Dropsy hits Jaunpur family, four dead, two under treatment at KGMU

LUCKNOW: A 65-year-old elderly and a four-year-old baby girl from UP's Jaunpur district have been admitted to King George's Medical University medicine department with a confirmed diagnosis of epidemic dropsy. The two patients belong to the same family which has already lost four members to the disease.
Dropsy is a disease that causes swelling of body parts. The diagnosis of epidemic dropsy is a strong possibility when there is clustering of cases in a single family with on and off gastrointestinal symptoms of vomiting and diarrhea in a mustard oil consuming belt.

Epidemic dropsy was reported in Lucknow in February 2005 when several died and over 75 had taken ill due to consumption adulterated mustard oil.
The patients, Ashok Kumar and Swati, who were admitted on Sunday afternoon, are being attended by Dr D Himanshu who said: "Though in a state of shock due to back to back deaths in the family, they are stable." Epidemic dropsy was reported in Lucknow in February 2005 when several died and over 75 had taken ill due to consumption adulterated mustard oil.
About the two patients, Dr Himanshu informed that the diagnosis was made by doctors at Institute of Medical Sciences Banaras Hindu University (BHU) and agreed with it. "Dropsy is determined symptomatically and the patients showed clear symptoms of the disease. What supports the diagnosis is the pattern of deaths in the family," he said.
Ashok's eldest son Pankaj told TNN that they had been living in Maharashtra's palghar area until december 2017 when they returned to their native village in Jaunpur. In March, when Ashok's health deteroriated, the entire family packed its bags and came to the native village.
"While the treatment of my father was underway, my mother complained of diarrhoea and swelling in the legs. She died in the course of treatment on April 26. Thereafter my younger brother's wife Kavita showed similar problem and she passed away on May 3. Few days later, my younger brothers Dheeraj and Neeraj developed the same disease which claimed their lives on May 14 and 24," the grief striken kin said.
Pankaj added that when his father developed swelling in the feet, he rushed him to BHU. "We came back from BHU on Saturday. But on Sunday, team from the district health office brought her to KGMU.
ABOUT THE DISEASE
DROPSY is a disease that causes swelling of body parts.
* It is caused by consumption of mustard oil adulterated with oil of prickly poppy — scientifically known as argemone mexicana.
* The adulterant contains alkaloids which have physiologically active toxins (sanguinarine and dihydrosanguinarine) which are harmful for health.
* It was first noted in 1877. The disease killed around 65 persons in Delhi in 1998. In 2005, several persons were killed and over 75 were affected in Lucknow. Sporadic cases have been reported in many parts of the country. In 2014, a family in Punjab's Fatehgarh district.
* IMPACT ON THE BODY: Sanguinarine causes metabolic disturbance in body and triggers typical symptoms which appears as swelling. The toxin affects the heart, liver and eyes and causes increased permeability of blood vessels. Death is almost certain when swelling reaches the heart or brain. When the toxin attacks the kidenys, renal failure leads to death.
SYMPTOMS:
Acute nausea, vomiting, loose motions, bloated stomach, erythema, swelling of hands and feet known as oedema especially pedal (feet) oedema.
WHO IS AT RISK: Anybody except for babies on breast feeding. Many members of the family are affected simultaneously due to common exposure.
PREVENTION:
- The only preventive measure is to refrain from using oil which has not been tested for quality.
- It is wiser to skip use of mustard oil when there is a fear of the epidemic.
- Eating pickles or fried eatables from the market should be avoided as adulterated mustard oil may have been used.
- The ISI Mark and FPO seals must be checked on the oil containers before buying them. If more than one member of a family complains of swellings accompanied by severe pain, medical help should be sought immediately.
DETECTION ADULTRATION IN MUSTARD OIL.
* Contamination of mustard oil with argemone oil can be checked in minutes using the ‘nitric acid test’. In fact it reveals the presence of any alien substance in the mustard oil. The list includes linseed oil, mahua oil, niger seed oil, safflower seed oil, sesame oil, olive oil, jute seed oil, tamarind oil and radish oil. For this:
- Take about 5 ml. oil add an equal amount of pure nitric acid.
- Shake for 1 minute so as to mix thoroughly.
- Give a few minutes for the layers to separate.
- The acid layer showing yellow to orange colour indicates presence of adultrant.
* Care may also be taken at the time of buying mustard oil. While pure mustard oil will be golden yellow in colour while the adulterated oil will have an orange tinge.
(Source: National Health Portal of India and TOI Archives).