Organophosphate poisoning due to a wheat bagel.
OBJECTIVE
Organophosphate compounds are possibly the most widely-used insecticides worldwide. Organophosphate compounds cause poisoning, inhibiting acetylcholinesterase at the cholinergic synapses. Civilian casualties resulted from a terrorist attack with sarin in a Tokyo subway. Recent terrorist activities have also raised concerns that organophosphate or nerve agents may be used as a weapon of terror or mass destruction.


METHODS
In this study, an extraordinary type of mass poisoning was evaluated. Especially by focusing on the way of poisoning, the demographic features and clinical findings of patients were analyzed.


RESULTS
After eating a wheat bagel, 13 patients with organophosphate poisoning were admitted to our emergency department. Seven were males and 6 were females. The mean age of the patients was 26 +/- 13.9. The mean serum acetylcholinesterase level was 2945.1+/-2648.9 U/L. Nine patients who had supportive treatment and who were given atropine and pralidoxime were hospitalized approximately 6.8+/-6.5 days. All of the patients recovered after the treatment and no deaths occurred.


CONCLUSIONS
If organophosphate poisoning is not diagnosed and treated in time, it may be fatal. When cases of food poisoning are admitted to the hospital, attention must be taken especially if it is a mass poisoning.
Kavalci
Cemil
C
Atatürk Training and Research Hospital Emergency Department, Ankara, Turkey. cemkavalci@yahoo.com
Durukan
Polat
P
Ozer
Mehmet
M
Cevik
Yunsur
Y
Kavalci
Gülsüm
G
D000110:Acetylcholinesterase / Q000097:blood; D000293:Adolescent; D000328:Adult; D000931:Antidotes / Q000627:therapeutic use; D001285:Atropine / Q000627:therapeutic use; D002800:Cholinesterase Inhibitors / Q000506:poisoning; D002801:Cholinesterase Reactivators / Q000627:therapeutic use; D004006:Dichlorvos / Q000506:poisoning; D005260:Female; D005506:Food Contamination / Q000032:analysis; D005517:Foodborne Diseases / Q000175:diagnosis / Q000188:drug therapy / Q000209:etiology*; D006801:Humans; D007306:Insecticides / Q000506:poisoning*; D008297:Male; D062025:Organophosphate Poisoning; D011220:Pralidoxime Compounds / Q000627:therapeutic use; D012189:Retrospective Studies; D014908:Triticum / Q000506:poisoning*; D014421:Turkey; D055815:Young Adult
D000931:Antidotes; D002800:Cholinesterase Inhibitors; D002801:Cholinesterase Reactivators; D007306:Insecticides; D011220:Pralidoxime Compounds; D001285:Atropine; D004006:Dichlorvos; D000110:Acetylcholinesterase; C028797:pralidoxime