Bangladesh: Pesticides in Litchis may have killed 14 kids

[Ronan Kelly]

Thursday, June 28, 2012
Pesticides in litchis cause 14 kids to die
Suspect experts after preliminary examination
Our Correspondent, Dinajpur
Experts investigating why 14 children died in Dinajpur and Thakurgaon this month with almost identical symptoms believe that pesticides used in litchis could be the reason for their deaths.

The children, aged between two and 16, died between June 1 and June 20.

Experts at the Institute of Epidemiology, Disease Control and Research (IEDCR) suspect that they died after eating litchis on which pesticides were used or after coming in contact with such litchis.

...

http://www.thedailystar.net/newDesign/news-details.php?nid=240106

[Emily]

Re: Bangladesh: Pesticides in Litchis may have killed 14 kids

An expert at IEDCR said in Dhamrai on the outskirts of Dhaka in 2009, three people died of a mysterious disease. They had suspected that pesticides used in paddy fields and vegetable gardens in the area might have had links with their deaths. Samples were collected and sent abroad for tests.

Three to four months later the test reports came in and confirmed their assumption.

The experts said pesticides on fruits generally affect children more than grownups. They have carried on a campaign in the affected areas advising parents to refrain from giving litchis to children.

In 2011 about this time of the year one doctor suspected litchis consumption by children in Bihar might be link to an encephalitis outbreak there, but he suspected a toxin naturally present in the fruit:

http://www.flutrackers.com/forum/sho...2&postcount=64

[alert]

Re: Bangladesh: Pesticides in Litchis may have killed 14 kids

Litchis are eaten worldwide without producing strange fatal neurological syndromes. That makes a naturally occurring toxin in litchi an unlikely suspect. That does not, however, exclude the possibility that a fungal toxin from mold growning on these particular litchis could be suspect.

However, the consensus seems to be that the outbreaks in Bihar are caused by an undetermined viral encephalitis, perhaps due to JE, Chandipura, or an enterovirus. In Bangladesh, that has to raise the specter of Nipah infection (which has actually been linked to fruit contaminated by infected bats). I hope the doctors investigating the current outbreak in Dinajpur have considered and excluded this possibility.

[alert]

Re: Bangladesh: Pesticides in Litchis may have killed 14 kids

I guess they did:

http://www.thedailystar.net/newDesign/news-details.php?nid=240106

[snip]

He said they found signs in the samples that point towards poisoning and that was why samples were sent to the US for confirmation.

He said that initially the Nipah virus was suspected but tests ruled that out.

He said it would take some time before the results were obtained from Atlanta.

[snip]

Moudud said no such incidents were reported after June 20.

[Ronan Kelly]

Re: Bangladesh: Pesticides in Litchis may have killed 14 kids

With relation to the Bihar outbreak, environmental factors are also being investigated this year and rightly so. Evidence of toxin caused encephalitis was found in Saharanpur, Uttar Pradesh in 2007 when seasonal encephalitis outbreaks were definitively linked to over consumption of cassia occidentalis beans (http://icmr.nic.in/ijmr/2007/june/0608.pdf). I think that the jury is still out on the cause of many other outbreaks of AES in both Bihar and Uttar Pradesh. The current trend is towards waterborne enteroviruses, but other schools of thought believe that this cannot be true due to the seasonality and localized nature of the outbreaks. (http://www.promedmail.org/?p=2400:10..._ID:1000,86430)
More work needs to be done. I would be interested in finding any descriptions of the symptoms in the Dinajpur poisoning cases.

[Ronan Kelly]

Re: Bangladesh: Pesticides in Litchis may have killed 14 kids

14 children die from pesticide on litchis

Fourteen of the 15 children who had fallen sick in Dinajpur after eating or coming in contact with litchis on which the growers used chemical pesticides died this month.

...
The New Age correspondent in Dinajpur said that 15 children were sent to Dinajpur Medical College Hospital unconscious with complaints of high temperature and convulsion, Waresh Ali Sarkar, a child specialist at the hospital, said.
All the children aged between two and six years were admitted to the hospital in June 1?12, he said. ?Thirteen of them died one to two hours after their admission.?
The deceased were Nibha of Dhainur at Pirganj in Thakurgoan, Saila of Maheshpur, Nur Kibria of Rampur, Sagar of Krishnapur, Manik of Madhabbati, Tasmina of Runia and Sujan of Jasoral at Birol in Dinajpur, Nagris of Chirirbandar in Dinajpur, Borhan of Sundarban, Nayan of Pargoan and Dhananjoy of Ekrarpur in the district headquarters, and Azizul of Chawk Kanchanpur and Ripon of Ramnagar at Khansama in Dinajpur
Mahmudur on Tuesday confirmed that another of the ailing children died on Monday night.
...

http://southasianmedia.net/Test21/DetailPage.aspx?StoryID=71286

[Ronan Kelly]

Re: Bangladesh: Pesticides in Litchis may have killed 14 kids

The New Age correspondent in Dinajpur said that 15 children were sent to Dinajpur Medical College Hospital unconscious with complaints of high temperature and convulsion, Waresh Ali Sarkar, a child specialist at the hospital, said.
All the children aged between two and six years were admitted to the hospital in June 1?12, he said. ?Thirteen of them died one to two hours after their admission.?

I would not have been surprised to see this description in a report from India about AES. Similarities and differences between the situation here and in Bihar should be investigated. It will be interesting to see what result if any comes back from Atlanta.

[alert]

Re: Bangladesh: Pesticides in Litchis may have killed 14 kids

http://www.promedmail.org/

Published Date: 2012-06-29 09:53:49
Subject: PRO> Undiagnosed deaths - Bangladesh: (RP), pesticide susp., RFI
Archive Number: 20120629.1184443

UNDIAGNOSED DEATHS - BANGLADESH: (RANGPUR), PESTICIDE SUSPECTED, REQUEST FOR INFORMATION
************************************************** ***************************************
A ProMED-mail post

http://www.promedmail.org

ProMED-mail is a program of the
International Society for Infectious Diseases

http://www.isid.org

Date: Thu 28 Jun 2012
Source: The Daily Star [edited]

http://www.thedailystar.net/newDesign/news-details.php?nid=240106

Experts investigating why 14 children died in Dinajpur and Thakurgaon [Rangpur Division] this month [June 2012] with almost identical symptoms, believe that pesticides used in litchis could be the reason for their deaths.

The children, aged between 2 and 16, died between 1 Jun 20 Jun 2012. Experts at the Institute of Epidemiology, Disease Control and Research (IEDCR) suspect that they died after eating litchis on which pesticides were used or after coming in contact with such litchis.

The IEDCR collected blood and urine samples from children with similar symptoms but in their primary tests they could not determine the reason for their deaths with certainty.

ASM Alamgir, an expert at IEDCR, told The Daily Star that the institute lacked the facilities for a thorough test. Samples have been sent to the Centre for Disease Control and Prevention in Atlanta, USA, for tests.

On 18 Jun 2012, a 4-member team of IEDCR led by its director Prof Mahmudur Rahman went to Dinajpur and visited different areas to collect samples. Mahmudur told The Daily Star that his team visited Dinajpur Medical College Hospital and the area from where the patients had gone to the hospital. He said they had looked into the types of disease the children showed symptoms of, what food they had, and what pesticides the litchi farmers used and their possible links. After some tests, they found evidence to support their assumption that pesticides used in the litchi orchards had links with their symptoms.

He said they found signs in the samples that point towards poisoning and that was why samples were sent to the US for confirmation.

He said that initially the Nipah virus was suspected but tests ruled that out.

He said it would take some time before the results were obtained from Atlanta.

An expert at IEDCR said in Dhamrai on the outskirts of Dhaka in 2009, 3 people died of a mysterious disease. They had suspected that pesticides used in paddy fields and vegetable gardens in the area might have had links with their deaths. Samples were collected and sent abroad for tests. 3 to 4 months later the test reports came in and confirmed their assumption.

The experts said pesticides on fruits generally affect children more than grownups. They have carried on a campaign in the affected areas advising parents to refrain from giving litchis to children.

Moudud Hossain, civil surgeon of Dinajpur, quoting the authorities of Dinajpur Medical College Hospital, said the 1st report of such mysterious deaths of children came in on 1 Jun 2012. 2 children were admitted to Dinajpur Medical College Hospital on 17 Jun 2012 in the morning, with mild fever and were shivering. They died in the evening.

"We collected information on other victims and found that the symptoms were the same," he said.

Moudud said no such incidents were reported after 20 Jun 2012.

--
Communicated by:
ProMED-mail
<promed@promedmail.org>

[We are all saddened by the death of this many children. Presumably this is preventable poisoning.

Litchis are a type of fruit, with a bit of a shell that may be bitter, but the pulp is sweet and enjoyable; it has a seed in the center. There are many names for this fruit, including lichee, _Litchi chinensis_, litchi tree, _Nephelium litchi_, leechee, lichi, litchee, litchi nut, lychee, litchi, etc. It is a very tasty fruit and enjoyed by many. It is generally grown in the Philippines, India, and it is native to China and other areas.

What is unclear is what type of pesticide, if any, was used. The clinical signs are extremely generic and could range from a wide array of infectious diseases, including such things as the flu to other maladies including fungal infections.

Perhaps a question of interest is why were the fruits not washed? Would washing the fruit have solved the problem or is the pesticide capable of being sprayed on the tree and being systemic to the plant, thus actually being in the fruit instead of on the fruit?

We look forward to a more thorough report and to the results from the CDC.

A photo of the fruit may be seen at http://www.hort.purdue.edu/newcrop/m...es/Plate32.jpg.

A HealthMap/ProMED-mail interactive map of Bangladesh can be seen at http://healthmap.org/r/2E*S. The country's divisions may be seen on the map at http://en.wikipedia.org/wiki/File:Ba...ns_english.png. - Mod.TG]

[Ronan Kelly]

Re: Bangladesh: Pesticides in Litchis may have killed 14 kids

IEDCR believes children’s deaths caused by pesticide poisoning

Staff Correspondent
...
Similar incidents of pesticide poisoning from fruit also took place in Naogaon in 2008 and at Dhamrai in Dhaka in 2009.

http://newagebd.com/detail.php?date=2012-06-29&nid=15421

Encephalitis in children A three years experience in a teaching hospital
Wahed MA, Sarker PC, Hossain MA

The ORION Medical Journal 2010 Jan; 33(1):707-709
Abstract
Background: Encephalitis is a very dreadful disease in children with high mortality rate. It is endemic throughout the year with occasional epidemics in various localities in our country. But there is no available data of this in the
northern districts.

Objectives: To know the present situation of the social, clinical and aetiological characteristics of acute endemic encephalitis in children admitted in a tertiary care hospital from the northern Districts of Bangladesh.

Methodology: This study was conducted for period of three years from January 2006 to December 2008. This was a descriptive type of study. The children were selected purposively (nonrandom sampling). At first, the children admitted with the complaints of fever, convulsion, impaired consciousness or
coma were provisionally diagnosed as encephalitis and selected for investigations. Cerebrospinal fluid (CSF) analysis was performed in all these cases along with Computed Tomographic (CT) scanning of brain and selected viral markers. The children having above clinical features with (a) diffuse or focal oedema of the brain or (b) lymphocytic pleocytosis with normal brain scan or (c) both were regarded as encephalitis and selected for analysis.

Results: A total of 705 children were admitted during the study period and after exclusion by defined criteria 285 were finalyzed for analysis. The mean age was 4&#177; 2.4 years and male:female ration was 63:37.
Death rate was 44.56&#37;. Coma (85%), convulsion (75%), respiratory prodromal features (75%) and fever (65%) were the presenting complaints. About 98% children came from rural areas and low socio-economic families and 88% of them were malnourished. Only 15% of the families were using mosquito nets during sleep time and 68% children had free movement surrounding the household environment. CSF analysis showed lymphocytic pleocytosis in 35% of cases. CT scanning findings showed generalized or focal
oedema of brain in 78% of cases and IgM antibody against Herpes Simplex Virus (HSV), cytomegallo virus (CMV) and Toxoplasma gondii were positive in 4% of cases each.

Conclusion: Acute endemic encephalitis is a serious infectious disease in children with high mortality. Clinical diagnosis remains the mainstay and etiological diagnosis remains uncertain in maximum cases.
...
Full PDF available (free) at http://www.orion-group.net/medicaljournal/pdf/342.pdf

Tuesday, May 5, 2009

Killer pesticides
Mindless use in Dhamrai farmlands causes death of 3 kids in a month; many others ill

Pinaki Roy
Excessive use of pesticides on farmlands in two villages of Dhamrai upazila caused death of at least three children last month.

It also killed a number of calves, dogs and fowls.

Besides, 13 more children, all aged below seven, were hospitalised, while some farmers fell sick during the same period.
...

http://www.thedailystar.net/newDesign/news-details.php?nid=86826

The article at this link: http://news.agropages.com/Feature/Fe...tail---851.htm reports confirmation from CDC Atlanta of organophosphates in samples sent from the 2009 Dhamrai outbreak.

[Ronan Kelly]

Re: Bangladesh: Pesticides in Litchis may have killed 14 kids

Tough drive against food adulteration planned
13 July, 2012 Friday
. Mithun Kamal
Ahead of the holy Ramadan,different government bodies are taking preparation to intensify the driveagainst food adulteration, especially of seasonal fruits that are mixed withpoisonous chemical. Such adulteration has turned to a dangerous proportion,posing a serious threat to public health.
Abul Hossain Miah, DirectorGeneral (DG) of the Directorate of National Consumer Rights Protection (DNCRP),told The New Nation yesterday: "We've taken a two-month long programmecountrywide to curb this malpractice. The drive is scheduled to start from the4th of the next month."
Some unscrupulous traders areusing harmful chemicals with mango, litchi, banana, Papya and vegetables, fish,milk, meat, fish, rice and sweetmeat.
...
Seasonal fruits are artificiallyripened by chemicals like ethylene oxide and formalin. Imported fruits apple,grapes are also adulterated with dangerous chemicals, which are available inthe market, sources said.
At least 13 children died aftereating toxic mixed litchis in different areas of Dinajpur recently. The localadministration has taken initiative to identify the culprits, officials said.
The officials further said suchanti-adulteration drive is already in place. The culprits are also being fined.Many fish sellers spray formalin on fish, an organic chemical, usually used forpreserving tissues. It makes fish stiff and apparently fresh for a longerperiod of time.
....

http://www.thenewnationbd.com/newsdetails.aspx?newsid=43987

[Emily]

Re: Bangladesh: Pesticides in Litchis may have killed 14 kids

The article in Ronan's first post referred to a pesticide poisoning case in 2009. Here's an article with more details on that incident which clearly shows the scope of the public health problem as far as acute poisonings from pesticide misuse. (Then there are indirect problems that could be involved such as immune suppression, autoimmune disease and blood brain barrier disruption that might be fueling worse outcomes from infectious diseases.)

http://www.dhakamirror.com/headlines/killer-pesticides/

Killer pesticides

May 5, 2009

Mindless use in Dhamrai farmlands causes death of 3 kids in a month; many others ill
Excessive use of pesticides on farmlands in two villages of Dhamrai upazila caused death of at least three children last month.
It also killed a number of calves, dogs and fowls.
Besides, 13 more children, all aged below seven, were hospitalised, while some farmers fell sick during the same period.
A committee formed by the Institute of Epidemiology, Disease Control and Research (IEDCR) under the health ministry reveals this in a primary investigation report.
Talking about reasons behind the recent deaths in Dhamrai?s Malancha and Naogakaith villages, IEDCR Director Dr Mahmudur Rahman told The Daily Star, ?We are sure it was pesticide poisoning. And we think it?s happening in other parts of the country as well.?
[snip]
During investigation, the IEDCR committee gathered that the farmers in the villages used furadan or carbofuran (recently banned in Kenya for being used in killing lions and other predators) on paddy fields.
Besides, some villagers were using organophosphate insecticides like cypermethrin, malathion and chlorpyrifos many times the recommended dose.
Local Agricultural Officer Khairul Alam said the farmers in Malancha and Naogakaith spray pesticides in amounts way more than what is safe....