Multiple Cases of Cyanide Poisoning by Apricot Kernels in Children from Gaza

Abstract

Two episodes of cyanide poisoning occurred in children after ingestion of apricot kernels. The first episode involved eight children who exhibited typical signs and symptoms of cyanide poisoning two hours after having ingested a large amount of apricot kernels. Seven children recovered. One died soon after admission. The second episode involved 16 children who had eaten a sweet prepared from such kernels. The symptoms and signs were identical with those in the first group but appeared one-half hour after the ingestion and were much more severe. Thirteen children recovered, two died shortly after admission, and a third child died two hours later. Apricot kernels contain a cyanogenetic substance called amygdalin, which after hydrolysis, liberates hydrocyanic acid. This activation usually occurs only after ingestion. In the second instance hydrolysis probably occurred during the preparation of the sweet, explaining the short interval between the ingestion and the appearance of the signs of poisoning.