Palm Island mystery disease

The Palm Island mystery disease, also known as hepatoenteritis and hepato-enteritis, was an outbreak of a hepatitis-like illness on Great Palm Island, Queensland, reported in 1979.[1] Associated in many cases with dehydration and bloody diarrhoea, 148 people (138 children and 10 adults) of Aboriginal and Torres Strait Islander descent were affected.[2]

View of Palm Island from Wallaby Point

Causes

The cause of the outbreak was determined to be the addition of excessive doses of copper sulfate to the water supply of Solomon Dam, which had been added to target a cyanobacteria bloom of Cylindrospermopsis raciborskii. The excessive dosing was following the use of least-cost contractors to control the algae, who were unqualified in the field.[3]

Toxins from the cyanobacteria itself had also been described as a possible cause.[4][5]

Early suggestions included toxocariasis.[6][7][8]

Presentation

Symptoms of hepatoenteritis included diarrhoea, vomiting attacks, loss of balance and disorientation.[9]

The perinatal effects of cyanobacteria contamination of drinking water include prematurity, low birth weight and congenital defects detected at birth. In 1996 there were 63 deaths attributed to drinking water contamination in Caruaru, Brazil.[10]

References
  1. Barceloux, Donald G. (2008). Medical toxicology of natural substances: foods, fungi, medicinal herbs, plants, and venomous animals. John Wiley and Sons. pp. 181–. ISBN 978-0-471-72761-3. Retrieved 4 August 2011.
  2. Schembri MA, Neilan BA, Saint CP (October 2001). "Identification of genes implicated in toxin production in the cyanobacterium Cylindrospermopsis raciborskii". Environ. Toxicol. 16 (5): 413–21. doi:10.1002/tox.1051. PMID 11594028.
  3. Prociv P (September 2004). "Algal toxins or copper poisoning--revisiting the Palm Island "epidemic"". Med. J. Aust. 181 (6): 344. PMID 15377259.
  4. Griffiths DJ, Saker ML (April 2003). "The Palm Island mystery disease 20 years on: a review of research on the cyanotoxin cylindrospermopsin". Environ. Toxicol. 18 (2): 78–93. doi:10.1002/tox.10103. PMID 12635096.
  5. Hawkins PR, Runnegar MT, Jackson AR, Falconer IR (November 1985). "Severe hepatotoxicity caused by the tropical cyanobacterium (blue-green alga) Cylindrospermopsis raciborskii (Woloszynska) Seenaya and Subba Raju isolated from a domestic water supply reservoir". Appl. Environ. Microbiol. 50 (5): 1292–5. PMC 238741. PMID 3937492.
  6. Moorhouse DE (February 1982). "Toxocariasis. A possible cause of the Palm Island mystery disease". Med. J. Aust. 1 (4): 172–3. PMID 7078487.
  7. Prociv P, Moorhouse DE, Wah MJ (July 1986). "Toxocariasis--an unlikely cause of Palm Island mystery disease". Med. J. Aust. 145 (1): 14–5. PMID 3724621.
  8. Muller, Ralph; Wakelin, Derek (15 January 2002). Worms and human disease. CABI. pp. 159–. ISBN 978-0-85199-516-8. Retrieved 4 August 2011.
  9. Wilson, Paul (March 1985). "Black Death White Hands Revisited: The Case of Palm Island". Aust. & NZ Journal of Criminology. 18: 50. doi:10.1177/000486588501800106.
  10. Pilotto et al. (1999) Archived 2007-05-27 at the Wayback Machine Rosenstiel School of Marine and Atmospheric Science, University of Miami, accessed 23 January 2007

Further reading
  • Bourke ATC, Hawes RB, Nielson A, Stallman ND. An outbreak of hepatoenteritis (the Palm Island mystery disease) possibly caused by algal intoxication [abstract]. Toxicon Suppl 1983;45-48.

See also
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