Several episodes of mass
poisoning by
organophosphates (OPs) have been reported from the developing countries. The diagnosis of OP-
poisoning is mainly based on the characteristic clinical features and history of exposure to a known OP compound. Estimation of serum and red blood cell (RBC)
cholinesterase activities are helpful in confirming the diagnosis. However, there is controversy regarding a definite relationship between serum
cholinesterase activity and the severity of clinical manifestations and prognosis. This report describes an episode of mass
monocrotophos poisoning that occurred due to accidental ingestion of
monocrotophos-contaminated millet (so-called bavta) flour involving eight severely poisoned persons. Clinical presentation included severe
abdominal pain, diarrhoea,
vomiting, pupil narrowing, and difficulty breathing. On hospital admission, plasma
cholinesterase (PChE) and especially RBC
acetylcholinesterase (AChE) activities correlated well with clinical symptoms presented by the patients. This case study highlights the need for clinicians to be aware of OP-
pesticide poisoning from food sources and the need to look for depressed PChE and AChE activities that may point to OP exposure, so that OP-
poisoning can be identified immediately and patients can receive specific treatment, rather than general treatment for
food poisoning.