How can chili powder kill a child? Dr. Rubidium explains.
by Dr. Rubidium, Ph.D., DXS contributor
On the evening of Sunday, January 6th, 2-year-old Joileen G. was pronounced dead at a San Bernardino hospital. A few hours into Monday, Joileen's caregiver for that Sunday -- Amanda Sorensen -- was arrested. On Wednesday, Ms. Sorensen, who is also the girlfriend of Joileen's father, was charged with "...malice aforethought murder..." and "...assault... by means of force that to a reasonable person would be likely to produce bodily injury, resulting in the child's death." The alleged "means of force" wasn't a belt or a fist, but chili powder.
Though it will likely take weeks before the exact cause and manner of death are known from an autopsy and toxicology tests, various media outlets are reporting that Joileen died of "chili powder poisoning."
Millions to billions of people enjoy chili peppers world-wide each day, from eating handfuls of whole chili peppers to a few shakes of hot sauce on their eggs. Chili peppers and their products aren't considered a poison, but that's because most of us have far too narrow a view of poisons. The field of poisons is actually very broad, as are its definitions.
For example, for toxicologists, a poison is any substance that is harmful when administered to a living organism. But quantity (dose) and species (you versus, say, a turtle) and route (mouth? skin?) and what it's combined with count, too. Other factors influencing whether or not something will poison you include age, sex, health, and genetics.
In other words, almost anything can be a poison at the right (or wrong) concentration given the right (or wrong) circumstances1. That includes chili peppers and their products.
Chili peppers, of the plant genus Capsicum, are a diverse bunch from the not-hot-at-all (bell peppers) to the hot-as-hell (bhut jolokia, also known as the ‘ghost pepper’). Hot peppers owe their pungency and heat to a class of chemicals called capsaicinoids. The most prevalent capsaicinoid in hot peppers is capsaicin, a neurotoxin -- meaning its poisonous action involves the nervous system.
Capsaicin binds to a specific molecule on a subgroup of neurons in our sensory systems, called ‘nociceptors’. When capsaicin binds this molecule, called a receptor, the result is fired up nociceptors, which we register as pain2. High temperatures can also act like capsaicin on nociceptors, which is why we feel a burning pain when eating capsaicin laden foods. From no feeling to warm to burning pain, the sensation we feel upon exposure to capsaicin depends on concentration.
We often focus on the pain capsaicin can provoke, but this chemical can elicit a range of other physiological responses. People who eat foods with hot peppers may complain of gastrointestinal issues, which are likely the work of capsaicin. Capsaicin also irritates the skin and mucous membranes (lining the eyelids, nose, mouth, genitals), provoking an inflammatory response often marked by redness and swelling, as well as sensations of warmth and pain.
If inhaled, capsaicin stimulates bronchopulmonary nociceptive C-fibers which can provoke apnea (temporary cessation of respiration), rapid shallow breathing, mucus secretion, bronchoconstriction (constriction of the smooth muscle of the airways in the lungs), and cough. In the most extreme cases, death by asphyxia3 (lack of oxygen) has occured.
In addition to chemical irritation of the respiratory system from capsaicin, particulate chili pepper products can physically irritate this system. Chili powder, like many particulates, can irritate and overwhelm our respiratory system. Inhalation of ground chilies can cause coughing, sneezing, and a runny nose, but the problem with particulates in our nose, trachea, bronchi, and lungs goes beyond coughing, sneezing, and running nose. Inhalation of particulates can physically block airways and lead to death by asphyxia3 (lack of oxygen). Their ability to mechanically obstruct airways adds to any type of physiological effect they might have. Particulates can cause asphyxia deaths by chemically or physically effecting respiration -- or by doing both.
Asphyxia deaths from inhalation have been noted for non-food items like talcum powder and sand, as well for the spices ground black mustard seeds and black pepper. Several black pepper deaths have resulted from this spice being used as a punishment to children. In one case, a foster parent turned to black pepper as a disciplinary tool (note: 'apneic' means "unable to breathe"):
This five-year-old white male was being disciplined for lying. His foster mother stated that she meant to shake a few grains of pepper onto his tongue. She removed the cap of the pepper shaker, and as she had the container poised above his mouth, he allegedly struck her arm with his, causing a large bolus of pepper to go into his mouth. He became rapidly dyspneic, and 5 min after the incident, emergency medical personnel observed him to take a few breaths and become apneic. On laryngoscopic examination, clumps of pepper and mucus were seen. A tracheostomy was performed. The trachea was found to be obstructed with masses of admixed pepper and mucus. Upon arrival to an emergency room he was pulseless and apneic, and he was pronounced dead about 1 h after the inhalation of the pepper. [Homicidal asphyxia by pepper aspiration by S.D. Cohle]
Like black pepper, hot peppers and their products have been used as punishments.
Three children, aged 3, 5, and 7, were repeatedly disciplined over a period of months in the following manner. A split jalapeno pepper was placed in the child’s mouth and a timer set for 15-20 minutes. If the child spit the pepper out, swallowed it, or vomited before the time expired, he was given a fresh pepper and the timer was reset. Liquid dishwashing detergent or tabasco sauce was given in a similar manner. ⁞ Interviews of the children revealed that the jalapeno peppers and tabasco sauce burned their mouth, throat and stomach, and in some instances, caused burning at the anus during passage of the stool. The children cried at night from residual pain. Vomiting and diarrhea occurred as a result of some of the mistreatments. [Capsicum and capsaicin--a review: case report of the use of hot peppers in child abuse by R.L. Tominack and D.A. Spyker]
A search of the scientific literature turned up no chili powder-related deaths4, although a red pepper poisoning death was documented in Johannesburg, South Africa. Red pepper is made using only dried, ground hot peppers. Chili powder is mostly dried, ground hot peppers, but also contains other spices -- usually garlic, cumin, and oregano. Both are 'hot' thanks to capsaicin, but red pepper is 'hotter' because more capsaicin is present. Unlike the hot pepper case mentioned above, in the Johannesburg red pepper poisoning case, punishment wasn't the aim -- treatment was:
An 8 month old well-nourished black male infant was admitted to hospital with a history of 7 days of severe coughing and 3 days of diarrhea and vomiting. These symptoms followed by treatment with a traditional remedy by his grandmother. The original illness was not elucidated, but on questioning the relatives stated the herb used was red pepper in the form of a red powder for which the Afrikaans name is “Rooipoeier”.
He suffered two cardio-respiratory arrests and died on the day of admission. [A fatal case of pepper poisoning by T. Snyman, M.J. Stewart and V. Steenkamp]
What was the motive in the case of Joileen G.? Is it child abuse involving chili powder or an accident? Those answers may prove elusive. Did Joileen G. actually die as a result of chili powder poisoning? Did the chili powder induce chemical and/or mechanical asphyxia? Only an autopsy will reveal those answers.
- 1Including an individual's specific sensitivity to a chemical, which may be quite severe depending on allergies or other health conditions, their age or weight, etc.
- 2Capsaicin's ability to fire-up nociceptors can also be used in pain management. Prolonged exposure to this fiery chemical can desensitize or knock-out nociceptors so they don't get provoked by other stimuli, which means we feel less pain.
- 3A board definition asphyxia is used here.
- 4The author could find no publications upon searching a variety of scholastic databases.
- Andrews, J. The Peppers Cookbook: 200 Recipes From The Pepper Lady's Kitchen; University of North Texas Press: Denton, 2005
- Buck, S.H.; Burks, T.F. The neuropharmacology of capsaicin: review of some recent observations. Pharmacol Rev. 1986, 38, 179-226.
- Caterina, M.J.; Schumacher, M.A.; Tominaga, M.; Rosen, T.A.; Levine, J.D.; Julius, D. The capsaicin receptor: a heat-activated ion channel in the pain pathway. Nature. 1997, 23, 816-24.
- Cohle, S.D. Homicidal asphyxia by pepper aspiration. J Forensic Sci. 1986, 31, 1475-1478.
- Cohle, S.D.; Trestrail, J.D.; Graham, M.A.; Oxley, D.W., Walp, B.; Jachimczyk, J. Fatal pepper aspiration. Am J Dis Child. 1988, 142, 633-6.
- Dine M.S.; McGovern, M.E. Intentional poisoning of children--an overlooked category of child abuse: report of seven cases and review of the literature. Pediatrics. 1982, 70, 32-35.
- Fuller, R.W. Pharmacology of inhaled capsaicin in humans. Respir Med. 1991, 85, Suppl A, 31-34.
- Fuller, R.W.; Dixon, C.M.; Barnes, P.J. Bronchoconstrictor response to inhaled capsaicin in humans. J Appl Physiol. 1985, 58, 1080-1084.
- Hodgson, E. Introduction to Toxicology. In A Textbook of Modern Toxicology, Third Edition , Hodgson, E., Ed.; John Wiley & Sons, Inc.: Hoboken, 2004; p3-12.
- Miller, K. and Chang, A. Acute inhalation injury. Emerg Med Clin N Am. 2003, 21, 533–557.
- N.A. Final report on the safety assessment of capsicum annuum extract, capsicum annuum fruit extract, capsicum annuum resin, capsicum annuum fruit powder, capsicum frutescens fruit, capsicum frutescens fruit extract, capsicum frutescens resin, and capsaicin. . Int J Toxicol. 2007, 26, 3-106.
- Pesonen, M.; Vähäkangas, K.; Halme, M.; Vanninen, P.; Seulanto, H.; Hemmilä, M.; Pasanen, M.; Kuitunen, T. Capsaicinoids, chloropicrin and sulfur mustard: possibilities for exposure biomarkers. Front Pharmacol. 2010, 1, 1-12.
- Snyman, T.; Stewart M.J.; Steenkamp, V. A fatal case of pepper poisoning. Forensic Sci Int. 2001, 124, 43-46.
- Tominack, R.L.; Spyker, D.A. Capsicum and capsaicin--a review: case report of the use of hot peppers in child abuse. J Toxicol Clin Toxicol. 1987, 25, 591-601.
- Undem, B. and Kollarik, M. The Role of Vagal Afferent Nerves in Chronic Obstructive Pulmonary Disease. Proc Am Thorac Soc. 2005, 2, 355–360
- Capsaicin molecule image: Oregon State University