People that do postmortem work see and hear a lot of weird stuff. The myriad ways people try to harm themselves or others is truly impressive at times. We also get a lot of “someone done them in” calls when a loved one dies, presumably because they watched CSI the night before – we call it the “CSI effect.” But truth be told, homicidal poisonings are fairly rare. As I talked about in the post “Homicidal Poisonings: Not Common, but Watch Out for the Chocolate Cremes“, poisoners have to put a bit of work into it, to research and procure the poison, then find ways to administer it undetected. It’s not for the lazy, rather the cowardly. So imagine my surprise when I saw this headline in January 2015:
The fact is though, I wanted to believe this. I love conspiracy theories. Remember the post about JFK being killed by a poisoned arrow? Myths are so much more interesting than reality, which is why so many gain traction, but at the end of the day reason takes over.
Back to the headline. In early January 2015, after a funeral for a small child in Mozambique, mourners gathered and drank pombe, an alcoholic beverage (beer) made from malted grains, that had been prepared by the deceased child’s mother. The following day, hundreds had clinical signs of poisoning, with the final death toll reaching 75. A mass poisoning is certainly suspicious, but the interesting part is the initial culprit: an intentional poisoning by crocodile bile.
Bile is vile stuff. It is continuously produced in the liver, then stored in the gall bladder, for aid in digestion of fats in the small intestine. This is why people who have their gallbladder newly removed stay away from fatty foods, or else risk diarrhea and other liquidy excretions. Bile is mostly water, but also contains bile acids, and the bile pigment bilirubin – the focus of my PhD research – and ranges in color from green to brown, and generally smells repulsive. Of all the postmortem specimens I’ve worked with (i.e. all of them) it ranks up there as one of my least favorites. It concentrates down to an oily sludge and is hard to work with. On the plus side it is forensically useful, as many opiates and opioids are detectable in it.
It’s nasty stuff, certainly, but poisonous? I wouldn’t drink it. Lethal? Hardly. The roots of crocodile bile as a poison, in central and east African countries like Mozambique, is grounded in witchcraft. The majority of the population in countries such as Mozambique and Zimbabwe believe in witchcraft, uroyi or ubutakati, as a sinister preternatural force. This belief is instilled at the earliest ages, being told of witches using recognizable objects to carry out their malevolent mischief, such as crocodile bile. It is told that bile from a crocodile’s gallbladder is so poisonous, that a tiny amount applied to a fingernail then dipped into a beverage, will cause the victim to experience severe abdominal pain and death within 24 hours. (1, 2)
Common sense, and a bit of knowledge, tells us this can’t be possible, nonetheless toxicity studies have been carried out. Crocodile bile administered to both mice and baboons results in live animals with no ill effects (2). So now we’re left with “what killed 75 people?” They obviously didn’t drop dead for no reason. Thankfully, we have more modern analytical tools at our disposal in the 21st century than the 19th and 20th, and the culprit has been identified as something familiar to faithful readers: Bongkrekic acid.
I first wrote about bongkrekic acid in regards to “Toxic Tempeh” – which you should totally read, hint, hint. Bongrekic acid is produced by Burkholderia cocovenenans, an aerobic gram-negative bacteria that is associated with food-borne poisonings and multiple deaths annually. Toxicity arises due to its inhibition of ADP/ATP translocase, a transporter protein that shuttles ATP out of the mitochondria and into the cytoplasm. ATP is our body’s energy currency, and bongkrekic acid is literally robbing it of fuel.
From a clinical viewpoint, toxicity manifests within a few hours of ingestion and presents with abdominal pain, general discomfort, sweating, fatigue, and eventual coma. Death can occur within 24 hours. There is an initial phase of hyperglycemia, and a complete elimination of glycogen in the liver, followed by a fatal hypoglycemia. To break it down, glycogen stores in muscle and the liver is our secondary long-term energy storage unit, with fat being the primary. When needed, glycogen is broken down into glucose, which we use for fuel in all parts of our body. When our glycogen stores in the liver are broken down to glucose, creating an excess in the blood (hyperglycemia), it is usually consumed very quickly. When we need more glucose, the liver is called upon but is sold out, resulting in sweating, shaking, a few seizures, then death from hypoglycemia.
It’s not pretty way to die, but in this case it sure didn’t involve crocodile bile, a maniacal poisoner, or witchcraft, but the pombe (beer) was. In analyses performed by the US Food and Drug Administration on samples of the pombe, fatal concentrations of bongkrekic acid was confirmed. Analysis of the corn flour used to prepare the pombe found the bacteria Burkholderia cocovenenans, suggesting the mechanism by which the bongkrekic acid made its way into the pombe. The intriguing thing about this mass poisoning in Mozambique is that prior, intoxications were isolated to south-east Asia. The arrival in Africa is new, and likely the result of increased trade world-wide, allowing microorganisms to be jet setters. (3)
- [FREE] Nyazema, N.Z. “Crocodile Bile, A Poison: Myth or Reality?” Central African Journal of Medicine 30.6 (1984): 102-103.
- [FREE] Nyazema, N.Z. “Crocodile (Crocodylus Niloticus) Bile Acids and Arrow Poisons” Central African Journal of Medicine 31.6 (1985): 114-116.
- Falconer, Travis M., Sara E. Kern, Jennifer L. Brzezinski, James A. Turner, Brian L. Boyd, and Jonathan J. Litzau. “Identification of the Potent Toxin Bongkrekic Acid in a Traditional African Beverage Linked to a Fatal Outbreak.” Forensic Science International 270 (2017): e5-e11.