My introduction to rat tail noodle began with a tragedy.

 

In October 1988, I received a phone call from the Ministry of Health in Malaysia asking if I were available to fly to Perak to help them investigate a mysterious outbreak of vomiting, fever, diarrhea, abdominal pain, seizures, and coma, that had affected 16 children and one adult. Initial laboratory findings suggested a pediatric condition called Reye Syndrome, which I was very familiar with.  This condition affects children’s brain and liver, causing symptoms not unlike those found in Perak. The cause of Reye Syndrome was unknown but the use of aspirin was implicated.

 

Professor Chao Tzee Cheng, the eminent forensic pathologist, Dr Daniel Wang, the Director-General of Public Health in the Ministry of Environment and I, were flown from Singapore to Kuala Lumpur and transferred to a propeller airplane that landed at Ipoh airport. We had to hand carry our luggage from the plane to the small non-airconditioned terminal building. Then I was promptly whisked to the hospital intensive care unit, where I saw several of the children, all of them unconscious, and receiving intravenous feeding, and some were mechanically ventilated. I reviewed the records and the investigation findings, and I noted that there was evidence of raised white blood count, acute hepatic and renal failure.

 

In the meantime Professor Chao and Dr Daniel Wang met with the Malaysian investigation team, and found that the common factor in all these cases, was that everyone had eaten rat tail noodle. This was their favorite food. In fact they had all bought their rat tail noodle from the same stall in a village outside Ipoh. Unfortunately by the time the investigative team went to this stall, the owner had already disposed of the rat tail noodles, and had cleaned up the premises where he stored the ingredients.

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Ultimately 13 children died, and postmortem confirmed the encephalopathy of the brain, necrosis of the liver and the kidneys. No infection was isolated, and there was no trace of aspirin. However toxicology subsequently showed abnormally high levels of boric acid, a banned food additive, and aflatoxin, a poison produced by a fungus that must have contaminated the stored ingredients.

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Why did the cook add boric acid to the rat tail noodle? It was during the 9-day festival of the Nine Emperor Gods. To increase sales of his rat tail noodle, boric acid was added to make the noodles appear whiter, to sparkle a little bit, and to enhance its crunchiness.

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What is the Nine Emperor Gods Festival? According to Taoist scriptures, the nine emperor gods were the sons of Doumu who became a deity herself. Her 9 sons became the star deities of the western constellations of the Northern Dipper. The Nine Emperor Gods are believed to grant wealth and longevity on their worshippers. During the festival’s nine days, worshippers give offerings in the temple and ask the nine gods for their blessings. Sadly the gods could not protect these children.

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Rat tail noodle 老鼠粉 resemble rat tails. They are also known as silver needle noodle 銀針粉. Ingredients include rice flour, wheat starch, tapioca flour, some salt and olive oil. They are rolled between the palms of the hands into the shape of the rat tail. They have a slightly chewy texture, and can be cooked in soup, cooked dry in a claypot, or stir-fried.

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Up to today, whenever I see rat tail noodle, I remember the poor children who died eating them.

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RIP

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Kenneth Lyen

29 Nov 2016

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Reference:

Mass poisoning in Perak, Malaysia or the Tale of the Nine Emperor Gods and rat tail noodles.

Chao TC1, Maxwell SM, Lyen KR, Wang D, Chia HK.

J Forensic Sci Soc. 1991 Apr-Jun;31(2):283-8.