Mon fils aime beaucoup manger des litchis quand on en trouve dans les magasins, mais j'ai entendu quelque part que ça pouvait être dangereux pour les enfants. Est-ce vrai que les litchis peuvent faire tomber malade très gravement, et surtout est-ce que je devrais faire attention à ce qu'il en mange ?
Poisoning

In 1962, it was found that lychee seeds contained methylenecyclopropylglycine (MCPG), a homologue of hypoglycin A, which caused hypoglycemia in human and animal studies. Since the end of the 1990s, unexplained outbreaks of encephalopathy occurred, appearing to affect only children in India (where it is called chamki bukhar), and northern Vietnam (where it was called Ac Mong encephalitis after the Vietnamese word for nightmare) during the lychee harvest season from May to June.

A 2013 investigation by the U.S. Centers for Disease Control and Prevention (CDC), in India, showed that cases were linked to the consumption of lychee fruit, causing a noninflammatory encephalopathy that mimicked symptoms of Jamaican vomiting sickness. Because low blood sugar (hypoglycemia) of less than 70 mg/dL in the undernourished children on admission was common, and associated with a poorer outcome (44% of all cases were fatal) the CDC identified the illness as a hypoglycemic encephalopathy.

The investigation linked the illness to hypoglycin A and MCPG toxicity, and to malnourished children eating lychees (particularly unripe ones) on an empty stomach.

The CDC report recommended that parents ensure their children limit lychee consumption and have an evening meal, elevating blood glucose levels that may be sufficient to deter illness.

Earlier studies had incorrectly concluded that transmission may occur from direct contact with lychees contaminated by bat saliva, urine, or guano or with other vectors, such as insects found in lychee trees or sand flies, as in the case of Chandipura virus. A 2017 study found that pesticides used in the plantations could be responsible for the encephalitis and deaths of young children in Bangladesh.
Toxicologie

Toutes les parties de la plante sont potentiellement toxiques, y compris les baies rouges qui peuvent attirer les enfants. En cas d'ingestion, la plante peut provoquer des douleurs abdominales, des nausées, des vomissements et des battements cardiaques irréguliers.
### Query ###
Mon fils aime beaucoup manger des litchis quand on en trouve dans les magasins, mais j'ai entendu quelque part que ça pouvait être dangereux pour les enfants. Est-ce vrai que les litchis peuvent faire tomber malade très gravement, et surtout est-ce que je devrais faire attention à ce qu'il en mange ?

### Main Text ###
Poisoning

In 1962, it was found that lychee seeds contained methylenecyclopropylglycine (MCPG), a homologue of hypoglycin A, which caused hypoglycemia in human and animal studies. Since the end of the 1990s, unexplained outbreaks of encephalopathy occurred, appearing to affect only children in India (where it is called chamki bukhar), and northern Vietnam (where it was called Ac Mong encephalitis after the Vietnamese word for nightmare) during the lychee harvest season from May to June.

A 2013 investigation by the U.S. Centers for Disease Control and Prevention (CDC), in India, showed that cases were linked to the consumption of lychee fruit, causing a noninflammatory encephalopathy that mimicked symptoms of Jamaican vomiting sickness. Because low blood sugar (hypoglycemia) of less than 70 mg/dL in the undernourished children on admission was common, and associated with a poorer outcome (44% of all cases were fatal) the CDC identified the illness as a hypoglycemic encephalopathy.

The investigation linked the illness to hypoglycin A and MCPG toxicity, and to malnourished children eating lychees (particularly unripe ones) on an empty stomach.

The CDC report recommended that parents ensure their children limit lychee consumption and have an evening meal, elevating blood glucose levels that may be sufficient to deter illness.

Earlier studies had incorrectly concluded that transmission may occur from direct contact with lychees contaminated by bat saliva, urine, or guano or with other vectors, such as insects found in lychee trees or sand flies, as in the case of Chandipura virus. A 2017 study found that pesticides used in the plantations could be responsible for the encephalitis and deaths of young children in Bangladesh.

### Supplementary Text ###
Toxicologie

Toutes les parties de la plante sont potentiellement toxiques, y compris les baies rouges qui peuvent attirer les enfants. En cas d'ingestion, la plante peut provoquer des douleurs abdominales, des nausées, des vomissements et des battements cardiaques irréguliers.

### Draft ###

### 1. Query Parsing

"Mon fils aime beaucoup manger des litchis..." → Child loves lychees, heard they're dangerous for kids.

Key claims to verify:
- Litchis can cause very serious illness in children ●
- Specific toxicity mechanism ?
- Geographic context (France ≠ endemic regions) ◐

### 2. Information Retrieval Challenge

⚠ Potential information gap: User in France, asking about global health risks.

Need to contextualize:
- Geographic distribution of documented cases
- Mechanism of toxicity  
- Risk factors in different populations

### 3. Medical Knowledge Triangulation

Lychee toxicity → primarily documented in:
- India: "chamki bukhar" outbreaks ●
- Vietnam: "Ac Mong encephalitis" ●  
- Timing: May-June harvest season ●

Mechanism: ●
- MCPG (methylenecyclopropylglycine) in seeds
- Hypoglycin A compounds → hypoglycemia
- Affects malnourished children specifically

### 4. Risk Assessment Framework

Child eating lychees in France → risk stratification:

**Baseline risk**: ◐ (low exposure, limited consumption, good nutrition)

**High-risk scenarios**: ●
- Malnourished children
- Empty stomach consumption  
- Large quantities
- Unripe fruit

**Key insight**: ! Geographic/nutritional context matters enormously

### 5. Evidence Synthesis

CDC 2013 investigation → ● confirmed link between lychee consumption + encephalopathy

Symptoms: ●
- Hypoglycemia (<70mg/dL)
- Confusion, lethargy  
- Seizures
- Coma potential

Mortality: ● ~44% in documented outbreaks

### 6. Practical Recommendations

For French context (typical child, adequate nutrition):
- **Risk level**: Low-moderate ◐
- **Safe practices**: 
  - Ensure meals before lychee consumption
  - Monitor portion sizes
  - Balance with other nutrients

**Critical difference**: Outbreak conditions ≠ typical home consumption

### 7. Response Construction

Structure:
1. Validate concern (serious documented risks) ●
2. Contextualize geographic/population factors ●  
3. Explain mechanism (MCPG toxicity) ●
4. Reassure (low individual risk in France) ◐
5. Practical guidelines ●

**Key message**: Risks real but geographically/nutritionally specific. France = low risk, proper moderation = safe.

∴ Context-dependent medical advice requiring risk-benefit analysis rather than blanket prohibition.

### Answer###
Votre préoccupation concernant les litchis et les enfants est justifiée. Effectivement, les litchis peuvent causer des problèmes de santé graves chez les enfants.

Depuis la fin des années 1990, des épidémies d'encéphalopathie inexpliquées ont affecté principalement les enfants en Inde (où cette maladie est appelée "chamki bukhar") et au Vietnam septentrional (appelée encéphalite Ac Mong) pendant la saison de récolte des litchis de mai à juin. Ces cas sont liés à la consommation de fruits de litchi, provoquant une encéphalopathie non inflammatoire qui imite les symptômes du "mal de vomissements jamaïcain".

L'investigation a identifié que la toxicité des composés comme la méthylène-cyclopropylglycine (MCPG) et l'hypoglycine A était responsable de ces effets. Ces substances peuvent provoquer une hypoglycémie dangereuse, particulièrement chez les enfants malnutris qui consomment des litchis, notamment les fruits non mûrs, à jeun. L'hypoglycémie à des niveaux inférieurs à 70 mg/dL est un facteur de risque majeur, avec une mortalité de 44% dans les cas documentés.

Pour votre fils, il est recommandé de limiter sa consommation de litchis et de lui faire manger un repas le soir pour maintenir les niveaux de glucose sanguin suffisamment élevés afin de prévenir la maladie.