I would urge us to put this at the top of our research agenda. On the other hand the clinical skills that many have in making the diagnoses are woefully inadequate. Recently the NGO community in West Africa learnt of an outbreak of Beri-Beri in an area with severe nutritional deprivation. I accompanied an ACF team, working in the area, to examine these patients. The only clinical feature that these patients had that resembled beri-beri was the oedema.
Clinical acumen is the most important.
Beri-beri occurs where there is a high carbohydrate or alcohol intake and a low thiamine intake. This classically occurs with polished rice, particularly where the rice is contaminated with moulds, and in alcoholism. Types of beri-beri. Beri-beri causes cardiovascular and neurological signs and symptoms. There are eight clinically recognisable syndromes - five in adults and three in children.