title: A foodborne disease outbreak due to the consumption of moldy sorghum and maize containing fumonisin mycotoxins.
abstract: BACKGROUND
  Unseasonal rains beginning in 1995 damaged the maize and sorghum crops harvested in a few villages of the Deccan plateau in India. Human consumption of those grains resulted in a foodborne disease outbreak characterized by abdominal pain, borborygmi and diarrhea.
  
  
  METHODS
  A rapid epidemiological survey was conducted in the affected villages and a detailed house to house survey in selected villages.
  
  
  RESULTS
  People in 27 out of 50 villages surveyed were affected and disease was seen only in households and subjects consuming the rain damaged moldy sorghum or maize. The disease was self limiting. Diarrhea was reproduced in day old cockerels fed contaminated grains from affected households. All 20 sorghum and 12 maize samples collected from affected households had Fusarium sp. as the dominant mycoflora and contained fumonisin B1 in the range of 0.14-7.8 mg/kg and 0.25-64.7 mg/kg, respectively. In contrast, samples collected from unaffected households had fumonisin B1 in low levels ranging from 0.07-0.36 mg/kg and 0.05-0.24 mg/kg, respectively.
  
  
  CONCLUSIONS
  The higher water activity in the grains left in the field following harvest led to the production of high levels of fumonisin B1 and consumption of such grains by humans resulted in the disease.
authors.affiliation: Food and Drug Toxicology Research Centre, National Institute of Nutrition, Indian Council of Medical Research, Hyderabad, India. icmrnin@ren.nic.in
authors.forename: R V
authors.initials: RV
authors.lastname: Bhat
authors.forename: P H
authors.initials: PH
authors.lastname: Shetty
authors.forename: R P
authors.initials: RP
authors.lastname: Amruth
authors.forename: R V
authors.initials: RV
authors.lastname: Sudershan
mesh_terms: D015746:Abdominal Pain / Q000139:chemically induced; D000293:Adolescent; D000328:Adult; D000818:Animals; D002264:Carboxylic Acids / Q000032:analysis / Q000378:metabolism / Q000506:poisoning*; D002274:Carcinogens, Environmental / Q000032:analysis / Q000378:metabolism / Q000506:poisoning*; D002645:Chickens; D002648:Child; D002675:Child, Preschool; D002851:Chromatography, High Pressure Liquid; D015331:Cohort Studies; D003625:Data Collection; D003967:Diarrhea / Q000139:chemically induced; D004196:Disease Outbreaks; D002523:Edible Grain / Q000737:chemistry / Q000382:microbiology / Q000506:poisoning*; D005260:Female; D005516:Food Microbiology; D005517:Foodborne Diseases / Q000453:epidemiology; D037341:Fumonisins; D006801:Humans; D007194:India / Q000453:epidemiology; D007223:Infant; D008297:Male; D009183:Mycotoxins / Q000032:analysis / Q000378:metabolism / Q000506:poisoning*; D003313:Zea mays / Q000737:chemistry / Q000382:microbiology / Q000506:poisoning*
chemical_list: D002264:Carboxylic Acids; D002274:Carcinogens, Environmental; D037341:Fumonisins; D009183:Mycotoxins; C056933:fumonisin B1