Case reports of aconite poisoning in mainland China from 2004 to 2015: A retrospective analysis

• Twenty-seven case reports of fatal aconite poisoning in China are reviewed.
• These reports represent 40 cases of poisoning that led to 53 deaths from 2004 to 2015.
• Case details are summarized to highlight the route and features of the poisonings.
• Close attention to biologic sample collection in aconite-poisoning cases is urged.
• Increasing public awareness of Aconitum alkaloid toxicity is strongly recommended.

Aconitum species have long been used in key traditional medicines in China, but cases of fatal aconite poisoning have also been reported. This paper presents a review of 40 single and multi-person cases of fatal aconite poisoning. The cases involved 53 victims in mainland China described in 27 case reports published between January 2004 and September 2015. We summarize the details of the case reports in order to highlight the features of fatal aconite-poisoning cases in China, including victims' sex and age, route of intoxication, clinical symptoms, medicolegal autopsy findings, and results of toxicological analysis. Our results indicate a need for legal medical experts encountering cases of fatal aconite poisoning to pay increased attention to the methods used for collecting biological samples. In addition, prevention strategies should focus on increasing public awareness regarding the potential toxicity of Aconitum, harm caused by medicinal liquors containing aconitine, and possibility of Aconitum alkaloids accumulating in the body.