Summary about Disease
Jequirity poisoning is caused by the ingestion or exposure to the seeds of the Abrus precatorius plant, also known as rosary pea or jequirity bean. These seeds contain a potent toxin called abrin, a ribosome-inactivating protein. Abrin inhibits protein synthesis, leading to cell death and potential organ damage. Even a small amount of abrin can be fatal. Poisoning can occur through ingestion, inhalation, or injection of the toxin. The seeds are particularly dangerous if the seed coat is damaged, allowing abrin to be released.
Symptoms
Symptoms vary depending on the route of exposure and the amount of toxin involved.
Ingestion: Nausea, vomiting, diarrhea (often bloody), abdominal pain, dehydration, internal bleeding, liver damage, kidney failure, seizures, shock, and potentially death.
Inhalation: Fever, cough, shortness of breath, pulmonary edema (fluid in the lungs), chest tightness, nausea.
Eye Exposure: Severe eye irritation, redness, pain, excessive tearing, and potential corneal damage.
Skin Exposure: Irritation, redness, swelling, and blistering (if the skin is broken).
Injection: Localized pain, swelling, and necrosis (tissue death) at the injection site, followed by systemic effects similar to ingestion.
Causes
The cause of jequirity poisoning is exposure to the abrin toxin found in Abrus precatorius seeds. This can happen through:
Accidental ingestion: Especially by children who may be attracted to the brightly colored seeds.
Intentional ingestion: Rarely, for suicidal or homicidal purposes.
Abrasion to the seed coat followed by Ingestion: Allowing the toxin to be released.
Inhalation: Occurs when the powder of jequirity seeds is inhaled.
Skin exposure: Through broken skin coming into contact with the toxin.
Injection: Extremely rare, but possible in a deliberate poisoning attempt.
Medicine Used
There is no specific antidote for abrin poisoning. Treatment is primarily supportive and aims to minimize absorption of the toxin and manage symptoms. This includes:
Decontamination: Gastric lavage (stomach pumping) or activated charcoal if the ingestion is recent (within an hour), although activated charcoal is less effective due to the toxin's rapid absorption. For skin exposure, washing the affected area thoroughly with soap and water. For eye exposure, flushing the eyes with copious amounts of water.
Supportive care: Intravenous fluids to combat dehydration, medications to control nausea and vomiting, pain management, respiratory support (including mechanical ventilation if needed), and treatment for seizures.
Blood transfusions: May be required to address internal bleeding.
Dialysis: For kidney failure.
Monitoring: Close monitoring of vital signs, liver and kidney function, and blood counts.
Antibiotics: To prevent secondary infections.
Is Communicable
Jequirity poisoning is not communicable. It cannot be spread from person to person. It is solely the result of exposure to the abrin toxin present in the Abrus precatorius seeds.
Precautions
Education: Educate children and adults about the dangers of Abrus precatorius* seeds and the importance of not handling or ingesting them.
Plant Identification: Be able to identify the plant and its seeds.
Removal: Remove Abrus precatorius plants from areas accessible to children and pets.
Safe Handling: If handling the seeds (e.g., for jewelry making), wear gloves and eye protection, and avoid creating dust.
Proper Storage: Keep seeds out of reach of children and pets.
Waste Disposal: Dispose of seeds properly in a sealed container to prevent accidental exposure.
Seek Medical Attention: If exposure is suspected, seek immediate medical attention.
How long does an outbreak last?
Jequirity poisoning does not typically occur in "outbreaks" in the traditional sense of a contagious disease. Poisoning events are usually isolated incidents involving a single individual or a small number of people who have been exposed to the toxin. The duration of symptoms and recovery depends on the severity of the poisoning, the amount of toxin involved, and the promptness and effectiveness of treatment. In severe cases, the effects of the poisoning can be long-lasting or even fatal.
How is it diagnosed?
Diagnosis of jequirity poisoning can be challenging as there is no readily available specific test for abrin in most clinical settings. Diagnosis relies heavily on:
History of Exposure: A history of possible exposure to Abrus precatorius seeds, either through ingestion, inhalation, skin contact, or injection is key.
Clinical Symptoms: Recognizing the characteristic symptoms of abrin poisoning.
Laboratory Tests: Blood tests (complete blood count, liver function tests, kidney function tests, coagulation studies) to assess organ damage.
Imaging Studies: Chest X-ray or CT scan to evaluate for pulmonary edema or other respiratory complications.
Exclusion of Other Causes: Ruling out other potential causes of the symptoms.
Forensic Toxicology: In some cases, forensic toxicology testing may be used to detect abrin in biological samples, but this is not routinely available.
Timeline of Symptoms
The timeline of symptoms can vary depending on the route of exposure and the dose of abrin. However, a general timeline is as follows:
Within a few hours (Ingestion): Nausea, vomiting, abdominal pain, diarrhea.
12-24 hours (Ingestion): Symptoms worsen, potentially leading to bloody diarrhea, dehydration, and internal bleeding.
24-72 hours (Ingestion): Liver and kidney damage may become apparent. Seizures, shock, and death can occur.
Inhalation: Symptoms such as fever, cough, and shortness of breath may appear within a few hours.
Skin Contact: Local irritation can occur within hours of exposure.
It is important to note: Symptoms and progression can vary greatly.
Important Considerations
Severity: Jequirity poisoning can be extremely dangerous, even fatal.
Rapid Action: Immediate medical attention is crucial if exposure is suspected.
Lack of Antidote: There is no specific antidote for abrin poisoning, so treatment focuses on supportive care.
Prevention: Prevention through education and plant removal is essential.
Public Health: Suspected cases should be reported to local health authorities.
Bioterrorism Agent: Abrin is classified as a potential bioterrorism agent.
Professional Handling: Those who handle the seeds for jewelry or other purposes should be aware of the risks and take appropriate precautions.