Abstract
Introduction: Few acute neurological syndrome illnesses including death had been reported since late 2020 involving two families residing in a fishing island in Selangor. An investigation has been conducted involving the Health Department together with Environmental, Chemistry and Agricultural Departments to identify the cause of the incident.
Methods: Active search of suspected cases were conducted 500m surrounding index houses using standard case definition. Data were collected through face-to-face interviews of cases or guardians using a modified and standard questionnaire. Treatment records of each case were reviewed. Information collected was sociodemographic, clinical, diet and chemical usage history. Blood samples were tested to rule out evidence of poisoning. Environmental inspection was conducted to look for evidence of any chemical-based control activities. Drinking water, items for cooking, available chemicals, swab surface and environmental samples like earth and herb leaves in the affected houses were tested to look for poisonous agents.
Results: Out of 369 island populations, six (6, 1.62%) cases from 2 related families fulfilled the case definition from 2nd December 2020 until 18th January 2021 with a CFR of 50%,3) and all had co-morbidities. The age of the cases ranged from 3 months old to 81 years old (Median: 30.5 years old). Five (5,83.3%) cases presented with seizures while two (2,33.3%) had gastrointestinal symptoms. No significant common meals were detected. Two (2) cases were brought in dead, one (1) was admitted and died in hospital, two (2) cases were admitted and discharged, and one (1) case was treated as an outpatient. Blood samples of two cases revealed the presence of zinc phosphide while the rest of the clinical and environmental investigation failed to detect any significant findings. Rat carcasses were observed surrounding the house occasionally. Conclusions: A cluster of acute zinc phosphide poisoning reported in a fishing island, localised to two related families. The mechanism of exposure could not be determined but was most probably caused by cross-contamination while preparing the food. Immediate evacuation and health education to family members have stopped the occurrence of the illness. Continuous surveillance, health education and enforcement of the chemical usage should be strengthened to prevent a similar incident from happening.
Links
- https://apcph.cphm.my/wp-content/uploads/2022/07/APCPH2022-P-28.pdf
- https://apcph.cphm.my/wp-content/uploads/wpforms/1176-1e04940bb5d885bf8711ed1909[...]
BibTeX (Download)
@proceedings{APCPH2022-P-28,
title = {Cluster Of Acute Neurological Syndromes Related to Zinc Phosphide Poisoning Detected At Fishing Island In Selangor},
author = {Nur Adibah MS and Harishah T and Siti Hasmah I and Sukhvinder SS and Tan SF and Rosnawati MR and Venugopalan B and Sharizat and Ngadiman S.},
url = {https://apcph.cphm.my/wp-content/uploads/2022/07/APCPH2022-P-28.pdf
https://apcph.cphm.my/wp-content/uploads/wpforms/1176-1e04940bb5d885bf8711ed19095a89ed/Poster-APCPH2022-P-28-3934ddeb28dd428742e0aa644b10d576.pdf},
year = {2022},
date = {2022-08-02},
urldate = {2022-08-02},
issue = {7},
abstract = {Introduction: Few acute neurological syndrome illnesses including death had been reported since late 2020 involving two families residing in a fishing island in Selangor. An investigation has been conducted involving the Health Department together with Environmental, Chemistry and Agricultural Departments to identify the cause of the incident.
Methods: Active search of suspected cases were conducted 500m surrounding index houses using standard case definition. Data were collected through face-to-face interviews of cases or guardians using a modified and standard questionnaire. Treatment records of each case were reviewed. Information collected was sociodemographic, clinical, diet and chemical usage history. Blood samples were tested to rule out evidence of poisoning. Environmental inspection was conducted to look for evidence of any chemical-based control activities. Drinking water, items for cooking, available chemicals, swab surface and environmental samples like earth and herb leaves in the affected houses were tested to look for poisonous agents.
Results: Out of 369 island populations, six (6, 1.62%) cases from 2 related families fulfilled the case definition from 2nd December 2020 until 18th January 2021 with a CFR of 50%,3) and all had co-morbidities. The age of the cases ranged from 3 months old to 81 years old (Median: 30.5 years old). Five (5,83.3%) cases presented with seizures while two (2,33.3%) had gastrointestinal symptoms. No significant common meals were detected. Two (2) cases were brought in dead, one (1) was admitted and died in hospital, two (2) cases were admitted and discharged, and one (1) case was treated as an outpatient. Blood samples of two cases revealed the presence of zinc phosphide while the rest of the clinical and environmental investigation failed to detect any significant findings. Rat carcasses were observed surrounding the house occasionally. Conclusions: A cluster of acute zinc phosphide poisoning reported in a fishing island, localised to two related families. The mechanism of exposure could not be determined but was most probably caused by cross-contamination while preparing the food. Immediate evacuation and health education to family members have stopped the occurrence of the illness. Continuous surveillance, health education and enforcement of the chemical usage should be strengthened to prevent a similar incident from happening.},
howpublished = {published online at https://apcph.cphm.my},
note = {Type: POSTER PRESENTATION; Organisation: Klang District Health Office; KLIA Health Office; Petaling District Health Office; National Institute of Health; Selangor State Health Department},
keywords = {acute neurological syndrome, fishing island, zinc phosphide},
pubstate = {published},
tppubtype = {proceedings}
}