Liquid Mosquito Repellent Ingestion in Children

  • Mounika V. Reddy
  • Saptharishi L. Ganesan
  • Karthik Narayanan
  • Muralidharan JayashreeEmail author
  • Sunit C. Singhi
  • Karthi Nallasamy
  • Arun Bansal
  • Arun K. Baranwal
Original Article



Hydrocarbons are a common cause of accidental poisoning in children, with kerosene being the most implicated agent in rural parts of India. However, lately, liquid mosquito repellent ingestion is emerging as an important cause of hydrocarbon (kerosene) poisoning in urban households.


This is a retrospective case series over a 5-y period (January 2013 – December 2017) of children with accidental liquid mosquito repellent ingestion presenting to the pediatric emergency. Epidemiology, clinical profile, management and outcomes are discussed.


Twenty-three children with median (IQR) age of 24 (18.8–32) mo presented after mean (SD) interval of 6 (3) h from ingestion. Majority (20, 87%) were seen during summer months (March–June) and all were from urban background. Sixteen (70%) had mild-moderate acute respiratory distress syndrome (ARDS) requiring supplemental oxygen with or without positive airway pressure for a mean (SD) duration of 3.3 (1.9) d. All except one survived.


Children with accidental liquid mosquito repellent ingestion had predominant aspiration pneumonitis due to hydrocarbon content rather than neurological complications attributable to synthetic pyrethroids. Ensuring child-proof containers, appropriate storage, regulatory surveillance and parental awareness are must for prevention.


Aspiration pneumonitis Hydrocarbons Poisoning Mosquito repellent Pyrethroids 


Authors’ Contribution

SLG and KN conceived the study. MVR, SLG and KN undertook data collection and entry. MVR analyzed the data. JM supervised data collection and analysis, including quality control. MVR, SLG and KN drafted the first draft of the manuscript, and JM contributed substantially to its revision. AB, AKB, KN, SCS contributed to supervision of data collection and quality control. JM takes responsibility for the paper as a whole. The final copy of the manuscript has been approved by all the authors. JM is the guarantor for this paper.

Compliance with Ethical Standards

Conflict of Interest



  1. 1.
    Jayashree M, Singhi S. Changing trends and predictors of outcome in patients with acute poisoning admitted to the intensive care. J Trop Pediatr. 2011;57:340–6.CrossRefGoogle Scholar
  2. 2.
    Tormoehlen LM, Tekulve KJ, Nañagas KA. Hydrocarbon toxicity: a review. Clin Toxicol. 2014;52:479–89.CrossRefGoogle Scholar
  3. 3.
    Makrygianni EA, Palamidou F, Kaditis AG. Respiratory complications following hydrocarbon aspiration in children. Pediatr Pulmonol. 2016;51:560–9.CrossRefGoogle Scholar
  4. 4.
    Jayashree M, Singhi S, Gupta A. Predictors of outcome in children with hydrocarbon poisoning receiving intensive care. Indian Pediatr. 2006;43:715–9.PubMedGoogle Scholar
  5. 5.
    Pediatric Acute Lung Injury Consensus Conference Group. Pediatric acute respiratory distress syndrome: consensus recommendations from the Pediatric Acute Lung Injury Consensus Conference. Pediatr Crit Care Med. 2015;16:428–39.CrossRefGoogle Scholar
  6. 6.
    Saptharishi LG, Karthik N, Bansal A, Singhi S. Mosquito repellent liquidizer poisoning in young children in summer – what to anticipate? Pediatr Crit Care Med. 2014;15:187.CrossRefGoogle Scholar
  7. 7.
    Garg P, Garg P. Mosquito coil (allethrin) poisoining in two brothers. Indian Pediatr. 2004;41:1177–8.PubMedGoogle Scholar
  8. 8.
    Shringi K, Dulara S, Aseri R, Daria U. Uncontrolled seizures and unusual rise in leucocyte counts: transfluthrin. liquid mosquito repellent suicidal poisoning. Indian J Anaesth. 2015;59:47–9.CrossRefGoogle Scholar
  9. 9.
    Ardhanari A, Srivastava U, Kumar A, Saxena S. Management of a case of prallethrin poisoning - an unusual agent for suicidal ingestion. Sri Lankan J Anaesthesiol. 2011;19:51–2.CrossRefGoogle Scholar
  10. 10.
    Chandra A, Dixit M, Banavaliker J. Prallethrin poisoning: a diagnostic dilemma. J Anaesthesiol Clin Pharmacol. 2013;29:121–2.CrossRefGoogle Scholar
  11. 11.
    Kedari V, Kulkarni R, Valvi C, Kinikar A, Khadse S. D-transallethrin: an unusual agent for accidental poisoning. Med J Dr Patil Univ. 2016;9:244–5.CrossRefGoogle Scholar
  12. 12.
    Bhaskar EM, Moorthy S, Ganeshwala G, Abraham G. Cardiac conduction disturbance due to prallethrin (pyrethroid) poisoning. J Med Toxicol. 2010;6:27–30.CrossRefGoogle Scholar
  13. 13.
    Prasad R, Singh A, Mishra OP. An accidental ingestion of mosquito repellent liquid vapouriser. Indian J Pediatr. 2015;82:1179–80.CrossRefGoogle Scholar
  14. 14.
    Chandelia S, Dubey NK, Ganguly N, et al. Mosquito repellent vaporizer poisoning – is the culprit transfluthrin or kerosene? Indian Pediatr. 2014;51:319–26.CrossRefGoogle Scholar
  15. 15.
    Bradberry SM, Cage SA, Proudfoot AT, Vale JA. Poisoning due to pyrethroids. Toxicol Rev. 2005;24:93–106.CrossRefGoogle Scholar
  16. 16.
    Ray DE, Ray D, Forshaw PJ. Pyrethroid insecticides: poisoning syndromes, synergies, and therapy. J Toxicol Clin Toxicol. 2000;38:95–101.CrossRefGoogle Scholar

Copyright information

© Dr. K C Chaudhuri Foundation 2019

Authors and Affiliations

  1. 1.Department of PediatricsSt John’s Medical College HospitalBengaluruIndia
  2. 2.Children’s Hospital - London Health Sciences Center, Schulich School of MedicineWestern UniversityLondonCanada
  3. 3.Department of Pediatric Intensive CareRainbow Children’s HospitalChennaiIndia
  4. 4.Division of Pediatric Critical Care, Advanced Pediatrics CentrePostgraduate Institute of Medical Education and Research (PGIMER)ChandigarhIndia
  5. 5.Department of PediatricsMedanta, The MedicityGurugramIndia

Personalised recommendations