Insufficient processing of cassava induced acute intoxications and the paralytic disease Konzo in a rural area of Mozambique

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Abstract
A small outbreak of paralysis was studied in a rural area of Mozambique. The seven subjects examined had an isolated spastic paraparesis with abrupt onset during a food shortage period following a drought. The diet at onset consisted almost exclusively of leaves and insufficiently processed roots from a recently introduced high‐yielding bitter cassava cultivar. Symptoms of acute intoxications some hours after meals were frequent. A high dietary cyanide exposure from cassava in the affected subjects was indicated by high urinary and serum levels of thiocyanate, the main metabolite. We conclude that the paraparesis observed was konzo, a disease recently reported from four widely separated rural areas of Africa. Our dietary findings are consistent with those in the other affected areas and indicate a causal role of cyanide exposure. Adherence to efficient processing is crucial to avoid toxic effects from cassava.