The recent death of four villagers of Salamji in Tsangkha gewog, Dagana, was due to bongkrekic acid poisoning, an investigation by the Royal Centre for Disease Control (RCDC) in Thimphu has concluded.
The bongkrekic acid (a kind of toxin), according to the RCDC, can be found in locally brewed alcohol that are not fermented properly or completely.
The RCDC, which released its investigation report yesterday, stated that other people from the same village had also consumed locally brewed alcohol like changkey during the same time. But the report adds that only those who consumed the bangchang that was fermented from corn fell sick.
An official from the RCDC clarified that the cause of the deaths were not the bangchang itself.
The patients exhibited similar signs and symptoms of acute gastrointestinal symptoms. The first case was reported to Tsirang hospital on August 26.
The deceased succumbed to illness with multiple organ dysfunction, according to the report. In total, six people who were related to each other had fallen sick recently.
The deceased were aged between 40 and 54 years. The patients died in Damphu and Gelephu hospitals. Two of the six patients are being treated in JDWNRH and reportedly recovering.
The RCDC states that it discourages people from consuming locally brewed bangchang from corn ferment. The centre has also urged people to incinerate and discard all the current corn fermented produce to avoid such fatal public health incidents.
The report stated that the centre performed epidemiological, microbiological, serological and toxicological analysis on the samples of the affected individuals and the bangchang. There were no pathogenic micro-organisms isolated from millet and corn fermented samples.
The investigation was carried out by a team consisting of toxicologist Adeep Monger, food microbiologist Vishal Chhetri from RCDC, and forensic technologist Dhan Raj Giri from JDWNRH.
The centre also tested blood serum samples for seven different communicable disease and current pandemic (Covid-19). One of the patients tested positive for hepatitis A, according to the report.
The RCDC reported that the toxicological investigation found no trace of pesticides, aconite derivatives and toxic alcohols of concern in either clinical samples or fermented corn samples. “However, a presumption of bongkrekic acid poisoning is highly suspected.”
The RCDC on August 28 had received a notification on National Early Warning and Response System (NEWARS) from Tsirang hospital regarding the deaths of three individuals that occurred at Salamji village.
A team comprising local leaders, health personals and de-suups conducted an investigation to find out the possible cause of deaths upon the recommendations from RCDC.
The report stated that there was no history of consumption of wild mushroom or any other suspected toxicants.
Supporting its conclusion, the RCDC report states that epidemiological investigation revealed that those that did not consume bangchang (made from corn) were not affected.
The report states that the raw materials used for brewing corn alcohol can be contaminated with many micro-organisms which can produce secondary metabolites that is toxic and lethal.
The RCDC also held verbal conversations with survivors and treating physicians to determine the possible cause of poisoning. The report adds that more confirmatory tests of this toxicant, however, are necessary using higher techniques.
The RCDC stated that food poisoning is a global public health concern and that consumption of corn fermentation product has been reported from Indonesia, China and recently from Mozambique leading to a case fatality rate of 40 percent.