Complaints - Please scroll to the bottom of the page
Search
« Tsunami | Main | Coromandel Marina »
Saturday
Mar032018

!080 vs. Botulinum in Kochumman Case

Back on 17 February I invited anyone interested to transcribe Prof. Ian Shaw's letter just to bring 'balance to the case.

Sure enough, Geoffrey Robinson took up the challenge, and transcibed into Word so that i could post it here, and I am happy to do so. It certainly raises interesting questions, coming as it does from someone so highly qualified in the field.

The only problem i have lies in the absolute assurances that have been provided by DoC that no drops or baiting had taken place anywhere in the area concerned. I guess that we have to take them at their word because they would know that if the contrary was proven, that they would 'be in the gun.'

Anyway, thank you Geoffrey - a sterling effort. Here is the letter:

College of Science

School of Physical and Chemical Sciences     <University of Canterbury Letterhead>

Te Kura Matu

Tel:  +64 3 369 3100

http://www.canterbury.ac.nz/science/

7th February, 2018


Kathy White

Councillor, Taupo-Rotorua General Constituency

Chair, Environmental and Services Performance Committee

Waikato Regional Council

 

Dear Kathy,

Kochumman poisoning case

I have listened to the TV interview with the poisoned family and considered the symptoms they and their doctors describe following consumption of possibly contaminated wild pig.

The symptoms described in summary are:

Shaking, vomiting, thrashing arms and legs, fever, confusion, agitation, eyes rolling upwards, eratic limb movement, biting.

The symptoms of 1080 (fluoroacetate) poisoning are:

Nausea, vomiting, abdominal pain, sweating, confusion, agitation,

And the symptoms of botulinum toxin (BT) poisoning are:

Difficulty swallowing, difficulty speaking, dry mouth, facial weakness, drooping eyelids, trouble breathing, nausea, paralysis.

These two sets of symptoms are consistent with the mechanisms of toxicity of 1080 and BT toxin respectively.  BT toxin inhibits neurotransmission by preventing the release of a key neurotransmitter (acetylcholine) from the pre-synaptic terminal.  This means that nervous impulses cannot be transmitted to muscles and other sites that utilise cholinergic transmission (e.g. salivary glands).  Paralysis, dry mouth, difficulty speaking, drooping eyelids, facial weakness, breathing difficulties, etc. are all consistent with neurotransmission failure.

On the other hand, 1080 works by blocking a key biochemical pathway (Kreb’s Cycle) due to the lethal synthesis of fluorocitrate in the body.  Fluorocitrate inhibits a key enzyme in Kreb’s Cycle.  The result is severely perturbed cell function consistent with sweating, confusion, agitation, nausea, etc.

In my opinion, the affected members of the family’s symptoms are consistent with 1080 and not BT poisoning.  Interestingly, it appears that the initial (albeit tentative) diagnosis was indeed 1080 poisoning, why this was dismissed in favour of BT poisoning is very difficult to understand when the symptoms are considered and the later negative BT tests are taken into account.

If the 1080 poisoning hypothesis had been followed, early collection of urine for fluoroacetate analysis might have significantly assisted the diagnosis.  In this case urine samples appear to have been stored some time (I think 18-days) prior to analysis giving a negative result that might be a false negative.   Fluoroacetate is chemically quite stable and stable at elevated temperatures (below 200°C – its boiling point), but is very susceptible to bacterial breakdown (hence its short  environmental half-life), and so if the urine sample was contaminated with bacteria (which is possible) I would expect there to be significant loss of any fluoroacetate presenting the urine during its long storage period.

In addition, early (for the bacterial contamination reasons outlined above) sampling and analysis of the food prepared from the pig, followed by fluoroacetate analysis might have provided useful exposure data.

In summary, I find the investigative strategy for this case somewhat awry.  The symptoms point to 1080 poisoning not BT poisoning, but the investigation seemed to blindly follow the BT route.  I base this conclusion on limited information and no access to the full clinical notes and analytical results.

Good wishes.

Yours sincerely,

<signed>

Ian C Shaw FRSC, FRCPath

Professor of Toxicology

 

 

 

PrintView Printer Friendly Version

EmailEmail Article to Friend

Reader Comments (5)

Bill,

Through the WRC I have made extensive enquiries about this matter and have been made aware that in addition to the DOC assurance, health officials have categorically ruled out 1080 toxin as having anything to do with what happened to the Kochumman family.

Regards,

Dal Minogue
WRC Councillor Thames-Coromandel ward

March 3, 2018 | Unregistered CommenterDal Minogue

And that is a fair enough assurance as far as I am concerned. But the lingering doubts created by Prof. Shaw's letter remain a problem, though his final sentence is to some degree an 'escape hatch.' -
"I base this conclusion on limited information and no access to the full clinical notes and analytical results."

March 3, 2018 | Registered CommenterBill Barclay

The children in the household had no health issues. From this it is fair to conclude that it was a "product" consumed only by the adults. The adults may not be entirely upfront about what was consumed?

March 5, 2018 | Unregistered Commenteraircolledguy

Ian Shaw is the Director of Biochemistry & Professor of Toxicology at University of Canterbury. Since Ian Shaw wrote this letter, he has been given access to more medical notes for the patients, and has confirmed that he still believes the symptoms displayed by the Kochumman family were in alignment with 1080 poisoning. On the phone, he said to me that if he had been in charge, he would have tested for 1080 poison immediately because that was his first thought when he read the symptoms.

Sadly, he wasn't in charge. No tests were done for 1080 on the patients, on the pork curry, or the wild boar in the freezer, even though 1080 poisoning was the doctors' first working diagnosis and continued to be in the working diagnosis for weeks. No one pursued this line of inquiry until the DHB received Official Information Act requests for toxicology results. Eighteen days after hospitalisation, the patients' urine was belatedly tested for 1080, but the urine test was outside the time and storage requirements of the Landcare Research sampling and testing protocol for 1080. Ian Shaw confirmed to me that urine wasn't the best thing to test - stomach contents would have been more reliable - and that it should have been tested immediately before bacteria started to break down the toxin. There was little chance of getting a positive result 18 days after the event. The other thing that might have produced a positive result was the frozen pork, but this still has not been tested.

In contrast, lots of tests were done for botulism on plasma and the pork curry, even though the symptoms (especially the extreme spasms and convulsions) excluded botulism as a possible cause. Tests were even done for things that were not in alignment with the symptoms at all. It appears that 1080 was the elephant in the room.

Under pressure from members of the public, the DHB finally tested the pork curry for 1080, two months after the patients had been hospitalised. In my opinion, the lack of 1080 testing was disgraceful. I have read all of the medical notes, have spoken with numerous people including toxicologists and doctors, and can find no reasonable explanation for ignoring 1080 as a possible cause, especially when doctors constantly made reference to it in their diagnosis.

March 6, 2018 | Unregistered CommenterKathy White

In regard to your comment about DoC assurances about there being no 1080 baiting in the area, no one collates details about poison operations by individual government agencies, councils and private landowners in one centralised location. However an Official Information Act reply from the DHB (received within the last week) confirmed that 109,786 ha of land has been poisoned with 1080 in the Waikato in 2017. A map compiled by TV Wild, using official pesticide summaries online, revealed numerous poison operations in or close to the South Waikato. It's time this information was made publicly available from one easily-accessed place, so hunters and fishermen know the locations to avoid, and so agencies are aware of just how much toxin is being used out there.

March 6, 2018 | Unregistered CommenterKathy White

PostPost a New Comment

Enter your information below to add a new comment.

My response is on my own website »
Author Email (optional):
Author URL (optional):
Post:
 
Some HTML allowed: <a href="" title=""> <abbr title=""> <acronym title=""> <b> <blockquote cite=""> <code> <em> <i> <strike> <strong>