When children begin vomiting for no reason, parents are bound to be distressed. Parents will become even more distressed if the condition worsens and the child begins to have fits or even lose consciousness. This concern is shared by parents worldwide and in many countries the cause is related to possible viral infections. In Jamaica, however, thanks to University of the West Indies researchers, doctors now know to not only consider viruses but to also think about possible ackee poisoning. The so-called 'vomiting sickness' caused by ackee poisoning today remains an important but uncommon illness.

The sickness was not always uncommon. Vomiting sickness was very common in Jamaica in the early 1900s and was even more common among poor people. The disease was of such great concern in Britain that in 1913 an expedition of the Liverpool School of Tropical Medicine was undertaken primarily to determine whether there was a link with yellow fever.

Although it was thought to be caused by many factors including worm infestation, poisoning and stomach inflammation, researchers at UWI in the early 1950s were able to definitely show that eating the unripe ackee was the cause of vomiting sickness.

significant reduction

The significant reduction in the occurrence of this disease and explanation for the cause is one of the major triumphs of the researchers of the University College of the West Indies, now UWI.

The story began in 1915 when the government bacteriologist, H.H. Scott, after analysing 32 cases of vomiting sickness, suggested that eating the unripe ackee was the cause. His suggestion was controversial and, therefore, his proposal was not widely accepted.

It finally took Professors Hill and Hassall, and their colleagues from the UCWI, until 1954 to make the link. They were able to show that a special compound that came out in the 'pot water' was poisonous and caused the vomiting sickness by severely dropping the blood sugar. Babies were more severely affected because they were often given the pot water to drink. The pot water should be thrown away and not be used in cooking.

The fruit continues to form a major staple in the Jamaican diet, thankfully, without incident, now that we understand when and how to use it. Children between 2-10 years are more severely affected as their brain's requirement for glucose is more absolute and also, as was stated by Scott, very often the children are given the most toxic part of the meal, the 'pot water', to drink as a soup.

story success

The success of this story rests in the virtual absence of 'vomiting sickness' in modern-day medicine in Jamaica and the confidence with which one can still enjoy a meal of ackee. This achievement is a credit to the work of doctors in the faculty of Medical Sciences at the UWI, Mona.

Dr Nadia Williams, the contributor of this article, is a senior lecturer in the Department of Pathology, UWI, Mona, and a consultant pathologist at the University Hospital of the West Indies. She is also a Matsumae International Foundation fellow and a Fellow of the American College of Gastroenterologists.