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A ProMED-mail post
<http://www.promedmail.org>
ProMED-mail is a program of the
International Society for Infectious Diseases
<http://www.isid.org>
Date: Sun 9 Jan 2011
Source: The Gleaner [edited]
<http://jamaica-gleaner.com/
An autopsy into the death of Argentinean tourist, who died after eating a
meal of fish and potatoes 2 weeks ago, points to an ingestion of saltpetre,
according to reports reaching The Sunday Gleaner.
Sodium nitrate (saltpetre) is often used for curing meats. It is believed
that the tourist, whose command of the English language was limited,
purchased the product, mistaking it for table salt. He reportedly used it
excessively in the meal that he prepared, and this was evidenced by the
half-empty bottle of saltpetre that was found at the villa he occupied in
St Mary.
The tourist was vacationing here with [a couple] who came to Jamaica to
renew their wedding vows, having married in Japan a year ago. [She] is a
Jamaican university teacher residing in Japan.
"Saltpetre (nitrate) prevents the haemoglobin in the blood from carrying
oxygen at high levels. So you get headache, blue colour to skin and
dizziness, trouble breathing, heart failure, and ultimately, death," a
biochemist, who is not part of the medical team investigating the case,
told this newspaper. He said if too much was inhaled, it could scorch the
nasal passages and the lungs. Unconfirmed reports are that the tourist's
throat was badly burnt from the effects of whatever he ate.
"The only type of fish that would trigger that type of result would likely
be barracuda or fugu (puffer fish) because of the level of toxicity that
could come from those types of fish," said the expert, dismissing
assumptions that the fish could have caused the death. Countries such as
the United States and the United Kingdom have regulated the use of
saltpetre, he said.
US Federal regulations permit a maximum addition of 2.75 oz of sodium, or
potassium nitrate, per 100 pounds of chopped meat, and 0.25 oz sodium, or
potassium nitrite, per 100 pounds of chopped meat. Since these small
quantities are difficult to weigh out on most available scales, it is
strongly recommended that a commercial pre-mixed cure be used when nitrate
or nitrite is called for in any recipe.
Dr Marion Ducasse, director of emergency, disaster management and special
services in the Ministry of Health said she could not say how soon the
autopsy would be released as investigations were still going on.
[byline: Janet Silvera]
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ProMED-mail
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[Sodium nitrate has on a number of occasions been mistaken for table salt.
Clinical signs of ingestion may include gastroenteritis, abdominal pains,
dizziness, bloody diarrhea, convulsions, and collapse. Purging and diuresis
are expected. If the victim receives small, repeated doses there may be
headache and mental impairment. Generally in the case of mistaking sodium
nitrate for sodium chloride, the dose may be larger for large meals typical
of celebrations. Rare cases of nitrates being converted to the more toxic
nitrites have been reported.
Sodium nitrate has been used in curing meat for centuries. Bacterial action
converts the nitrate to nitrite, which kills the organism responsible for
botulism poisoning. Generally sodium nitrite has replaced sodium nitrate,
except in slow-cured hams.
Nitrite is added to certain foods to prevent the growth of the
spore-forming bacterium _Clostridium botulinum_, whose toxin causes
botulism, leading to paralysis and, potentially, death. The word botulinum
comes from the Latin word botulus, meaning sausage, which was responsible
for many deaths centuries ago before curing with nitrite was used. In
addition to serving as an antimicrobial, nitrite is used to produce the
characteristic flavor, texture, and pink color of cured meats.
At significant blood levels, the nitrite's oxidation of the iron in
hemoglobin from the ferrous to the ferric state yields methemoglobin, which
does not carry oxygen and imparts a brown hue to the blood. Symptoms of
methemoglobinemia include headaches, fatigue, tachycardia (fast heart
rate), weakness, and dizziness. As oxygenation of tissues decreases to the
point of becoming truly inadequate, dyspnea (shortness of breath),
acidosis, arrhythmias (irregular heart rhythms), coma, convulsions, and
even death may occur.
This article mentions a limitation imposed by some countries on
nitrites/nitrates in meat preservation. The combination of nitrites or
nitrates with meat can form nitrosamines, which has been shown to cause
cancers, especially gastric cancers and esophageal cancers. Because of the
nitrate concentration in processed meats, there has also been a link to
colon cancer.
So while these nitrous compounds can be beneficial for preserving meat, it
must be done correctly, using small amounts of the preservative. - Mod.TG
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