Jamaican Vomiting Sickness Following Ingestion of Ackee Fruit

 

Plant: Blighia sapida

 

The plant produces a pod which splits open when ripe to show 2-3 light yellow arilli, which are the fruits that are eaten after being cooked. Usually the arilli are boiled in water for 15 to 20 minutes.

 

Toxin: hypoglycin (alpha-amino-beta-methylenecyclopropanyl proprionic acid)

 

Clinical features:

(1) acute hypoglycemia (toxic hypoglycemic syndrome), which responds to intravenous glucose infusion

(2) teratogenic to the human fetus

 

One fruit can be fatal in the adult.

 

Risk factors for toxicity:

(1) eating an unripe fruit

(2) improper preparation

(3) purchase of ackee fruit from a street vendor who has tampered with and forcibly opened the pod or improperly prepared the fruit

(4) using the water used in boiling the fruit for other cooking

(5) malnutrition