Citation: Solanki J, Patel R, Jagani DC, Raval D, Yasobant S and Saxena D. Tricresyl Phosphate (TCP) Induced Polyneuropathy: Case Series from Dehgam, Gujarat, India. Austin J Public Health Epidemiol. 2017; 4(1): 1057. Austin J Public Health Epidemiol - Volume 4 Issue 1 - 2017 ISSN : 2381-9014 | www.austinpublishinggroup.com Solanki et al. © All rights are reserved Austin Journal of Public Health and Epidemiology Open Access Abstract Background: Prevalence of polyneuropathy in the general population has been estimated to be 2.1% globally, with gigantic morbidities. One of the rare predictor is an organo-phosphate compound called Tricresyl Phosphate (TCP). In India, TCP exposure happens through traditional food preservation practices (i.e. Castro Oil with Wheat). Thus, this study aims to document the incidence of polyneuropathy and it’s underneath factors in one of the block of Gujarat, India. Methodology: After reporting of irst case (July 2015) of Polyneuropathy, a snow ball sampling was adapted to identify the other possible affected families within 20 km of geographical radius in Dehgam. Followed which, active surveillance was conducted to identify all potential cases through house-to- house investigation. Identiied cases were investigated clinically and history of consumption was collected, followed by investigation of food samples. Results: Until May 2016, about 50 cases were identiied from 13 families of Dehgam block. Most of them complained about peripheral muscular pain along with immobility since last 2 months. The differential diagnosis report indicated no such identiiable predictors; hence food investigation was conducted. It has been found that most of them have TCP in their food, presented in the form of Castor Oil. The epidemiological distribution indicates that there were 27 males & 23 females with mean age of 34.5±18.8, 34.8±19.5 years respectively. Conclusion: This is unique kind of surveillance study where an inherent predictor of Polyneuropathy has been identiied through community survey. In addition to this, TCP in food, a rare compound identiied in this study need further investigations. There is an urgent need to develop a monitoring strategy along with appropriate IEC for reducing further burden. Keywords: Polyneuropathy; Tricresyl phosphate; Surveillance; India which crippled as many as 50,000 in the U.S.A. in the 1930s [5]. Since then several other epidemics have occurred elsewhere, the outbreaks in Morocco [6], Durban [7] including in India Bombay [8] & Calcutta [9], being some of the better known. In most instances poisoning occurred ater consumption of edible oils accidentally contaminated or adulterated with mineral oils containing TCP. Because TCP is a widely used industrial chemical and is found in organic solvents and lubricating oils, it has always been a likely contaminant of food. herefore, this case series aims to document the incidence of TCP induced polyneuropathy and it’s underneath factors in one of the block of Gujarat, India. Methods his case series [10] represents an observational study that reports on data from group of diagnosed polyneuropathy subject group without a comparison population. Ater reporting of irst case (July 2015) of Polyneuropathy in one block (Dehgam) of Gujarat, a snow ball sampling was adapted to identify the other possible afected families within 20 km of geographical radius in Dehgam. Followed which, active surveillance was conducted to identify all potential cases through house-to-house investigation. Identiied cases were investigated clinically and history of food consumption was collected, Introduction Polyneuropathy is a peripheral neuropathy characterized by symmetrical sensory symptoms, such as numbness, paresthesia and pain, and muscle weakness, which are predominantly located in the distal parts of arms and legs. Polyneuropathy is a disabling disease and has a negative impact on a person’s quality of life [1]. Although it is assumed that polyneuropathy afects a considerable proportion of the population, the exact prevalence and incidence of the disease are not well known [2]. Crude point prevalence of polyneuropathy in studies using this, or a similar protocol, ranged from 0.8 to 32.5 per 1000 (0.1–3.3 %) persons across all ages [2,3]. Several diseases and factors have been associated with polyneuropathy. Since polyneuropathy probably is a multifactorial disease, it is not entirely appropriate to attribute the development of polyneuropathy to only one factor. hese factors should be considered as component causes, and not as one suicient cause. Except diabetes and alcohol abuse; other known important causes of polyneuropathy include toxic agents, such as chemotherapeutic drugs, nutritional deiciencies, immune-mediated causes and hereditary factors [4]. Neurotoxic efects of Tri-Cresyl Phosphates (TCP) have been well recognized since the dramatic outbreak of “Ginger Jake Paralysis” Rapid Communication Tricresyl Phosphate (TCP) Induced Polyneuropathy: Case Series from Dehgam, Gujarat, India Solanki J 1 *, Patel R 1 , Jagani DC 1 , Raval D 1 , Yasobant S 2 and Saxena D 2 1 Department of Health & Family Welfare, Government of Gujarat, India 2 Department of Epidemiology, Indian Institute of Public Health Gandhinagar, India *Corresponding author: Solanki J, Department of Health & Family Welfare, Government of Gujarat, India Received: January 02, 2017; Accepted: March 17, 2017; Published: March 27, 2017