Jamaican vomiting sickness

Jamaican vomiting sickness
Synonyms	Toxic hypoglycemic syndrome
Pronounce	N/A
Specialty	N/A
Symptoms	Vomiting, hypoglycemia, convulsions, coma
Complications	Seizures, death
Onset	2 to 6 hours after ingestion
Duration	Variable
Types	N/A
Causes	Consumption of unripe Ackee fruit
Risks	Eating unripe or improperly prepared ackee
Diagnosis	Clinical evaluation, history of ackee consumption
Differential diagnosis	Hypoglycemia, gastroenteritis, poisoning
Prevention	Avoiding unripe ackee, proper preparation of ackee
Treatment	Supportive care, intravenous glucose
Medication	N/A
Prognosis	Good with prompt treatment
Frequency	Rare outside of regions where ackee is consumed
Deaths	N/A

Jamaican Vomiting Sickness is a severe form of poisoning that is most commonly caused by the ingestion of unripe fruits of the Ackee tree (Blighia sapida), which is native to West Africa but also found in Jamaica and other parts of the Caribbean. The disease is characterized by sudden onset of vomiting, hypoglycemia (low blood sugar), and even seizures or coma in severe cases. The toxic compounds responsible for the condition are hypoglycin A and B, which are found in higher concentrations in the unripe ackee fruit.

Symptoms and Diagnosis

The primary symptoms of Jamaican Vomiting Sickness include severe vomiting, fatigue, abdominal pain, and confusion. These symptoms can rapidly progress to more severe conditions such as seizures, coma, and can be fatal if not treated promptly. Diagnosis is primarily based on the clinical presentation of symptoms and a history of ingestion of unripe ackee fruit. Laboratory tests may show severe hypoglycemia and elevated levels of liver enzymes.

Treatment

Treatment of Jamaican Vomiting Sickness focuses on the immediate correction of hypoglycemia and supportive care. Intravenous glucose is administered to rapidly correct the hypoglycemia, and monitoring of vital signs and liver function is essential. In cases where liver damage is suspected, further treatments may be necessary to support liver function.

Prevention

Prevention of Jamaican Vomiting Sickness is primarily through education about the dangers of consuming unripe ackee fruit. The fruit should only be eaten when fully ripe and properly prepared, which involves removing the toxic parts of the fruit such as the seeds and the aril (the red fibrous material attached to the seeds).

Epidemiology

While cases have been reported in West Africa and other parts of the Caribbean, Jamaican Vomiting Sickness is most commonly associated with Jamaica. The condition tends to occur in outbreaks, often related to the consumption of ackee fruit that has not been properly prepared.

Cultural and Economic Impact

The ackee fruit is a key component of the Jamaican diet and culture, most famously as part of the dish ackee and saltfish, which is considered the national dish of Jamaica. The economic impact of Jamaican Vomiting Sickness is significant, as it affects the ackee export industry. Regulations and public health initiatives aim to reduce the incidence of the disease and ensure the safe consumption of ackee both domestically and internationally.

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