Author Topic: Lychee Fruit: Mystery of Deadly Outbreaks in India Is Solved  (Read 6723 times)

Saltcayman

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Lychee Fruit: Mystery of Deadly Outbreaks in India Is Solved
« on: January 31, 2017, 02:56:44 PM »
https://www.nytimes.com/2017/01/31/world/asia/lychee-litchi-india-outbreak.html

NEW DELHI — Three years ago, Dr. Rajesh Yadav, an investigator with the India Epidemic Intelligence Service, moved to the city of Muzaffarpur, the site of one of the country’s most mysterious outbreaks. And he waited.

Every year in mid-May, as temperatures reached scorching heights, parents took children who had been healthy the night before to the hospital. The children awakened with a high-pitch cry in the early morning, many parents said.

Then the youths began having seizures and slipping into comas. In about 40 percent of cases, they died.

Every year in July, with the arrival of monsoon rains, the outbreak ended as suddenly as it began.

Beginning in 1995, investigations variously ascribed the phenomenon to heat stroke; to infections carried by rats, bats or sand flies; or to pesticides used in the region’s ubiquitous lychee orchards. But there were few signposts for investigators.

Instead of occurring in clusters, the illness typically struck only one child in a village, often leaving even siblings unaffected.

A joint investigation by India’s National Center for Disease Control and the India office of the Centers for Disease Control and Prevention in Atlanta, published in the British medical journal The Lancet Global Health on Tuesday, has identified a surprising culprit: the lychee fruit itself, when eaten on an empty stomach by malnourished children.

In 2015, as a result of the investigation, health officials began urging parents in the area to be sure to feed young children an evening meal and to limit their consumption of lychees (sometimes spelled litchi). In two seasons, the number of reported cases per year dropped to less than 50 from hundreds.

“It was an unexplained illness for so many years,” said Padmini Srikantiah, a senior epidemiologist with the C.D.C. and the senior author of the paper. “This is kind of emblematic of why we collaborate, to build this kind of systematic approach.”

The Lancet article walks through a two-year medical detective story, as epidemiologists like Dr. Yadav closely examined the lives of hundreds of afflicted children, trying to understand everything they had eaten, drunk and breathed.

“It was a very intense situation, because we witnessed children dying in front of our eyes every day, as soon as they arrived at the hospital,” said Dr. Yadav, who now works with the C.D.C. in Atlanta. Especially difficult were the detailed interviews of parents, many of whom had carried a convulsing or comatose child for hours to get to the hospital.

“They were in a kind of panic,” he said. “Their children were dying, and it was an unknown thing.”

The first clue: There was no evidence the children had infections.

For 20 years, clinicians were unable to determine if the disease, which led to acute brain swelling known as encephalopathy, was caused by an infection — the immediate assumption in many outbreaks here.

Sorting through lychees in India. The fruit has been blamed for causing sickness in children. Credit Jaipal Singh/European Pressphoto Agency
Investigators pored over records from the previous year’s outbreak and were struck by the fact that many of the sick children did not have a fever. Analysis of spinal fluid samples overwhelmingly showed that the affected children did not have elevated counts of white blood cells, a sign the body is fighting infection.

The second clue: Most of the victims had very low blood sugar levels.

Having collected biological samples from more than 300 children, the researchers were able to scan a large number of markers — including some they hadn’t suspected.

Glucose had never been a particular concern for investigators. But some of the affected children had strikingly low levels, and those with low blood glucose were twice as likely to die, Dr. Srikantiah said.

“It seemed to be a little signal,” she continued. “One of the things we heard multiple times from the children’s mothers was that they didn’t really eat dinner properly.”

The third clue: Outbreaks had been associated with the ackee fruit, which is in the same family as the lychee.

It was in the fall of 2013, during a conference call with colleagues in Atlanta, that someone mentioned “Jamaican vomiting sickness,” an outbreak in the West Indies that for many decades caused brain swelling, convulsions and altered mental states in children.

The outbreak turned out to be tied to hypoglycin, a toxin found in the ackee fruit that inhibits the body’s ability to synthesize glucose, leading to acute hypoglycemia, or low blood glucose levels. “It had been going on for a decade, if not a century, before people really figured out what it was,” Dr. Srikantiah said. “Now, the grandmothers and the mothers teach their kids, ‘Don’t eat the unripe ackee fruit.’ ”

By late 2014, laboratory tests confirmed that lychees also contain high levels of hypoglycin, as well as a similar toxin known as methylenecyclopropyl glycine, or MCPG.

This was an answer hiding in plain sight. The Muzaffarpur area produces about 70 percent of India’s lychee harvest, and around the affected villages, “you really couldn’t go 100 meters without bumping into a lychee orchard,” Dr. Srikantiah said, referring to a distance of 330 feet.

Though orchards were typically guarded by caretakers, children often ate lychees that were unripe or that had fallen to the ground. But because everyone in the region eats them, it was difficult for many to believe that, in isolated cases, it could set off a catastrophic illness.

The fourth clue: Affected children had huge metabolic imbalances.

By early 2015, C.D.C. laboratories had developed a test to measure hypoglycin in urine. They found extraordinary abnormalities in the affected children. “The folks in the genetic labs said ‘We haven’t seen anything like this,’ ” Dr. Srikantiah said. “This was clearly abnormal.”

With that established, the investigators asked participants if they would be comfortable issuing recommendations based on their findings: that young children in the affected areas be encouraged to always eat an evening meal, and that consumption of lychees should be limited.

Everyone agreed. And it was done.
« Last Edit: January 31, 2017, 03:32:55 PM by Saltcayman »

Central Floridave

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Re: Lychee Fruit: Mystery of Deadly Outbreaks in India Is Solved
« Reply #1 on: January 31, 2017, 04:07:10 PM »
Interesting. thanks for the link.

fruitlovers

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Re: Lychee Fruit: Mystery of Deadly Outbreaks in India Is Solved
« Reply #2 on: January 31, 2017, 04:59:53 PM »
Some doctors suspected hypoglycin during initial outbreaks. But there was no way to prove this was the case. I don't think ripe lychees have any hypoglycin. If so i would have been dead long time ago. I think these kids are either eating unripe fruits, or even more likely, swallowing some of the seeds. The seed of akee, in same family sapindaceae, is also highly toxic.
Oscar

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Re: Lychee Fruit: Mystery of Deadly Outbreaks in India Is Solved
« Reply #3 on: January 31, 2017, 05:31:37 PM »
Gee I must be a ZOMBIE!

fruitlovers

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Re: Lychee Fruit: Mystery of Deadly Outbreaks in India Is Solved
« Reply #4 on: January 31, 2017, 10:16:08 PM »
From Morton's Fruits of Warm Climates:\

Medicinal Uses: Ingested in moderate amounts, the lychee is said to relieve coughing and to have a beneficial effect on gastralgia, tumors and enlargements of the glands. One stomach-ulcer patient in Florida, has reported that, after eating several fresh lychees he was able to enjoy a large meal that, ordinarily, would have caused great discomfort. Chinese people believe that excessive consumption of raw lychees causes fever and nosebleed. According to legends, ancient devotees have consumed from 300 to 1,000 per day.

In China, the seeds are credited with an analgesic action and they are given in neuralgia and orchitis. A tea of the fruit peel is taken to overcome smallpox eruptions and diarrhea. In India, the seeds are powdered and, because of their astringency, administered in intestinal troubles, and they have the reputation there, as in China, of relieving neuralgic pains. Decoctions of the root, bark and flowers are gargled to alleviate ailments of the throat. Lychee roots have shown activity against one type of tumor in experimental animals in the United States Department of Agriculture/National Cancer Institute Cancer Chemotherapy Screening Program.
Oscar

Saltcayman

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Re: Lychee Fruit: Mystery of Deadly Outbreaks in India Is Solved
« Reply #5 on: February 01, 2017, 05:29:11 AM »
They seem pretty certain. But the findings suggest it is only small children that are susceptible when they have not eaten any other food

In 2015, as a result of the investigation, health officials began urging parents in the area to be sure to feed young children an evening meal and to limit their consumption of lychees (sometimes spelled litchi). In two seasons, the number of reported cases per year dropped to less than 50 from hundreds.

fruitlovers

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Re: Lychee Fruit: Mystery of Deadly Outbreaks in India Is Solved
« Reply #6 on: February 01, 2017, 05:48:38 AM »
 Heavy ingestion of the immature aril of ackee (Blighia sapida) or other members of the soapberry family (Sapindaceae), including lychee (Litchi sinensis), rambutan (Nephelium lappaceum), and longan (Dimocarpus longan), by an undernourished child with low glycogen/glucose stores probably has the potential to result in toxic hypoglycemic syndrome.

https://wwwnc.cdc.gov/eid/article/21/5/14-1650_article
Oscar

Saltcayman

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Re: Lychee Fruit: Mystery of Deadly Outbreaks in India Is Solved
« Reply #7 on: February 01, 2017, 08:51:45 AM »
Certainly could be seeds... But you would think they would have found the seeds in the stomachs of those affected.  Thanks

Doglips

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Re: Lychee Fruit: Mystery of Deadly Outbreaks in India Is Solved
« Reply #8 on: February 01, 2017, 09:00:44 AM »
I saw this.

The article I saw suspected a genetic component since it was not wide spread.


Strange stuff.

shot

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Re: Lychee Fruit: Mystery of Deadly Outbreaks in India Is Solved
« Reply #9 on: February 01, 2017, 09:22:41 AM »
Peanuts way more dangerous by Quantum ,typical internet sudo science hype.

Gnarled J Trunk

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Re: Lychee Fruit: Mystery of Deadly Outbreaks in India Is Solved
« Reply #10 on: February 02, 2017, 06:40:48 AM »
Whew, that was a close one! I just pulled out all my lychee trees. Fortunately they haven't fruited.
I have very good fruit. They're huge!

shinzo

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Re: Lychee Fruit: Mystery of Deadly Outbreaks in India Is Solved
« Reply #11 on: February 02, 2017, 07:13:26 AM »

Daintree

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Re: Lychee Fruit: Mystery of Deadly Outbreaks in India Is Solved
« Reply #12 on: February 02, 2017, 11:50:55 AM »
Interesting, and very sad.  Glad they figured it out!  Reminds me of what happens when dogs eat toothpaste, or some idiot makes their own hummingbird food and uses xylitol instead of sugar.  It causes the same 'seizures/coma/death' thing.

Carolyn

Gnarled J Trunk

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Re: Lychee Fruit: Mystery of Deadly Outbreaks in India Is Solved
« Reply #13 on: February 02, 2017, 02:00:08 PM »
Of course we are trusting the word of these plant detectives in India. There's the remote possibility they are covering something up or just needing to close the case and I pulled up all my Lychees for nothing. Better safe than sorry tho
I have very good fruit. They're huge!

fruitlovers

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Re: Lychee Fruit: Mystery of Deadly Outbreaks in India Is Solved
« Reply #14 on: February 02, 2017, 04:47:01 PM »
Of course we are trusting the word of these plant detectives in India. There's the remote possibility they are covering something up or just needing to close the case and I pulled up all my Lychees for nothing. Better safe than sorry tho
You better pull out ALL your fruit trees. They are all extremely dangerous. Let's review:
Starfruit causes kidney failures.
Soursop, and really all annonas, cause Parkinsons disease.
Lychee, and really all sapindaceae family: rambutan, pulasan, akee, cause insulin shock.
Grapefruits interfere with the drugs you are taking.
Mangoes are really in poison oak family and you are about to have your skin explode in a rash.
White sapote causes sleeping sickness. You may never wake up again if you eat one.
Did i forget some other lethal fruit? Live dangerously! Eat a fruit.
Oscar

FrankDrebinOfFruits

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Re: Lychee Fruit: Mystery of Deadly Outbreaks in India Is Solved
« Reply #15 on: February 02, 2017, 05:01:36 PM »
! No longer available

Two of my favorite lines:
"Everyone's dying, lets get some fruit"
"I eat stickers all the time dude" https://www.youtube.com/watch?v=96CaWH5St7I
« Last Edit: February 02, 2017, 05:51:10 PM by FrankDrebinOfFruits »

sildanani

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Re: Lychee Fruit: Mystery of Deadly Outbreaks in India Is Solved
« Reply #16 on: February 02, 2017, 10:55:45 PM »
Oh, I came across this article on the Fruit Hunters movie page. Interesting finding.
Anisha

Daintree

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Re: Lychee Fruit: Mystery of Deadly Outbreaks in India Is Solved
« Reply #17 on: February 03, 2017, 12:24:37 AM »
Yeah, no matter what you do, the death rate is 100%.


Carolyn

Gnarled J Trunk

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Re: Lychee Fruit: Mystery of Deadly Outbreaks in India Is Solved
« Reply #18 on: February 03, 2017, 03:44:21 AM »
Good one Oscar but don't forget Apple seeds can grow in your stomach which would end up being very uncomfortable and you can slip and fall on a banana peel leading to certain death for sure
I have very good fruit. They're huge!

BigIslandGrower

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Re: Lychee Fruit: Mystery of Deadly Outbreaks in India Is Solved
« Reply #19 on: February 03, 2017, 01:05:07 PM »
. I don't think ripe lychees have any hypoglycin.

The article says that they do.  A sad story, for sure.  Poor starving kids.

Gnarled J Trunk

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Re: Lychee Fruit: Mystery of Deadly Outbreaks in India Is Solved
« Reply #20 on: February 03, 2017, 09:52:07 PM »
I deduce from the evidence presented thus far that it must be that Indian mothers send the children out of the house on an empty stomach but that Chinese do not. I do not know much about either country but it must be that there is more food to go around in China?
I have very good fruit. They're huge!

fruitlovers

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Re: Lychee Fruit: Mystery of Deadly Outbreaks in India Is Solved
« Reply #21 on: February 03, 2017, 10:34:58 PM »
I deduce from the evidence presented thus far that it must be that Indian mothers send the children out of the house on an empty stomach but that Chinese do not. I do not know much about either country but it must be that there is more food to go around in China?
The section of India hardest hit, Bihar province, is the economically poorest area of India. There are lots of children there (and adults) dying of malnourishment and malnutrition. Bihar also happens to be the largest grower of lychees in India. I am guessing what is happening is that after harvest of lychees children go into the fields and eat all the unpicked, fallen, and rotting lychees on the ground.
« Last Edit: February 03, 2017, 10:38:23 PM by fruitlovers »
Oscar

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Re: Lychee Fruit: Mystery of Deadly Outbreaks in India Is Solved
« Reply #22 on: February 03, 2017, 11:04:51 PM »
From what I read on an Indian news site, the poor kids ate lots of unripe lychees. They either didn't have dinner, or their families couldn't afford food that day.

Gnarled J Trunk

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Re: Lychee Fruit: Mystery of Deadly Outbreaks in India Is Solved
« Reply #23 on: February 04, 2017, 06:43:21 AM »
Sad to hear that. Being the largest growing area I wonder why all that fruit production is not helping the local economy more?
I have very good fruit. They're huge!

Gnarled J Trunk

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Re: Lychee Fruit: Mystery of Deadly Outbreaks in India Is Solved
« Reply #24 on: February 04, 2017, 06:49:05 AM »
Understanding that severe malnutrition was a big factor does remove my earlier scepticism
I have very good fruit. They're huge!