ArticleJournal of Taibah University Medical Sciences2025
Outbreak of carbofuran and bifenthrin poisoning in siblings after ingestion of contaminated food in KSA: Clinical management and public health implications.
Article in Journal of Taibah University Medical Sciences, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Who cites it
1 citing paper in PubMed.
- Integrated Network Toxicology and Metabolomics Reveal the Ovarian Toxicity Mechanisms of Chronic Carbofuran Exposure in Female Mice.International journal of molecular sciences · 2025Article
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Authors and funding
12 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Background: Pesticide poisoning remains a major global health concern contributing to an estimated 371,594 deaths annually. Both accidental and deliberate pesticide exposure, particularly in developing countries, pose challenges to public health systems. In KSA, pesticide poisoning is prevalent, and insecticides such as carbamates and organophosphates are the primary culprits. Case presentation: Four cases of acute poisoning caused by the ingestion of contaminated shawarma sandwiches containing carbofuran and bifenthrin, a carbamate and pyrethroid mixture, respectively, are described. The affected individuals, all siblings, exhibited varying degrees of cholinergic symptoms, including muscle fasciculations, excessive secretions, and respiratory distress. Despite their severe symptoms, three patients had normal or low-normal acetylcholinesterase levels, probably because of individual variability, delayed testing, or improper sample handling. One patient exhibited diminished acetylcholinesterase activity, thus suggesting severe inhibition; pancreatitis was a further complication that contributed to delayed recovery. Early clinical management included atropine, pralidoxime, and botulinum antitoxin, because of initial suspicion for botulism. Toxicological analysis confirmed carbofuran poisoning, and food safety investigations identified improper pesticide use in food preparation areas. Conclusion: The reported cases underscore the importance of timely toxicological consultation, proper testing, and appropriate sample handling to guide treatment of pesticide-related poisoning. These findings highlight the crucial need for adherence to WHO regulations and monitoring of pesticide use, as well as strict food safety practices to prevent future outbreaks. The successful multidisciplinary approach to managing these cases demonstrates the critical role of coordinated efforts between clinical teams and public health authorities in addressing such public health threats.
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