outbreak of veno-occlusive disease of the liver in northern Iraq

This paper describes an outbreak of veno-occlusive disease of the liver which occurred in Mosul, northern Iraq in 1994. It was caused by the consumption of wheat accidentally contaminated with Senecio seeds which produced toxic pyrrolizidine alkaloids. The outbreak involved 14 people [eight males and six females] who were members of three Bedouin families. Half of the cases were under the age of 15 years. The striking clinical features were abdominal pain, rapidly filling ascites and hepatomegaly. Two deaths occurred during hospitalization, with an estimated case fatality rate of 14%