Manchineel poisoning, a personal anecdote and experience - a Caribbean fruit toxic in small amounts. I recovered and survived.
Feb 22 2015

In July of 2013 I took a week long sailing trip on the Mandalay, a three-masted ship built in the 1920s and now part of Windjammer Sailing Adventures. On day 5 of the trip we came to the island of Carriacou, located in the Grenadine islands north of the island of Grenada and I took a 5 minute long tender ride from the ship to town. While many of the passengers on the ship took a tour of the island in a van, myself and two other friends took a walk on the beach about 10 am. Half an hour into the walk I saw a few small apple-like green fruits on the sand right below a tree. I reached up to one of the fruits still on the branches and tasted a couple of small bites. It did not seem too inviting to eat and something told me not to continue with the rest of the fruit. I'm estimating that I ingested about 10 to 20 percent of the plum sized fruit. A few minutes later I noticed burning in my mouth and started to realize that I had potentially eaten something toxic. I continued on my walk while my other two friends went ahead of me. A temporary storm rolled in with an impressive rainfall and I took advantage of it to open my mouth and let the raindrops cool my mouth. Half an hour later the burning in my mouth was getting worse and I started getting worried. I walked back into town and bought two mangos and ate them right away. It did not help. A block later I came across a juice bar and decided to increase my fluid intake by drinking guava juice, passion fruit juice and soursop juice. I told the owners of the juice bar that I had taken a bite of the Manchineel fruit. They immediately became very concerned and suggested I go see a doctor or go to the local hospital. Sitting at the table next to me at the juice bar was a man who said he was a doctor and suggested I take an antihistamine. He happened to have some with him and I took two tablets of loratadine (I don't think histamine release is a cause of the toxicity so I am not sure whether taking an antihistamine was of help or not). At about noon, an hour and a half after my initial ingestion of the Manchineel, I was supposed to go back to the tender that would take me back to the ship. It was a difficult decision: should I stay on the island and go to the hospital (the owners of the bar warned me about potential spasms in the trachea and other serious problems) or go on the ship with the risk that if anything happened it would take much more time to get back to the island and medical help. I decided not to panic and took the tender back to the ship. Immediately I told the captain and the purser about my foolishness and asked them not to tell the other crew members or passengers. I felt really stupid and embarrassed.
   At about 1 pm my mouth was still burning but it did not seem that it was getting worse. I was naked in my cabin lying on the bed trying to stay calm and not to panic. Then I felt the need to visit the bathroom. I soon as I made it there I had severe diarrhea. My first thought was that it was from all the fruit juices I had drunk. A few minutes later I had the runs again. So I decided to go on my iphone and searched for manchineel toxicity and poisoning. I found some sites that did mention that the toxins in the fruit can destroy tissue in the gastrointestinal system. The diarrhea continued every 10 to 20 minutes or so. I kept reading on line about treatment and it seemed supportive care was all that was required. The purser came down to check up on me in cabin every hour or so to make sure I was not getting worse. The only think I could do was maintain my fluid intake, lay down on my bed, and try not to panic. By about 4:30 pm, 5 hours after ingestion, I started feeling better and took a walk on deck. I gradually improved, the burning in my mouth decreased, and my diarrhea became less frequent. By 7 pm I was feeling better enough to eat dinner. During dinner I added pepper to the fish and noticed that it irritated the top of my palate. With my tongue I could feel some destruction of tissue in my mouth and the pepper had made it worse. I realized that perhaps the rest of my gastrointestinal system was also damaged causing the runs. I thought about drinking milk, and sipping some milk did help with my palate.
   The loose stools became less frequent but did last almost two days. But I had complete recovery.
   Who would have thought that an innocuous looking green apple-like fruit from a tree on a common beach would be so toxic in such small amounts? I can't imagine what I would have experienced if I had consumed the whole manchineel fruit or several of them. I could have been miserable for days!!
   The sailing week was wonderful, I did a lot of swimming, wading, snorkeling, dancing, meeting new people, taking pictures, eating fresh fish, drinking fresh fruit juices, and seeing beautiful isolated coves and authentic Caribbean towns. In addition to the manchineel toxic reaction, one could say I had the full Caribbean experience!!

Manchineel symptoms I had, worse toxicity i have ever experienced
Burning in the mouth followed by some tissue destruction in my palate a few hours later. Resolved within a day.
Toxin induced gastroenteritis that lasted almost two days. It started two hours after ingestion and the worst part was over by 10 hours.

Manchineel treatment that I did
Not much. I tried to stay calm and not to panic. I lay down on my cabin bed and sipped on fluids. I am not sure if all the fruit juices I drank helped or not. Did they carry the toxins to the GI tract and caused or made the diarrhea worse? I am not sure.

I still taste different plants and fruits when I am walking around, but now in only the tiniest portions.

About the tree
Manchineel tree can found in parts of northern South America, the Caribbean, the Bahamas, the Gulf of Mexico, and even in the U.S. state of Florida. When the Spanish first found the tree during their conquest of the Americas, they named it “arbol de la muerte,” which means "tree of death."