da Silva Lima JF, 1866. Contribuições para a história de uma molestia que reina atualmente na Bahia, sob a forma epidêmica e caracterizada por paralisia, edema e fraqueza geral. Gazeta Medica da Bahia 1: 110–113.
Lima HC, Porto EA, Marins JR, Alves RM, Machado RR, Braga KN, de Paiva FB, Carmo GM, Silva e Santelli AC, Sobel J, 2010. Outbreak of beriberi in the state of Maranhão, Brazil: revisiting the mycotoxin aetiologic hypothesis. Trop Doct 40: 95–97.
Tanphaichitr V, 1998. Thiamin. Shils M, Shike M, Olso J, Ross AC, eds. Modern Nutrition in Health and Disease, 9th ed. Baltimore, MD: Williams & Wilkins, 381–389.
World Health Organization, 1974. Handbook on Human Nutritional Requirements. WHO Monograph Series No. 61. Geneva, Switzerland: World Health Organization.
World Health Organization, 1976. Beriberi. Nutrition in Preventive Medicine. The Major Deficiency Syndromes, Epidemiology and Approaches to Control. WHO Monograph Series No. 62. Geneva, Switzerland: World Health Organization, 136–145.
Takahashi K, 1981. Thiamine deficiency neuropathy. Int J Neurol 15: 245–253.
Davis RE, Icke GC, 1983. Clinical chemistry of thiamin. Adv Clin Chem 23: 93–140.
Kril JJ, 1996. Nerupathology of thiamine deficiency disorders. Metab Brain Dis 11: 9–17.
World Health Organization, 1985. Energy and Protein Requirements: Report of a Joint FAO/WHO/UNU Expert Consultation. WHO Technical Report Series No. 724. Geneva, Switzerland: World Health Organization.
Mcardle WD, Katch FI, Katch VL, 2003. Fisiologia do Exercício, Energia e Desempenho Humano, 5th ed. Rio de Janeiro, Brazil: Guanabara Koogan.
Macias-Matos C, Rodriguez-Ojea A, Chi N, Jimenez S, Zulueta D, Bates CJ, 1996. Biochemical evidence of thiamine depletion during the Cuban neuropathy epidemic, 1992–1993. Am J Clin Nutr 64: 347–353.
World Health Organization, 1999. Thiamine Deficiency and Its Prevention and Control in Major Emergences. Geneva, Switzerland: World Health Organization.
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Edema, parasthesias, and paresis affected 10 residents of an Indian community in Roraima state; three died. Mining with mercury occurs locally; caxirí, a traditional alcoholic drink, is consumed daily. We conducted a 1:2 unmatched case-control study; a case was an Indian from Uiramutã county (population of 9,127) who presented ≥ 1 of lower extremity edema, paresthesias, paresis, or weakness. Controls were asymptomatic Indians randomly selected from the population. We identified 90 cases (prevalence of 1%) and 180 controls; all were enrolled. Among cases, 79% were male, and the median age was 31 years. Ethnicity was Macuxí, and 49% had income. Cases had lower extremity edema (85%), upper extremity paresthesias (84%), and lower extremity weakness and pain (78%). Risk factors were male sex (odds ratio [OR] = 6.8; P < 0.001), age 31–40 years (OR = 5.63; P < 0.001), and consumption of caxirí (OR = 2.7; P < 0.003). Mercury exposure was not a risk. Thiamine therapy produced complete rapid clinical recovery in all cases, confirming the diagnosis of beriberi. We recommend surveillance, thiamine supplementation, and nutritional intervention.
Authors' addresses: Matheus P. Cerroni, Jean C. S. Barrado, and Aglaer A. Nobrega, Field Epidemiology Training Program, Secretariat of Health Surveillance, Ministry of Health, Brasilia, Distrito Federal, Brazil, E-mails: firstname.lastname@example.org, email@example.com, and firstname.lastname@example.org. Alysson B. M. Lins, Secretaria Estadual de Saúde de Roraima, Boa Vista, RR, Brazil, E-mail: email@example.com. Iolanda P. da Silva, Conselho Indígena do Estado de Roraima, Boa Vista, Roraima, Brasil, E-mail: firstname.lastname@example.org. Robson R. Mangueira, Fundação Nacional de Saúde do Estado de Roraima, Ministério da Saúde, Boa Vista, Roraima, Brasil, E-mail: email@example.com. Rômulo H. da Cruz, Fundação Nacional de Saúde do Brasil, Ministério da Saúde, Brasília, Distrito Federal, Brasil, E-mail: Romulo.firstname.lastname@example.org. Sandra M. F. Mendes, Unidade Regional de Saúde de Imperatriz, Maranhão, Brasil, E-mail: email@example.com. Jeremy Sobel, Center for Global Health, Centers for Disease Control and Prevention, Atlanta, GA, E-mail: firstname.lastname@example.org.