The problem of Rat Poison Ingestion
GS PAPER 3
SCIENCE AND TECHNOLOGY
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- In 2019, a survey conducted by TN-ISG found 450 cases of liver toxicity due to rat poison ingestion in six districts of Tamil Nadu.
- Extrapolating this data for the entire state, an estimated 1,584 cases with 554 deaths occurred in six months.
- Rat poison containing yellow phosphorus was identified as the cause of liver toxicity.
Plasma Exchange Treatment Initiative:
- Beginning December 2017, CMC Vellore initiated plasma exchange treatment for acute liver failure caused by rat poison ingestion.
- The success of this treatment led the Tamil Nadu government to implement plasma exchange in six apex government hospitals in March 2022, expanding to 17 government hospitals across 15 districts.
- Plasma exchange has shown promising results in treating rodenticide-induced acute liver injury and acute liver failure cases.
Effectiveness of Plasma Exchange:
- Retrospective studies at CMC Vellore showed a survival rate of 75% in extremely sick children and 80.2% in adults undergoing plasma exchange.
- Plasma exchange dampens overactive immune responses, potentially saving lives by mitigating acute liver failure.
Comparison with Liver Transplantation:
- Lack of access to urgent liver transplantation affects over 99% of hepatotoxicity patients in Tamil Nadu due to rat poison ingestion.
- Plasma exchange is a more accessible and cost-effective alternative to liver transplantation, costing significantly less and avoiding the need for lifelong immunosuppressant medications.
Future Directions:
- Plasma exchange treatment is being initiated earlier, even in patients with acute liver injury, resulting in increased survival rates.
- Worldwide, plasma exchange has shown advantages over regular dialysis in removing macro molecules, potentially improving outcomes in acute liver failure cases.
Government Initiative and Stakeholder Involvement:
- Sensitization efforts, including field visits and stakeholder interactions, led to the establishment of a government program for the care of patients with rat poison ingestion.