AFLATOXIN POISONING - KENYA
 

 
Dr S K Sharif,
Ministry of Health, Kenya

The death toll due to aflatoxin poisoning has risen to 80 in the Eastern province. It is expected that [it] may rise further.

Initial reports of aflatoxin poisoning were reported in 2 districts, but more cases are reported from other districts in Eastern Province.

Aflatoxin is a naturally occurring mycotoxin produced by 2 types of mold: _Aspergillus flavus_ and _Aspergillus parasiticus_.  _A. flavus_ is widespread in nature and is most often found when certain grains are grown under stressful conditions such as drought. The mold occurs in soil, decaying vegetation, hay, and grains undergoing microbiological deterioration and invades all types of organic substrates whenever and wherever the conditions are favorable for its growth. Favorable conditions include high moisture content and high temperature. 

At least 13 different types of aflatoxin are produced in nature, with aflatoxin B1 considered the most toxic. While the presence of _A. flavus_ does not always indicate harmful levels of aflatoxin, it does mean that the potential for aflatoxin production is present.


Aflatoxins are acutely toxic and have been shown to be carcinogenic for some animals. Their toxicity varies between different species, but data from a large outbreak of poisoning in India in 1974 involving moldy maize and in which nearly 100 people died, suggests that the toxicity of aflatoxin B1 for humans lies somewhere between that for the dog and that for the rat. The involvement of aflatoxins with human cancer is more complex and remains to be defined.


Studies of aflatoxin poisoning in animals have shown that low-level chronic intake may be more devastating than one-time high-level intake. The situation described above may well be a case of chronic low-level intoxication. In such cases, aflatoxicosis affects a number of different body systems, most notably the liver. Various parameters of the liver may be affected, including clotting factors when the levels of toxin is very high.  Chronic low-level intake is often associated with diarrhea, gastric upset and vomiting, lethargy,
dehydration, and as the liver fails, other organs fail also. Consequently kidneys often fail, and the complications associated with both failing liver and failing kidneys may have been seen.

Treatment is generally considered to be supportive and include some liver supportive therapies.  In the event of internal bleeding due to clotting failure, vitamin K1 has been shown to be helpful in some animal studies, although the rationale is not well understood. - Mod.TG]
 
For additional information, contact:
Pure Air Control Services
800-422-7873, ext. 802