of examined intoxicated population were equipped with CO detectors. Complex cardiological screening covering troponin levels, ECG, blood pressure and heart rate measurements as well as complete blood count with particular attention to platelet parameters should be performed in each case where CO intoxication is suspected. More emphasis on education on CO poisoning is needed.

Plant Poisoning among Children in Rural Sri Lanka

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M. B. Kavinda Chandimal Dayasiri

2017-01-01

Full Text Available Plant poisoning is a common presentation in paediatric practice and an important cause of preventable mortality and morbidity in Sri Lanka. The burden of plant poisoning is largely underexplored. The current multicenter study based in rural Sri Lanka assessed clinical profiles, poison related factors, clinical management, complications, outcomes, and risk factors associated with plant poisoning in the paediatric age group. Among 325 children, 57% were male with 64% being below five years of age. 99.4% had ingested the poison. Transfer rate was 66.4%. Most had unintentional poisoning. Commonest poison plant was Jatropha circus and poisoning event happened mostly in home garden. 29% of parents practiced harmful first-aid practices. 32% of children had delayed presentations to which the commonest reason was lack of parental concern regarding urgency of seeking medical care. Presence of poisonous plants in home garden was the strongest risk factor for plant poisoning. Mortality rate was 1.2% and all cases had Oleander poisoning. The study revealed the value of community awareness regarding risk factors and awareness among healthcare workers regarding the mostly benign nature of plant poisoning in children in view of limiting incidence of plant poisoning and reducing expenditure on patient management.

Carbon Monoxide Poisoning

Directory of Open Access Journals (Sweden)

Alisa Wray

2016-07-01

Full Text Available Audience: This oral boards case is appropriate for all emergency medicine learners (residents, interns, and medical students. Introduction: Carbon monoxide (CO is a colorless and odorless gas that typically results from combustion. It binds hemoglobin, dissociating oxygen, causing headache, weakness, confusion and possible seizure or coma. Pulse oxygen levels may be falsely elevated. Practitioners should maintain a high index of suspicion for carbon monoxide poisoning. If caught early CO poisoning is reversible with oxygen or hyperbaric oxygen therapy. Objectives: The learner will assess a patient with altered mental status and weakness, ultimately identifying that the patient has carbon monoxide poisoning. The learner will treat the patient with oxygen and admit/transfer the patient for hyperbaric oxygenation. Method: Oral boards case

Heterogeneous burnable poisons:

International Nuclear Information System (INIS)

Leiva, Sergio; Agueda, Horacio; Russo, Diego

1989-01-01

The use of materials possessing high neutron absorption cross-section commonly known as 'burnable poisons' have its origin in BWR reactors with the purpose of improving the efficiency of the first fuel load. Later on, it was extended to PWR to compensate of initial reactivity without infringing the requirement of maintaining a negative moderator coefficient. The present tendency is to increase the use of solid burnable poisons to extend the fuel cycle life and discharge burnup. There are two concepts for the burnable poisons utilization: 1) heterogeneously distributions in the form of rods, plates, etc. and 2) homogeneous dispersions of burnable poisons in the fuel. The purpose of this work is to present the results of sinterability studies, performed on Al 2 O 3 -B 4 C and Al 2 O 3 -Gd 2 O 3 systems. Experiments were carried on pressing at room temperature mixtures of powders containing up to 5 wt % of B 4 C or Gd 2 O 3 in Al 2 O 3 and subsequently sintering at 1750 deg C in reducing atmosphere. Evaluation of density, porosity and microstructures were done and a comparison with previous experiences is shown. (Author) [es

Fission product poisoning in KS-150 reactor operation

International Nuclear Information System (INIS)

Rana, S.B.

1978-01-01

A three-dimensional model of the KS-150 reactor was used to study reactivity changes induced by reactor poisoning with fission products Xe 135 and Sm 149 . A comparison of transients caused by the poisoning showed the following differences: (1) the duration of the transient Xe poisoning (2 days) is shorter by one order of magnitude than the duration of Sm poisoning (20 days); however, the level of Xe poisoning is greater approximately by one order than the level of the Sm poisoning; (2) the level of steady-state Xe poisoning depends on the output level of the reactor; steady-state Sm poisoning does not depend on this level; (3) following reactor shutdown Xe poisoning may increase to the maximum value of up to Δrhosub(Xe)=20% and will then gradually decrease; Sm poisoning may reach maximum values of up to Δrhosub(Sm)=2% and does not decrease. (J.B.)

Arsenical poisoning of racehorses

Energy Technology Data Exchange (ETDEWEB)

Sutherland, G.N.; Fawell, E.V.; Brown, J.K.

1964-03-07

A case of arsenic poisoning in a training stable of Thoroughbred racehorses is described. This was due to the accidental spilling of an arsenical rat poison into the corn bin. Nine horses were affected. The mortality rate was 100 per cent. 1 table.

Potassium permanganate poisoning--a rare cause of fatal self poisoning.

OpenAIRE

Ong, K L; Tan, T H; Cheung, W L

1997-01-01

Attempted suicide by self poisoning is common because of the ready availability of drugs, whether prescribed or bought over the counter. In some cases, the ingestion of seemingly innocuous household products or chemicals can result in death. Potassium permanganate is an example. Poisoning with potassium permanganate can be fatal when a significant amount is ingested, as shown by a patient who suffered both the corrosive and systemic toxic effects of this chemical.

Cartap Hydrochloride Poisoning.

Science.gov (United States)

Kalyaniwala, Kimmin; Abhilash, Kpp; Victor, Peter John

2016-08-01

Cartap hydrochloride is a moderately hazardous nereistoxin insecticide that is increasingly used for deliberate self-harm in India. It can cause neuromuscular weakness resulting in respiratory failure. We report a patient with 4% Cartap hydrochloride poisoning who required mechanical ventilation for 36-hours. He recovered without any neurological deficits. We also review literature on Cartap hydrochloride poisoning. © Journal of the Association of Physicians of India 2011.

American Association of Poison Control Centers

Science.gov (United States)

... add poison control as a contact in your smartphone. Take the pledge! National Poison Prevention Week is March 19-25! Be a part of the conversation by following #PreventPoison and #NPPW2017 on social media, and check out AAPCC's NPPW webpage and press ...

RPV housed ATWS poison tank

International Nuclear Information System (INIS)

Oosterkamp, W.J.

1992-01-01

This patent describes a boiling water reactor (BWR) wherein housed within a reactor pressure vessel (RPV) is a nuclear core and an upper steam dome connected to a steam outlet in the RPV. The improvement comprises: a pressurized vessel disposed in the steam dome containing a neutron poison effective for inactivating the core and a first line for assaying the poison which first line runs to the outside of the RPV, the vessel being vented to the steam dome to pressurize the poison contained therein, the vessel being connected by a second line terminating beneath the core, the second line containing a valve which is actuable to release the poison through the line upon its actuation

49 CFR 172.540 - POISON GAS placard.

Science.gov (United States)

2010-10-01

... 49 Transportation 2 2010-10-01 2010-10-01 false POISON GAS placard. 172.540 Section 172.540... SECURITY PLANS Placarding § 172.540 POISON GAS placard. (a) Except for size and color, the POISON GAS... the POISON GAS placard and the symbol must be white. The background of the upper diamond must be black...

Common causes of poisoning: etiology, diagnosis and treatment.

Science.gov (United States)

Müller, Dieter; Desel, Herbert

2013-10-01

In 2011, German hospitals treated approximately 205 000 patients suffering from acute poisoning. Change is seen over time both in the types of poisoning that occur and in the indications for specific treatment. This article is based on a selective review of the literature, with special attention to the health reports of the German federal government, the annual reports of the GIZ-Nord Poisons Center (the poison information center for the four northwestern states of Germany, i.e. Bremen, Hamburg, Lower Saxony and Schleswig-Holstein), and the recommendations of international medical associations. From 1996 to 2011, the GIZ-Nord Poisons Center answered more than 450 000 inquiries, most of which involved exposures to medical drugs, chemicals, plants, foods, or cosmetics. Poisoning was clinically manifest in only a fraction of these cases. Ethanol intoxication is the commonest type of acute poisoning and suicide by medical drug overdose is the commonest type of suicide by poisoning. Death from acute poisoning is most commonly the result of either smoke inhalation or illegal drug use. Severe poisoning is only rarely due to the ingestion of chemicals (particularly detergents and cleaning products), cosmetics, or plant matter. Medical procedures that are intended to reduce the absorption of a poison or enhance its elimination are now only rarely indicated. Antidotes (e.g., atropine, 4-dimethylaminophenol, naloxone, toluidine blue) are available for only a few kinds of poisoning. Randomized clinical trials of treatment have been carried out for only a few substances. Most exposures to poisons can be treated with general emergency care and, if necessary, with symptomatic intensive-care measures. Poison information centers help ensure that cases of poisoning are dealt with efficiently. The data they collect are a useful aid to toxicological assessment and can serve as a point of departure for research projects.

49 CFR 172.416 - POISON GAS label.

Science.gov (United States)

2010-10-01

... 49 Transportation 2 2010-10-01 2010-10-01 false POISON GAS label. 172.416 Section 172.416... SECURITY PLANS Labeling § 172.416 POISON GAS label. (a) Except for size and color, the POISON GAS label... POISON GAS label and the symbol must be white. The background of the upper diamond must be black and the...

Modified poisoning severity score for early prognostic evaluation in acute paraquat poisoning

Directory of Open Access Journals (Sweden)

Feng-lin SONG

2018-04-01

Full Text Available Objective To study the applied value of modified poisoning severity score (PSS for early prognostic evaluation in acute paraquat poisoning. Methods Thirty-seven patients with acute paraquat poisoning from June 2013 to June 2016 were enrolled. The PSS score, the modified PSS score, the acute physiology and the chronic health status Ⅱ score (APACHE Ⅱ of the patients were calculated. The relationship between modified PSS and APACHE Ⅱ was analyzed. Also the factors that affect outcome were analyzed by logistic regression analysis. The work characteristic curve (ROC curve of the PSS, the modified PSS and the APECH Ⅱ were drawn and compared. Results There was a positive correlation between the risk of death and admission time, poisonous dose, the concentration of urine paraquat, and white blood cell count (P<0.05. There was a significant correlation between the modified PSS and the APACHE Ⅱ(P<0.0001. The immediate PSS score, the modified PSS score, and the APACHE Ⅱ score were significant for the prognosis of patients with acute paraquat poisoning. The area under the curve (AUC was in turn 0.774, 0.788, 0.799. Among them, the best bound of the modified PSS score was 6.5 (when the score is greater than 6.5, the risk of death is higher. Further comparison of the area under the three curves showed that there was no significant difference in the area under the ROC curve between the three scores in predicting the prognosis of death [P=0.7633(PSS-DPSS, P=0.7791(PSS-APACHE Ⅱ, P=0.8918(DPSS-APACHE Ⅱ]. Conclusion Modified PSS is helpful in early predicting the prognosis of acute paraquat poisoning. DOI: 10.11855/j.issn.0577-7402.2018.04.13

Chelation Therapy for Mercury Poisoning

OpenAIRE

Rong Guan; Han Dai

2009-01-01

Chelation therapy has been the major treatment for heavy metal poisoning. Various chelating agents have been developed and tested for treatment of heavy metal intoxications, including mercury poisoning. It has been clearly shown that chelating agents could rescue the toxicity caused by heavy metal intoxication, but the potential preventive role of chelating agents against heavy metal poisoning has not been explored much. Recent paper by Siddiqi and colleagues has suggested a protective role o...

National Poison Prevention Week Promotional Materials.

Science.gov (United States)

Poison Prevention Week Council, Washington, DC.

This collection of materials for parents, early childhood workers, the elderly, and anyone in situations requiring safeguards against poisoning, spans the years 1993 and 1994 and is intended to promote National Poison Prevention Week. The materials included are: (1) the 31-page, illustrated report on National Poison Prevention Week for 1993,…

Paraquat poisoning in the dog

International Nuclear Information System (INIS)

O'Sullivan, S.P.

1989-01-01

Recovery from paraquat poisoning in the dog is rare. This is a report of a case of recovery from confirmed paraquat poisoning in a clinical setting. The dog exhibited the usual signs of paraquat poisoning. The diagnosis was confirmed on toxicological analysis of urine using an ion exchange technique. The dog was treated with frusemide, nicotinamide, corticosteroids, α-tocopherol, vitamin A, etamiphylline camsylate and ampicillin. He recovered after seven weeks of intensive therapy. Alternative treatments are discussed

Levothyroxine Poisoning - Symptoms and Clinical Outcome

DEFF Research Database (Denmark)

Nygaard, Birgitte; Saedder, Eva A; Dalhoff, Kim

2015-01-01

Levothyroxine (LT), T4, poisoning is rarely associated with a severe outcome. However, cases with significant complications have been reported. The aim of this study was to identify factors associated with symptoms of poisoning including late-onset symptoms. All enquiries to the Danish Poison...... Information Centre (DPIC) concerning LT poisoning between March 2007 and September 2012 were reviewed and the following parameters were recorded: age, dose, time from ingestion, multiple drug intake and symptoms. To evaluate the frequency of late-onset symptoms, a subgroup of patients without initial symptoms...... patients, neither in children nor in adults (age 16-92 years) (p poisoning at the time of enquiry; however, in 9 of 21 (43%) patients, we were able to contact, late-onset symptoms existed. In none of the cases...

Characteristics of poisoning cases in Adiyaman city

Directory of Open Access Journals (Sweden)

Öznur Uludağ

2015-09-01

Full Text Available Objective: Aim of this study was to retrospectively evaluate poisoning cases in an intensive care unit (ICU in order to determine the profile of poisoning cases, update epidemiological data in Adiyaman, and contribute to data about poisoning in our country. Methods: Between 01-01-2012 and 31-12-2013 174 patients (116 males, 58 females with a mean age of 23.7 years were treated. Demographic characteristics, reasons and ways of poisoning, types of toxic substances, length of their ICU stay and prognosis were evaluated. Results: 2733 patients admitted to the intensive care unit were 174 poisoning cases. Poisoning ways were suicide by drug overdose (n=162, 93.1%, and accidental poisoning (n=12,6.9%.119 patients (66.5% had single drug intake, thirty-three patients (18.4% with multiple drug intake, and 16 (8.9% were poisoned by organic phosphates. The most common drug used for suicide was antidepressants (n=87.5%. 32 patients (18.4% took analgesics and anti-inflammatory drugs. A total of 152 patients taking the drug, 22 patients were poisoned by other means. The median length of patient stay was 2 days (range 1-20 days. Ninety-nine patients (56.9% recovered and were discharged.72 patients (41.4% were admitted to inpatient after intensive care unit. Patients were followed up by asking poisoning suicidal psychiatric consultation.1 patient was followed up for 20 days in intensive care due to alcohol poisoning but was died.2 patients (1.1% were referred to a center forward. Conclusion: Majority of the patients were females, who took drugs with suicidal intention. Frequent use of antidepressants, which are not subject to control by authorities, to commit suicide was remarkable.

Chronic arsenic poisoning following ayurvedic medication.

Science.gov (United States)

Pinto, Benzeeta; Goyal, Palvi; Flora, S J S; Gill, K D; Singh, Surjit

2014-12-01

Ayurveda, Indian traditional system of medicine, is practiced commonly in South East Asia and in many parts of the world. Many ayurvedic drugs contain heavy metals and may lead to metal toxicity. Of these, chronic lead poisoning is the most common. Chronic arsenic poisoning following the use of ayurvedic medication, though reported, is rare. We describe three patients who presented with features of chronic arsenic poisoning following prolonged ayurvedic medication use. The diagnosis of chronic arsenic poisoning was confirmed by high arsenic levels in the blood, urine, hair, and nails in all the three patients and in ayurvedic drug in two patients. The ayurvedic medication was discontinued and treatment with D-penicillamine started. At 6 months after treatment, blood arsenic levels returned to normal with clinical recovery in all of them. Arsenic poisoning following ayurvedic medication is much less common than lead poisoning, though mineral ayurvedic medicines may lead to it. We used D-penicillamine as chelator and all of them recovered. Whether withdrawal of medication alone or D-penicillamine also played a role in recovery is unclear and needs to be assessed.

Pulmonary edema in acute carbon monoxide poisoning

International Nuclear Information System (INIS)

Kim, Kun Sang; Chang, Kee Hyun; Lee, Myung Uk

1974-01-01

Acute carbon monoxide poisoning has frequently occurred in Korean, because of the coal briquette being widely used as fuel in Korean residences. Carbon monoxide poisoning has been extensively studied, but it has been sparsely reported that pulmonary edema may develop in acute CO poisoning. We have noticed nine cases of pulmonary edema in acute CO poisoning last year. Other possible causes of pulmonary edema could be exclude in all cases but one. The purpose of this paper is to describe nine cases of pulmonary edema complicated in acute CO poisoning and discuss the pathogenesis and the prognosis

Article Commentary: Chelation Therapy for Mercury Poisoning

Directory of Open Access Journals (Sweden)

Rong Guan

2009-01-01

Full Text Available Chelation therapy has been the major treatment for heavy metal poisoning. Various chelating agents have been developed and tested for treatment of heavy metal intoxications, including mercury poisoning. It has been clearly shown that chelating agents could rescue the toxicity caused by heavy metal intoxication, but the potential preventive role of chelating agents against heavy metal poisoning has not been explored much. Recent paper by Siddiqi and colleagues has suggested a protective role of chelating agents against mercury poisoning, which provides a promising research direction for broader application of chelation therapy in prevention and treatment of mercury poisoning.

Pulmonary edema in acute carbon monoxide poisoning

Energy Technology Data Exchange (ETDEWEB)

Kim, Kun Sang; Chang, Kee Hyun; Lee, Myung Uk [Seoul National University College of Medicine, Seoul (Korea, Republic of)

1974-10-15

Acute carbon monoxide poisoning has frequently occurred in Korean, because of the coal briquette being widely used as fuel in Korean residences. Carbon monoxide poisoning has been extensively studied, but it has been sparsely reported that pulmonary edema may develop in acute CO poisoning. We have noticed nine cases of pulmonary edema in acute CO poisoning last year. Other possible causes of pulmonary edema could be exclude in all cases but one. The purpose of this paper is to describe nine cases of pulmonary edema complicated in acute CO poisoning and discuss the pathogenesis and the prognosis.

[A relational database to store Poison Centers calls].

Science.gov (United States)

Barelli, Alessandro; Biondi, Immacolata; Tafani, Chiara; Pellegrini, Aristide; Soave, Maurizio; Gaspari, Rita; Annetta, Maria Giuseppina

2006-01-01

Italian Poison Centers answer to approximately 100,000 calls per year. Potentially, this activity is a huge source of data for toxicovigilance and for syndromic surveillance. During the last decade, surveillance systems for early detection of outbreaks have drawn the attention of public health institutions due to the threat of terrorism and high-profile disease outbreaks. Poisoning surveillance needs the ongoing, systematic collection, analysis, interpretation, and dissemination of harmonised data about poisonings from all Poison Centers for use in public health action to reduce morbidity and mortality and to improve health. The entity-relationship model for a Poison Center relational database is extremely complex and not studied in detail. For this reason, not harmonised data collection happens among Italian Poison Centers. Entities are recognizable concepts, either concrete or abstract, such as patients and poisons, or events which have relevance to the database, such as calls. Connectivity and cardinality of relationships are complex as well. A one-to-many relationship exist between calls and patients: for one instance of entity calls, there are zero, one, or many instances of entity patients. At the same time, a one-to-many relationship exist between patients and poisons: for one instance of entity patients, there are zero, one, or many instances of entity poisons. This paper shows a relational model for a poison center database which allows the harmonised data collection of poison centers calls.

Outsmarting Poison Ivy and Other Poisonous Plants

Science.gov (United States)

... poison sumac. Protectants such as baking soda or colloidal oatmeal relieve minor irritation and itching. Aluminum acetate ... Food and Drug Administration 10903 New Hampshire Avenue Silver Spring, MD 20993 1-888-INFO-FDA (1- ...

16 CFR 1700.15 - Poison prevention packaging standards.

Science.gov (United States)

2010-01-01

... 16 Commercial Practices 2 2010-01-01 2010-01-01 false Poison prevention packaging standards. 1700.15 Section 1700.15 Commercial Practices CONSUMER PRODUCT SAFETY COMMISSION POISON PREVENTION PACKAGING ACT OF 1970 REGULATIONS POISON PREVENTION PACKAGING § 1700.15 Poison prevention packaging...

Poison ivy - oak - sumac rash

Science.gov (United States)

... this page: //medlineplus.gov/ency/article/000027.htm Poison ivy - oak - sumac rash To use the sharing features on this page, please enable JavaScript. Poison ivy, oak, and sumac are plants that commonly ...

Extracorporeal Treatment in Phenytoin Poisoning

DEFF Research Database (Denmark)

Anseeuw, Kurt; Mowry, James B; Burdmann, Emmanuel A

2016-01-01

The Extracorporeal Treatments in Poisoning (EXTRIP) Workgroup conducted a systematic literature review using a standardized process to develop evidence-based recommendations on the use of extracorporeal treatment (ECTR) in patients with phenytoin poisoning. The authors reviewed all articles......) despite its high protein binding and made the following recommendations. ECTR would be reasonable in select cases of severe phenytoin poisoning (neutral recommendation, 3D). ECTR is suggested if prolonged coma is present or expected (graded 2D) and it would be reasonable if prolonged incapacitating ataxia...... is present or expected (graded 3D). If ECTR is used, it should be discontinued when clinical improvement is apparent (graded 1D). The preferred ECTR modality in phenytoin poisoning is intermittent hemodialysis (graded 1D), but hemoperfusion is an acceptable alternative if hemodialysis is not available...

Is Your Child Safe from Lead Poisoning?

Centers for Disease Control (CDC) Podcasts

In this podcast, Dr. Mary Jean Brown, chief of CDC's Lead Poisoning and Prevention Program, discusses the importance of testing children for lead poisoning, who should be tested, and what parents can do to prevent lead poisoning.

Amnesic Shellfish Poisoning (ASP)

DEFF Research Database (Denmark)

Ravn, H.

HAB Publ. Ser. vol 1 is a supplement to Chapter 7 Mehtods for Domoic Acid, the Amnesic Shellfish Poisons in the IOC Manual of Harmful Marine Microalgae......HAB Publ. Ser. vol 1 is a supplement to Chapter 7 Mehtods for Domoic Acid, the Amnesic Shellfish Poisons in the IOC Manual of Harmful Marine Microalgae...

Reactor scram device using fluid poison tubes

International Nuclear Information System (INIS)

Iwasaki, Toshio; Hasegawa, Koji.

1979-01-01

Purpose: To improve the response function in the reactor scram with no wide space by injecting poisons in soluble poison guide tubes to such a liquid level as giving no effect on usual reactor operation. Constitution: Soluble poison guide tubes in a reactor are connected at their upper ends to a buffer tank and at their lower ends to a pressurizer by way of a header and an injection valve. The header is connected by way of a valve with a level meter, one end of which is connected to the buffer tank. During reactor operation, the injection valve is closed and the soluble poisons in the pressurizer vessel is maintained at a pressurized state and, while on the other hand, soluble poisons are injected by way of the header to the lower end of the soluble poison guide tubes by the opening of a valve, which is thereafter closed. Upon scram, a valve is closed to protect the level meter and pressurized poisons are rapidly filled in the guide tubes by the release of the injection valve. (Kawakami, Y.)

Usage of burnable poison on research reactors

International Nuclear Information System (INIS)

Villarino, Eduardo Anibal

2002-01-01

The fuel assemblies with burnable poison are widely used on power reactors, but there are not commonly used on research reactors. This paper shows a neutronic analysis of the advantages and disadvantages of the burnable poison usage on research reactors. This paper analyses both burnable poison design used on research reactors: Boron on the lateral wall and Cadmium wires. Both designs include a parametric study on the design parameters like the amount and geometry of the burnable poison. This paper presents the design flexibility using burnable poisons, it does not find an optimal or final design, which it will strongly depend on the core characteristics and fuel management strategy. (author)

Carbon monoxide poisoning at motels, hotels, and resorts.

Science.gov (United States)

Weaver, Lindell K; Deru, Kayla

2007-07-01

Each year, more than 200 people in the United States die from carbon monoxide (CO) poisoning. Poisoning has occurred at motels, hotels, and resorts. Congressional mandate requires smoke alarms in all guest rooms; however, smoke alarms do not detect CO. Data on patients poisoned at hotels, motels, and resorts were evaluated at a hyperbaric medicine service. In 2005, legal databases and online news databanks were searched to discover additional incidents. Only victims evaluated in hospitals or declared dead at the scene were included. Cases of intentional poisoning and poisoning from fires were excluded. Between 1989 and 2004, 68 incidents of CO poisoning occurring at hotels, motels, and resorts were identified, resulting in 772 accidentally poisoned: 711 guests, 41 employees or owners, and 20 rescue personnel. Of those poisoned, 27 died, 66 had confirmed sequelae, and 6 had sequelae resulting in a jury verdict. Lodging-operated, faulty room heating caused 45 incidents, pool/spa boilers 16, CO entrained from outdoors 5, and unreported sources caused 2 incidents. Public verdicts have averaged $4.8 million per incident (range, $1 million to $17.5 million). Poisoning occurred at hotels of all classes. Despite these incidents, most properties did not install CO alarms, and requirements for CO alarms at hotels, motels, and resorts are rare. Guests of motels, hotels, and resorts remain at risk for injury or death from CO poisoning. Measures to prevent CO poisoning of guests and employees of the lodging industry should be evaluated.

Poison control center - emergency number

Science.gov (United States)

For a POISON EMERGENCY call: 1-800-222-1222 ANYWHERE IN THE UNITED STATES This national hotline number will let you ... is a free and confidential service. All local poison control centers in the United States use this ...

Benzodiazepine poisoning in elderly.

Science.gov (United States)

Vukcević, Natasa Perković; Ercegović, Gordana Vuković; Segrt, Zoran; Djordjević, Snezana; Stosić, Jasmina Jović

2016-03-01

Benzodiazepines are among the most frequently ingested drugs in self-poisonings. Elderly may be at greater risk compared with younger individuals due to impaired metabolism and increased sensitivity to benzodiazepines. The aim of this study was to assess toxicity of benzodiazepines in elderly attempted suicide. A retrospective study of consecutive presentations to hospital after self-poisoning with benzodiazepines was done. Collected data consisted of patient's characteristics (age, gender), benzodiazepine ingested with its blood concentrations at admission, clinical findings including vital signs and Glasgow coma score, routine blood chemistry, complications of poisoning, details of management, length of hospital stay and outcome. According the age, patients are classified as young (15-40-year old), middle aged (41-65-year old) and elderly (older than 65). During a 2-year observational period 387 patients were admitted because of pure benzodiazepine poisoning. The most frequently ingested drug was bromazepam, the second was diazepam. The incidence of coma was significantly higher, and the length of hospital stay significantly longer in elderly. Respiratory failure and aspiration pneumonia occurred more frequently in old age. Also, flumazenil was more frequently required in the group of elderly patients. Massive benzodiazepines overdose in elderly may be associated with a significant morbidity, including deep coma with aspiration pneumonia, respiratory failure, and even death. Flumazenil is indicated more often to reduce CNS depression and prevent complications of prolonged unconsciousness, but supportive treatment and proper airway management of comatose patients is the mainstay of the treatment of acute benzodiazepine poisoning.

Poisoning of animals by industrial fumes

Energy Technology Data Exchange (ETDEWEB)

Hofmann, P

1937-01-01

Autopsy findings of game that died presumably due to poisoning by arsenic are presented. Corrosive gastroenteritis with edema and ecchymosis of the mucosa, and partly ulceration of the stomach, and fatty degeneration of the kidneys and liver were found in hares and stags. Arsenic was detected in the gastric content, liver, and other organs. These cases were diagnosed as acute to subacute poisoning by arsenic. Catarrhal gastrointestinal mucosa, pseudomembranes, in the esophagus, inflammatory edema of the nasal septum and laryngeai mucosa, and sometimes liver cirrhosis and edema of the spleen were found in red deer, roes, and hares. In these cases, poisoning by arsenic could not be identified as the primary cause of death. The symptoms of the poisoning were similar to cause of death. The symptoms of the poisoning were similar to those observed in game around a smelter prior to the installation of an efficient arsenic trap.

Differential toxin profiles of ciguatoxins in marine organisms: Chemistry, fate and global distribution.

Science.gov (United States)

Soliño, Lucía; Costa, Pedro Reis

2018-05-17

Ciguatoxins (CTXs) are fish metabolism products and a result of biotransformation of precursor gambiertoxins produced, in the first instance, by benthic dinoflagellates Gambierdiscus and Fukuyoa. Ciguatoxins are potent neurotoxins that selectively open voltage gated sodium channels in excitable cells causing the human food poisoning known as Ciguatera (CFP). Endemic from tropical areas in central Pacific and West Indian Ocean, and the Caribbean Sea, CTX may affect up to 500,000 people annually due to fish consumption. Their recent occurrence in European waters highlights the need for a multidisciplinary approach of CTX research in order to better understand the diversity and transformation of microalgae products through food webs. This article intends to review available information on chemistry, toxicity, distribution and fate of known CTX compounds from a critical perspective to provide an overview of future trends and needs on ciguatera research. Copyright © 2018 Elsevier Ltd. All rights reserved.

Experimental lead poisoning in chickens

Energy Technology Data Exchange (ETDEWEB)

Silven, L.

1967-01-01

Poisoning of water fowl due to the intake of lead shot is not rare in the USA. In order to study this kind of poisoning more closely domestic fowl were given varying amounts of lead shot and lead powder. This treatment did not provoke any symptoms of poisoning. Chemical analyses of different organs, muscles, skeleton and eggs yielded low lead values. It is concluded that the low toxicity of lead administered as lead shot to the domestic fowl is due to a low absorption rate from the gastro-intestinal tract.

Vital Signs-Alcohol Poisoning Deaths

Centers for Disease Control (CDC) Podcasts

This podcast is based on the January 2015 CDC Vital Signs report. In the United States, an average of six people die every day from alcohol poisoning. Learn what you can do to prevent binge drinking and alcohol poisoning.

Unearthing poison use and consequent anecdotal vulture mortalities ...

African Journals Online (AJOL)

Aldicarb or carbofuran were the most commonly used poisons, but strychnine is still used by about one farmer out of 10. Poison is typically used by means of distributing poisoned baits in the landscape. Furthermore, willingness to use poison in the future was highest for farmers who own large properties with high livestock ...

Study on the treatment of acute thallium poisoning.

Science.gov (United States)

Zhang, Hong-Tao; Qiao, Bao-Ping; Liu, Bao-Ping; Zhao, Xian-Guo

2014-05-01

Acute thallium poisoning rarely occurs but is a serious and even fatal medical condition. Currently, patients with acute thallium poisoning are usually treated with Prussian blue and blood purification therapy. However, there are few studies about these treatments for acute thallium poisoning. Nine patients with acute thallium poisoning from 1 family were treated successfully with Prussian blue and different types of blood purification therapies and analyzed. Prussian blue combined with sequential hemodialysis, hemoperfusion and/or continuous veno-venous hemofiltration were effective for the treatment of patients with acute thallium poisoning, even after delayed diagnosis. Blood purification therapies help in the clearance of thallium in those with acute thallium poisoning. Prussian blue treatment may do the benefit during this process.

Alcohol Poisoning Deaths PSA (:60)

Centers for Disease Control (CDC) Podcasts

This 60 second Public Service Announcement is based on the January 2015 CDC Vital Signs report. In the United States, an average of six people die every day from alcohol poisoning. Learn what you can do to prevent binge drinking and alcohol poisoning.

Presentations of patients of poisoning and predictors of poisoning-related fatality: Findings from a hospital-based prospective study

Directory of Open Access Journals (Sweden)

Lin Hung-Jung

2008-01-01

Full Text Available Abstract Background Poisoning is a significant public health problem worldwide and is one of the most common reasons for visiting emergency departments (EDs, but factors that help to predict overall poisoning-related fatality have rarely been elucidated. Using 1512 subjects from a hospital-based study, we sought to describe the demographic and clinical characteristics of poisoning patients and to identify predictors for poisoning-related fatality. Methods Between January 2001 and December 2002 we prospectively recruited poisoning patients through the EDs of two medical centers in southwest Taiwan. Interviews were conducted with patients within 24 hours after admission to collect relevant information. We made comparisons between survival and fatality cases, and used logistic regressions to identify predictors of fatality. Results A total of 1512 poisoning cases were recorded at the EDs during the study period, corresponding to an average of 4.2 poisonings per 1000 ED visits. These cases involved 828 women and 684 men with a mean age of 38.8 years, although most patients were between 19 and 50 years old (66.8%, and 29.4% were 19 to 30 years. Drugs were the dominant poisoning agents involved (49.9%, followed by pesticides (14.5%. Of the 1512 patients, 63 fatalities (4.2% occurred. Paraquat exposure was associated with an extremely high fatality rate (72.1%. The significant predictors for fatality included age over 61 years, insufficient respiration, shock status, abnormal heart rate, abnormal body temperature, suicidal intent and paraquat exposure. Conclusion In addition to well-recognized risk factors for fatality in clinical settings, such as old age and abnormal vital signs, we found that suicidal intent and ingestion of paraquat were significant predictors of poisoning-related fatality. Identification of these predictors may help risk stratification and the development of preventive interventions.

14 CFR 137.39 - Economic poison dispensing.

Science.gov (United States)

2010-01-01

... 14 Aeronautics and Space 3 2010-01-01 2010-01-01 false Economic poison dispensing. 137.39 Section... AIRCRAFT OPERATIONS Operating Rules § 137.39 Economic poison dispensing. (a) Except as provided in... economic poison that is registered with the U.S. Department of Agriculture under the Federal Insecticide...

Transdermal carbamate poisoning – a case of misuse

Directory of Open Access Journals (Sweden)

Lalit Kumar Rajbanshi

2017-01-01

Full Text Available Acute pesticide poisoning is a common mode of intentional self harm. Oral ingestion is the usual mode of poisoning. However, inhalation, accidental or occupational transdermal exposure leading to acute or chronic poisoning can be the other route of poisoning. It has been seen that the purpose of poising is suicidal intensity in most of the cases. We report an unusual case where the victim had acute pesticide poisoning through transdermal route that was intended for non suicidal purpose. The patient was managed successfully with immediate decontamination and adequate antidote.

Benzodiazepine poisoning in elderly

Directory of Open Access Journals (Sweden)

Perković-Vukčević Nataša

2016-01-01

Full Text Available Background/Aim. Benzodiazepines are among the most frequently ingested drugs in self-poisonings. Elderly may be at greater risk compared with younger individuals due to impaired metabolism and increased sensitivity to benzodiazepines. The aim of this study was to assess toxicity of benzodiazepines in elderly attempted suicide. Methods. A retrospective study of consecutive presentations to hospital after self-poisoning with benzodiazepines was done. Collected data consisted of patient's characteristics (age, gender, benzodiazepine ingested with its blood concentrations at admission, clinical findings including vital signs and Glasgow coma score, routine blood chemistry, complications of poisoning, details of management, length of hospital stay and outcome. According the age, patients are classified as young (15-40-year old, middle aged (41-65-year old and elderly (older than 65. Results. During a 2-year observational period 387 patients were admitted because of pure benzodiazepine poisoning. The most frequently ingested drug was bromazepam, the second was diazepam. The incidence of coma was significantly higher, and the length of hospital stay significantly longer in elderly. Respiratory failure and aspiration pneumonia occurred more frequently in old age. Also, flumazenil was more frequently required in the group of elderly patients. Conclusion. Massive benzodiazepines overdose in elderly may be associated with a significant morbidity, including deep coma with aspiration pneumonia, respiratory failure, and even death. Flumazenil is indicated more often to reduce CNS depression and prevent complications of prolonged unconsciousness, but supportive treatment and proper airway management of comatose patients is the mainstay of the treatment of acute benzodiazepine poisoning.

Benzodiazepine poisoning in elderly

OpenAIRE

Perković-Vukčević Nataša; Vuković-Ercegović Gordana; Šegrt Zoran; Đorđević Snežana; Jović-Stošić Jasmina

2016-01-01

Background/Aim. Benzodiazepines are among the most frequently ingested drugs in self-poisonings. Elderly may be at greater risk compared with younger individuals due to impaired metabolism and increased sensitivity to benzodiazepines. The aim of this study was to assess toxicity of benzodiazepines in elderly attempted suicide. Methods. A retrospective study of consecutive presentations to hospital after self-poisoning with benzodiazepines was done. Collecte...

VENENO-PONZOÑA, ENVENENAMIENTO-EMPONZOÑAMIENTO, ANIMALES VENENOSOS-ANIMALES PONZOÑOSOS: ¿CUÁLES SON LAS DIFERENCIAS? | VENOM-POISON, ENVENOMATION-POISONING, VENOMOUS ANIMALS-POISONOUS ANIMALS: WHAT ARE THE DIFFERENCES?

Directory of Open Access Journals (Sweden)

Dalmiro Cazorla-Perfetti

2016-08-01

Full Text Available In the specialized scientific literature of Latin America, the terms venom and poison, envenomation and poisoning, venomous animals and poisonous animals are frequently implemented improperly as synonyms. Thus, in the present communication the differences of these terms are discussed in the context of the Clinical Toxinology lexic and the need for homogenizing such a nomenclature is highlighted.

Depletion optimization of lumped burnable poisons in pressurized water reactors

International Nuclear Information System (INIS)

Kodah, Z.H.

1982-01-01

Techniques were developed to construct a set of basic poison depletion curves which deplete in a monotonical manner. These curves were combined to match a required optimized depletion profile by utilizing either linear or non-linear programming methods. Three computer codes, LEOPARD, XSDRN, and EXTERMINATOR-2 were used in the analyses. A depletion routine was developed and incorporated into the XSDRN code to allow the depletion of fuel, fission products, and burnable poisons. The Three Mile Island Unit-1 reactor core was used in this work as a typical PWR core. Two fundamental burnable poison rod designs were studied. They are a solid cylindrical poison rod and an annular cylindrical poison rod with water filling the central region.These two designs have either a uniform mixture of burnable poisons or lumped spheroids of burnable poisons in the poison region. Boron and gadolinium are the two burnable poisons which were investigated in this project. Thermal self-shielding factor calculations for solid and annular poison rods were conducted. Also expressions for overall thermal self-shielding factors for one or more than one size group of poison spheroids inside solid and annular poison rods were derived and studied. Poison spheroids deplete at a slower rate than the poison mixture because each spheroid exhibits some self-shielding effects of its own. The larger the spheroid, the higher the self-shielding effects due to the increase in poison concentration

Self-harm and self-poisoning in southern India

DEFF Research Database (Denmark)

Bose, Anuradha; Sandal Sejbaek, Camilla; Suganthy, Pearline

2009-01-01

over a period of 2 years. RESULTS AND CONCLUSION: The overall suicide rate was 71.4 per 100 000 population; the highest burden was among men. Most people died through hanging (81, 54%) and self-poisoning (46, 31%). Of the 46 who died from self-poisoning, 78.3% had taken pesticides and 19.7% had eaten...... poisonous plants. Eighty per cent of the self-poisoning cases obtained the poisonous substance in or in close proximity to the home, highlighting the importance of safe storage in the domestic environment. Of the 110 fatal and non-fatal self-poisoning cases, 87 (57.5%) were taken for treatment; 50 (57.......4%) went to government hospitals and 37 (42.5%) to private facilities. This indicates the importance of including the private sector in the efforts to improve case management. Furthermore, the fact that 31 (67%) of the self-poisoning patients, who eventually died, were alive after 4 h provides an incentive...

Cardiac Glycoside Plants Self-Poisoning

Directory of Open Access Journals (Sweden)

Radenkova-Saeva J.

2014-06-01

Full Text Available Cardiac glycosides are found in a diverse group of plants including Digitalis purpurea and Digitalis lanata (foxgloves, Nerium oleander, Convallaria majalis (lily of the valley, Strophanthus gratus, etc. Nerium Oleander is an indoor and ornamental plant of an evergreen shrub. It’s widespread in countries with a Mediterranean climate. Oleander is one of the most poisonous plants known to humans. All parts of the nerium oleander are poisonous, primarily due to the contained cardiac glycosides - oleandrin, nerin, digitoxigenin, and olinerin of which oleandrin is the principal toxin. The bark contains the toxic substances of rosagenin which causes strychnine-like effects. Signs of poisoning appear a few hours after the adoption of the parts of the plant. Two cases of Nerium Oleander poisoning were presented. Clinical picture included gastrointestinal, cardiovascular and central nervous system effects. The clinical symptoms were characterized by nausea, vomiting, salivation, colic, diarrhoea, ventricular tachycardia, dysrhythmia, heart block, ataxia, drowsiness, muscular tremor. Treatment included administration of activated charcoal, symptomatic and supportive care.

Pre-hospital treatment of acute poisonings in Oslo

Science.gov (United States)

Heyerdahl, Fridtjof; Hovda, Knut E; Bjornaas, Mari A; Nore, Anne K; Figueiredo, Jose CP; Ekeberg, Oivind; Jacobsen, Dag

2008-01-01

Background Poisoned patients are often treated in and discharged from pre-hospital health care settings. Studies of poisonings should therefore not only include hospitalized patients. Aims: To describe the acutely poisoned patients treated by ambulance personnel and in an outpatient clinic; compare patients transferred to a higher treatment level with those discharged without transfer; and study the one-week mortality after pre-hospital discharge. Methods A one-year multi-centre study with prospective inclusion of all acutely poisoned patients ≥ 16 years of age treated in ambulances, an outpatient clinic, and hospitals in Oslo. Results A total of 3757 health service contacts from 2997 poisoning episodes were recorded: 1860 were treated in ambulances, of which 15 died and 750 (40%) were discharged without transfer; 956 were treated in outpatient clinic, of which 801 (84%) were discharged without transfer; and 941 episodes were treated in hospitals. Patients discharged alive after ambulance treatment were mainly poisoned by opiates (70%), were frequently comatose (35%), had respiratory depression (37%), and many received naloxone (49%). The majority of the patients discharged from the outpatient clinic were poisoned by ethanol (55%), fewer were comatose (10%), and they rarely had respiratory depression (4%). Among the hospitalized, pharmaceutical poisonings were most common (58%), 23% were comatose, and 7% had respiratory depression. Male patients comprised 69% of the pre-hospital discharges, but only 46% of the hospitalized patients. Except for one patient, who died of a new heroin overdose two days following discharge from an ambulance, there were no deaths during the first week after the poisonings in the 90% of the pre-hospital discharged patients with known identity. Conclusion More than half of the poisoned patients treated in pre-hospital treatment settings were discharged without transfer to higher levels. These poisonings were more often caused by drug and

Pre-hospital treatment of acute poisonings in Oslo

Directory of Open Access Journals (Sweden)

Nore Anne K

2008-11-01

Full Text Available Abstract Background Poisoned patients are often treated in and discharged from pre-hospital health care settings. Studies of poisonings should therefore not only include hospitalized patients. Aims: To describe the acutely poisoned patients treated by ambulance personnel and in an outpatient clinic; compare patients transferred to a higher treatment level with those discharged without transfer; and study the one-week mortality after pre-hospital discharge. Methods A one-year multi-centre study with prospective inclusion of all acutely poisoned patients ≥ 16 years of age treated in ambulances, an outpatient clinic, and hospitals in Oslo. Results A total of 3757 health service contacts from 2997 poisoning episodes were recorded: 1860 were treated in ambulances, of which 15 died and 750 (40% were discharged without transfer; 956 were treated in outpatient clinic, of which 801 (84% were discharged without transfer; and 941 episodes were treated in hospitals. Patients discharged alive after ambulance treatment were mainly poisoned by opiates (70%, were frequently comatose (35%, had respiratory depression (37%, and many received naloxone (49%. The majority of the patients discharged from the outpatient clinic were poisoned by ethanol (55%, fewer were comatose (10%, and they rarely had respiratory depression (4%. Among the hospitalized, pharmaceutical poisonings were most common (58%, 23% were comatose, and 7% had respiratory depression. Male patients comprised 69% of the pre-hospital discharges, but only 46% of the hospitalized patients. Except for one patient, who died of a new heroin overdose two days following discharge from an ambulance, there were no deaths during the first week after the poisonings in the 90% of the pre-hospital discharged patients with known identity. Conclusion More than half of the poisoned patients treated in pre-hospital treatment settings were discharged without transfer to higher levels. These poisonings were more often

Extracorporeal treatment for tricyclic antidepressant poisoning

DEFF Research Database (Denmark)

Yates, Christopher; Galvao, Tais; Sowinski, Kevin M

2014-01-01

The Extracorporeal Treatments In Poisoning (EXTRIP) workgroup was formed to provide recommendations on the use of extracorporeal treatments (ECTR) in poisoning. Here, the workgroup presents its results for tricyclic antidepressants (TCAs). After an extensive literature search, using a predefined...... methodology, the subgroup responsible for this poison reviewed the articles, extracted the data, summarized findings, and proposed structured voting statements following a predetermined format. A two-round modified Delphi method was chosen to reach a consensus on voting statements and RAND...... yielding a very low quality of evidence for all recommendations. Data on 108 patients, including 12 fatalities, were abstracted. The workgroup concluded that TCAs are not dialyzable and made the following recommendation: ECTR is not recommended in severe TCA poisoning (1D). The workgroup considers...

Burnable poison fuel element and its fabrication

International Nuclear Information System (INIS)

Zukeran, Atsushi; Inoue, Kotaro; Aizawa, Hiroko.

1985-01-01

Purpose: To enable to optionally vary the excess reactivity and fuel reactivity. Method: Burnable poisons with a large neutron absorption cross section are contained in fuel material, by which the excess reactivity at the initial stage in the reactor is suppressed by the burnable poisons and the excess reactivity is released due to the reduction in the atomic number density of the burnable poisons accompanying the burning. The burnable poison comprises spherical or rod-like body made of a single material or spherical or rod-like member made of a plurality kind of materials laminated in a layer. These spheres or rods are dispersed in the fuel material. By adequately selecting the shape, combination and the arrangement of the burnable poisons, the axial power distribution of the fuel rods are flattened. (Moriyama, K.)

Extracorporeal treatment for acetaminophen poisoning

DEFF Research Database (Denmark)

Gosselin, S; Juurlink, D N; Kielstein, J T

2014-01-01

BACKGROUND: The Extracorporeal Treatments in Poisoning (EXTRIP) workgroup was created to provide evidence-based recommendations on the use of extracorporeal treatments (ECTR) in poisoning and the results are presented here for acetaminophen (APAP). METHODS: After a systematic review of the litera...... of NAC has not been definitively demonstrated....

Poisonous plants in New Zealand: a review of those that are most commonly enquired about to the National Poisons Centre.

Science.gov (United States)

Slaughter, Robin J; Beasley, D Michael G; Lambie, Bruce S; Wilkins, Gerard T; Schep, Leo J

2012-12-14

New Zealand has a number of plants, both native and introduced, contact with which can lead to poisoning. The New Zealand National Poisons Centre (NZNPC) frequently receives enquiries regarding exposures to poisonous plants. Poisonous plants can cause harm following inadvertent ingestion, via skin contact, eye exposures or inhalation of sawdust or smoked plant matter. The purpose of this article is to determine the 15 most common poisonous plant enquiries to the NZNPC and provide a review of current literature, discussing the symptoms that might arise upon exposure to these poisonous plants and the recommended medical management of such poisonings. Call data from the NZNPC telephone collection databases regarding human plant exposures between 2003 and 2010 were analysed retrospectively. The most common plants causing human poisoning were selected as the basis for this review. An extensive literature review was also performed by systematically searching OVID MEDLINE, ISI Web of Science, Scopus and Google Scholar. Further information was obtained from book chapters, relevant news reports and web material. For the years 2003-2010 inclusive, a total of 256,969 enquiries were received by the NZNPC. Of these enquiries, 11,049 involved exposures to plants and fungi. The most common poisonous plant enquiries, in decreasing order of frequency, were: black nightshade (Solanum nigrum), arum lily (Zantedeschia aethiopica), kowhai (Sophora spp.), euphorbia (Euphorbia spp.), peace lily (Spathiphyllum spp.), agapanthus (Agapanthus spp.), stinking iris (Iris foetidissima), rhubarb (Rheum rhabarbarum), taro (Colocasia esculentum), oleander (Nerium oleander), daffodil (Narcissus spp.), hemlock (Conium maculatum), karaka (Corynocarpus laevigatus), foxglove (Digitalis purpurea) and ongaonga/New Zealand tree nettle (Urtica ferox). The combined total of enquiries for these 15 species was 2754 calls (representing approximately 25% of all enquiries regarding plant exposures). The signs

Toad poisoning in three dogs: case reports

Directory of Open Access Journals (Sweden)

CM Barbosa

2009-01-01

Full Text Available Toad poisoning is frequent in dogs, but has been infrequently addressed in published case reports and review articles. Dogs can be poisoned when they bite a toad or otherwise ingest the venom. The venom effects manifest soon after the accident, since the toxin is rapidly absorbed by the mucous membrane of the digestive system. Hospital records of three dogs, diagnosed with toad poisoning, were retrospectively reviewed from January 2005 to July 2007. Poisoned dogs may present only local irritation or systemic signs in the gastrointestinal, cardiac and neurological systems. All three cases presented herein had clinical signs of gastrointestinal alterations including vomiting, sialorrhea and diarrhea. Two dogs developed abnormal cardiac rhythm and two exhibited neurological signs. A poisoned animal requires emergency care and symptomatic therapy with intense monitoring of its clinical parameters. Although there have been reports on the low mortality of dogs poisoned by toads, one animal died even after appropriate therapy. The severity of clinical signs and the risk of death must be considered by the veterinarian.

An Outbreak of Foxglove Leaf Poisoning

Directory of Open Access Journals (Sweden)

Chun-Chi Lin

2010-02-01

Full Text Available Comfrey (Symphytum officinale leaves resemble those of foxglove (Digitalis purpurea when the plant is not in bloom and, therefore, cardiac glycoside poisoning may occur when people confuse foxglove with comfrey. We report an outbreak of foxglove leaf poisoning following the use of alleged “comfrey” herbal tea. Nine patients were involved and initially presented with nausea, vomiting, diarrhea and dizziness. Significant cardiotoxicity developed later among the 3 patients who also had mild hyperkalemia. Peak serum digoxin concentration measured by immunoassay was elevated in all patients and ranged from 4.4 ng/mL to 139.5 ng/mL. Patients with severe cardiotoxicity were treated with temporary cardiac pacing. Moreover, 40–80 mg of digoxin-specific antibody therapy was given without any effect. All patients recovered uneventfully. Our report highlights the potential risk of misidentification of herbs; in this case, D. purpurea was mistaken for S. officinale. Physicians should be aware that cardiac glycoside poisoning could arise from such misidentification. Public education about the toxicity of D. purpurea poisoning may reduce the risk of misidentification and subsequent poisoning.

Burnable poison management in a HTR

Energy Technology Data Exchange (ETDEWEB)

Pedersen, J

1971-09-21

It is the purpose with this paper to describe the state-of-the-art of burnable poison investigations made within the Dragon Project and to give the results of a number of calculations, which show that it is possible to control the large initial surplus reactivity of the first core and the radial power distribution with two types of burnable poison sticks with Gadolinium (one type of stick to be used in the inner core region, the other in the outer core region), where the poison will burn away so that keff always stays around the desired value 1.03, and with the radial form-factor not exceeding 1.20. The calculations made for this paper are not too accurate, especially the chosen timestep for calculating the burn-up of the burnable poison stick proved to be too large. Nevertheless, the calculations are good enough to draw the above mentioned conclusions, although they have not given the concentration of Gadolinium to be used in the burnable poison sticks very accurately.

Is Your Child Safe from Lead Poisoning?

Centers for Disease Control (CDC) Podcasts

2008-10-02

In this podcast, Dr. Mary Jean Brown, chief of CDC's Lead Poisoning and Prevention Program, discusses the importance of testing children for lead poisoning, who should be tested, and what parents can do to prevent lead poisoning.  Created: 10/2/2008 by National Center for Environmental Health (NCEH).   Date Released: 10/2/2008.

Is poisoning a problem in South Sudan?

African Journals Online (AJOL)

2011-11-04

Nov 4, 2011 ... (e.g. mesothelioma caused by contact with asbestos). Criminal act of poisoning: e.g. “spiking” of a drink at a party. Poisoning in uganda. When I was working in Uganda I saw several cases of poisoning with organophosphates and was horrified by the mortality. Almost ten years ago, we carried out a simple.

Alcohol Withdrawal Mimicking Organophosphate Poisoning

Directory of Open Access Journals (Sweden)

Nezihat Rana Disel

2014-02-01

Full Text Available Organophosphates, which can cause occupational poisoning due to inappropriate personal protective measures, are widely used insecticides in agricultural regions of southern Turkey. Therefore, the classical clinical findings of this cholinergic poisoning are myosis, excessive secretions, bradicardia and fasciculations are easy to be recognized by local medical stuff. Diseases and conditions related to alcoholism such as mental and social impairments, coma, toxicity, withdrawal, and delirium are frequent causes of emergency visits of chronic alcoholic patients. Here we present a case diagnosed and treated as organophosphate poisoning although it was an alcohol withdrawal in the beginning and became delirium tremens, due to similar symptoms.

Acetone poisoning

Science.gov (United States)

... this page: //medlineplus.gov/ency/article/002480.htm Acetone poisoning To use the sharing features on this page, please enable JavaScript. Acetone is a chemical used in many household products. ...

Carbon Monoxide Poisoning in Children

Directory of Open Access Journals (Sweden)

Chi-Hsiun Cho

2008-08-01

Conclusion: Children with CO poisoning had good outcomes in this series. Although improperly vented exhaust from water heaters and house fires were the most common causes, intentional poisoning by parents through charcoal burning was also an important factor. Early identification of DNS risk factors might help to provide better care.

Amitraz poisoning: case report

Directory of Open Access Journals (Sweden)

Jaime Alexander Molina-Bolaños

2017-10-01

Full Text Available Amitraz is an insecticide compound used worldwide for controlling pests, especially in agricultural and livestock areas. However, amitraz poisoning in Colombia is rare. This article reports the case of an 18-year-old female patient who was admitted in the emergency service 3 hours after the intake of an unknown amount of Triatox® (amitraz. The patient presented with a depressed level of consciousness, respiratory distress, hypotension, bradycardia, myosis and metabolic acidosis compensated with respiratory alkalosis. Initial treatment was provided using life support measures in the emergency ward, and subsequent transfer and support in the intensive care unit. She was discharged 24 hours after admission. This case considers the clinical similarity between amitraz poisoning and poisoning caused by other more frequent toxic compounds such as carbamates, organophosphates and opioids, which require different management.

Cutting system for burnable poison rod

International Nuclear Information System (INIS)

Shiina, Atsushi; Toyama, Norihide; Koshino, Yasuo; Fujii, Toshio

1989-01-01

Burnable poison rods attached to spent fuels are contained in a containing box and transported to a receiving pool. The burnable poison rod-containing box is provisionally situated by the operation to a handling device to a provisional setting rack in a cutting pool and attached to a cutting guide of a cutting device upon cutting. The burnable poison rod is cut only in a cutting pool water and tritium generated upon cutting is dissolved into the cutting pool water. Diffusion of tritium is thus restricted. Further, the cutting pool is isolated by a partition device from the receiving pool during cutting of the burnable poison rod. Accordingly, water in which tritium is dissolved is inhibited from moving to the receiving pool and prevail of tritium contamination can be avoided. (T.M.)

Snakebite poisoning in Spain.

Science.gov (United States)

Martín-Sierra, Cristina; Nogué-Xarau, Santiago; Pinillos Echeverría, Miguel Ángel; Rey Pecharromán, José Miguel

2018-01-01

Emergencies due to snakebites, although unusual in Spain, are potentially serious. Of the 13 species native to the Iberian peninsula, only 5 are poisonous: 2 belong to the Colubridae family and 3 to the Viperidae family. Bites from these venemous snakes can be life-threatening, but the venomous species can be easily identified by attending to certain physical traits. Signs denoting poisoning from vipers, and the appropriate treatment to follow, have changed in recent years.

PROFILE OF POISONING CASES IN A TERTIARY CARE HOSPITAL , TELANGANA , INDIA

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Naresh

2015-05-01

Full Text Available BACKGROUND : Poisoning with various substances is an important cause of death and disability worldwide . The types of poisons that are encountered in the emergency medicine departments encompass a wide range of substances . Apparently , geographic location , socio - demographic factors , ease of availability of poisons and many other cryptic factors contribute to the wide spectrum of substances that cause poisoning . Pesticides , drugs and chemicals are reported to be the most commo nly used poisons in India . Management of poisoning is quite challenging for the health care professionals globally . Factors such as the uncertainty in the identification of allegedly consumed poison , varied clinical features and the need for timely access to specific information for treatment , complicates poisoning management . This study was therefore conducted to explore the clinical features , management and outcomes of poisoning cases reporting to a tertiary care centre in south India . OBJECTIVE : To ident ify the spectrum of poisons and evaluate their clinical manifestations , medical management and clinical outcomes . METHODOLOGY : All cases of poisoning that were reported at a tertiary care hospital in South India for a period of 18 months from January 1 , 20 13 to June 30 , 2014 were included in this study . A data abstraction sheet was designed to document demographic details ( age and gender , poison consumed , duration of stay in the hospital , clinical features , treatment administered , need for life support and patient outcomes . RESULTS : A total of 145 poisoning cases were reported during the study period . Among them , 58 . 5% were males and 41 . 3% were females . Majority of victims were in the age group of 21 - 30 years . Intentional poisoning was observed in 86 . 2% , whereas the rest were accidental poisonings . Organophosphorus ( OP poisoning was the most common poisoning encountered in this study . It accounted for 25 . 5% of the total

Lead poisoning

Energy Technology Data Exchange (ETDEWEB)

Beijers, J A

1952-01-01

Three cases of acute lead poisoning of cattle herds via ingestion are reported, and reference is made to several other incidents of lead in both humans and animals. The quantity of lead which was found in the livers of the dead cows varied from 6.5 to 19 mg/kg, while 1160 mg/kg of lead in the liver was found for a young cow which was poisoned experimentally with 5 gms of lead acetate per day; hence, there appears to be great variability in the amounts deposited that can lead to intoxication and death. No evidence was found for a lead seam around the teeth, prophyrinuria, or basophil granules in the erythrocytes during acute or chronic lead poisoning of cattle or horses examined. Reference is made to attempts of finding the boundary line between increased lead absorption and lead intoxication in humans, and an examination of 60 laborers in an offset-printing office containing a great deal of inhalable lead (0.16 to 1.9 mg/cu m air) is reviewed. Physical deviation, basophylic granulation of erythrocytes, increased lead content of the urine, and porphyrinuria only indicate an increased absorption of lead; the use of the term intoxication is justified if, in addition, there are complaints of lack of appetite, constipation, fatigue, abdominal pain, and emaciation.

Epidemiology of acute poisoning in children presenting to the poisoning treatment center at Ain Shams University in Cairo, Egypt, 2009-2013.

Science.gov (United States)

Azab, Sonya M S; Hirshon, Jon Mark; Hirshon, John Mark; Hayes, Bryan D; El-Setouhy, Maged; Smith, Gordon S; Sakr, Mahmoud Lotfy; Tawfik, Hany; Klein-Schwartz, Wendy

2016-01-01

Pediatric poisonings represent a major and preventable cause of morbidity and mortality throughout the world. Epidemiologic information about poisoning among children in many lower- and middle-income countries is scarce. This study describes the epidemiology of acute poisonings in children presenting to Ain Shams University's Poisoning Treatment Center (ASU-PTC) in Cairo and determines the causative agents and characteristics of acute poisoning in several pediatric age groups. This retrospective study involved acutely poisoned patients, 0-18 years of age, who presented to the ASU-PTC between 1 January 2009 and 31 December 2013. Data were extracted from electronic records maintained by the ASU-PTC. Collected data included demographics, substance of exposure, circumstances of the poisoning, patient disposition, and outcome. During the 5-year study period, 38 470 patients meeting our criteria were treated by the ASU-PTC; 19 987 (52%) were younger than 6 years of age; 4196 (11%) were 6-12 years; and 14 287 (37%) were >12 years. Unintentional poisoning accounted for 68.5% of the ingestions, though among adolescents 84.1% of ingestions were with self-harm intent. In all age groups, the most frequent causative drugs were non-opioid analgesics, antipyretics, and antirheumatics. The most common nonpharmaceutical agents were corrosives in preschool children and pesticides in adolescents. Most patients had no/minor effects (29 174 [75.8%]); hospitalization rates were highest among adolescents. There were 119 deaths (case fatality rate of 0.3), primarily from pesticide ingestion. Poisoning in preschool children is mainly unintentional and commonly due to nonpharmaceutical agents whereas poisoning in adolescents is mainly intentional (self-harm). Pesticides, mainly organophosphorous compounds and carbamates, were the most frequent agents leading to morbidity and mortality.

The good and the bad of poisonous plants: an introduction to the USDA-ARS Poisonous Plant Research Laboratory.

Science.gov (United States)

Welch, Kevin D; Panter, Kip E; Gardner, Dale R; Stegelmeier, Bryan L

2012-06-01

This article provides an overview of the Poisonous Plant Research Laboratory (PPRL), about the unique services and activities of the PPRL and the potential assistance that they can provide to plant poisoning incidences. The PPRL is a federal research laboratory. It is part of the Agricultural Research Service, the in-house research arm of the U.S. Department of Agriculture. The mission of the PPRL is to identify toxic plants and their toxic compounds, determine how the plants poison animals, and develop diagnostic and prognostic procedures for poisoned animals. Furthermore, the PPRL's mission is to identify the conditions under which poisoning occurs and develop management strategies and treatments to reduce losses. Information obtained through research efforts at the PPRL is mostly used by the livestock industry, natural resource managers, veterinarians, chemists, plant and animal scientists, extension personnel, and other state and federal agencies. PPRL currently has 9 scientists and 17 support staff, representing various disciplines consisting of toxicology, reproductive toxicology, veterinary medicine, chemistry, animal science, range science, and plant physiology. This team of scientists provides an interdisciplinary approach to applied and basic research to develop solutions to plant intoxications. While the mission of the PPRL primarily impacts the livestock industry, spinoff benefits such as development of animal models, isolation and characterization of novel compounds, elucidation of biological and molecular mechanisms of action, national and international collaborations, and outreach efforts are significant to biomedical researchers. The staff at the PPRL has extensive knowledge regarding a number of poisonous plants. Although the focus of their knowledge is on plants that affect livestock, oftentimes, these plants are also poisonous to humans, and thus, similar principles could apply for cases of human poisonings. Consequently, the information provided

Detection of ciguatoxin-like and paralysing toxins in Trichodesmium spp. from New Caledonia lagoon.

Science.gov (United States)

Kerbrat, Anne-Sophie; Darius, H Taiana; Pauillac, Serge; Chinain, Mireille; Laurent, Dominique

2010-01-01

Marine pelagic cyanobacteria Trichodesmium are widespread in the New Caledonia lagoon. Blooms of these Oscillatoriales are suspected to be a potential source of toxins in the ciguatera food chain and were previously reported to contain certain types of paralysing toxins. In the present study, toxicity experiments were conducted on lipid- and water-soluble extracts of freeze-dried samples of these cyanobacteria. Lipid-soluble fractions revealed a ciguatoxin-like activity in both in vivo (mouse bioassay) and in vitro (mouse neuroblastoma cells assay and receptor binding assay using tritiated brevetoxin-3) assays. The water-soluble fractions tested on mice exhibited neurotoxicity with paralytic symptoms. These toxicities have also been observed with benthic filamentous cyanobacteria within the Oscillatoriales order, also collected in New Caledonia. This study provides an unprecedented evidence of the toxicity of Trichodesmium species from the New Caledonia lagoon. This survey also demonstrates the possible role of these cyanobacteria in ciguatera fish poisoning. Copyright (c) 2010 Elsevier Ltd. All rights reserved.

Lead poisoning: The invisible disease

Science.gov (United States)

Friend, Milton

1989-01-01

Lead poisoning is an intoxication resulting from absorption of hazardous levels of lead into body tissues. Lead pellets from shot shells, when ingested, are the most common source of lead poisoning in migratory birds. Other far less common sources include lead fishing sinkers, mine wastes, paint pigments, bullets, and other lead objects that are swallowed.

webPOISONCONTROL: can poison control be automated?

Science.gov (United States)

Litovitz, Toby; Benson, Blaine E; Smolinske, Susan

2016-08-01

A free webPOISONCONTROL app allows the public to determine the appropriate triage of poison ingestions without calling poison control. If accepted and safe, this alternative expands access to reliable poison control services to those who prefer the Internet over the telephone. This study assesses feasibility, safety, and user-acceptance of automated online triage of asymptomatic, nonsuicidal poison ingestion cases. The user provides substance name, amount, age, and weight in an automated online tool or downloadable app, and is given a specific triage recommendation to stay home, go to the emergency department, or call poison control for further guidance. Safety was determined by assessing outcomes of consecutive home-triaged cases with follow-up and by confirming the correct application of algorithms. Case completion times and user perceptions of speed and ease of use were measures of user-acceptance. Of 9256 cases, 73.3% were triaged to home, 2.1% to an emergency department, and 24.5% directed to call poison control. Children younger than 6 years were involved in 75.2% of cases. Automated follow-up was done in 31.2% of home-triaged cases; 82.3% of these had no effect. No major or fatal outcomes were reported. More than 91% of survey respondents found the tool quick and easy to use. Median case completion time was 4.1 minutes. webPOISONCONTROL augments traditional poison control services by providing automated, accurate online access to case-specific triage and first aid guidance for poison ingestions. It is safe, quick, and easy to use. Copyright © 2016 The Authors. Published by Elsevier Inc. All rights reserved.

Gasoline poisoning

Science.gov (United States)

... this page: //medlineplus.gov/ency/article/002806.htm Gasoline poisoning To use the sharing features on this ... This article discusses the harmful effects from swallowing gasoline or breathing in its fumes. This article is ...

Sachet poisoning

Science.gov (United States)

... of perfumed powder or a mix of dried flowers, herbs, spices, and aromatic wood shavings (potpourri). Some ... further instructions. This is a free and confidential service. All local poison control centers in the United ...

Organophosphorus pesticide poisoning : cases and developments

NARCIS (Netherlands)

Aardema, H.; Ligtenberg, J. J. M.; Peters-Polman, O. M.; Tulleken, J. E.; Zijlstra, J. G.; Meertens, John H. J. M.

Self-poisoning with organophosphate pesticides is a major health problem world-wide. Through the inhibition of acetylcholinesterase, organophosphorus poisoning is characterised by the clinical picture of acute cholinergic crisis. Other manifestations are the intermediate neurotoxic syndrome and

Nitric Acid Poisoning: Case Report

International Nuclear Information System (INIS)

Quintero Giraldo, Maria Paulina; Quiceno Calderon, William de Jesus; Melo Arango Catalina

2011-01-01

Nitric acid (HNO 3 ) is a corrosive fluid that, when in contact with reducing agents, generates nitrogen oxides that are responsible for inhalation poisoning. We present two cases of poisoning from nitric acid gas inhalation resulting from occupational exposure. Imaging findings were similar in both cases, consistent with adult respiratory distress syndrome (ARDS): bilaterally diffuse alveolar opacities on the chest X-ray and a cobblestone pattern on computed tomography (CT).one of the patients died while the other evolved satisfactorily after treatment with n-acetyl cysteine and mechanical ventilation. The diagnosis of nitric acid poisoning was made on the basis of the history of exposure and the way in which the radiological findings evolved.

Burnable poison management in light water reactor lattices

Energy Technology Data Exchange (ETDEWEB)

Buenemann, D; Mueller, A

1970-07-01

For a better reactivity control and power flattening as well as for an increase in dynamic stability the use of burnable poisons in light water reactors has been considered. The main goals for a burnable poison management and its technological realisation are discussed. The poison is assumed to be in the form of separate poison rods or homogeneous or inhomogeneous poisoning in the fuel rods. A new concept with a central poison rod within the fuel rod is discussed. The balance-equation for the needed concentration of burnable poisons for reactivity central as well as the problems of optimization of lumped poisons are treated in connection with the fuel lattice burnup. A first approximation for the design is found. For the calculation of the microburnup of lumped poison and fuel the special code NEUTRA has been developed. The burnup-equation can be chosen either in a simplified burnup-version with 2 pseudo fission products for each fissionable isotope or with an extended system of burnup equations to be used at sophisticated calculations. These burnup equations are coupled to S{sub N}-routines optionally for cylindrical or x-y-geometry for the proper calculation of the microscopic isotope density-, flux-, and power distributions. The theoretical predictions have been checked by means of special experiments so as to determine the accuracy of the computations. Even for a relatively long burnup of the fuel the predicted values are found to be within the experimental error in the case of lumped rods containing a cadmium-alloy or boron carbide. (auth)

Comparison of poison exposure data: NHIS and TESS data.

Science.gov (United States)

Polivka, Barbara J; Elliott, Michael B; Wolowich, William R

2002-01-01

To identify age-adjusted poisoning episode rates, and poison control center contacts due to poisonings in children under 6 years old based on 1997-1999 National Health Interview Survey data; and compare findings with 1997-1999 Toxic Exposure Surveillance System data. Secondary analysis of National Health Interview Survey poisoning episode data for children 5 years and younger. Respondents were asked about poison exposures during the previous 3 months. Based on National Health Interview Survey population weighted data there were 196/10,000 poisonings to young children < 6 years. These exposures resulted primarily from harmful solid or liquid substances. A poison control center was called in 86% of exposures to children < 4 years, but only in 70% of the 4-5 year old exposures. The odds of a poison control center not being called were 3.2 times greater for 4-5 year olds (compared to < or = 3 years) and 4.5 times greater for African-American (compared with White-Americans). Comparison of National Health Interview Survey data with data in the 1997-1999 Annual Reports of the Toxic Exposure Surveillance System revealed the number of estimated exposures in the National Health Interview Survey data were approximately half those reported in the Toxic Exposure Surveillance System data. In both datasets, children 1-2 years of age had the highest percent of poisoning exposures. Using multiple datasets to explore poisoning rates in young children provides a broader perspective. Differences in findings reflect divergent data collection methods and biases inherent in each database. Although the majority of National Health Interview Survey respondents reporting contacting a poison control center for a poisoning exposure, rates are lower in specific subgroups indicating a need for targeted educational efforts.

Differences in Poisoning Mortality in the United States, 2003–2007: Epidemiology of Poisoning Deaths Classified as Unintentional, Suicide or Homicide

Science.gov (United States)

Muazzam, Sana; Swahn, Monica H.; Alamgir, Hasanat; Nasrullah, Muazzam

2012-01-01

Introduction Poisoning, specifically unintentional poisoning, is a major public health problem in the United States (U.S.). Published literature that presents epidemiology of all forms of poisoning mortalities (i.e., unintentional, suicide, homicide) together is limited. This report presents data and summarizes the evidence on poisoning mortality by demographic and geographic characteristics to describe the burden of poisoning mortality and the differences among sub-populations in the U.S. for a 5-year period. Methods Using mortality data from the Center for Disease Control and Prevention's Web-based Injury Statistics Query and Reporting System, we presented the age-specific and age-adjusted unintentional and intentional (suicide, homicide) poisoning mortality rates by sex, age, race, and state of residence for the most recent years (2003–2007) of available data. Annual percentage changes in deaths and rates were calculated, and linear regression using natural log were used for time-trend analysis. Results There were 121,367 (rate=8.18 per 100,000) unintentional poisoning deaths. Overall, the unintentional poisoning mortality rate increased by 46.9%, from 6.7 per 100,000 in 2003 to 9.8 per100.000 in 2007, with the highest mortality rate among those aged 40–59 (rate=15.36), males (rate=11.02) and whites (rate=8.68). New Mexico (rate=18.2) had the highest rate. Unintentional poisoning mortality rate increased significantly among both sexes, and all racial groups except blacks (p<0.05 time-related trend for rate). Among a total of 29,469 (rate=1.97) suicidal poisoning deaths, the rate increased by 9.9%, from 1.9 per 100,000 in 2003 to 2.1 per 100,000 in 2007, with the highest rate among those aged 40–59 (rate=3.92), males (rate=2.20) and whites (rate=2.24). Nevada (rate=3.9) had the highest rate. Mortality rate increased significantly among females and whites only (p<0.05 time-related trend for rate). There were 463 (rate=0.03) homicidal poisoning deaths and the

Fuel assembly and burnable poison rod

International Nuclear Information System (INIS)

Hirukawa, Koji.

1993-01-01

In a fuel assembly having burnable poison rods arranged therein, the burnable poison comprises an elongate small outer tube and an inner tube coaxially disposed within the outer tube. Upper and lower end tubes each sealed at one end are connected to both of the upper and lower ends in the inner and the outer tubes respectively. A coolant inlet hole is disposed to the lower end tube, while a coolant leakage hole is disposed to the upper end tube. Burnable poison members are filled in an annular space. Further, the burnable poison-filling region is disposed excepting portions for 1/20 - 1/12 of the effective fuel length at each of the upper and the lower ends of the fuel rod. Then, the concentration of the burnable poisons in a region above a boundary defined at a position 1/3 - 1/2, from beneath, of the effective fuel length is made smaller than that in the lower region. This enables to suppress excess reactions of fuels to reduce the mass of the burnable neutron. Excellent reactivity control performance at the initial stage of the burning can be attained. (T.M.)

An outbreak of foxglove leaf poisoning.

Science.gov (United States)

Lin, Chun-Chi; Yang, Chen-Chang; Phua, Dong-Haur; Deng, Jou-Fang; Lu, Li-Hua

2010-02-01

Comfrey (Symphytum officinale) leaves resemble those of foxglove (Digitalis purpurea) when the plant is not in bloom and, therefore, cardiac glycoside poisoning may occur when people confuse foxglove with comfrey. We report an outbreak of foxglove leaf poisoning following the use of alleged "comfrey" herbal tea. Nine patients were involved and initially presented with nausea, vomiting, diarrhea and dizziness. Significant cardiotoxicity developed later among the 3 patients who also had mild hyperkalemia. Peak serum digoxin concentration measured by immunoassay was elevated in all patients and ranged from 4.4 ng/mL to 139.5 ng/mL. Patients with severe cardiotoxicity were treated with temporary cardiac pacing. Moreover, 40-80 mg of digoxin-specific antibody therapy was given without any effect. All patients recovered uneventfully. Our report highlights the potential risk of misidentification of herbs; in this case, D. purpurea was mistaken for S. officinale. Physicians should be aware that cardiac glycoside poisoning could arise from such misidentification. Public education about the toxicity of D. purpurea poisoning may reduce the risk of misidentification and subsequent poisoning. Copyright 2010 Elsevier. Published by Elsevier B.V. All rights reserved.

Gastrolobium spp. poisoning in sheep: A case report

Science.gov (United States)

This report describes the history and investigation of a suspected plant poisoning event in Western Australia where fifteen sheep died. One of the poisoned sheep was necropsied and gross and microscopic pathology of the poisoned sheep is described. Monofluoroacetate was detected in rumen contents ...

Iodine-adsorbent poisoning: FY-82 summary report

International Nuclear Information System (INIS)

Jolley, J.G.; Casper, L.A.

1982-10-01

Along with its positive attributes as an adsorbent of radioiodine in nuclear plant air cleaning systems, silver zeolite has the disadvantage of being susceptible to poisoning. (Poisoning is defined as the reduction of efficiency in radioiodine removal.) In view of the gravimetric and infrared spectroscopy data presented, π-bonded hydrocarbons, oxygenated organics, and halocarbons appear to be probable poisons of a silver zeolite filtration system

A Narrative Review of Acute Adult Poisoning in Iran

Directory of Open Access Journals (Sweden)

Samira Alinejad

2017-07-01

Full Text Available Poisoning is a frequent cause of referral to medical emergencies and a major health problem around the world, especially in developing countries. We aimed to review the epidemiology and pattern of adult poisoning in Iran in order to facilitate the early diagnosis and management of poisoning. The pattern of poisoning is different in various parts of Iran. Pharmaceutical compounds were the most common cause of poisoning in most parts of Iran. Pesticide-related toxicities were more common in northern agricultural regions, whereas bites and stings were seen more commonly in southern Iran. Carbon monoxide poisoning was common in cities with many motor vehicles such as Tehran and in colder climates such as in northern and western regions due to inadequately vented gas appliances such as stoves and heaters. Majoon Birjandi (containing cannabis is a unique substance used in eastern Iran. Poisoning by opioids, tramadol, and pesticides (organophosphate and aluminum phosphide has remained a common hazard in Iran. Poisoning-associated morbidity and mortality rates vary by region and have changed over time due to the introduction of new drugs and chemicals. Early diagnosis and proper treatment may be lifesaving; thus, understanding the general pattern of poisoning in different regions is important.

Poison control center - Emergency number (image)

Science.gov (United States)

For a poison emergency call 1-800-222-1222 anywhere in the United States. This national hotline number will let you ... is a free and confidential service. All local poison control centers in the U.S. use this national ...

Poison Prevention

Science.gov (United States)

... Safely , for more information . If you use an e-cigarette, keep the liquid nicotine refills locked up out ... to a child. See Liquid Nicotine Used in E-Cigarettes Can Kill Children . Never place poisonous products in ...

Deodorant poisoning

Science.gov (United States)

... Poisoning and Drug Overdose . 4th ed. Philadelphia, PA: Elsevier Saunders; 2007:chap 100. Farmer B, Seger DL. ... Textbook of Critical Care . 7th ed. Philadelphia, PA: Elsevier; 2017:chap 153. Meehan TJ. Approach to the ...

[Acute lithium poisoning: epidemiology, clinical characteristics, and treatment].

Science.gov (United States)

Burguera Vion, Víctor; Montes, José Manuel; Del Rey, José Manuel; Rivera-Gorrín, Maite; Rodao, José María; Tenorio, Maite; Saiz-Ruiz, Jerónimo; Liaño, Fernando

2017-02-01

Lithium continues to be the treatment of choice for bipolar disorder. Acute lithium poisoning is a potentially serious event. We present a retrospective observational significative study of episodes of acute lithium poisoning during a 52- month period. Poisoning was defined by a blood lithium concentration of 1.5 mEq/L or higher. We analyzed treatment and epidemiologic and clinical characteristics of 70 episodes were identified (incidence density among treated patients, 1.76 per 100 patient-years). The most frequent cause of lithium poisoning was a concurrent medical condition (46%). Most poisonings were mild (74.2%), but neurologic involvement was identified in 40.3%. Electrocardiographic abnormalities were found in 8 cases. Acute renal failure, found in 23 patients (37.1%), was mild in most cases, although 11 patients required hemodialysis. We concluded that acute lithium poisoning is an uncommon complication, but risk needs to be lowered. Patients should be warned to avoid dosage errors and to take special care during concurrent illnesses and while taking other medications.

Prospects of poisoning – a multi facet study

Directory of Open Access Journals (Sweden)

Pradeep K. Mishra

2017-06-01

Full Text Available Aim of the study is to find out demographic profile, clinical characteristics and analysis of poison in clinical set up. The study carried out in Sri Aurobindo Medical College and PG Institute Indore, Madhya Pradesh. Total 75 cases of poisoning were studied for demographic profile, vitals (BP, pulse, heart rate, pupils, etc., clinical features (such as vomiting, salivation, consciousness, etc., type of poison and its analysis. Results : Poisoning was more common in cases between 15 and 25 years of age, in males than in females and in Hindu religion. Poisoning cases were predominantly from rural areas and in married people. Majority of cases were discharged after proper treatment and counseling. Altered vitals and clinical features were found in most of the cases. Organophosphate and aluminum phosphide compound were evaluated in most of the cases. Conclusions : Preventive measures should be applied through educating people, proper counseling, promoting poison information centers, and introducing separate toxicological units in hospitals.

Personality traits in persons with manganese poisoning

Energy Technology Data Exchange (ETDEWEB)

Platonov, A A

1976-10-01

Results of studies with the Minnesota Multiphasic Personality Inventory (MMPI) in 3 groups of arc welders with various degrees of manganese poisoning (22 symptom-free, 23 with functional disturbances, 55 with organic symptoms) and 50 controls were discussed. There was a close relation between the severity of the poisoning and quantitative and qualitative personality changes. Personality tests are considered a useful addition to the clinical diagnosis of chronic manganese poisoning.

Hemlock (Conium Maculatum) Poisoning In A Child.

Science.gov (United States)

Konca, Capan; Kahramaner, Zelal; Bosnak, Mehmet; Kocamaz, Halil

2014-03-01

Poison hemlock (Conium maculatum) is a plant that is poisonous for humans and animals. Accidental ingestion of the plant may result in central nervous system depression, respiratory failure, acute rhabdomyolysis, acute renal failure and even death. The main treatment of hemlock poisoning is supportive care. The case of a 6-year-old girl who was admitted to the emergency department with complaints of burning sensation in mouth, hypersalivation, tremor in hands and ataxia after ingestion of poison hemlock is presented here with clinical and laboratory features. In this case, we aim to report that accidental ingestion of plants resembling vegetables that are consumed daily can lead to serious complications and even death.

Hemlock (Conium Maculatum Poisoning In A Child

Directory of Open Access Journals (Sweden)

Capan KONCA

2014-03-01

Full Text Available Poison hemlock (Conium maculatum is a plant that is poisonous for humans and animals. Accidental ingestion of the plant may result in central nervous system depression, respiratory failure, acute rhabdomyolysis, acute renal failure and even death. The main treatment of hemlock poisoning is supportive care. The case of a 6-year-old girl who was admitted to the emergency department with complaints of burning sensation in mouth, hypersalivation, tremor in hands and ataxia after ingestion of poison hemlock is presented here with clinical and laboratory features. In this case, we aim to report that accidental ingestion of plants resembling vegetables that are consumed daily can lead to serious complications and even death.

Diagnosis & Treatment of Poisoning by Pesticides.

Science.gov (United States)

Environmental Protection Agency, Washington, DC. Office of Pesticide Programs.

This report succinctly discusses the steps necessary to diagnose and treat poisoning from pesticides, especially organophosphates, carbamates and chlorinated hydrocarbons. Immediate and continuing steps in the care of poisoning victims are outlined with supportive information on where to locate emergency assistance. (CS)

Vital Signs-Alcohol Poisoning Deaths

Centers for Disease Control (CDC) Podcasts

2015-01-06

This podcast is based on the January 2015 CDC Vital Signs report. In the United States, an average of six people die every day from alcohol poisoning. Learn what you can do to prevent binge drinking and alcohol poisoning.  Created: 1/6/2015 by National Center for Chronic Disease Prevention and Health Promotion (NCCDPHP).   Date Released: 1/6/2015.

Do poison center triage guidelines affect healthcare facility referrals?

Science.gov (United States)

Benson, B E; Smith, C A; McKinney, P E; Litovitz, T L; Tandberg, W D

2001-01-01

The purpose of this study was to determine the extent to which poison center triage guidelines influence healthcare facility referral rates for acute, unintentional acetaminophen-only poisoning and acute, unintentional adult formulation iron poisoning. Managers of US poison centers were interviewed by telephone to determine their center's triage threshold value (mg/kg) for acute iron and acute acetaminophen poisoning in 1997. Triage threshold values and healthcare facility referral rates were fit to a univariate logistic regression model for acetaminophen and iron using maximum likelihood estimation. Triage threshold values ranged from 120-201 mg/kg (acetaminophen) and 16-61 mg/kg (iron). Referral rates ranged from 3.1% to 24% (acetaminophen) and 3.7% to 46.7% (iron). There was a statistically significant inverse relationship between the triage value and the referral rate for acetaminophen (p variability in poison center triage values and referral rates for iron and acetaminophen poisoning. Guidelines can account for a meaningful proportion of referral variation. Their influence appears to be substance dependent. These data suggest that efforts to determine and utilize the highest, safe, triage threshold value could substantially decrease healthcare costs for poisonings as long as patient medical outcomes are not compromised.

Interpersonal Problem-Solving Deficits in Self-Poisoning Patients.

Science.gov (United States)

McLeavey, Breda C.; And Others

1987-01-01

Compared self-poisoning patients with psychiatric patients and nonpatient controls on problem-solving skills and locus of control. The psychiatric and self-poisoning groups showed deficits on interpersonal problem solving compared with nonpatient controls. The self-poisoning group performed below or at the level of the psychiatric group. Locus of…

Differences in Poisoning Mortality in the United States, 2003–2007: Epidemiology of Poisoning Deaths Classified as Unintentional, Suicide or Homicide

Directory of Open Access Journals (Sweden)

Sana Muazzam

2012-08-01

Full Text Available Introduction: Poisoning, specifically unintentional poisoning, is a major public health problem in the United States (U.S.. Published literature that presents epidemiology of all forms of poisoning mortalities (i.e., unintentional, suicide, homicide together is limited. This report presents data and summarizes the evidence on poisoning mortality by demographic and geographic characteristics to describe the burden of poisoning mortality and the differences among sub-populations in the U.S. for a 5-year period.Methods: Using mortality data from the Center for Disease Control and Prevention’s Web-based Injury Statistics Query and Reporting System, we presented the age-specific and age-adjusted unintentional and intentional (suicide, homicide poisoning mortality rates by sex, age, race, and state of residence for the most recent years (2003–2007 of available data. Annual percentage changes in deaths and rates were calculated, and linear regression using natural log were used for time-trend analysis.Results: There were 121,367 (rate¼8.18 per 100,000 unintentional poisoning deaths. Overall, the unintentional poisoning mortality rate increased by 46.9%, from 6.7 per 100,000 in 2003 to 9.8 per100.000 in 2007, with the highest mortality rate among those aged 40–59 (rate¼15.36, males(rate¼11.02 and whites (rate¼8.68. New Mexico (rate¼18.2 had the highest rate. Unintentional poisoning mortality rate increased significantly among both sexes, and all racial groups except blacks (p,0.05 time-related trend for rate. Among a total of 29,469 (rate¼1.97 suicidal poisoning deaths, the rate increased by 9.9%, from 1.9 per 100,000 in 2003 to 2.1 per 100,000 in 2007, with the highest rate among those aged 40–59 (rate¼3.92, males (rate¼2.20 and whites (rate¼2.24. Nevada(rate¼3.9 had the highest rate. Mortality rate increased significantly among females and whites only (p,0.05 time-related trend for rate. There were 463 (rate¼0.03 homicidal poisoning

Hospitalized poisonings after renal transplantation in the United States

Directory of Open Access Journals (Sweden)

Viola Rebecca A

2002-11-01

Full Text Available Abstract Background The national incidence of and risk factors for hospitalized poisonings in renal transplant recipients has not been reported. Methods Historical cohort study of 39,628 renal transplant recipients in the United States Renal Data System between 1 July 1994 and 30 June 1998. Associations with time to hospitalizations for a primary diagnosis of poisonings (ICD-9 codes 960.x-989.x within three years after renal transplant were assessed by Cox Regression. Results The incidence of hospitalized poisonings was 2.3 patients per 1000 person years. The most frequent causes of poisonings were immunosuppressive agents (25.3%, analgesics/antipyretics (14.1%, psychotropic agents (10.0%, and insulin/antidiabetic agents (7.1%. In Cox Regression analysis, low body mass index (BMI, 28.3 kg/m2, adjusted hazard ratio (AHR, 3.02, 95% CI, 1.45–6.28, and allograft rejection, AHR 1.83, 95% CI, 1.15–2.89, were the only factors independently associated with hospitalized poisonings. Hospitalized poisonings were independently associated with increased mortality (AHR, 1.54, 95% CI 1.22–1.92, p = 0.002. Conclusions Hospitalized poisonings were associated with increased mortality after renal transplantation. However, almost all reported poisonings in renal transplant recipients were due to the use of prescribed medications. Allograft rejection and low BMI were the only independent risk factors for poisonings identified in this population.

Alkaloid-Containing Plants Poisonous to Cattle and Horses in Europe.

Science.gov (United States)

Cortinovis, Cristina; Caloni, Francesca

2015-12-08

Alkaloids, nitrogen-containing secondary plant metabolites, are of major interest to veterinary toxicology because of their occurrence in plant species commonly involved in animal poisoning. Based on epidemiological data, the poisoning of cattle and horses by alkaloid-containing plants is a relatively common occurrence in Europe. Poisoning may occur when the plants contaminate hay or silage or when forage alternatives are unavailable. Cattle and horses are particularly at risk of poisoning by Colchicum autumnale (meadow saffron), Conium maculatum (poison hemlock), Datura stramonium (jimson weed), Equisetum palustre (marsh horsetail), Senecio spp. (ragwort and groundsel) and Taxus baccata (European yew). This review of poisonous alkaloid-containing plants describes the distribution of these plants, conditions under which poisoning occurs, active toxic principles involved and subsequent clinical signs observed.

Finding of CT and clinical in paraquat poisoning pulmonary injury

International Nuclear Information System (INIS)

He Zaifang; Li Hongbing; Cheng Shoulin; Li Qixiang; Huang Zhen; Zeng Jianguo

2012-01-01

Objective: To investigate the CT features of pulmonary injury in paraquat poisoning. Methods: The chest CT image of lung injury in 6 cases of paraquat poisoning were analyzed retrospectively. According to different period of poisoning, the 6 cases were divided into 3 types:the early stage of poisoning (within 2 d), the middle stage of poisoning (3-14 d), the late stage of poisoning (>14 d). A comparison between CT signs and the pathological features of patients was made. Results: Among this 6 cases, 3 cases died, 2 cases pulmonary fibrosis was noted, 1 cases recovered. According to different period of poisoning, the 6 cases were divided into 3 stages: in the early stage of poisoning (within 2 d), 3 cases of all patients showed nothing remarkable, 2 cases showed ground-glass opacity, 1 case showed fuzzy lung-marking.In the middle stage of poisoning (3-14 d), all 6 cases showed ground-glass opacity, mosaic attenuation; 6 cases showed pulmonary consolidation; 4 cases showed subpleural lines; 4 cases showed bronchiectasis; 2 cases showed mid-lower pleural effusion. In the late stage of poisoning (>14 d), 4 cases showed pulmonary consolidation and pulmonary fibrosis, 3 cases showed ground-glass opacity and mosaic attenuation, 1 case showed mid-lower pleural effusion; 1 case showed mediastinal emphysema. Conclusion: The clinical pathology process of paraquat poisoning was in line with CT finding which was related with clinical stage and was helpful for clinical assessment of paraquat poisoning promptly and to guide the clinical treatment. (authors)

49 CFR 172.555 - POISON INHALATION HAZARD placard.

Science.gov (United States)

2010-10-01

... 49 Transportation 2 2010-10-01 2010-10-01 false POISON INHALATION HAZARD placard. 172.555 Section... REQUIREMENTS, AND SECURITY PLANS Placarding § 172.555 POISON INHALATION HAZARD placard. (a) Except for size and color, the POISON INHALATION HAZARD placard must be as follows: ER22JY97.025 (b) In addition to...

Risk factors for acute pesticide poisoning in Sri Lanka

DEFF Research Database (Denmark)

van der Hoek, Wim; Konradsen, Flemming

2005-01-01

This report describes the characteristics of patients with acute pesticide poisoning in a rural area of Sri Lanka and, for intentional self-poisoning cases, explores the relative importance of the different determinants. Data were collected for 239 acute pesticide-poisoning cases, which were...... admitted to two rural hospitals in Sri Lanka. Sociodemographic characteristics, negative life events and agricultural practices of the intentional self-poisoning cases were compared with a control group. Most cases occurred among young adults and the large majority (84%) was because of intentional self-poisoning....... Case fatality was 18% with extremely high case fatality for poisoning with the insecticide endosulfan and the herbicide paraquat. Cases were generally younger than controls, of lower educational status and were more often unemployed. No agricultural risk factors were found but a family history...

49 CFR 172.429 - POISON INHALATION HAZARD label.

Science.gov (United States)

2010-10-01

... 49 Transportation 2 2010-10-01 2010-10-01 false POISON INHALATION HAZARD label. 172.429 Section... REQUIREMENTS, AND SECURITY PLANS Labeling § 172.429 POISON INHALATION HAZARD label. (a) Except for size and color, the POISON INHALATION HAZARD label must be as follows: ER22JY97.023 (b) In addition to complying...

Epidemiology of acute poisoning in children presenting to the poisoning treatment center at Ain Shams University in Cairo, Egypt, 2009–2013

Science.gov (United States)

Azab, Sonya M. S.; Hirshon, Jon Mark; Hayes, Bryan D.; El-Setouhy, Maged; Smith, Gordon S.; Sakr, Mahmoud Lotfy; Tawfik, Hany; Klein-Schwartz, Wendy

2016-01-01

Introduction Pediatric poisonings represent a major and preventable cause of morbidity and mortality throughout the world. Epidemiologic information about poisoning among children in many lower- and middle-income countries is scarce. This study describes the epidemiology of acute poisonings in children presenting to Ain Shams University's Poisoning Treatment Center (ASU-PTC) in Cairo and determines the causative agents and characteristics of acute poisoning in several pediatric age groups. Methods This retrospective study involved acutely poisoned patients, 0 to 18 years of age, who presented to the ASU-PTC between 1/1/2009 and 12/31/2013. Data were extracted from electronic records maintained by the ASU-PTC. Collected data included demographics, substance of exposure, circumstances of the poisoning, patient disposition, and outcome. Results During the 5-year study period, 38,470 patients meeting our criteria were treated by the ASU-PTC; 19,987 (52%) were younger than 6 years of age; 4,196 (11%) were 6 to 12 years; and 14,287 (37%) were >12 years. Unintentional poisoning accounted for 68.5% of the ingestions, though among adolescents 84.1% of ingestions were with self-harm intent. In all age groups, the most frequent causative drugs were non-opioid analgesics, antipyretics, and antirheumatics. The most common nonpharmaceutical agents were corrosives in preschool children and pesticides in adolescents. Most patients had no/minor effects (29,174 [75.8%]); hospitalization rates were highest among adolescents. There were 119 deaths (case fatality rate of 0.3), primarily from pesticide ingestion. Conclusion Poisoning in preschool children is mainly unintentional and commonly due to nonpharmaceutical agents while poisoning in adolescents is mainly intentional (self-harm). Pesticides, mainly organophosphorous compounds and carbamates, were the most frequent agent leading to morbidity and mortality. PMID:26653953

Alcohol Poisoning Deaths PSA (:60)

Centers for Disease Control (CDC) Podcasts

2015-01-06

This 60 second Public Service Announcement is based on the January 2015 CDC Vital Signs report. In the United States, an average of six people die every day from alcohol poisoning. Learn what you can do to prevent binge drinking and alcohol poisoning.  Created: 1/6/2015 by National Center for Chronic Disease Prevention and Health Promotion (NCCDPHP).   Date Released: 1/6/2015.

Acute selenium poisoning in lambs

Energy Technology Data Exchange (ETDEWEB)

Gabbedy, B J; Dickson, J

1969-10-01

An outbreak of sodium selenite poisoning is reported in which 180 of 190 six-weeks-old lambs died. The estimated dose rate of the selenium was 6.4 mg/kg body weight. Liver concentrations of selenium at the time of poisoning averaged 64 ppM and 15 days later liver and kidney concentrations of selenium averaged 26 ppM and 7.4 ppM respectively.

Tropane alkaloids in food: poisoning incidents

NARCIS (Netherlands)

Adamse, P.; Egmond, van H.P.; Noordam, M.Y.; Mulder, P.P.J.; Nijs, de W.C.M.

2014-01-01

A large number of wild and cultured plants produce secondary metabolites that can be toxic to humans and animals. The present study aims to provide insight into the routes of (un)intentional poisonings of humans by tropane alkaloids. Poisonings of humans by tropane alkaloids occur as unintended

Erbium: alternative poison? stabilisation additive? what future?

International Nuclear Information System (INIS)

Porta, J.; Asou, M.

2001-01-01

Erbium was proposed as alternative poison to gadolinium at a very early stage. The potential interest of this poison compared to gadolinium is that it presents a relatively low ( 167 Er) absorption cross section in the thermal range and a non-negligible resonance integral that lead to a relatively slow consumption kinetic rather adapted to long or even very long cycles. The poisoning mode adapted to this poison, homogeneous in low concentration (< 3 %), does not downgrade the power distribution, on the one hand, as the absorption is low and spatially homogeneous, and the thermal conductivity, on the other hand, as the addition in the fuel oxide is in low quantity. A review of knowledge acquired as regards Er, from the 1960's to now, is presented. (authors)

Acute Poisoning with Methadone (Dolphin (Review

Directory of Open Access Journals (Sweden)

Georgy A. Livanov

2017-01-01

Full Text Available Most publications report on the use of methadone as a medication, however an increase of the illegal use of methadone has been demonstrated worldwide over the recent years, thus increasing the number of hospitalizations due to acute poisoning with this synthetic opioid. The aim of the present review was to summarize current data on the mechanisms of toxicity, selective toxicity, toxicokinetics and toxicodynamics of methadone (Dolphin. The involvement of CNS, respiratory, cardiovascular and urinary systems in acute poisoning with methadone was dis- cussed. The practice of use of methadone in many countries as a medicine for the replacement therapy for opiate addicts was analyzed. In addition, it was suggested that the results of the use of naloxone antidote therapy in acute opioid poisoning do not always clearly demonstrate its sufficient efficacy. Ways to improve of the intensive therapy of severe acute poisoning by methadone were substantiated; in addition to general critical care methods, treatment with a complex metabolic antihypoxant cytoflavin should be considered. 

Practical route to the left wing of CTX1B and total syntheses of CTX1B and 54-deoxyCTX1B.

Science.gov (United States)

Yamashita, Shuji; Takeuchi, Katsutoshi; Koyama, Takuya; Inoue, Masayuki; Hayashi, Yujiro; Hirama, Masahiro

2015-02-02

Ciguatoxins, the principal causative agents of ciguatera seafood poisoning, are extremely large polycyclic ethers. We report herein a reliable route for constructing the left wing of CTX1B, which possesses the acid/base/oxidant-sensitive bisallylic ether moiety, by a 6-exo radical cyclization/ring-closing metathesis strategy. This new route enabled us to achieve the second-generation total synthesis of CTX1B and the first synthesis of 54-deoxyCTX1B. © 2015 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

Hemlock (Conium Maculatum) Poisoning In A Child

OpenAIRE

KONCA, Capan; KAHRAMANER, Zelal; BOSNAK, Mehmet; KOCAMAZ, Halil

2016-01-01

SUMMARY Poison hemlock (Conium maculatum) is a plant that is poisonous for humans and animals. Accidental ingestion of the plant may result in central nervous system depression, respiratory failure, acute rhabdomyolysis, acute renal failure and even death. The main treatment of hemlock poisoning is supportive care. The case of a 6-year-old girl who was admitted to the emergency department with complaints of burning sensation in mouth, hypersalivation, tremor in hands and ataxia after ingestio...

Metal Poisons for Criticality in Waste Streams

International Nuclear Information System (INIS)

Williamson, T.G.; Goslen, A.Q.

1996-01-01

Many of the wastes from processing fissile materials contain metals which may serve as nuclear criticality poisons. It would be advantageous to the criticality evaluation of these wastes to demonstrate that the poisons remain with the fissile materials and to demonstrate an always safe poison-to-fissile ratio. The first task, demonstrating that the materials stay together, is the job of the chemist, the second, calculating an always safe ratio, is an object of this paper

Organophosphate acetylcholine esterase inhibitor poisoning from a home-made shampoo.

Science.gov (United States)

Sadaka, Yair; Broides, Arnon; Tzion, Raffi Lev; Lifshitz, Matitiahu

2011-07-01

Organophosphate acetylcholine esterase inhibitor poisoning is a major health problem in children. We report an unusual cause of organophosphate acetylcholine esterase inhibitor poisoning. Two children were admitted to the pediatric intensive care unit due to organophosphate acetylcholine esterase inhibitor poisoning after exposure from a home-made shampoo that was used for the treatment of head lice. Owing to no obvious source of poisoning, the diagnosis of organophosphate acetylcholine esterase inhibitor poisoning in one of these patients was delayed. Both patients had an uneventful recovery. Organophosphate acetylcholine esterase inhibitor poisoning from home-made shampoo is possible. In cases where the mode of poisoning is unclear, direct questioning about the use of home-made shampoo is warranted, in these cases the skin and particularly the scalp should be rinsed thoroughly as soon as possible.

Alkaloid-Containing Plants Poisonous to Cattle and Horses in Europe

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Cristina Cortinovis

2015-12-01

Full Text Available Alkaloids, nitrogen-containing secondary plant metabolites, are of major interest to veterinary toxicology because of their occurrence in plant species commonly involved in animal poisoning. Based on epidemiological data, the poisoning of cattle and horses by alkaloid-containing plants is a relatively common occurrence in Europe. Poisoning may occur when the plants contaminate hay or silage or when forage alternatives are unavailable. Cattle and horses are particularly at risk of poisoning by Colchicum autumnale (meadow saffron, Conium maculatum (poison hemlock, Datura stramonium (jimson weed, Equisetum palustre (marsh horsetail, Senecio spp. (ragwort and groundsel and Taxus baccata (European yew. This review of poisonous alkaloid-containing plants describes the distribution of these plants, conditions under which poisoning occurs, active toxic principles involved and subsequent clinical signs observed.

Hair dye poisoning

Science.gov (United States)

Hair tint poisoning ... Different types of hair dye contain different harmful ingredients. The harmful ingredients in permanent dyes are: Naphthylamine Other aromatic amino compounds Phenylenediamines Toluene ...

Recent Advances in the Treatment of Organophosphorous Poisonings

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Mahdi Balali-Mood

2012-06-01

Full Text Available Organophosphorous compounds have been employed as pesticides and chemical warfare nerve agents. Toxicity of organophosphorous compounds is a result of excessive cholinergic stimulation through inhibition of acetyl cholinesterase. Clinical manifestations include cholinergic syndromes, central nervous system and cardiovascular disorders. Organophosphorous pesticide poisonings are common in developing worlds including Iran and Sri Lanka. Nerve agents were used during the Iraq-Iran war in 1983-1988 and in a terrorist attack in Japan in 1994-1995. Following decontamination, depending on the severity of intoxication the administration of atropine to counteract muscarinic over-stimulation, and an oxime to reactivate acetyl cholinesterase are indicated. Supportive and intensive care therapy including diazepam to control convulsions and mechanical respiration may be required. Recent investigations have revealed that intravenous infusion of sodium bicarbonate to produce mild to moderate alkalinization is effective. Gacyclidine; an antiglutamatergic compound, was also proved to be beneficial in conjunction with atropine, pralidoxime, and diazepam in nerve agent poisoning. Intravenous magnesium sulfate decreased hospitalization duration and improved outcomes in patients with organophosphorous poisoning. Bio-scavengers including fresh frozen plasma or albumin have recently been suggested as a useful therapy through clearing of free organophosphates. Hemofiltration and antioxidants are also suggested for organophosphorous poisoning. Recombinant bacterial phosphotriesterases and hydrolases that are able to transfer organophosphorous-degrading enzymes are very promising in delayed treatment of organophosphorous poisoning. Recently, encapsulation of drugs or enzymes in nanocarriers has also been proposed. Given the signs and symptoms of organophosphorous poisoning, health professionals should remain updated about the recent advances in treatment of

Recent Advances in the Treatment of Organophosphorous Poisonings

Science.gov (United States)

Balali-Mood, Mahdi; Saber, Hamidreza

2012-01-01

Organophosphorous compounds have been employed as pesticides and chemical warfare nerve agents. Toxicity of organophosphorous compounds is a result of excessive cholinergic stimulation through inhibition of acetyl cholinesterase. Clinical manifestations include cholinergic syndromes, central nervous system and cardiovascular disorders. Organophosphorous pesticide poisonings are common in developing worlds including Iran and Sri Lanka. Nerve agents were used during the Iraq-Iran war in 1983-1988 and in a terrorist attack in Japan in 1994-1995. Following decontamination, depending on the severity of intoxication the administration of atropine to counteract muscarinic over-stimulation, and an oxime to reactivate acetyl cholinesterase are indicated. Supportive and intensive care therapy including diazepam to control convulsions and mechanical respiration may be required. Recent investigations have revealed that intravenous infusion of sodium bicarbonate to produce mild to moderate alkalinization is effective. Gacyclidine; an antiglutamatergic compound, was also proved to be beneficial in conjunction with atropine, pralidoxime, and diazepam in nerve agent poisoning. Intravenous magnesium sulfate decreased hospitalization duration and improved outcomes in patients with organophosphorous poisoning. Bio-scavengers including fresh frozen plasma or albumin have recently been suggested as a useful therapy through clearing of free organophosphates. Hemofiltration and antioxidants are also suggested for organophosphorous poisoning. Recombinant bacterial phosphotriesterases and hydrolases that are able to transfer organophosphorous-degrading enzymes are very promising in delayed treatment of organophosphorous poisoning. Recently, encapsulation of drugs or enzymes in nanocarriers has also been proposed. Given the signs and symptoms of organophosphorous poisoning, health professionals should remain updated about the recent advances in treatment of organophosphorous poisoning

Initial Management of Poisoned Patients in Emergency Medical Services and Non-poisoning Hospitals in Tehran: The Comparison between Expected and Performed Managements

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Hossein Hassanian-Moghadam

2014-06-01

Full Text Available Background: There is no clear data on the adherence of emergency medical services (EMS paramedics and hospital staff rather than those working in poisoning centers to the guidelines for managing acutely poisoned patients in developing countries. Methods: During a 6-month period, all EMS-managed poisoned patients along with those initially managed in a non-poisoning center before being referred to a poisoning hospital in Tehran, Iran, were instructed. Then the indications for administrating the activated charcoal (AC as well as performing gastric lavage (GL and tracheal intubation were studied and compared to the recommended guidelines. Results: A total of 3347 cases, including 1859 males (55.6%, were evaluated. There were significant differences between expected and performed endotracheal intubations in both EMS and other medical centers (P-value = 0.002 and 0.001, respectively as well as the administration of GL and AC in other medical centers (P-values= 0.003 and 0.03, respectively. Conclusion: More extensive educational programs should be established to improve the preliminary management of poisoned patients performed by EMS paramedics and staff of hospitals other than poisoning centers.

Detection of Poisonous Herbs by Terahertz Time-Domain Spectroscopy

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Zhang, H.; Li, Z.; Chen, T.; Liu, J.-J.

2018-03-01

The aim of this paper is the application of terahertz (THz) spectroscopy combined with chemometrics techniques to distinguish poisonous and non-poisonous herbs which both have a similar appearance. Spectra of one poisonous and two non-poisonous herbs (Gelsemium elegans, Lonicera japonica Thunb, and Ficus Hirta Vahl) were obtained in the range 0.2-1.4 THz by using a THz time-domain spectroscopy system. Principal component analysis (PCA) was used for feature extraction. The prediction accuracy of classification is between 97.78 to 100%. The results demonstrate an efficient and applicative method to distinguish poisonous herbs, and it may be implemented by using THz spectroscopy combined with chemometric algorithms.

Russula subnigricans Poisoning: From Gastrointestinal Symptoms to Rhabdomyolysis.

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Lin, Shide; Mu, Maoyuan; Yang, Fangwan; Yang, Chunfei

2015-09-01

Wild mushroom poisoning is often reported to cause acute liver or renal failure. However, acute rhabdomyolysis caused by wild mushroom poisoning has rarely been reported. We describe 7 patients of 1 family with Russula subnigricans Hongo poisoning. Their clinical manifestations varied from gastrointestinal symptoms to rhabdomyolysis, with 1 fatality. Our report provides supporting evidence that rhabdomyolysis may result from ingestion of R subnigricans mushrooms. A key to survival for patients with rhabdomyolysis caused by R subnigricans poisoning may be early recognition and intensive supportive care. Copyright © 2015 Wilderness Medical Society. Published by Elsevier Inc. All rights reserved.

Residential carbon monoxide poisoning from motor vehicles.

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Hampson, Neil B

2011-01-01

Although morbidity and mortality from accidental carbon monoxide (CO) poisoning are high in the United States, identification of common but poorly recognized sources should help prevention efforts. The study aimed to describe CO poisoning of home occupants due to a vehicle left running in an attached garage. News stories reporting incidents of US CO poisoning were collected daily from March 2007 to September 2009 via a news.Google.com search and data extracted. Patients were individuals reported in the media to have been poisoned with CO in their home by a vehicle running in the attached garage. Main outcome measures were frequency of occurrence, geographic distribution, patient demographics, and mortality. Of 837 CO poisoning incidents reported in US news media over 2 and a half years, 59 (8%) were the result of a vehicle left running in the garage. The elderly were disproportionately affected, with incidents most common in states with larger elderly populations and 29% of cases with age specified occurring in individuals older than 80 years. Among those older than 80 years, 15 of 17 were found dead at the scene. Residential CO poisoning from a vehicle running in the garage is common, disproportionately affects the elderly, has a high mortality rate, and should be preventable with a residential CO alarm. Copyright © 2011 Elsevier Inc. All rights reserved.

Management of acute organophosphorus pesticide poisoning.

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Eddleston, Michael; Buckley, Nick A; Eyer, Peter; Dawson, Andrew H

2008-02-16

Organophosphorus pesticide self-poisoning is an important clinical problem in rural regions of the developing world, and kills an estimated 200,000 people every year. Unintentional poisoning kills far fewer people but is a problem in places where highly toxic organophosphorus pesticides are available. Medical management is difficult, with case fatality generally more than 15%. We describe the limited evidence that can guide therapy and the factors that should be considered when designing further clinical studies. 50 years after first use, we still do not know how the core treatments--atropine, oximes, and diazepam--should best be given. Important constraints in the collection of useful data have included the late recognition of great variability in activity and action of the individual pesticides, and the care needed cholinesterase assays for results to be comparable between studies. However, consensus suggests that early resuscitation with atropine, oxygen, respiratory support, and fluids is needed to improve oxygen delivery to tissues. The role of oximes is not completely clear; they might benefit only patients poisoned by specific pesticides or patients with moderate poisoning. Small studies suggest benefit from new treatments such as magnesium sulphate, but much larger trials are needed. Gastric lavage could have a role but should only be undertaken once the patient is stable. Randomised controlled trials are underway in rural Asia to assess the effectiveness of these therapies. However, some organophosphorus pesticides might prove very difficult to treat with current therapies, such that bans on particular pesticides could be the only method to substantially reduce the case fatality after poisoning. Improved medical management of organophosphorus poisoning should result in a reduction in worldwide deaths from suicide.

[Poison cases and types of poisons based on data obtained of patients hospitalized from 1995-2009 with acute poisoning in the second internal ward in a multi-profile provincial hospital in Tarnow].

Science.gov (United States)

Lata, Stanisław; Janiszewski, Jacek

2010-01-01

The thesis presents a short history and organization of an acute poisoning centre in the1995 functioning within the internal diseases department in a multi-profile provincial hospital. The data show the number of patients treated beetween 1995-2009 an the types of toxic substances that caused poisoning. The conclusions presented refer to the role of the centre to help people suffering from acute poisoning within the city of Tarnow.

[Poisoning with Jatropha curcas: 24 cases reported to Paris and Marseille Poisons Centers].

Science.gov (United States)

Langrand, J; Médernach, C; Schmitt, C; Blanc-Brisset, I; Villa, A F; de Haro, L; Garnier, R

2015-03-01

Jatropha curcas L. is an inedible plant belonging to the Euphorbiaceae family that is growing in subtropical zones of all continents. We report a series of 24 cases of poisoning with J. curcas seeds or fruits reported to poison centers in Paris and Marseille between December 2000 and June 2014. Fifteen adults and 9 children ingested J. curcas seeds or fruits. All patients experienced gastrointestinal disorders, within the first hours following ingestion: nausea, vomiting, diarrhea and abdominal pain. Laboratory investigations performed in 10 patients revealed minor abnormalities: CK elevation (8 cases), dehydration (5 cases) with moderate elevation of serum creatinine levels (3 cases), and mildly increased serum bilirubin (8 cases). Complete remission of all clinical signs was observed within 48 hours in the 20 cases for which the outcome was known. Previously published cases of J. curcas poisoning were very similar to ours: As in our series, gastrointestinal disorders were always present. They were sometimes associated with neurological or cardiovascular signs, and hepatic or renal disorders; these were generally interpreted as complications of severe gastroenteritis, although direct toxic effects could not be formally excluded. In most cases, simple supportive measures were sufficient to ensure complete recovery within 24-48 hours. J Curcas poisoning incidence is certainly increasing because the plant is cultivated to produce biodiesel and is now largely present in most subtropical countries. As a consequence, local health professionals should be informed of the toxic properties of this plant.

76 FR 9585 - Poison Control Program

Science.gov (United States)

2011-02-18

... delay or gap in poison center services. The State of New York has determined that the Research... Noncompetitive Replacement Awards to the Research Foundation of SUNY and the New York City Health & Hospitals... the Research Foundation of SUNY d.b.a. the Upstate New York Poison Control Center. HRSA will also...

Validation of a Poison Prevention Program.

Science.gov (United States)

Gill, Noel C.; Braden, Barbara T.

Two way analyses of variance and cross-group descriptive comparisons assessed the effectiveness of the Siop Poison Prevention Program, which included an educational program and the use of warning labels, on improving verbal and visual discrimination of poisonous and nonpoisonous products for preschool children. The study sample consisted of 156…

VIGILANCE POISON: Illegal poisoning and lead intoxication are the main factors affecting avian scavenger survival in the Pyrenees (France).

Science.gov (United States)

Berny, Philippe; Vilagines, Lydia; Cugnasse, Jean-Marc; Mastain, Olivier; Chollet, Jean-Yves; Joncour, Guy; Razin, Martine

2015-08-01

A specific surveillance program has been set up to monitor avian scavenger populations in the French Pyrenean Mountains, hosting a high proportion of the French populations. The two main purposes of the study were to identify all causes of death and to investigate poisoning cases. All 170 birds found dead during the 7-year program were submitted to full necropsy, X-Ray, parasitological investigations and consistent analytical toxicology screenings (Cholinesterase inhibitors, anticoagulant rodenticides, organochlorine insecticides, Pb, Cd). Over the study period, 8 Bearded Vultures, 120 Griffon Vultures, 8 Egyptian Vultures and 34 Red kites were eventually collected. Mortality events were often multifactorial, but poisoning was by far the most common cause of death (24.1%), followed by trauma/fall (12%), bacterial diseases and starvation (8%) and electrocution (6%). Illicit use of banned pesticides was identified as a common cause of poisoning (53% of all poisoning cases) and lead poisoning was also identified as a significant toxicant issue (17% of all poisoning cases). Lead isotopic signature could be associated primarily with ammunition. Last, a positive association between trauma and lead contamination was detected, indicating that lead could be a significant contributor to different causes of death. These results urge for severe restrictions on the use of lead ammunition to prevent scavengers from detrimental exposure. Copyright © 2015 Elsevier Inc. All rights reserved.

Pharmacological treatment of cardiac glycoside poisoning.

Science.gov (United States)

Roberts, Darren M; Gallapatthy, Gamini; Dunuwille, Asunga; Chan, Betty S

2016-03-01

Cardiac glycosides are an important cause of poisoning, reflecting their widespread clinical usage and presence in natural sources. Poisoning can manifest as varying degrees of toxicity. Predominant clinical features include gastrointestinal signs, bradycardia and heart block. Death occurs from ventricular fibrillation or tachycardia. A wide range of treatments have been used, the more common including activated charcoal, atropine, β-adrenoceptor agonists, temporary pacing, anti-digoxin Fab and magnesium, and more novel agents include fructose-1,6-diphosphate (clinical trial in progress) and anticalin. However, even in the case of those treatments that have been in use for decades, there is debate regarding their efficacy, the indications and dosage that optimizes outcomes. This contributes to variability in use across the world. Another factor influencing usage is access. Barriers to access include the requirement for transfer to a specialized centre (for example, to receive temporary pacing) or financial resources (for example, anti-digoxin Fab in resource poor countries). Recent data suggest that existing methods for calculating the dose of anti-digoxin Fab in digoxin poisoning overstate the dose required, and that its efficacy may be minimal in patients with chronic digoxin poisoning. Cheaper and effective medicines are required, in particular for the treatment of yellow oleander poisoning which is problematic in resource poor countries. © 2015 The British Pharmacological Society.

Methadone Related Poisoning on the Rise in Tehran, Iran

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Kambiz Soltaninejad

2014-09-01

Full Text Available Background: In Iran, methadone has been used for methadone maintenance treatment (MMT as well as analgesic treatment in pain clinics. Recently, there are some reports regarding accidental and intentional methadone poisonings and deaths. The aim of this study was to evaluate the trend of methadone poisonings and deaths during a 10-year period in Tehran, Iran. Methods: This was a retrospective cross-sectional study over 2000 to 2010. Patients with a documented methadone poisoning who were admitted in Loghman Hakim Hospital Poison Center in Tehran, Iran were identified and included in the study. The data including patients’ age, gender, ingested dose, co-ingestants, intention of ingestion and outcome were extracted from the patients’ medical records. Results: During the study period, 1426 cases of methadone poisoning were recorded, of which, 1041 cases (73% were men. Thirty-six cases (2.5% died. Mean age of the patients was 29.9 ± 17 years. In 476 cases, the intention of poisoning could not be determined, and in the remaining, the intention was misuse (n = 273, 28.7%, suicide (n = 254, 26.7%, accidental (n = 245, 25.8% and abuse (n = 178, 18.8%. Mean of the ingested dose of methadone was 120.6 ± 306.8 mg. The incidence of acute methadone poisoning per one million population of Tehran was 0.43 in 2000 that rose to 37.62 in 2010. Conclusion: The results indicate that methadone poisoning and deaths have increased in Tehran. MMT clinics should be strictly run according to the national guideline to prevent methadone poisoning. With regard to high frequency of poly-drug use in methadone poisoning, it seems important to warn health care providers against prescription of other drugs with methadone. 

Accidental Carbon Monoxide Poisonings in Adana, Turkey: A 14-year Study

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Murat Darçın

2017-03-01

Full Text Available Aim: Carbon monoxide (CO is often referred to as the “silent killer” because its victims cannot see it, smell it or taste it. CO is responsible for a large percentage of the accidental poisonings and deaths reported throughout the world. CO poisoning therefore is considered a serious global health threat. The aim of the present study was to describe the cases of CO poisoning in a rural areas of Adana, Turkey between 2002 and 2015 based on data collected from incident reports. Methods: The cases of accidental CO poisoning were statistically analyzed. During that period, 74 incidents occurred and 154 people were poisoned by accidental CO poisoning. Results: The results of this analysis indicate that men and adults aged ≥65 years were more likely to die from CO poisoning than others. The number of CO poisoning cases was highest during the heating season. The majority (72% of poisoning resulting in hospitalization with a life-threatening condition or death occurred within the home. Conclusion: CO poisoning is a serious danger. People must be informed about this hazard. By educating risk groups about the dangers of CO poisoning, it is possible to save many lives as well as reduce the health risks.

A consolidation process for spent burnable poison rod assemblies

International Nuclear Information System (INIS)

Yamamoto, Y.; Harada, M.; Komatsu, Y.

1985-01-01

A new consolidation system for the spent burnable poison assembly utilizing a sequence control robot operated under water was proposed. A credible accident in the system was analyzed mainly from the viewpoint of tritium release, based on the diffusion analysis of tritium in borosilicate glass. It was found that the amount of tritium released would be small even after the rupture of burnable poison rods. An experiment on a new consolidation system was performed using spent burnable poison assemblies. The volume of burnable poison assemblies was reduced safely and securely by a factor of 7 to 14 for burnable poison rods and by 22 for hold-down portions. It was proved that the consolidation system is collectively feasible

Hemodialysis in the Poisoned Patient

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Megan Boysen-Osborn

2017-09-01

Full Text Available Audience: This classic team based learning (cTBL didactic is aimed for emergency medicine residents and fourth year medical students entering emergency medicine. Introduction: Over one million visits per year to United States (US emergency departments (ED are related to poisonings.1 Extracorporeal treatment (ECTR, specifically hemodialysis (HD, is one potential method to enhance elimination of certain drugs and their toxic metabolites.2-12 While HD may be life-saving in certain poisonings, it may have no effect on others and it carries associated risks and costs. It is essential that emergency physicians know the indications for HD in the poisoned patient. This cTBL reviews many poisonings which may be managed by HD. Objectives: By the end of this cTBL, the learner will: 1 recognize laboratory abnormalities related to toxic alcohol ingestion; 2 calculate an anion gap and osmolal gap; 3 know the characteristics of drugs that are good candidates for HD; 4 discuss the management of patients with toxic alcohol ingestions; 5 discuss the management of patients with salicylate overdose; 6 know the indications for HD in patients with overdoses of antiepileptic drugs; 7 discuss the management of patients with lithium toxicity. Method: This didactic session is a cTBL (classic team based learning.

Food poisoning. Pt. 2

Energy Technology Data Exchange (ETDEWEB)

Askar, A.; Treptow, H.

1982-01-15

In the present study information about food poisoning is compared and reviewed. From the viewpoint of a food technologist the toxic substances are represented in four sections: 1. Residues of substances used by plants and animals: pesticides, antibiotics, sexual hormones and psychopharmaces. 2. Environmental contaminants: heavy metals, radionuclides and polycyclic hydrocarbons. 3. Substances developing during the manufacture: food additives, asbest, parts of packing materials, and residual solvents. 4. Substances arising from processing: smoked and roasted food, non enzymatic reaction, oxidized and heated fats and irradiated foods. The mere presence of toxic substances does not make food unsafe or poisonous. Dangerous, because of their toxic or carcinogenic effects are: Pesticides (especially chlorinated organic pesticides), heavy metals (especially lead, mercury and cadmium), polycyclic hydrocarbons (3,4-benzpyren), nitrosamines and vinyl chloride. The other components are only dangerous if they are present in large ammounts. A good and responsible practise of agriculture and food manufacture processes, a watchful and competent official food control and well informed consumers can limit the danger of food poisoning and human health.

Phonon-Mediated Quasiparticle Poisoning of Superconducting Microwave Resonators

OpenAIRE

Patel, U.; Pechenezhskiy, Ivan V.; Plourde, B. L. T.; Vavilov, M. G.; McDermott, R.

2016-01-01

Nonequilibrium quasiparticles represent a significant source of decoherence in superconducting quantum circuits. Here we investigate the mechanism of quasiparticle poisoning in devices subjected to local quasiparticle injection. We find that quasiparticle poisoning is dominated by the propagation of pair-breaking phonons across the chip. We characterize the energy dependence of the timescale for quasiparticle poisoning. Finally, we observe that incorporation of extensive normal metal quasipar...

[A case of Veratrum poisoning].

Science.gov (United States)

Festa, M; Andreetto, B; Ballaris, M A; Panio, A; Piervittori, R

1996-05-01

A poisoning from a Veratrum album infusion mistaken for Gentiana lutea is described. Confusion between these two plants can easily occur because they are very similar, although flowers and disposition of leaves allow their botanic determinat: V. album leaves are alternate and flowers are white, while G. lutea leaves are opposite and flowers yellow. The poisoning involves gastrointestinal (pyrosis, vomiting) and cardiocirculatory systems (bradyarrhy-thmias, A-V dissociation, vasodilatation) Atropine is the drug of choice.

Pattern of Acute Poisoning Attending a Tertiary Care Hospital of Western Nepal

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Raju Prasad Shakya

2016-12-01

Full Text Available Introduction: Poisoning with various substances is a major public health problem and a reason for significant morbidity and mortality throughout the globe. It is one of the most common presentation in an emergency department. This study was conducted to determine the sociodemographic, poisoning types, and mode of poisoning in cases attending a tertiary hospital of Western Nepal. Methods: A retrospective observational study of two years was conducted from July 2014 to June 2016. Demography details, name of poisonous substance, and reasons for poisoning were reviewed and analyzed using descriptive statistics. Results: A total of 65 cases of poisoning were recorded. The occurrence was more common in female (n=44, 67.7% than in male (n=21, 32.3% with a F:M ratio of 2.1:1.  Poisoning  was most  common in the age group of 11-20 years (32.3%. Most of the cases were students (37% followed by farmers (26%. The most commonly abused poisoning substance were organophosphorous compounds, zinc-phosphate,  and  kerosene in adults, adolescents, and children respectively. Oral route was the most common (99% route of administration. Suicidal attempt, as a mode of poisoning, accounted for 70.8% of total poisoning cases. Conclusion: Female and young people are at greater risk of acute poisoning. Insecticide was the most common agent and self administer poisoning was the most common mode of poisoning. The occurrence of poisoning and its morbidity and mortality can be reduced by developing and implementation of effective prevention strategies like restricting easy poison sales, establishing drug and poison information centers,  and community awareness programs.

The Poison Control Center--Its Role

Science.gov (United States)

Manoguerra, Anthony S.

1976-01-01

Poison Control Centers are being utilized by more schools of pharmacy each year as training sites for students. This paper discusses what such a center is, its services, changes anticipated in the poison center system in the next several years and how they may influence pharmacy education, specifically as it relates to clinical toxicology.…

Blumea lacera Plant Poisoning in Cattle; Epidemiology and Management

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Mst. Nusrat Zahan

2015-07-01

Full Text Available Plant poisoning in grazing animals is more common in Bangladesh, especially during the scarcity period. The present study was undertaken to find out the epidemiology of Blumea lacera fresh plant poisoning and its management in cattle. A total of 765 suspected clinical cases were examined, of these 48 were diagnosed as Blumea lacera plant poisoning. The poisoning was found more in local cattle (92% than that of crossbred (8% cattle. Most of the cases were found in autumn (71%, in compare to summer (23% and winter (6%. The highest occurrence of poisoning was observed in cattle of 6 months to 2 years of age (57% in comparison to other age category. Therapeutic response (16% was found if treatments were given within 4 hours of ingestion of the plant and the effective treatment was a combination of laxative, normal saline, vitamin B1. Veterinarian can apply this treatment during Blumea lacera poisoning in animals.

[Forensic Analysis for 54 Cases of Suxamethonium Chloride Poisoning].

Science.gov (United States)

Zhao, Y F; Zhao, B Q; Ma, K J; Zhang, J; Chen, F Y

2017-08-01

To observe and analyze the performance of forensic science in the cases of suxa- methonium chloride poisoning, and to improve the identification of suxamethonium chloride poisoning. Fifty-four cases of suxamethonium chloride poisoning were collected. The rules of determination of suxamethonium chloride poisoning were observed by the retrospective analysis of pathological and toxicological changes as well as case features. The pathological features of suxamethonium chloride poisoning were similar to the general changes of sudden death, which mainly included acute pulmonary congestion and edema, and partly showed myocardial disarray and fracture. Suxamethonium chloride could be detected in the heart blood of all cases and in skin tissue of part cases. Suxa-methonium chloride poisoning has the characteristics with fast death and covert means, which are difficult to rescue and easily miss inspection. For the cases of sudden death or suspicious death, determination of suxamethonium chloride should be taken as a routine detection index to prevent missing inspection. Copyright© by the Editorial Department of Journal of Forensic Medicine

Histamine (Scombroid) Fish Poisoning: a Comprehensive Review.

Science.gov (United States)

Feng, Charles; Teuber, Suzanne; Gershwin, M Eric

2016-02-01

Histamine fish poisoning, also known as scombroid poisoning, is the most common cause of ichythyotoxicosis worldwide and results from the ingestion of histamine-contaminated fish in the Scombroidae and Scomberesocidae families, including mackerel, bonito, albacore, and skipjack. This disease was first described in 1799 in Britain and re-emerged in the medical literature in the 1950s when outbreaks were reported in Japan. The symptoms associated with histamine fish poisoning are similar to that of an allergic reaction. In fact, such histamine-induced reactions are often misdiagnosed as IgE-mediated fish allergy. Indeed, histamine fish poisoning is still an underrecognized disease. In this review, we discuss the epidemiology, pathophysiology, evaluation, and treatment of scombroid disease. Because more than 80% of fish consumed in the USA is now imported from other countries, the disease is intimately linked with the global fish trade (National Marine Fisheries Service, 2012). Preventing future scombroid outbreaks will require that fishermen, public health officials, restaurant workers, and medical professionals work together to devise international safety standards and increase awareness of the disease. The implications of scombroid poisoning go far beyond that of fish and have broader implications for the important issues of food safety.

Epidemiological analysis of poisoning cases in Van, Turkey

International Nuclear Information System (INIS)

Aydin, I.; Karadas, S.; Gonullu, H.; Dulger, A. C.

2014-01-01

Objective: To investigate the etiological and demographical characteristics of acute adult poisoning cases in eastern Turkey. Methods: The retrospective study was conducted at the Emergency Department of Yuzuncu Yil University, School of Medicine, and comprised data related to the period between 2007 and 2009. The data obtained included age, gender, referrals, manner of poisoning, manner of application, the department which followed up on the patients, duration of hospital stay. All data was noted on proforma. SPSS 15 was used for statistical analysis. Results: Of the total cases visiting the Emergency Department, 1207 (1.1%) related to poisoning. Of them, 880 (72.9%) had attempted suicide; 858 (71.1%) were female; 349 (29%) were male. The average age of the females was 25.4+-8.5 years, and that of the males 28.3+-14.3 years. Single-medicine was noted in poisoning 544 (45.1%) patients. Other poisoning types were multidrugs 373 (30.9%); rat poisoning, insecticide and pesticides, 145 (12%); corrosives 38 (3.1%); and weed, mushroomang; food 47 (3.8%). Oral poisoning was noted in 1141 (94.5%) cases. A total of 1019 (84.4%) patients received treatment and were followed up in the Emergency Department. Six (0.6%) patients died. Conclusion: There is a need to generate more awareness about the hazards of domestic cleaning products and to keep it away at some distinct place to minimised chances of confusion. (author)

Poison pills and CEOs: The résumé matters

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Douglas Sanford Jr.

2012-07-01

Full Text Available Previous research has linked poison pill to corporate governance characteristics such as ownership structure and board composition while overlooking the attributes of top managers involved in poison pill decision. Based on upper echelons perspective, we changed the focus by investigating the effect of CEO characteristics on poison pills, as measured by age, business education, and outside directorships. Using a sample of Fortune 500 manufacturing firms, we found that CEO business education is positively associated with poison pills, while CEOs’ outside directorships are negatively associated with poison pills. Furthermore, we found that CEO duality moderates the relationship between CEO business education and poison pills. We make implications for both corporate governance research and managerial practices regarding firms’ anti-takeover provisions.

Amitraz, an underrecognized poison: A systematic review

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Sahajal Dhooria

2016-01-01

Results: The original search yielded 239 articles, of which 52 articles described human cases. After following the inclusion and exclusion criteria, 32 studies describing 310 cases (151 females, 175 children of human poisoning with amitraz were included in this systematic review. The most commonly reported clinical features of amitraz poisoning were altered sensorium, miosis, hyperglycaemia, bradycardia, vomiting, respiratory failure, hypotension and hypothermia. Amitraz poisoning carried a good prognosis with only six reported deaths (case fatality rate, 1.9%. Nearly 20 and 11.9 per cent of the patients required mechanical ventilation and inotropic support, respectively. The role of decontamination methods, namely, gastric lavage and activated charcoal was unclear. Interpretation & conclusions: Our review shows that amitraz is an important agent for accidental or suicidal poisoning in both adults and children. It has a good prognosis with supportive management.

Intentional and accidental paracetamol poisoning in childhood – a retrospective analysis

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Katarzyna Kominek

2015-04-01

Full Text Available Paracetamol is one of the most commonly used analgesics and antipyretics available without limits as preparations of the OTC group (over the counter drugs. Overdose and poisoning with this drug always brings about the risk of acute hepatic failure. The objective of the study was a retrospective evaluation of patients hospitalized in the Paediatric Clinic during the period 2004–2012 due to poisoning with paracetamol.The analysis covered 44 patients hospitalized in the Paediatric Clinic during 2004–2012 due to poisoning with paracetamol. Patients were divided into three groups: intentional poisonings, accidental poisonings, and drug overdose.During the period of the study, 44 patients aged 2.1–17.1, poisoned with paracetamol, were hospitalized. Among these patients there were 30 (68.2% cases of intentional poisonings, 10 (22.7% of accidental poisonings, and only 4 patients (9.1% were children hospitalized after a paracetamol overdose. The majority of patients in all groups were females (93.3%.Paracetamol intoxication may occur after exceeding a single allowable dose, in the case of intentional poisoning, more rarely after exceeding the daily dose, in the case of intense pain complaints, or in the treatment of persistent fever.Based on the analysis performed, an increase was observed in the frequency of poisoning with paracetamol, especially intentional poisoning. Unlimited access to paracetamol as an OTC drug should be reconsidered.

Paraphenylenediamine Poisoning in Tunisia: A Case Report

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Dorra Amira

2015-05-01

Full Text Available Paraphenylenediamine (PPD represents the main active substance in the color of hair dyes. In Tunisia, PPD poisoning is very common, especially in rural areas where the consequences linked to this toxic substance are still unknown. In this paper, we report a case of PPD poisoning and confirm the diagnosis by a qualitative method of analysis. We discuss the clinical manifestations and study the kinetics of biological parameters during the monitoring of the poisoning. The main complication was renal failure and the treatment was basically symptomatic.

[Poisonings with paracetamol, salicylates and dextromethorphan – problem evaluation based on data from Toxicological Laboratory and Poison Information Center in Krakow in 2010-2015].

Science.gov (United States)

Gomółka, Ewa; Hydzik, Piotr; Szkolnicka, Beata

The aim of the paper was to study frequency of laboratory determinations and toxicological information related to over-the-counter drugs (OTC): paracetamol (acetaminophen), salicylates and dextromethorphan. The research was based on data from Toxicological Laboratory and Poison Information Center UJ CM in Krakow in years 2010-2015. Paracetamol was determined averagely 102 times a year, more than 50% (57 cases) were positive with confirmation of poisoning. The least number of paracetamol poisoning was noted in 2011 (35 cases), the most were in 2015 (98 cases). In the time span there were averagely 40 salicylates check measurements a year, less than 50% (15 cases) were positive. Dextromethorphane was confirmed averagely in 31 patients a year, decrease of the drug intoxications was noted in 2013-2015. Paracetamol and dextromethorphan were the most often the cause of poisoning in group of patients 13-18 years old, salicylates – more than 30 years. In the group of small children there were only a few poisonings with paracetamol. Toxicological information data related to paracetamol, salicylates and dextromethorphan were similar to data from toxicological laboratory. Mean year numbers of drug poisoning information were: 90 (paracetamol), 14 (salicylates), 30 (dextromethorphan). The differences were in patients age distribution. Acute poisonings with OTC were related mainly to paracetamol, young patients (13- 18 years) and young adults (19-29 years). Salicylates poisoning information were related mainly to the group of adult patients (> 30 years), dextromethorphan was abused mainly by oung patients (13-18 years). There were no observed poisonings with salicylates and dextromethorphan in children, but there were toxicological information about paracetamol and salicylates poisoning and overdose in group of children (1-6 years).

Extracorporeal Treatment in Phenytoin Poisoning: Systematic Review and Recommendations from the EXTRIP (Extracorporeal Treatments in Poisoning) Workgroup.

Science.gov (United States)

Anseeuw, Kurt; Mowry, James B; Burdmann, Emmanuel A; Ghannoum, Marc; Hoffman, Robert S; Gosselin, Sophie; Lavergne, Valery; Nolin, Thomas D

2016-02-01

The Extracorporeal Treatments in Poisoning (EXTRIP) Workgroup conducted a systematic literature review using a standardized process to develop evidence-based recommendations on the use of extracorporeal treatment (ECTR) in patients with phenytoin poisoning. The authors reviewed all articles, extracted data, summarized findings, and proposed structured voting statements following a predetermined format. A 2-round modified Delphi method was used to reach a consensus on voting statements, and the RAND/UCLA Appropriateness Method was used to quantify disagreement. 51 articles met the inclusion criteria. Only case reports, case series, and pharmacokinetic studies were identified, yielding a very low quality of evidence. Clinical data from 31 patients and toxicokinetic grading from 46 patients were abstracted. The workgroup concluded that phenytoin is moderately dialyzable (level of evidence = C) despite its high protein binding and made the following recommendations. ECTR would be reasonable in select cases of severe phenytoin poisoning (neutral recommendation, 3D). ECTR is suggested if prolonged coma is present or expected (graded 2D) and it would be reasonable if prolonged incapacitating ataxia is present or expected (graded 3D). If ECTR is used, it should be discontinued when clinical improvement is apparent (graded 1D). The preferred ECTR modality in phenytoin poisoning is intermittent hemodialysis (graded 1D), but hemoperfusion is an acceptable alternative if hemodialysis is not available (graded 1D). In summary, phenytoin appears to be amenable to extracorporeal removal. However, because of the low incidence of irreversible tissue injury or death related to phenytoin poisoning and the relatively limited effect of ECTR on phenytoin removal, the workgroup proposed the use of ECTR only in very select patients with severe phenytoin poisoning. Copyright © 2016 National Kidney Foundation, Inc. Published by Elsevier Inc. All rights reserved.

Hallmarks of opium poisoning in infants and toddlers.

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Zamani, Nasim; Sanaei-Zadeh, Hossein; Mostafazadeh, Babak

2010-10-01

Accidental opium intoxication in children is an extremely dangerous poisoning if it remains undiagnosed and untreated. The classic triad of miosis, decreased level of consciousness and bradypnea, which are the hallmarks of opiate intoxication, are used for the diagnosis of opium poisoning in adults and children. Little attention has been paid to the signs of opium intoxication in children and no published study has explored the frequency of hallmarks of this type of poisoning in the paediatric population. We conducted a study in order to evaluate the prevalence of major signs of opium poisoning in infants and toddlers. In this study, a total of 228 infants and 82 toddlers who had been admitted to Loghman Hakim Hospital as a result of opium poisoning between 2001 and 2009 were evaluated, retrospectively. The most usual sign of opium poisoning was miosis (90%) followed by a decreased level of consciousness (88.4%), bradypnea (28.4%) and seizure (10.3%). The prevalence of the triad of miosis, bradypnea and a decreased level of consciousness was 25.2%. Miosis in association with decreased level of consciousness was detected in 82.6% of our patients. Bradypnea was present in 74 infants and 14 toddlers, which shows a statistically significant difference (P = 0.01). The mean age and weight of the patients with bradypnea were significantly less than those without bradypnea (P = 0.008 and P = 0.0001, respectively). Bradypnea and seizure were significantly more common in females (36.7% versus 26%; P = 0.05 and 15.2% versus 6.5%; P = 0.01, respectively). Miosis in association with a decreased level of consciousness is the most useful indicator of opium poisoning in infants and toddlers. Furthermore, seizure is a more common feature of this type of poisoning in infants, especially in those who are less than 1 month old.

Beryllium poisonings; Les intoxications par le beryllium

Energy Technology Data Exchange (ETDEWEB)

Alibert, S.

1959-03-15

This note reports a bibliographical study of beryllium toxicity. Thus, this bibliographical review addresses and outlines aspects and issues like aetiology, cases of acute poisoning (cutaneous manifestations, pulmonary manifestations), chronic poisoning (cutaneous, pulmonary and bone manifestations), excretion and localisation, and prognosis.

Accidental childhood poisoning in Benin City: Still a problem ...

African Journals Online (AJOL)

Accidental poisoning (AP) is a leading cause of ill – health and deaths among. Nigerian children. Reports on AP are infrequent in Nigeria. This retrospective descriptive study examined the prevailing pattern of accidental childhood poisoning in Benin City. Accidental poisonings were identified in 226 (3.3%) of the cases ...

Fatal poisonings in Oslo: a one-year observational study.

Science.gov (United States)

Bjornaas, Mari A; Teige, Brita; Hovda, Knut E; Ekeberg, Oivind; Heyerdahl, Fridtjof; Jacobsen, Dag

2010-06-06

Acute poisonings are common and are treated at different levels of the health care system. Since most fatal poisonings occur outside hospital, these must be included when studying characteristics of such deaths. The pattern of toxic agents differs between fatal and non-fatal poisonings. By including all poisoning episodes, cause-fatality rates can be calculated. Fatal and non-fatal acute poisonings in subjects aged > or =16 years in Oslo (428 198 inhabitants) were included consecutively in an observational multi-centre study including the ambulance services, the Oslo Emergency Ward (outpatient clinic), and hospitals, as well as medico-legal autopsies from 1st April 2003 to 31st March 2004. Characteristics of fatal poisonings were examined, and a comparison of toxic agents was made between fatal and non-fatal acute poisoning. In Oslo, during the one-year period studied, 103 subjects aged > or =16 years died of acute poisoning. The annual mortality rate was 24 per 100 000. The male-female ratio was 2:1, and the mean age was 44 years (range 19-86 years). In 92 cases (89%), death occurred outside hospital. The main toxic agents were opiates or opioids (65% of cases), followed by ethanol (9%), tricyclic anti-depressants (TCAs) (4%), benzodiazepines (4%), and zopiclone (4%). Seventy-one (69%) were evaluated as accidental deaths and 32 (31%) as suicides. In 70% of all cases, and in 34% of suicides, the deceased was classified as drug or alcohol dependent. When compared with the 2981 non-fatal acute poisonings registered during the study period, the case fatality rate was 3% (95% C.I., 0.03-0.04). Methanol, TCAs, and antihistamines had the highest case fatality rates; 33% (95% C.I., 0.008-0.91), 14% (95% C.I., 0.04-0.33), and 10% (95% C.I., 0.02-0.27), respectively. Three per cent of all acute poisonings were fatal, and nine out of ten deaths by acute poisonings occurred outside hospital. Two-thirds were evaluated as accidental deaths. Although case fatality rates were

EPIDEMIOLOGY OF CARBON MONOXIDE POISONING IN LJUBLJANA FROM 1990 TO 1999

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Miran Brvar

2002-02-01

Full Text Available Background. Carbon monoxide (CO is the most common lethal poisoning. The incidence of sublethal CO poisoning in Slovenia is not known. The aim of the study was to investigate the epidemiology of sublethal acute CO poisoning in Ljubljana region (Slovenia.Methods. A retrospective study involved CO poisoned patients admited to Poison Control Centre and Centre of Intensive Care Medicine of the University Medical Centre Ljubljana, between January 1, 1990 and December 31, 1999.Results. There were annualy approximately 2.4 cases of sublethal CO poisonings per 100.000 population in Ljubljana region. Of these, 25% were suicide attempts and 75% were unintentional poisonings (28% happened in domestic environment as a result of heating, cooking or bathing, 22% were associated with fire, 11% happened in the working site, 10% happened in the workroom at home and only 3% occurred in the moving vehicle. Among the patients there were 72% male and 28% female. The domestic source of CO was a gas water heater or residential heating device in the 63% of the cases, a coal stove in the 32% and an oil heater in the 6%. In the 18% of the suicide attempts we found also acute drug or alcohol intoxication, and 18% of patients poisoned in the fire were intoxicated with alcohol. Collective poisoning happened in the 25% of cases affecting from 2 to 6 persons.Conclusions. The incidence of sublethal CO poisoning in Ljubljana region appers to be seven times lower than in other countries. The main reason is misdiagnosing of CO poisoning. In the future we should consider CO poisoning more often, particularly in all patients with flu-like symptoms, unexplained headache and worsening of pre-existing diseases. We should always exclude the collective poisoning and the presence of alcohol or other drugs.

Jerusalem cherry poisoning

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... this page: //medlineplus.gov/ency/article/002871.htm Jerusalem cherry poisoning To use the sharing features on this page, please enable JavaScript. The Jerusalem cherry is a plant that belongs to the ...

A Danish Survey of Antihistamine Use and Poisoning Patterns

DEFF Research Database (Denmark)

Jensen, Louise; Rømsing, Janne; Dalhoff, Kim

2017-01-01

with equally distributed coingestants. Hospitalization was recommended in 78% of DPIC exposures. Admissions required only 1-day of treatment in 91% of the SSI exposures. One of the 14 identified deaths in the SSI study population was directly related to antihistamine poisoning. Results support the limited...... of the antihistamine use and poisoning pattern from 2007 to 2013 in Denmark based on two independent databases. There were 1049 antihistamine exposures in the national, advisory telephone service specialized in poisonings, the Danish Poison and Information Centre (DPIC), and 456 exposures in the three registers used...

Pathogenesis of Granozan (ethylmercury chloride) poisoning in pigs

Energy Technology Data Exchange (ETDEWEB)

Ardatova, A N; Yakusheva, O V

1971-01-01

This paper deals with the pathology of mercury poisoning in pigs aged 3-4 months, given daily 2 g Granozan (40 mg ethylmercury chloride) in compounded feed for up to 19 days, and also in pigs of various ages that developed mercury poisoning after consuming grain treated with Granozan. The pigs were killed and examined before the appearance of symptoms and also after acute and chronic mercury poisoning. The onset of mercury poisoning was characterized by anorexia, loss of weight, diarrhea, weakness and paralysis. The organs and tissues of animals killed 1-2 days before the appearance of symptoms (usually on day 14), or dying from mercury poisoning, contained the following amounts of accumulated Hg (mg per 100 g): kidneys 10.35, liver 4.3, muscles 1.36, spleen 1.38, pancreas 0.43, medulla oblongata 0.65, cerebellum 0.79, heart 0.75, mesenteric lymph nodes 0.71, submandibular salivary glands 0.59, stomach wall 0.69, and cecal wall 0.76. In subclinical cases the symptoms and lesions were absent, but the mercury content of organs and tissue was similar to that in animals dying from poisoning, i.e. (mg per 100g): kidneys 10.35, liver 4.3, muscles 1.36, and brain 0.8.

Mushroom poisoning in Ireland: the collaboration between the National Poisons Information Centre and expert mycologists.

LENUS (Irish Health Repository)

Cassidy, Nicola

2012-02-01

BACKGROUND: Occasionally, mycologist assistance is requested to reliably identify mushroom species in symptomatic cases where there is a concern that a toxic species is involved. The aim of this study was to describe the epidemiology of mushroom poisoning in Ireland, to describe the working arrangement between the National Poisons Information Centre (NPIC) and professional mycologists and to present a case series detailing the circumstances when mycologists were consulted. METHODS: Computerised records from 1 January 2004 to 31 December 2009 were retrospectively reviewed and data on patient demographics, circumstances, and mushroom species collated. In 1999, the NPIC established a national registry of volunteer professional mycologists who are available 24 h\\/day for mushroom identification. The NPIC staff liaises directly with the mycologist and arranges transport of mushroom material. Digital photographic images are requested if there is likely to be a delay in arranging transportation of mushroom material, and the images are subsequently emailed to a mycologist. Five cases of suspected mushroom poisoning were chosen to demonstrate the inter-professional collaboration between the NPIC and mycologists. RESULTS: From 2004 to 2009, the NPIC was consulted about 70 cases of suspected mushroom exposures. Forty-five children ingested unknown mushrooms, 12 adults and 2 children ingested hallucinogenic mushrooms and 11 adults ingested wild toxic mushrooms that were incorrectly identified or confused with edible species. The mycologists were consulted 10 times since 1999. In this series, Amanita species were identified in two cases. In three cases, the species identified were Clitocybe nebularis, Coprinus comatus and Panaeolina foenisecii, respectively, and serious poisoning was excluded. Incorrect mushroom identification by a health care professional using the Internet occurred in two cases. The mycologists assisted Poisons Information Centres in Northern Ireland and the

Mushroom poisoning in Ireland: The collaboration between the National Poisons Information Centre and expert mycologists.

LENUS (Irish Health Repository)

Cassidy, Nicola

2011-03-01

Background. Occasionally, mycologist assistance is requested to reliably identify mushroom species in symptomatic cases where there is a concern that a toxic species is involved. The aim of this study was to describe the epidemiology of mushroom poisoning in Ireland, to describe the working arrangement between the National Poisons Information Centre (NPIC) and professional mycologists and to present a case series detailing the circumstances when mycologists were consulted. Methods. Computerised records from 1 January 2004 to 31 December 2009 were retrospectively reviewed and data on patient demographics, circumstances, and mushroom species collated. In 1999, the NPIC established a national registry of volunteer professional mycologists who are available 24 h\\/day for mushroom identification. The NPIC staff liaises directly with the mycologist and arranges transport of mushroom material. Digital photographic images are requested if there is likely to be a delay in arranging transportation of mushroom material, and the images are subsequently emailed to a mycologist. Five cases of suspected mushroom poisoning were chosen to demonstrate the inter-professional collaboration between the NPIC and mycologists. Results. From 2004 to 2009, the NPIC was consulted about 70 cases of suspected mushroom exposures. Forty-five children ingested unknown mushrooms, 12 adults and 2 children ingested hallucinogenic mushrooms and 11 adults ingested wild toxic mushrooms that were incorrectly identified or confused with edible species. The mycologists were consulted 10 times since 1999. In this series, Amanita species were identified in two cases. In three cases, the species identified were Clitocybe nebularis, Coprinus comatus and Panaeolina foenisecii, respectively, and serious poisoning was excluded. Incorrect mushroom identification by a health care professional using the Internet occurred in two cases. The mycologists assisted Poisons Information Centres in Northern Ireland

Asphalt cement poisoning

Science.gov (United States)

... petroleum material that hardens when it cools. Asphalt cement poisoning occurs when someone swallows asphalt. If hot ... found in: Road paving materials Roofing materials Tile cements Asphalt may also be used for other purposes.

Sodium hydroxide poisoning

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Sodium hydroxide is a very strong chemical. It is also known as lye and caustic soda. This ... poisoning from touching, breathing in (inhaling), or swallowing sodium hydroxide. This article is for information only. Do ...

Poison Ivy Dermatitis

Science.gov (United States)

... Category: Share: Yes No, Keep Private Poison Ivy Dermatitis Share | "Leaves of three - let it be!" aptly ... is caused by an allergic reaction ( allergic contact dermatitis ) to the oily coating that covers of these ...

Carbon Monoxide Poisoning

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... found in fumes produced any time you burn fuel in cars or trucks, small engines, stoves, lanterns, ... prevent CO poisoning in my home? Install a battery-operated or battery back-up CO detector in ...

Poison Ivy Dermatitis

Science.gov (United States)

... than the other two. Poison ivy clings to tree trunks and other vertical surfaces with hair-like ... urushiol". These are called Rhus plants after the old scientific name (it was changed to toxidendron). A ...

Sodium hypochlorite poisoning

Science.gov (United States)

... that can cause choking and serious breathing problems. Symptoms of sodium hypochlorite poisoning may include: Burning, red eyes Chest pain Coma Coughing (from the fumes) Delirium Gagging sensation Low blood pressure Pain in the ...

Extending reactor time-to-poison and reducing poison shutdown time by pre-shutdown power alterations

Energy Technology Data Exchange (ETDEWEB)

Kerr, Edward

1963-10-15

Manipulation of reactor power prior to shutdown and increasing the time- to-poison a sufficient amount to enable the required maintenance work to be completed and the reactor immediately restarted are discussed. The method employed in the NRU Reactor to gain the maximum timeto-poison with the least production loss is outlined. The method is based on intuition and is described by means of an analog of the iodine--xenon equations rather than the equations themselves. (C.E.S.)

A retrospective analysis of acute organophosphorus poisoning ...

African Journals Online (AJOL)

organophosphorus (OP) poisoning cases in a tertiary care hospital. Materials and ... In a pre-structured proforma, data regarding age, sex, time elapsed after intake, circumstances of poisoning, duration of hospitalization ... responsible for majority of self-attempted deaths ... cleansed with water at the time of admission.

ANALYSIS OF ORGANOPHOSPHORUS POISONING, AT TERTIARY CARE HOSPITAL: A REPORT

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Shakuntala

2015-01-01

Full Text Available BACKGROUND: Organophosphorus (OP compounds are the most common suicidal poison in developing countries and mortality continues to be high. The present study was aimed to know the pattern and outcome of the OP poisoning. METHODOLOGY: A record based retrospective study from January 2013 - December 2013 was Conducted in a tertiary care hospital and data regarding age, gender, domicile, type of poison, manner of poisoning, seasonal trends, marital status, motive behind poisoning , socio - economic status and outcome was collected in a pre - structured Performa. All data were documented, analyzed and interpreted as per the laid down protocol. RESULTS : out of total 1575 cases of OP compound poisoning, 71.73% (1130 were male, 28.27% (445 were female, 34.6% were in the age group 21 - 30 years, 70.95% were of low socio - economic status, Occupation wise agricultural workers were on top of the list (70.07%, The commonest (93.78% motive behind poisoning was suicidal in both males and females, Financial problem was one of the commonest (51.22% reasons of poisoning. The mortality rate in our study was 13.47%. CONCLUSION : Y oung and adult males of Low socio - economic class, rural, both literate and illiterate agriculturists commonly abuse this substance to commit suicide

AN ANALYTICAL STUDY OF DEATHS DUE TO POISONING IN VISAKHAPATNAM

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V. Chandrasekhar

2017-11-01

Full Text Available BACKGROUND The aim of this study was to determine and classify the various types of poisoning deaths as seen at Andhra Medical College Mortuary, Visakhapatnam city. MATERIALS AND METHODS This is a retrospective study of all the deaths due to poisoning seen in the Department of Forensic Medicine & Toxicology, Andhra Medical College, Visakhapatnam City over a 15 year period (January 2001‐December 2015 as recorded in the autopsy registers and postmortem reports of the department. RESULTS Poisoning is one of the commonest methods of committing suicide especially in developing countries like India. A total of 22475 autopsies were done during the period. Two thousand seventy four cases representing 9.23% of all bodies received by the mortuary were deaths due to poisoning. Organophosphate compounds were the most commonly 78.98% abused substance. The common motive of poisoning was suicidal 93.43%with male to female ratio 6.69:1.Peak incidence was observed in the age group 21-40 years. Type of poison consumed, socioeconomic status and place of household are also ascertained. CONCLUSION This study shows the pattern of poisoning deaths in Visakhapatnam and this preliminary data will provide a baseline for future research and help in formulating policies to prevent deaths due to poisoning.

The pattern of acute poisoning in a teaching hospital, north-west Ethiopia.

Science.gov (United States)

Abula, Teferra; Wondmikun, Yared

2006-04-01

Poisoning by means of hazardous chemicals through ignorance, mishap or intentionally is becoming a serious health problem worldwide. Epidemiological data on this important health issue are, however, scarce in Ethiopia. The purpose of this study is to assess the pattern of acute poisonings and determine the approaches employed for the management of poisoning. The medical records of patients with acute poisonings presented to the Gondar University hospital between July 2001 and June 2004 were reviewed retrospectively. One hundred and two patients presenting to the emergency department of the hospital were due to acute poisoning; accounting for about 0.45% of emergency room admissions. Organophosphates, rat poison and alcohol were the commonly encountered poisoning agents (in about 70% of cases) mainly in adults possibly with suicidal or para-suicidal intention. The approaches employed in the management of poisoning mainly involved gastrointestinal decontamination procedures. Specific antidotes were used in a substantial number of patients. The fatality rate was 2.4%. Poisoning with suicidal intention is becoming a serious health problem particularly in adults. Pesticides are commonly used toxicants. The approaches in the management of poisoning are justifiable in some cases. However, much is to be done to improve the recording of patient-related information and record-keeping processes. Further large scale studies are required to investigate national trends of poisoning and factors associated with poisoning.

AN OBSERVATIONAL CLINICAL STUDY OF ASSESSING THE UTILITY OF PSS (POISON SEVERITY SCORE AND GCS (GLASGOW COMA SCALE SCORING SYSTEMS IN PREDICTING SEVERITY AND CLINICAL OUTCOMES IN OP POISONING

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S. Chandrasekhar

2017-05-01

Full Text Available BACKGROUND Organophosphorus compound poisoning is the most common poisonings in India because of easy availability often requiring ICU care and ventilator support. Clinical research has indicated that respiratory failure is the most important cause of death due to organophosphorus poisoning. It results in respiratory muscle weakness, pulmonary oedema, respiratory depression, increased secretions and bronchospasm. These complications and death can be prevented with timely institution of ventilator support. MATERIALS AND METHODS Hundred consecutive patients admitted with a history of organophosphorus poisoning at Kurnool Medical College, Kurnool, were taken for study after considering the inclusion and exclusion criteria. Detailed history, confirmation of poisoning, examination and other than routine investigations, serum pseudocholinesterase and arterial blood gas analysis was done. The severity and clinical outcomes in OP poisoning is graded by PSS (poison severity score and GCS (Glasgow coma scale scoring systems. RESULTS This study was conducted in 100 patients with male preponderance. Majority of poisoning occurred in 21-30 age group (n=5. Most common compound consumed in our study was methyl parathion and least common was phosphoran. Slightly more than half of the patients consumed less than 50 mL of poison. 21 patients consumed between 50 to 100 mL. Distribution of poison severity score of patients studied showed 45 cases of grade 1 poisoning. 26 cases of grade 2 poisoning, 23 cases of grade 3 poisoning and 6 cases of grade 4 poisoning (death within first 24 hours. Distribution of GCS score of patients studied GCS scores were <10 in 25 patients at admission and 24 patients after 24 hours. GCS scores were ≥10 in 75 patients at admission and 76 patients after 24 hours. Poison severity score is not prognostic, but merely defines severity of OP poisoning at a given time. CONCLUSION Both Glasgow coma scale and poison severity scoring systems

NCHS - Drug Poisoning Mortality by County: United States

Data.gov (United States)

U.S. Department of Health & Human Services — This dataset describes drug poisoning deaths at the county level by selected demographic characteristics and includes age-adjusted death rates for drug poisoning...

Sodium carbonate poisoning

Science.gov (United States)

Sodium carbonate (known as washing soda or soda ash) is a chemical found in many household and industrial products. This article focuses on poisoning due to sodium carbonate. This article is for information only. Do NOT ...

Lip moisturizer poisoning

Science.gov (United States)

... Science of Poisons . 8th ed. New York, NY: McGraw-Hill Education/Medical; 2013:chap 6. Review Date ... urac.org). URAC's accreditation program is an independent audit to verify that A.D.A.M. follows ...

Nail polish poisoning

Science.gov (United States)

... Science of Poisons . 8th ed. New York, NY: McGraw-Hill Medical; 2013:chap 24. Kulig K. General ... urac.org). URAC's accreditation program is an independent audit to verify that A.D.A.M. follows ...

Poisons Implicated in Homicidal, Suicidal and Accidental Cases in North-West Pakistan

International Nuclear Information System (INIS)

Jan, A.; Khan, M. T. H.; Khan, M. J.; Fatima, S.; Khan, T. M.

2016-01-01

Background: Pakistan has one of the highest prevalence of poisoning in the world. However, limited data exist on the frequency of poisons implicated in homicidal, suicidal, and accidental cases in North-West Pakistan (Khyber Pakhtunkhwa). Methods: This retrospective study of 353 cases and biological specimens of poisoning received at the department of Forensic medicine and toxicology, Khyber Medical College Peshawar from 13 districts of Khyber Pakhtunkhwa. Frequency of poisoning was assessed by testing each specimen for 17 different poisons. Results: Of all the specimens, 250 (70.8 percent) specimens tested positive and the rest did not show any indication of poisoning (n=103, 29.2 percent). The most frequent poisons detected were benzodiazepines (total n=75), organophosphates (total n=58), phencyclidine (total n=30) and morphine (total n=23). Gender had a significant association with benzodiazepines (p=0.011), tricyclic antidepressants (p=0.001), and organophosphates (p<0.001). Organophosphates were the most common cause of poisoning in females while benzodiazepines were the most common cause of poisoning in males. Conclusion: Poisoning by benzodiazepines, organophosphates and phencyclidine are the most common causes of intoxication in population of Khyber Pakhtunkhwa. Source of poisoning varies with gender for organophosphates, benzodiazepines and tricyclic antidepressants. (author)

Lead poisoning in a Mississippi sandhill crane

Science.gov (United States)

Franson, J. Christian; Hereford, Scott G.

1994-01-01

Lead poisoning from the ingestion of spent lead shot is well documented in waterfowl (Sanderson and Bellrose 1986) and has been reported in other wetland (Locke et al. 1991, Windingstad et al. 1984) and upland (Hunter and Rosen 1965, Locke and Bagley 1967) avian species. Ingested fishing weights have been implicated in lead poisoning of Trumpeter Swans (Cygnus buccinator) (Blus et al. 1989), Common Loons (Gavia immer) (Locke et al. 1982, Franson and Cliplef 1992, Pokras and Chafe1 1992), Mute Swans (Cygnus olor) (Birkhead 1982), and Sandhill Cranes (Grus canadensis) (Windingstad et al. 1984). The significance of lead poisoning as a mortality factor in avian species other than waterfowl is probably underestimated (Locke and Friend 1992), and any cause of mortality becomes particularly important in species with small population sizes. We report here the first known case of lead poisoning in a Mississippi Sandhill Crane (Grus canadensis pulla), a critically endangered subspecies.

Status and trends in poisonings in Denmark 2007-2009

DEFF Research Database (Denmark)

Dalhoff, Kim Peder; Bøgevig, Søren; Høgberg, Lotte Christine Groth

2011-01-01

INTRODUCTION: The Danish Poison Information Centre (DPIC) provides information to the public and health care professionals on acute poisonings. The DPIC received 41,000 enquiries during the first three years of its existence as an open 24h telephone service. The aim of this data register study...... was to classify all substance exposures, to gain knowledge of the status and trends in poisonings (toxico-surveillance) and to evaluate the development in the number of contacts. MATERIAL AND METHODS: Information and inquiries were continuously entered into a poison-centre database. A new classification system...... in the Danish population were registered in 2009. For all groups, except drugs of abuse, the data showed an increase in the actual number of exposures from 2008 to 2009. Pharmaceuticals represent one third of substance exposures, and analgesics constitute a third of these poisonings. A relative increase...

Acute poisoning in the community and its associated mortality at the ...

African Journals Online (AJOL)

Background: Acute poisoning is a common event in the community. Despite the high prevalence of acute poisoning in the community, there are very few studies done on the subject in Zambia. Lack of research on acute poisoning has resulted in lack of information on the pattern of poisoning, morbidity, mortality and pitfalls in ...

[Analysis of acute pesticide poisoning in Ningbo city from 2011 to 2016].

Science.gov (United States)

Li, X H; Leng, P B; Mao, G C; Wang, A H

2018-01-20

Objective: To analyze the characteristics of acute pesticide poisoning in Ningbo, and to provide scientific basis for the prevention and control strategy. Methods: In February 2017, the pesticide poisoning report card of Ningbo from 2011 to 2016 was drawn from the China Disease Control and prevention information system. The data of the report card was organized by Excel and analyzed by SPSS19.0 software. Results: 2593 cases of acute pesticide poisoning were reported in Ningbo from 2011 to 2016, 125 deaths, and the case fatality rate was 4.82%. The productive pesticide poisoning and unproductive pesticide poisoning were 299 and 2294, respectively, the ratio was 1: 7.67. The case fatality rate were 0.33% and 5.41%, respectively. The difference was statistically significant (χ(2)=14.83, PPesticide poisoning mainly occurred from July to September (55.85%) , the unproductive pesticides mainly occurred from April to June (30.64%) and July to September (30.34%). The seasonal distribution of the pesticide poisoning in the two groups was statistically significant (χ2=82.21, Ppesticide poisoning in male (80.27%) was significantly higher than the proportion of unproductive pesticide poisoning (52.09%) , the differences in gender composition between the two types of pesticide poisoning was significant (χ2=84.97, Ppesticide poisoning from 55 to 65 years old group was in the largest number (35.45%) , and the distribution of unproductive pesticide poisoning was uniform in each age group including 25 years old and above, the difference in age composition between two types of pesticide poisoning was statistically significant (χ2=177.84, Ppesticide poisoning. The counties with more reports were Ninghai county (18.28%) , Fenghua district (14.69%) and Yuyao (12.42%). The acute pesticide poisoning was mainly caused by pesticides and herbicides, mainly in organophosphorus (45.74%) and paraquat (16.81%) . Conclusions: At present, the pesticide poisoning in Ningbo is given priority to

Pharmacological treatment of cardiac glycoside poisoning

OpenAIRE

Roberts, Darren M.; Gallapatthy, Gamini; Dunuwille, Asunga; Chan, Betty S.

2015-01-01

Cardiac glycosides are an important cause of poisoning, reflecting their widespread clinical usage and presence in natural sources. Poisoning can manifest as varying degrees of toxicity. Predominant clinical features include gastrointestinal signs, bradycardia and heart block. Death occurs from ventricular fibrillation or tachycardia. A wide range of treatments have been used, the more common including activated charcoal, atropine, ??adrenoceptor agonists, temporary pacing, anti?digoxin Fab a...

Accidental poisoning with detomidine and butorphanol.

Science.gov (United States)

Hannah, N

2010-09-01

This is a case report concerning a veterinarian who spilled detomidine and butorphanol on dermatitic hands while sedating a horse. This resulted in acute poisoning from which the patient spontaneously recovered with supportive management. Veterinarians often suffer from occupational dermatitis and handle strong sedatives with no gloves while working around unpredictable animals. Thus, this group is at risk of accidental self-poisoning from this method.

Prevalence of Organophosphate Poisoning In Batticaloa, Sri Lanka

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maheswaran umakanth

2017-12-01

Full Text Available Background: Deliberate self-harm (DSH is a global problem which has steadily increased over the past few years in developing countries and has become as one of the major causes of morbidity and mortality in these countries. The aim of this prospective study was to analyze the prevalence of organophosphate poisoning among other acute DSH cases admitted to the medical ward at Batticaloa Teaching Hospital, Sri Lanka. We report the socio-demographic, and outcome of organophosphate poisoning. Method: The prospective study comprises of 121 cases of acute poisoning admitted at Batticaloa Teaching Hospital (BTH, Sri Lanka. This study was conducted for a period of three months from April 12 through July 12, 2017. Results: Among the subjects, 119 (98.34% cases had intentional poisoning and only two cases (1.65% accidental poisoning. Poisoning with organophosphate compounds (OP 23 (19% was the second leading type. There were 13 (56.5% males and 10 (43.5% females. Most of the patients were under the age group of 20-29 years old. 21 cases lived in rural areas and 2 in urban areas. Out of 23 patients, there were 2 (8.7% deaths, 18 (78.3% were discharged without any complications. Conclusion: DSH in Sri Lanka is reported to be associated with interpersonal conflict, short premeditation, as well as alcohol misuse among males.

A Tale of two Systems: Poisoning Management in Iran and the United States

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Omid Mehrpour

2013-05-01

Full Text Available Poisoning morbidity and mortality is high in the developing world. Systems for care of poisoned patients differ markedly between countries. In this paper a comparison of two very different systems for the care of poisoned patients, is presented. Specifically, the role of poison centers and poison treatment centers in the US and Iran are contrasted. A systematic literature search was undertaken utilizing the PubMed, Scopus, and Google Scholar and the keywords “poison centers”, “treatment” “Iran” “United States of America” and 100 publications were identified. From these, relevant data were found in 23 publications. The information was double-checked and data were summarized herein.We find that the system of the care of poisoned patients relies heavily on certified poison centers in the US and that only a few hospitals have well developed medical toxicology services. In contrast, in Iran, the poison center system is somehow less developed and the care of poisoned patients is provided in centralized high volume hospital poison units.Although both the US and Iran have highly developed systems for the care of poisoned patients they are distinctly different. Comparative studies based on these systems could provide important data for developing countries with more rudimentary poison control and treatment facilities.

A rare case report of Strychnos nux-vomica poisoning with bradycardia

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Lesley Ponraj

2017-01-01

Full Text Available Strychnine poisoning is a rare method of deliberate self-harm in adults. Poisoning with strychnine leaves is a rare form of strychnine poisoning, as the usual plant parts used are nuts, bark, and seeds. Although the common cardiac manifestations of strychnine positioning include tachycardia and hypertension, we report a patient with mild strychnine poisoning with bradycardia.

Accidental Poisoning with Otapiapia: a Local Organophasphate ...

African Journals Online (AJOL)

Children are prone to accidental poisoning. We report this fatal organophosphate poisoning of a 3-year-old Nigerian boy following accidental ingestion of a homemade cocktail of kerosene and 'Otapiapia': a local rodenticide to highlight the dangers inherent in un-regulated production, home use and storage of this ...

Mercury poisoning | Shamley | South African Medical Journal

African Journals Online (AJOL)

The diagnosis of mercury poisoning requires a high index of suspicion. Mercury poisoning in a patient involved in illicit gold extraction is reported and 6 other cases considered. Some of the clinical features and treatment of this condition are discussed. S Afr Med J 1989; 76: 114-116 ...

Poisons Implicated In Homicidal, Suicidal And Accidental Cases In North-West Pakistan.

Science.gov (United States)

Jan, Adil; Khan, Muhammad Jaffar; Humayun Khan, Muhammad Tariq; Masood Khan, Muhammad Tariq; Fatima, Sadia

2016-01-01

Pakistan has one of the highest prevalence of poisoning in the world. However, limited data exist on the frequency of poisons implicated in homicidal, suicidal, and accidental cases in North-West Pakistan (Khyber Pakhtunkhwa). This retrospective study of 353 cases and biological specimens of poisoning received at the department of Forensic medicine and toxicology, Khyber Medical College Peshawar from 13 districts of Khyber Pakhtunkhwa. Frequency of poisoning was assessed by testing each specimen for 17 different poisons. Of all the specimens, 250 (70.8%) specimens tested positive and the rest didn't show any indication of poisoning (n=103, 29.2%). The most frequent poisons detected were benzodiazepines (total n=75), organophosphates (total n=58), phencyclidine (total n=30) and morphine (total n=23). Gender had a significant association with benzodiazepines (p=0.011), tricyclic antidepressants (p=0.001), and organophosphates (ppoisoning in females while benzodiazepines were the most common cause of poisoning in males. Poisoning by benzodiazepines, organophosphates and phencyclidine are the most common causes of intoxication in population of Khyber Pakhtunkhwa. Source of poisoning varies with gender for organophosphates, benzodiazepines and tricyclic antidepressants.

Epidemiological Study of Poisoning in Teaching Hospitals in Shiraz in 1387

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M. Aryaie

2012-04-01

Full Text Available Background/Objective: Poisoning is One common cause of referred cases , especially in the adolescent and young group to hospital emergency department. This study was designed to determine Epidemiologic of poisoning in teaching hospitals, shiraz in 1387 Methods: This is a cross-sectional study that 266 sample via random sampling with 95% confidence interval and α 0.05 were considered. Results: There were 47% female and 53% male. 67.2 percent of poisoned patient were single and 32.8% were married. This study showed, highest rate of poisoning was between the age of 20-35 years. Most common season of poisoning was in spring. Overall mortality of our study was 1.6 percent. Conclusions: Regional epidemiological information, make rational use of resources in order to prevention and control of poisoning and with using analysis of effective factors will be reduced poisoning by policymakers and planners.

Drain cleaner poisoning

Science.gov (United States)

... Activated charcoal, which is used to treat other types of poisoning does not effectively treat (adsorb) sodium hydroxide. For skin exposure, treatment may include: Surgical removal of burned skin (debridement) Transfer to a hospital that specializes in burn ...

Clinical and electrocardiographic evaluation during experimental toad poisoning in dogs

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AC Camplesi

2010-01-01

Full Text Available Accidents involving toad poisoning are frequent and dogs are the most common victims; they become poisoned by biting or ingesting a toad. When released in the organism, the venom is absorbed by both the oral mucosa and the digestive tract, initiating its toxic action. The aim of this work was to evaluate the clinical and electrocardiographic aspects of dogs subjected to experimental toad poisoning, as well as their response to treatment with propranolol. Twenty dogs were divided into two groups, a control group (n = 5 and a poisoned group (n = 15. After general anesthesia, the control group received a placebo, while the poisoned group received a venom aliquot through an orogastric tube. Results were tested through multivariate analysis (p < 0.05. The animals in the poisoned group had gastrointestinal symptoms including emesis, intense salivation, hyperemic or congested oral mucosa and pasty diarrhea. Non-responsive mydriasis, nystagmus, depression, stupor, tachypnea, opisthotonus and ataxia were also manifested by 100% of the poisoned animals. Affected dogs had an increase in blood pressure, statistically significant throughout study. Five poisoned animals developed ventricular tachycardia and were treated with propranolol (0.5 mg/kg IV. All propranolol-treated animals returned to normal sinus rhythm, which evidences the efficacy of this drug to treat ventricular arrhythmias caused by toad venom.

Delayed encephalopathy after acute carbon monoxide poisoning

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Mehmet İbrahim Turan

2014-03-01

Full Text Available Carbon monoxide poisoning is a major cause of death following attempted suicide and accidental exposures. Although clinical presentation depends on the duration and the intensity of exposure, the assessment of the severity of intoxication is difficult. A small percentage of patients who show complete initial recovery may develop delayed neurological deficits. Delayed encephalopathy after acute carbon monoxide poisoning is a rare and poor prognosis neurologic disorders and there is no specific treatment. We present a case with early onset of delayed encephalopathy after acute carbon monoxide poisoning with typical cranial imaging findings in a child with atypical history and clinical presentation.

Fatal poisoning among patients with drug addiction

DEFF Research Database (Denmark)

Simonsen, Kirsten Wiese; Christoffersen, Dorte J; Banner, Jytte

2015-01-01

INTRODUCTION: Fatal poisonings among drug addicts in Denmark in 2012 were examined. Cause of death, abuse pattern and geographic differences are discussed and data are compared with previous studies. METHODS: All fatal poisonings examined at the three institutes of forensic medicine in Denmark...... on Funen and in South Jutland. Cocaine was most frequently detected in East Denmark, while amphetamine was more frequent in West Denmark. CONCLUSIONS: The number of fatal poisonings among drug addicts has stabilised around 200. The increase in methadone deaths continued and, as in 2007, methadone...... with 2007, indicating that a considerable number of drug addicts also have psychiatric illness. FUNDING: none. TRIAL REGISTRATION: not relevant....

Fatal poisoning among patients with drug addiction

DEFF Research Database (Denmark)

Simonsen, K. W.; Christoffersen, D. J.; Banner, J.

2015-01-01

Introduction: Fatal poisonings among drug addicts in Denmark in 2012 were examined. Cause of death, abuse pattern and geographic differences are discussed and data are compared with previous studies. Methods: All fatal poisonings examined at the three institutes of forensic medicine in Denmark...... on Funen and in South Jutland. Cocaine was most frequently detected in East Denmark, while amphetamine was more frequent in West Denmark. ConclusionS: The number of fatal poisonings among drug addicts has stabilised around 200. The increase in methadone deaths continued and, as in 2007, methadone...... with 2007, indicating that a considerable number of drug addicts also have psychiatric illness....

Nodal Diffusion Burnable Poison Treatment for Prismatic Reactor Cores

International Nuclear Information System (INIS)

Ougouag, A.M.; Ferrer, R.M.

2010-01-01

The prismatic block version of the High Temperature Reactor (HTR) considered as a candidate Very High Temperature Reactor (VHTR)design may use burnable poison pins in locations at some corners of the fuel blocks (i.e., assembly equivalent structures). The presence of any highly absorbing materials, such as these burnable poisons, within fuel blocks for hexagonal geometry, graphite-moderated High Temperature Reactors (HTRs) causes a local inter-block flux depression that most nodal diffusion-based method have failed to properly model or otherwise represent. The location of these burnable poisons near vertices results in an asymmetry in the morphology of the assemblies (or blocks). Hence the resulting inadequacy of traditional homogenization methods, as these 'spread' the actually local effect of the burnable poisons throughout the assembly. Furthermore, the actual effect of the burnable poison is primarily local with influence in its immediate vicinity, which happens to include a small region within the same assembly as well as similar regions in the adjacent assemblies. Traditional homogenization methods miss this artifact entirely. This paper presents a novel method for treating the local effect of the burnable poison explicitly in the context of a modern nodal method.

Self-poisoning with baclofen in alcohol-dependent patients: national reports to French Poison Control Centers, 2008-2013.

Science.gov (United States)

Pelissier, Fanny; de Haro, Luc; Cardona, Florence; Picot, Cyndie; Puskarczyk, Emmanuel; Sapori, Jean-Marc; Tournoud, Christine; Franchitto, Nicolas

2017-04-01

Alcohol use disorders are frequently associated with self-intoxication in attempted suicide. In France since 2008, the off-label use of baclofen for treatment of alcohol dependence has greatly increased, leading to temporary regulation of use of the drug. At the request of the national authorities, the French Poison Control Centers carried out a retrospective survey to give an overview of baclofen exposure in this population. A retrospective study was carried out from January 2008 to December 2013, focusing on baclofen exposures in alcohol-dependent patients managed by the nine national French Poison Control Centers. 294 observations of baclofen exposures in alcohol-dependent patients were identified in our database. Of these, 220 were suicide attempts by self-poisoning and 74 were unintentional. The mean age of patients was 41.7 years, with a sex-ratio of 1.6. Patients attempting suicide with baclofen were younger than those with unintentional exposures, and 43.6% of them were women (vs 22.9%, p < 0.01). The mean supposed ingested dose was higher (480.7 mg) in patients who attempted suicide (vs 192.5 mg, p < 0.0001). 21.8% of intentional exposures involved baclofen alone. Psychiatric comorbidity (50.4%) was more frequent in the group of self-poisoning (p < 0.001). 132 patients were coded as severely exposed (60.0%). Nine victims died, but the causal link between self-poisoning with baclofen and fatal outcome should be interpreted with particular caution. Baclofen self-poisoning by alcohol-dependent patients is a serious concern for the French health authorities. Our results are similar to those previously published, suggesting that most patients with baclofen overdose should be admitted to an intermediate or intensive care unit as the clinical course requires close monitoring. Because suicidal ideation and suicide attempts are more prevalent in people with substance use disorders than in the general population, and because of the lack of

Cartap poisoning: A rare case report.

Science.gov (United States)

Kumar, A S Praveen; Amalnath, Deepak; Dutta, T K

2011-10-01

Cartap is a pesticide commonly used to control weevil and caterpillars. It is an analogue of nereistoxin, a neurotoxic substance isolated from the marine annelid Lumbriconereis heteropoda. It causes neuromuscular blockade. Poisoning with cartap is very rare and not yet reported from India. We report a 35-year-old lady with cartap poisoning who presented with nausea, vomiting, and dyspnea. She improved with N-acetyl cysteine and symptomatic management.

Cartap poisoning: A rare case report

OpenAIRE

Kumar, A. S. Praveen; Amalnath, Deepak; Dutta, T. K.

2011-01-01

Cartap is a pesticide commonly used to control weevil and caterpillars. It is an analogue of nereistoxin, a neurotoxic substance isolated from the marine annelid Lumbriconereis heteropoda. It causes neuromuscular blockade. Poisoning with cartap is very rare and not yet reported from India. We report a 35-year-old lady with cartap poisoning who presented with nausea, vomiting, and dyspnea. She improved with N-acetyl cysteine and symptomatic management.

Low reactivity penalty burnable poison rods

International Nuclear Information System (INIS)

1978-01-01

A nuclear reactor burnable poison rod is described which consists of an elongated tubular sheath enclosing a neutron absorbing material which, at least during reactor operation, also encloses a neutron moderating material. The excess reactivity existing at the beginning of core life is compensated for by the depletion of the burnable poison throughout the life of the core, so that the life of the core is extended. (UK)

Lipid resuscitation in acute poisoning

DEFF Research Database (Denmark)

Hoegberg, Lotte C G; Gosselin, Sophie

2017-01-01

PURPOSE OF REVIEW: The decision to provide intravenous lipid emulsion (ILE) therapy as a treatment modality for the reversal of various drug toxicity was discovered in the last decade. Numerous publications, in both humans and animals attest to its clinical use, but current supporting evidence...... is inconsistent. RECENT FINDINGS: A recent systematic review reported evidence for benefit of ILE in bupivacaine toxicity. Human randomized trials, large observational studies as well as animal models of orogastric poisoning failed to report a clear benefit of ILE for nonlocal anesthetics poisoning. SUMMARY: ILE...

[Living conditions and pattern of acute poisonings in Oslo].

Science.gov (United States)

Kolvik, Hallgeir Mæsel; Heyerdahl, Fridtjof; Bjørnaas, Mari Asphjell; Hovda, Knut Erik; Jacobsen, Dag; Ekeberg, Øivind

2011-08-09

Hospitalized patients with acute poisoning come from all classes of society. The relationship between living conditions and pattern of poisoning is, however, unclear. The aim of this study was to examine the connection between living conditions in Oslo and the pattern of acute poisonings, measured by incidence, main toxic agents and intention. A one-year multi-centre study with prospective inclusion of all patients ≥ 18 years of age with a registered address in Oslo admitted to an Oslo hospital with acute poisoning from 1 April 2003 through 31 March 2004. The 15 city districts were grouped into three, according to the official living conditions index in Oslo: city district group 1 (best living conditions), city district group 2 (average living conditions) and city district group 3 (most difficult living conditions). Of a total of 947 patients admitted with acute poisoning as their main diagnosis in the study period, 691 were included in the study, 660 of whom had self-inflicted poisoning. In city district group 3, the annual incidence of acute poisonings was 2.14 per 1000 inhabitants, significantly higher than city district group 2, with 1.50 (p < 0.001), and city district group 1, with 1.36 (p < 0.001). Measured as intention assessed by the treating physician, suicidal and drug related poisonings and those induced by a "cry for help" were more common in city district group 3 (0.74, 0.59 and 0.74 per 1000 inhabitants, respectively) than in city district group 2 (0.62, 0.40 and 0.41, respectively) and city district group 1 (0.52, 0.32 and 0.45, respectively). The main toxic agents were predominantly benzodiazepines (20 %), ethanol (18 %) and paracetamol (12 %). There were no statistically significant differences in the distribution of main toxic agents between the city district groups. The findings show a social gradient, with the highest incidence of poisonings in the city district group with the most difficult living conditions.

Carbon monoxide poisoning

Science.gov (United States)

... Animals can also be poisoned by carbon monoxide. People who have pets at home may notice that their animals become ... or unresponsive from carbon monoxide exposure. Often the pets will ... these conditions. This can lead to a delay in getting help.

Argument Strategies: Antidote to Tylenol's Poisoned Image.

Science.gov (United States)

Benoit, William L.; Lindsey, James J.

1987-01-01

Analyzes how the manufacturer dealt with the Tylenol poisonings: the link between Tylenol and the poisoning was denied, its image as a safe product was bolstered, capsules were differentiated from other products, and as a result, sales recovered. Extends the applicability of apologia as a way to analyze other media campaigns. (SKC)

Poisonings in the Nordic countries in 2007

DEFF Research Database (Denmark)

Andrew, Erik; Tellerup, Markus; Termälä, Anna-Mariia

2012-01-01

To map mortality and morbidity of poisonings in Denmark, Finland, Iceland, Norway and Sweden in 2007 and undertake a comparison with a corresponding study in 2002.......To map mortality and morbidity of poisonings in Denmark, Finland, Iceland, Norway and Sweden in 2007 and undertake a comparison with a corresponding study in 2002....

Profile of hospital Admissions of childhood poisoning at a North ...

African Journals Online (AJOL)

Background: Childhood poisoning is an important but preventable cause of morbidity and mortality in the paediatric subpopulation. There is the continuous need to describe the pattern of childhood poisoning and to create public awareness on the common agents of poison in this environment. Objectives: To determine the ...

International Variability in Gastrointestinal Decontamination With Acute Poisonings.

Science.gov (United States)

Mintegi, Santiago; Dalziel, Stuart R; Azkunaga, Beatriz; Prego, Javier; Arana-Arri, Eunate; Acedo, Yordana; Martinez-Indart, Lorea; Benito, Javier; Kuppermann, Nathan

2017-08-01

Identifying international differences in the management of acute pediatric poisonings may help improve the quality of care. The objective of this study was to assess the international variation and appropriateness of gastrointestinal decontamination (GID) procedures performed in children and adolescents who present with acute poisonings to emergency departments. This was an international, multicenter, cross-sectional prospective study including children poisoning exposures presenting to 105 emergency departments in 20 countries from 8 global regions belonging to the Pediatric Emergency Research Networks. Data collection started between January and September 2013 and continued for 1 year. The appropriateness of GID procedures performed was analyzed using the American Academy of Clinical Toxicology and the European Association of Poisons Centres and Clinical Toxicologists' recommendations. Multivariate logistic regression was performed to identify independent risk factors for performing GID procedures. We included 1688 patients, 338 of whom (20.0%, 95% confidence interval 18.1%-22.0%) underwent the following GID procedures: activated charcoal (166, 49.1%), activated charcoal and gastric lavage (122, 36.1%), gastric lavage (47, 13.9%), and ipecac (3, 0.9%). In 155 (45.8%, 40.5%-51.2%), the GID procedure was considered appropriate, with significant differences between regions. Independent risk factors for GID procedures included age, toxin category, mechanism of poisoning, absence of symptoms, and the region where the intoxication occurred ( P management of pediatric poisonings. International best practices need to be better implemented. Copyright © 2017 by the American Academy of Pediatrics.

CFD analysis of poison injection in AHWR calandria

International Nuclear Information System (INIS)

Kansal, A.K.; Kamble, M.T.; Maheshwari, N.K.; Vijayan, P.K.

2014-01-01

The present work intends to give details of design and performance validation of SDS-2. The performance is evaluated on the basis of dispersion of poison in calandria in a given period of time. Location of injection tube and injection holes, size of jet hole and number of holes are some of the design parameters which greatly affect dispersion of poison in calandria. A Computational Fluid Dynamic (CFD) study for axial and radial injection of poison was carried out using open source CFD code OpenFOAM. CFD benchmarking was done using experiments performed by Johari (Johari et al. 1997) to identify suitable turbulence model for this problem. An experimental facility simulating poison injection in moderator in presence of calandria tubes was used to further validate the CFD model is shown in the paper. CFD analysis was carried out for axial as well as radial injection for AHWR geometry. CFD analysis using OpenFOAM has been carried out to study high pressure poison injection for single jet of Shut Down System - 2 (SDS- 2) of Advanced Heavy Water Reactor (AHWR) for various design options. CFD model used in analysis have been validated with experimental data available in literature as well as experiments performed for AHWR specific geometry. Various turbulence models are tested and their adequacy for such flow problems has been established. The CFD model is then used to simulate poison injection for two design options for AHWR and their performance is compared. (author)

[Acute poisoning in patients over 65 years of age].

Science.gov (United States)

Miranda Arto, P; Ferrer Dufol, A; Ruiz Ruiz, F J; Menao Guillén, S; Civeira Murillo, E

2014-01-01

There are few Spanish studies on acute poisoning in the elderly despite the associated risk factors of this group of patients. Retrospective descriptive study of acute poisonings treated in the Emergency Service of the University Hospital of Zaragoza from 1995 to 2009 on patients 65 years old or older. A total of 762 patients were selected in the study (4.74% of all acute poisonings) with a mean age of 74.16 (SD ± 6) years. Ingestion was the major route of exposure (85%) and alcohol overdose (28,7%) was the most frequent type of poisoning. A trend was also observed showing a lower emetic treatment and gastric lavage and an increase in activated charcoal. Benzodiazepines (14.3%) and toxic household products (11%) with caustic properties were also the main toxics found in the study. Acute poisonings in the elderly required more hospitalizations, have a higher mortality and more autolytic attempts which result in death.

[Characteristics of emergency poisoning cases in elderly versus younger patients].

Science.gov (United States)

Supervía Caparrós, August; Pallàs Villaronga, Oriol; Clemente Rodríguez, Carlos; Aranda Cárdenas, María Dolores; Pi-Figueras Valls, María; Cirera Lorenzo, Isabel

2017-10-01

To compare cases of poisoning according to age to detect differences in frequency of visits to the emergency department, patient characteristics, case management, and immediate outcome in terms of related mortality. Descriptive study of a retrospective series of patients who visited a university hospital emergency department for treatment of poisoning between 2009 and 2014. We collected patient characteristics and data related to the event, case management, and poisoning-related death. Patients were grouped according to age (cut-off 65 y). Of a total of 3847 poisoning episodes, 341 (8.9%) were in patients aged 65 years or older. The percentage of women among these older patients (61.3%) was greater than among younger patients (36.3%; P<.001). Poisoning was accidental in older patients more often than younger ones (64.4% vs 9.5%, respectively; P<.001), occurred more often in the home (82.1% vs 37%, P<.001), and more often required active treatment (73.3% vs 57.4%; P<.001) and admission to hospital (21.4% vs 7.3%, P<.001). The related mortality rate was also higher in the older patients (2.1% vs 0.1% in younger patients, P<.001). The percentage of poisonings in patients aged 65 years or older is not negligible. Poisoning in patients of advanced age tends to be accidental and take place in the home. Older patients more often require active treatment and hospital admission; poisoning-related death is more common in older patients than younger ones.

Four-Year Study on Acute Poisoning Cases Admitted to a Tertiary Hospital in Bangladesh: Emerging Trend of Poisoning in Commuters

Directory of Open Access Journals (Sweden)

Mohammad Shafiqul Bari

2014-12-01

Conclusion:Commuter or travel-related poisoning is an emerging public health threat in this part of Bangladesh. Public awareness should be raised and school-based educational programs should be emphasized regarding the commuter poisoning and the consequence of accepting and eating food from strangers.

Nicotinic plant poisoning.

Science.gov (United States)

Schep, Leo J; Slaughter, Robin J; Beasley, D Michael G

2009-09-01

A wide range of plants contain nicotinic and nicotinic-like alkaloids. Of this diverse group, those that have been reported to cause human poisoning appear to have similar mechanisms of toxicity and presenting patients therefore have comparable toxidromes. This review describes the taxonomy and principal alkaloids of plants that contain nicotinic and nicotinic-like alkaloids, with particular focus on those that are toxic to humans. The toxicokinetics and mechanisms of toxicity of these alkaloids are reviewed and the clinical features and management of poisoning due to these plants are described. This review was compiled by systematically searching OVID MEDLINE and ISI Web of Science. This identified 9,456 papers, excluding duplicates, all of which were screened. Reviewed plants and their principal alkaloids. Plants containing nicotine and nicotine-like alkaloids that have been reported to be poisonous to humans include Conium maculatum, Nicotiana glauca and Nicotiana tabacum, Laburnum anagyroides, and Caulophyllum thalictroides. They contain the toxic alkaloids nicotine, anabasine, cytisine, n-methylcytisine, coniine, n-methylconiine, and gamma-coniceine. These alkaloids act agonistically at nicotinic-type acetylcholine (cholinergic) receptors (nAChRs). The nicotinic-type acetylcholine receptor can vary both in its subunit composition and in its distribution within the body (the central and autonomic nervous systems, the neuromuscular junctions, and the adrenal medulla). Agonistic interaction at these variable sites may explain why the alkaloids have diverse effects depending on the administered dose and duration of exposure. Nicotine and nicotine-like alkaloids are absorbed readily across all routes of exposure and are rapidly and widely distributed, readily traversing the blood-brain barrier and the placenta, and are freely distributed in breast milk. Metabolism occurs predominantly in the liver followed by rapid renal elimination. Following acute exposure

The brain imaging study of the organophosphorus pesticides poisoning

International Nuclear Information System (INIS)

Yang Yanmei; Liu Huaijun; Li Shuling; Wang Yongsheng; Huang Boyuan; Chi Cen; Shi Zhenyang; Cui Caixia; Zhou Lixia; Liu Runtian

2004-01-01

Objective: To summarize the CT and MR imaging findings in acute organophosphorus pesticides poisoning patients, and to improve the early diagnostic ability. Methods: The imaging of 34 patients of organophosphorus pesticides poisoning was analyzed, the poisons were all taken orally. The pesticides included methamidophos (12 cases), omethoate (15 cases), DDV (3 cases), and methylparathion (4 cases). According to the diagnosis and classification diagnosis criterion of acute organophosphorus pesticides poisoning, the patients were divided into two groups: mild or moderate grade group (24 cases) and severe grade group (10 cases). The relationship between the clinic grade and CT and MRI findings was studied. Results: in the severe grade group, 4 patients showed brain edema, presenting as sulcus and fissure flattened or disappeared, and ventricles and cisterns narrowed or closed 2-3 days after poisoning. In 3 patients 3 days to 3 months after poisoning, bilateral basal ganglion and cerebral cortex showed prolonged T 1 and T 2 signals, and high signal intensity was detected on FLAIR, and bilateral basal ganglion low density was revealed on CT. T 1 relaxation was shortened, T 2 WI and FLAIR imaging showed high signal intensity in 1 patient. The imaging of 1 patient 6 months after poisoning showed the cerebral sulcus, fissure and ventricle were enlarged. CT and MRI in the mild or moderate group were normal. By the Fisher's exact probabilities test, the imaging exhibition difference between the severe grade and mild or moderate grade patients was significant. Conclusion: The CT and MRI can reflect the brain injury after poisoning, and the imaging exhibitions were various. The imaging information can provide credible foundation for the therapy for lightening the brain edema and nourishing the brain cell

A promising poison information centre model for Africa

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Carine Marks

2016-06-01

Conclusion: A number of benefits might result from such a poisons centre network hub, including: (1 Improved cooperation between countries on poisoning problems; (2 Harmonisation and strengthening of research and surveillance; (3 Common standards and best practices e.g. regulating chemicals, data management, and staff training; and (4 Greater bargaining power to secure resources. Further investigation is needed to identify the most suitable location for the network hub, the activities it should fulfil, and the availability of specialists in poisons information who could become members of the hub.

Variability in the management of lithium poisoning.

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Roberts, Darren M; Gosselin, Sophie

2014-01-01

Three patterns of lithium poisoning are recognized: acute, acute-on-chronic, and chronic. Intravenous fluids with or without an extracorporeal treatment are the mainstay of treatment; their respective roles may differ depending on the mode of poisoning being treated. Recommendations for treatment selection are available but these are based on a small number of observational studies and their uptake by clinicians is not known. Clinician decision-making in the treatment of four cases of lithium poisoning was assessed at a recent clinical toxicology meeting using an audience response system. Variability in treatment decisions was evident in addition to discordance with published recommendations. Participants did not consistently indicate that hemodialysis was the first-line treatment, instead opting for a conservative approach, and continuous modalities were viewed favorably; this is in contrast to recommendations in some references. The development of multidisciplinary consensus guidelines may improve the management of patients with lithium poisoning but prospective randomized controlled trials are required to more clearly define the role of extracorporeal treatments. © 2014 Wiley Periodicals, Inc.

EPIDEMIOLOGY OF HUMAN RODENTICIDES POISONING IN BRAZIL

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Maíra Costa Ferreira

2013-09-01

Full Text Available This work aims to analyze the epidemiological profile of human poisoning by rodenticides in Brazil and Regions, in the period 2000 to 2008. This is a descriptive epidemiological study based on secondary data from the National System of Toxic- harmacological Information. Calculations were performed in the incidence rate and fatality rate. The North and Northeast regions had the highest mortality rates for the period. Children from 1 to 4 years had high incidence in all regions except in Northeast, where teenagers were most affected. The rodenticide poisoning was more incident in urban areas and among females, and had attempt suicide as predominant circumstance. Although most cases have evolved for healing, there was almost 40% unconfirmed healing in the South region and 57% of ignored evolution in Southeast. Deaths caused by ingestion of rodenticides were below 5%. The rodenticide poisoning has remained in Brazil with a major public health problem and, despite the differences in the country, the poisoning profile did not change significantly between different regions.

Poison Prevention Program

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Office of Substance Misuse and Addiction Prevention Finance & Management Services Health Care , Technology: For more info about the national Poison Help program and to request materials visit: http Seniors & Disabilities Services Substance Misuse and Addiction Prevention State of Alaska myAlaska My

Management of acute organophosphorus pesticide poisoning

OpenAIRE

Eddleston, Michael; Buckley, Nick A; Eyer, Peter; Dawson, Andrew H

2008-01-01

Summary Organophosphorus pesticide self-poisoning is an important clinical problem in rural regions of the developing world, and kills an estimated 200?000 people every year. Unintentional poisoning kills far fewer people but is a problem in places where highly toxic organophosphorus pesticides are available. Medical management is difficult, with case fatality generally more than 15%. We describe the limited evidence that can guide therapy and the factors that should be considered when design...

Poison hemlock (Conium maculatum L.).

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Vetter, J

2004-09-01

One of the most poisonous species amongst higher plants is Conium maculatum. It is a very common nitrophile weed species, belonging to the Apiaceae (formerly Umbelliferae) family. It contains some piperidine alkaloids (coniine, N-methyl-coniine, conhydrine, pseudoconhydrine, gamma-coniceine), which are formed by the cyclisation of an eight-carbon chain derived from four acetate units. gamma-Coniceine is the precursor of the other hemlock alkaloids. All vegetative organs, flowers and fruits contain alkaloids. The concentrations (both absolute and relative) of the different alkaloids depend on plant varieties, on ecological conditions and on the age of the plant. The characteristic biological effects of the plants are summarised on cattle, sheep, goat, swine, rabbit, elk, birds and insects and the symptoms of the human toxicosis (some cases of poisonings) are discussed according to the literature data. The general symptoms of hemlock poisoning are effects on nervous system (stimulation followed by paralysis of motor nerve endings and CNS stimulation and later depression), vomiting, trembling, problems in movement, slow and weak later rapid pulse, rapid respiration, salivation, urination, nausea, convulsions, coma and death.

The evaluation of forensic cases reported due to food poisoning

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Beyza Urazel

2014-03-01

Full Text Available Objective: In this study it is aimed to examine forensic food poisoning cases and to evaluate the clinical presentation of food poisoning in people within the context of forensic medicine. Methods: In the study, 215 food poisoning cases are evaluated, which applied to the forensic medicine branch office in our city between 01.01.2007 and 31.12.2011. The forensic reports and forensic investigations of these cases are analyzed retrospectively. The cases are examined in terms of gender, age, the type of food consumed, the treatment applied and the result of the forensic report. Results: It is determined that in 83 cases (38.6% food poisoning was caused by chicken products, and in 178 cases (82.8% the poisoned people were students. In 3 cases (1.4% the poisoning was life threatening. For 75 cases (34.9% no forensic report was prepared in emergency service and among the 140 cases for which a forensic report was prepared, only 3 of the reports were prepared in a correct manner. Conclusions: It is determined that the demographic data of the cases complies with the city where the study was conducted. It is found out that in emergency services the food poisoning cases are usually misevaluated.

Predictive values of urine paraquat concentration, dose of poison, arterial blood lactate and APACHE II score in the prognosis of patients with acute paraquat poisoning.

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Liu, Xiao-Wei; Ma, Tao; Li, Lu-Lu; Qu, Bo; Liu, Zhi

2017-07-01

The present study investigated the predictive values of urine paraquat (PQ) concentration, dose of poison, arterial blood lactate and Acute Physiology and Chronic Health Evaluation (APACHE) II score in the prognosis of patients with acute PQ poisoning. A total of 194 patients with acute PQ poisoning, hospitalized between April 2012 and January 2014 at the First Affiliated Hospital of P.R. China Medical University (Shenyang, China), were selected and divided into survival and mortality groups. Logistic regression analysis, receiver operator characteristic (ROC) curve analysis and Kaplan-Meier curve were applied to evaluate the values of urine paraquat (PQ) concentration, dose of poison, arterial blood lactate and (APACHE) II score for predicting the prognosis of patients with acute PQ poisoning. Initial urine PQ concentration (C0), dose of poison, arterial blood lactate and APACHE II score of patients in the mortality group were significantly higher compared with the survival group (all Ppoison and arterial blood lactate correlated with mortality risk of acute PQ poisoning (all Ppoison, arterial blood lactate and APACHE II score in predicting the mortality of patients within 28 days were 0.921, 0.887, 0.808 and 0.648, respectively. The AUC of C0 for predicting early and delayed mortality were 0.890 and 0.764, respectively. The AUC values of urine paraquat concentration the day after poisoning (Csec) and the rebound rate of urine paraquat concentration in predicting the mortality of patients within 28 days were 0.919 and 0.805, respectively. The 28-day survival rate of patients with C0 ≤32.2 µg/ml (42/71; 59.2%) was significantly higher when compared with patients with C0 >32.2 µg/ml (38/123; 30.9%). These results suggest that the initial urine PQ concentration may be the optimal index for predicting the prognosis of patients with acute PQ poisoning. Additionally, dose of poison, arterial blood lactate, Csec and rebound rate also have referential significance.

Poisoning by carbon monoxide in Morocco from 1991 to 2008.

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Aghandous, Rachida; Chaoui, Hanane; Rhalem, Naima; Semllali, Ilham; Badri, Mohamed; Soulaymani, Abdelmajid; Ouammi, Lahcen; Soulaymani-Bencheikh, Rachida

2012-04-01

To describe the characteristics relating to the provenance of statements, patients and to evaluate the spatiotemporal evolution of carbon monoxide poisoning reported to Poison Control Center and Pharmacovigilance of Morocco (CAPM). This is a retrospective study over a period of 18 years from 1991 to 2008, for all cases of poisoning by carbon monoxide reported to CAPM. The epidemiological study focused on 12 976 cases of carbon monoxide poisoning reported to CAPM between 1991 and 2008. The average age of patients was 25.5 +/- 15.6 years, sex ratio was 0.5. The poisoning occurred by accident in 98.7% of cases, especially at home (96.7%) and in cold months. The urban population was the most affected (89.0%). The region of Meknes Tafilalt was the most concerned with 16.6% of cases. The symptomatology was characterized by the predominance of gastrointestinal tract diseases (37.1%). Deaths have reached a percentage of 0.9%. These qualitative and quantitative information is useful to highlight warnings and plan a strategy against carbon monoxide poisoning in Morocco.

Acute organo-phosphorus pesticide poisoning in North Karnataka ...

African Journals Online (AJOL)

Background: Pesticide poisoning is an important cause of morbidity and mortality in India. Objectives: To assess the oxidative damage, hemoglobin level and leukocyte count in acute organophosphorus pesticide poisoning. Methods: Plasma cholinesterase was assessed as a toxicity marker. Oxidative damage was ...

Intravenous Poison Hemlock Injection Resulting in Prolonged Respiratory Failure and Encephalopathy.

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Brtalik, Douglas; Stopyra, Jason; Hannum, Jennifer

2017-06-01

Poison hemlock (Conium maculatum) is a common plant with a significant toxicity. Data on this toxicity is sparse as there have been few case reports and never a documented poisoning after intravenous injection. We present a case of intravenous poison hemlock injection encountered in the emergency department. We describe a 30-year-old male who presented to the emergency department after a brief cardiac arrest after injecting poison hemlock. The patient had return of spontaneous circulation in the emergency department but had prolonged muscular weakness and encephalopathy later requiring tracheostomy. Intravenous injection of poison hemlock alkaloids can result in significant toxicity, including cardiopulmonary arrest, prolonged weakness, and encephalopathy.

[Characterization of severe acute occupational poisoning accidents in China between 1989 and 2003].

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Zhang, Min; Li, Tao; Wang, Huan-Qiang; Wang, Hong-Fei; Chen, Shu-Yang; Du, Xie-Yi; Zhang, Shuang; Qin, Jian

2006-12-01

To analyze severe acute occupational poisoning accidents reported in China between 1989 and 2003, and to study the characteristics of severe acute occupational poisoning accidents and provide scientific evidences for prevention and control strategies. The data from the national occupational poisoning case reporting system were analyzed with descriptive methods. (1) There were 506 acute severe occupational poisoning accidents for 15 years with 4 657 workers poisoned. The total poisoning rate was 54.8%, and the total mortality was 16.5%. The average poisoning age was (31.9 +/- 9.8) years old and the average death age was (33.7 +/- 10.3) years old. The poisoning accidents occurred more in men than in women. (2) There were more than 112 chemicals which caused these poisoning accidents. Most of the accidents caused by hydrogen sulfide, carbon monoxide, benzene and homologs, metal and metalloid and carbon dioxide, and the types of chemicals varied in different types of industries. (3) The accidents mainly occurred in chemical industry, manufacture, water disposal industry, mining and construction industry, and the risk was higher in some jobs than others, such as cleanout, machine maintenance and repair, production, mine and digging. The accidents occurred more frequently from April to August each year. (1) The control over the severe acute occupational poisoning is urgent. (2) The trend of the characteristics of severe acute occupational poisoning accidents is centralized in the high risk industries, poisons and jobs. (3) The characteristics of the accidents varied in different types of industries. (4) It is the key point to strengthen the supervision on poisoning.

Accidental poisoning with autumn crocus.