PSM medical food toxins

1. FOODBORNE TOXINS & DISEASES
Dr. Dhara Zalavadiya
Associate Professor
Community Medicine

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❖Definition :
“ A disease usually either infectious or toxic
in nature, caused by agents that enter through the
ingestion of food.”
❖Why ?
►Urbanization
► Industrialization
► Tourism
► Mass catering systems
FOODBORNE DISEASES

3. Food Borne Diseases
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FOODBORNE
INTOXICATIONS
• Naturally occurring
toxins
• Bacterial toxins
• Fungal toxins
• Food borne chemical
poisoning
FOOD BORNE
INFECTIONS
• Bacterial diseases
• Viral diseases
• Parasites

4. A. FOODBORNE INTOXICATIONS
❖ Naturally occurring toxins :
A. Lathyrism (beta oxalyl amino-alanine)
B. Endemic ascites ( pyrrolizidine alkaloids)
❖ Bacterial toxins :
A. Botulism
B. Staphylococcus poisons
❖ Fungal toxins
A. Aflatoxin
B. Ergot
C. Fusarium toxins

5. Continue….
❖Food borne chemical poisoning
➢ Heavy metals, e.g., mercury (usually in fish)
cadmium ( in certain shellfish) and lead (in
canned food)
➢ Oils, petroleum derivatives and solvents
➢ Migrant chemicals from package materials
➢ Asbestos
➢ Pesticide residues (DDT, BHC )

6. B. Food Borne Infections
1. Bacterial diseases : Typhoid and para typhoid
fevers, Salmonellosis, Staphylococcal
intoxication, Cl. Perfringens illness, Botulism, B.
Cereus food poisoning, E.coli diarrhoea, Non-
Cholera Vibrio illness, V. Parahaemolyticus
illness, Streptococcal infection. Shigellosis,
Brucellosis.
2. Viral diseases: Viral hepatitis, Gastroenteritis
3. Parasites: Taeniasis hydatidosis, trichinosis,
Ascariasis, Amoebiasis

7. Food Toxicants
• Neurolathyrism
• Aflatoxins
• Ergot
• Epidemic dropsy
• Endemic ascites
• Fusarium toxins
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8. Neurolathyrism
• Neurolathyrism is a crippling neurodegenerative disease of the
nervous system characterized by gradually developing spastic
paralysis of lower limbs, occurring mostly in adults consuming
the pulse, Lathyrus sativus in large quantities.
• Lathyrus sativus is commonly known as "Khesari dhal“
• Neurolathyrism is prevalent in parts of MP, UP, Bihar and
Orissa. It has also been reported in Maharashtra, West Bengal,
Rajasthan, Assam and Gujarat where the pulse is grown.
• No fresh outbreaks of the disease in endemic areas due to
shifting trends in agronomical practices in the region

9. The pulse- Lathyrus sativus
• The seeds of lathyrus have a characteristic triangular shape and
grey colour.
• When dehusked the pulse looks similar to red gram dhal or bengal
gram dhal.
• Like other pulses, lathyrus is a good source of protein, but for its
toxin which affects the nerves. It is eaten mostly by the poor
agricultural labourer because it is relatively cheap.
• Studies have shown that diets containing over 30% of this dhal if
taken over a period of 2-6 months will result in neurolathyrism.
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10. The pulse- Lathyrus sativus
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11. The toxin-BOAA:
• Toxin present is BOAA -Beta oxalyl amino
alanine
• It has been isolated in crystalline form and
is water soluble, this property has been
made use in removing the toxin from pulse
by soaking in hot water and rejecting the
water.

12. The Disease:
It mostly affects young men 15-45 years age. Manifests in the
following stages:
• Latent stage- ungainly gait (walking clumsy)-important in
prevention aspect
• No stick stage- short jerky steps without the aid of the stick
• One stick stage-crossed gait with tendency to walk on toes.
Muscular stiffness makes it necessary to use stick while walking to
maintain balance.
• Two stick stage- severe condition. Due to excessive bending of
knees and crossed legs, the patient needs two crutches to walk
• Crawler stage- erect posture becomes impossible with atrophy of
thigh and leg muscles.

14. Interventions
• Vitamin C prophylaxis
• Banning of the crop
• Removal of the toxin
• Education
• Genetic
• Socio-economic changes

15. 1. Vitamin C prophylaxis
• Although this condition is irreversible
• Damages can be repaired to certain extent by
administration of 500-1000mg of ascorbic
acid daily for a week or so

16. 2. Banning the crop
• These is extreme step not feasible for immediate
intervention.
• The Prevention of food adulteration act in India
has banned the crop lathyrus in all forms- whole,
spilt or flour
• If however, it is not possible to avoid consuming
khesari dal, it is desirable that the proportion of
the dhal should never be more than a quarter of
the total amount of cereals and pulses eaten per
day

17. 3. Removal of toxin
• Steepeing method –soaking the pulse in large
quantity boiled water for 2 hours after which
the water is discarded.
• Parboiling (partial cooking in steam)
• Soaking in lime water overnight and
discarding rest of water

18. 4. Health Education- The public must be educated on
the dangers of consuming this pulse and the need for
removing its toxin before consumption.
5. Genetic control- Certain strains of lathyrus contain
very low levels of toxin (0.1%). The selective
propagation and cultivation of such strains may be the
most effective way to eradicate lathyrism without any
drastic change in the food habits of the people.
6. Socioeconomic changes- overall development that
can root out lathyrism.

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AFLATOXINS

20. AFLATOXINS
❖A group of mycotoxins produced by fungi :
Aspergillus flavus and Aspergillus parasiticus.
❖ Food grains infested: groundnuts, maize,
parboiled rice, sorghum, wheat, rice, cotton
seeds under conditions of improper storage.
❖ Aflatoxins B1 and G1 are the most common
hepatotoxins, in addition to being carcinogenic.

22. Continue…
❖Factors affecting toxin formation:
Moisture and temperature
✓Moisture level above 16 percent
✓Temperature between 11 to 37 degree C.
❖In 1975- report of 400 cases including 100 deaths from
Banswada and Panchmahal districts of Rajasthan and
Gujarat respectively highlight the problem in India.
❖Aflatoxin B1 detected in breast milk and urine samples
collected from children suffering from infantile cirrhosis.

23. CONTROL AND PREVENTIVE MEASURES
✓Proper storage after drying
✓Moisture content below 10%
✓Food contaminated should not be consumed.
✓Health education

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ERGOT

25. ERGOT
• Field fungus
• Food grains like bajra, sorghum and wheat have a
tendency to get infested during its flowering stage.
• Fungus grows as a blackish mass and the seeds
become black and irregular and are harvested
along with food grains. Consumption of ergot
infested grain leads to ergotism.

27. ✓Symptoms: acute but rarely fatal
✓Nausea, repeated vomiting, giddiness, and
drowsiness up to 24 to 48 hours.
✓In chronic cases painful cramps in limbs and
peripheral gangrene.
✓High yielding varieties of bajra are more infested.
✓Removed by floating them in 20 percent of salt water or
hand picking
Continue…

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Epidemic dropsy

29. Epidemic dropsy
outbreaks of "epidemic dropsy" are reported in India. The cause of
epidemic dropsy was not known until 1926, when Sarkar ascribed
it to the contamination of mustard oil with argemone oil.
Lal and Roy (1937) and Chopra et.al., (1939) gave experimental
proof of the cause of epidemic dropsy.
Mukherji et.al., (1941) isolated a toxic alkaloid, sanguinarine from
argemone oil and found out its chemical formula. This toxic
substance interferes with the oxidation of pyruvic acid which
accumulates in the blood.

30. SYMPTOMS
✓ Sudden, non-inflammatory, bilateral
swelling of legs
✓Diarrhoea
✓Dyspnoea
✓Cardiac failure
✓Death
✓Glaucoma in some cases
✓All ages except breast-fed infants
✓Mortality 5-50 percent

31. Contamination
✓Seeds ofArgemone mexicana (prickly poppy)
closely resembles mustard seeds.
✓It has prickly leaves with bright yellow flower.
✓Crops of mustard are gathered during March,& seeds of
argemone also mature during this period, so likely to be
harvested with mustard seeds
✓Argemone oil is orange in colour with and acrid odour.

34. TESTS
❖NITRICACIDTEST :
✓Add nitric acid to the sample of oil in a test tube.
✓Development of a brown to orange-red colour shows the
presence of argemone oil.
✓Positive with the level of 0.25 percent of argemone oil.
❖PAPER CHROMATOGRAPHYTEST:
Most sensitive detect up to 0.0001 % argemone oil.

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ENDEMIC ASCITES

36. ENDEMIC ASCITES
✓In Kusmi Block in Madhya pradesh during
1973 again during 1976.
✓Outbreak of rapidly developing ascites and
jaundice among Nagesia tribals.
✓Except infants all age groups affected.
✓Overall mortality 40%.
✓Panicum millare which gets contaminated with
seeds of Crotalaria. (Jhunjhunia)
✓Pyrrolizidine alkaloids which are hepatotoxins.

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Studies conducted by the National Institute of
Nutrition, Hyderabad showed that the local population
subsist on the millet Panicum miliare (known locally
as Gondhli) which gets contaminated with weed seeds
of Crotalaria (locally known as Jhunjhunia).
On chemical analysis. Jhunjhunia seeds were found to
contain pyrrolizidine alkaloids which are hepatotoxins.
ENDEMIC ASCITES

38. PREVETIVE MEASURES
✓Health education
✓Deweeding of the Jhunjhunia plants which grow
along with staples.
✓Simple sieving of the millet at the household level
to remove the seeds of Jhunjhunia which are
considerably smaller than those of the millet..

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FUSARIUMTOXINS

40. FUSARIUMTOXINS
✓Field fungi
✓Fusarium contamination of sorghum on the
increase.
✓Rice is also a good substrate.
✓National Institute of Nutrition to isolate the
metabolites produced by fusarium.

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Thank You!