Mass Chlorfenapyr Poisoning: A Family Cluster Case Report

Chlorfenapyr is a broad-spectrum pyrrole-based insecticide featuring high mammalian toxicity, and no specific antidote has been developed for intoxication induced by this agent. Mass poisoning incidents are scarcely documented in existing literature, particularly familial cluster cases presenting differentiated clinical manifestations and disparate clinical outcomes. This article describes an outbreak of chlorfenapyr poisoning affecting five members from a single family, with the objective of summarizing its clinical characteristics, toxicokinetic profiles, therapeutic protocols, and corresponding nursing experiences.

Five family members developed poisoning following ingestion of contaminated sweet potato porridge. The 60‑year‑old male grandfather (Case 1) died, with a blood tralopyril concentration of 4732 ng/mL. The remaining four patients presented corresponding blood tralopyril concentrations of 2362 ng/mL, 322 ng/mL, 1.7 ng/mL, and 108 ng/mL, respectively. All four surviving patients achieved favourable clinical recovery. Their blood tralopyril levels declined to below 5 ng/mL at 10 days post-discharge, and no delayed-onset organ injuries were identified throughout the 6-month follow-up period.

Emergency nurses should maintain a high level of vigilance when encountering clustered non-specific clinical manifestations. Dynamic monitoring of neurological and cardiac conditions should be performed rigorously, alongside timely initiation of gastrointestinal decontamination and sequential blood purification therapies. Furthermore, psychological intervention and multidisciplinary collaborative management are indispensable measures to avert delayed clinical deterioration.

Chlorfenapyr poisoning manifests as non-specific early symptoms and carries a risk of delayed toxic injury. Timely toxicological testing, early gastrointestinal decontamination, sequential blood purification therapy, and standardized supportive care collectively help improve patient prognoses.