Disease of the vomiting of Jamaica

The Maladie of the vomiting of Jamaica is a disease characterized by important Vomissement S and a Hypoglycémie being able to be mortal, caused by a acute Food poisoning after fruit ingestion of Akée (Blighia sapida). The victims are mainly young children.

The first descriptions of the disease under the name of " disease of the vomisseurs of Jamaïque" were made in 1875.

The accidents due to the toxicity of this fruit are a recurring problem in particular in Jamaica and Haiti, but also in Ivory Coast, in Togo or Burkina Faso. The Jamaican administration recorded 271 cases between 1980 and 1991. A case was observed with the the United States, 28 other cases in Jamaica since 1992 and more recently 29 deaths with the Burkina Faso between January and May 1998.

The death rate of this intoxication is very high; the Décès generally occurs between 2 and 48 hours after ingestion. The age of the poisoned children ranges typically between 2 and 6 years.

The Maladie of the vomiting of Jamaica is a traditional cause of:

Steatosis microvésiculaire;
toxic Hypoglycemia.

Consumption of Aki

The fruit of Aki is not edible entirely: only the fleshy arilles surmounting seeds are edible, while the remainder of the fruit as well as the seeds are toxic.

The green or too ripe fruits are also poisonous. The fruit should thus be collected only with complete maturity, when it opens naturally. It must thus also be consumed fresh.

The aki with the Morue is the national dish of the Jamaica. The salted cod is jumped with the akis, of the lard, onions, peppers, tomatos, sweet herbs, and can be furnished with fried bacon and fresh tomatos.

Toxicity

The flesh of the immature arille and the seeds contain a quite particular toxin, the Hypoglycine, which is an amino-acid methylcyclopropyl-proprionic. That Ci causes, after ingestion, a major reduction in the glycemia, causing incoercible vomiting, convulsions and possibly death, in particular in the children.

The hypoglycine, or acid acetic methylene cyclopropyl, the irreversible shape of esters of Coenzyme have and of Carnitine. These two molecules are essential to the oxidation of the fatty-acids, which provides Acétyl-CoA, precursor essential to the synthesis of energy (ATP). This same energy is normally used by the organization (except the brain, the globules red and the medullary renal one) but also particularly by the liver for to synthesize glucose remotely meals. In the absence of the oxidation of the fatty-acids, the liver is unable to adjust with the rise the glycemia, which involves a very strong hypoglycemia.

Anecdote

the aki is the symbol and the national fruit of Jamaica.
One of the episodes of the series Urgencies with for clinical case an intoxication with akée.

See too

Tragedy in Milot: More than 50 deaths by intoxication with the ackee.

Random links: