Back to Search Start Over

Investigation of an acute neurological outbreak in Eluru, India, 2020

Authors :
P. Sivaperumal
K Sree Ramakrishna
Ananthan Rajendran
Raghavendra Pandurangi
J. J. Babu Geddam
Mahesh Kumar Mummadi
Pagidoju Sreenu
Sukesh Narayan Sinha
Naveen Kumar Ramachandrappa
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.

Details

Language :
English
ISSN :
19326203
Volume :
16
Issue :
11
Database :
OpenAIRE
Journal :
PLoS ONE
Accession number :
edsair.doi.dedup.....44921b35ea14d9fa2cc96de9b190adee