Fatal parathion poisoning caused by contamination of flour in international commerce

In January 1976, 79 persons in Jamaica were acutely poisoned by the organophosphorus insecticide parathion. Seventeen died. Cases occurred in three episodes at separate locations, but all patients had consumed wheat flour from a single lot consisting of 5264 cotton bags. Parathion in concentrations of less than 1 to 9900 ppm was identified in flour from six bags in this lot; three had splash marks. The flour had been milled in Western Europe from European wheat, carried in trucks to a dockside warehouse, and loaded aboard ship after 2-5 days' storage. In Jamaica, the flour had moved from quayside to outbreak locations along separate routes through two import houses. Site inspections and review of shipping records suggested that the likely point of contamination was the European port, where foodstuffs and insecticides were stored in the same warehouse.