Chelonitoxism in breast-fed child: cases in Mahajanga, Madagascar

Chelonitoxism is a form of food poisoning due to the consumption of sea turtle flesh or viscera, which contain marine toxins called chelonitoxins. Because the passage of these toxins into breast milk is thought to be fatal to breastfed babies, we sought to confirm the possibility of this transmission of toxins through breastfeeding and to determine the symptoms of mothers and the severity of poisoning in babies. A recent case of collective consumption of sea turtle meat from the species Eretmochelys imbricata in western Madagascar affected 76 victims. We conducted a retrospective descriptive study of the lactating women and their babies (7 of each) in that group. The maximum latency period was 24 hours for all breastfed babies. The initial clinical signs of mothers and babies differed. Signs of severity were present in the four breastfed babies who died. No maternal deaths were reported. Breast milk seems to be as toxic as turtle meat, especially when a large amount of milk is consumed; prognosis was good for the babies whose mothers did not breast-feed them after they ate sea turtle. During cases of poisoning by marine animals or episodes of chelonitoxism, breastfeeding must be suspended immediately.