Can you die from Manioc poisoning?

Introduction

In some part of the world manioc has been eaten as a staple food during times when rice was scarce. Many accidental deaths were reported during such times (eg. World War II). It is the doctor’s duty educate the patient and relatives , on prevention, before discharging a patient who has been treated for the poisoning.

Manioc poisoning occurs due to the presence a cyanogenic glycoside(CG) , linamarin and the enzyme linase in the leaves and the roots of the plant. The cyanogenic glycoside occurs in two forms;

1. Autolysable form
2. Hydrolysable form

In the presence of the enzyme linase the autolysableform is autolysed to form hydrocyanic (HCN). When exposed the hydrolysable form is hydrolysed and release HCN.

Therefore, old yam (because of exposure) and crushed yam (because the enzyme and glycoside are brought together) are more dangerous. However, when the fruit is cut, washedand cooked at a temperature over 72 ºC with its lid open for an adequate period of tim, the enzyme is destroyed and any formed HCN will evaporate. The level of water should be well above the level of yam.
It was thought that ginger should not be eaten together with manioc as it has linase like enzyme/action. Although the concentration of this substance in ginger does not appear to be adequate to cause clinical symptoms, the combination is best avoided.

Signs and symptoms

Faintness
Nausea
Vomiting
Abdominal distention
Respiratory distress

Treatment

1. clear airway, give 100% oxygen and ventilate if necessary
2. inhalation of amyl nitrate while monitoring blood pressure
3. gastric lavage
4. treat convulsion and hypotension
5. correct fluid balance
6. correct acidosis with sodium bicarbonate