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Investigation of an acute neurological outbreak in Eluru, India, 2020
- Source :
- PLoS ONE, Vol 16, Iss 11 (2021), PLoS ONE, Vol 16, Iss 11, p e0259192 (2021), PLoS ONE
- Publication Year :
- 2021
- Publisher :
- Public Library of Science (PLoS), 2021.
-
Abstract
- On 4th December 2020, a sudden outbreak, with neurological symptoms like seizures, loss of consciousness etc., was reported in a town from south India. By 3rdday about 400 people were involved. A multi disciplinary team from our institute visited the site to investigate the outbreak. Based on the case history and clinical examination of the patients, the team suspected a probable diagnosis of an acute pesticide, heavy metal and/or mycotoxin exposure for which, biological samples (blood, urine) were collected from those who reported the symptoms as well as from a few who did not report symptoms (controls). To identify the source, water and food samples were collected. The samples were subjected to ICP-MS for heavy metal analysis, LC-MS/MS for pesticide analysis, microbiological analysis and ELISA-Kit method for aflatoxins if any. Clinical and dietary details were collected from a total of 112 participants, of which, 103 cases (77 active cases at Hospital and 26 recovered cases from community) and 9 were controls. A total of 109 biological samples, 36 water samples and food samples were collected. The mean age of the study participants was 29.2 years. Among cases, Seizures were seen in 84%, loss of consciousness in 66%, mental confusion in 35%, pinpoint pupil in 11%. Triazophos (organophosphate) pesticide was present in 74% of Blood samples and its metabolites were present in 98% of the urine samples collected from the cases. All the ten heavy metals investigated including lead, mercury and nickel were found to be within permissible limits except for a few samples. No presence of mycotoxins was observed in Food samples. Water samples which included Head pump and reservoir were free from pesticides; however, all water samples from households of cases had triazophos pesticide with a mean concentration of 1.00 ug/L. Thus, it was concluded that, the probable cause of outbreak was Triazophos (Organophosphate) pesticide contamination in water at the Household level. Regular surveillance for the presence of residual pesticides in soil, water and food with heightened vigour is recommended to prevent future outbreaks.
- Subjects :
- Male
Metallic Lead
Aflatoxin
Veterinary medicine
Physiology
Urine
Heavy Metals
Toxicology
Pathology and Laboratory Medicine
Disease Outbreaks
chemistry.chemical_compound
Tandem Mass Spectrometry
Natural Resources
Medicine and Health Sciences
Toxins
Medicine
Multidisciplinary
medicine.diagnostic_test
Organic Compounds
Agriculture
Heavy metals
Pollution
Organophosphates
Body Fluids
Chemistry
Blood
Physical Sciences
Water Resources
Female
Anatomy
Agrochemicals
Research Article
Chemical Elements
Ethers
Science
Toxic Agents
India
Food Contamination
Physical examination
Humans
Pesticides
Mycotoxin
business.industry
Organothiophosphates
Ecology and Environmental Sciences
Organic Chemistry
Water Pollution
Chemical Compounds
Biology and Life Sciences
Outbreak
Mycotoxins
Triazoles
Metal analysis
Pesticide
Heavy Metal Poisoning
chemistry
Pest Control
Nervous System Diseases
business
Chromatography, Liquid
Subjects
Details
- Language :
- English
- ISSN :
- 19326203
- Volume :
- 16
- Issue :
- 11
- Database :
- OpenAIRE
- Journal :
- PLoS ONE
- Accession number :
- edsair.doi.dedup.....44921b35ea14d9fa2cc96de9b190adee