TY  - JOUR
PY  - 2018//
TI  - Description of a mass poisoning in a rural district in Mozambique: the first documented bongkrekic acid poisoning in Africa
JO  - Clinical infectious diseases
A1  - Gudo, Eduardo Samo
A1  - Cook, Kyla
A1  - Kasper, Amelia M.
A1  - Vergara, Alfredo
A1  - Salomão, Cristolde
A1  - Oliveira, Fernanda
A1  - Ismael, Hamida
A1  - Saeze, Cristovão
A1  - Mosse, Carla
A1  - Fernandes, Quinhas
A1  - Viegas, Sofia Omar
A1  - Baltazar, Cynthia S.
A1  - Doyle, Timothy J.
A1  - Yard, Ellen
A1  - Steck, Alaina
A1  - Serret, Mayda
A1  - Falconer, Travis M.
A1  - Kern, Sara E.
A1  - Brzezinski, Jennifer L.
A1  - Turner, James A.
A1  - Boyd, Brian L.
A1  - Jani, Ilesh V.
SP  - 1400
EP  - 1406
VL  - 66
IS  - 9
N2  - BACKGROUND: On January 9, 2015, in a rural town in Mozambique, over 230 people became sick and 75 died from an illness linked to drinking pombe, a traditional alcoholic beverage. <br><br>METHODS: An investigation was conducted to identify cases and determine the cause of the outbreak. A case was defined as any resident of Chitima who developed any new or unexplained neurologic, gastrointestinal, or cardiovascular symptom from January 9 at 6:00 a.m. through January 12. We conducted medical record reviews; healthcare worker and community surveys; anthropological and toxicological investigations of local medicinal plants and commercial pesticides; and laboratory testing of the suspect and control pombe. <br><br>RESULTS: We identified 234 cases; 75 (32%) died and 159 recovered. Overall, 61% of cases were female (n=142), and ages ranged from 1-87 years (median: 30 years). Signs and symptoms included abdominal pain, diarrhea, vomiting, and generalized malaise. Death was preceded by psychomotor agitation and abnormal posturing. The median interval from pombe consumption to symptom onset was 16 hours. Toxic levels of bongkrekic acid (BA) were detected in the suspect pombe but not in the control pombe. Burkholderia gladioli pathovar cocovenenans, the bacteria that produces BA, was detected in the flour used to make the pombe. <br><br>CONCLUSIONS: We report for the first time an outbreak of a highly lethal illness linked to BA, a deadly food-borne toxin in Africa. Given that no previous outbreaks have been recognized outside of Asia, our investigation suggests that BA might be an unrecognized cause of toxic outbreaks globally.<p />  <p>Language: en</p>
LA  - en
SN  - 1058-4838
UR  - http://dx.doi.org/10.1093/cid/cix1005
ID  - ref1
ER  -