Dangerous Falafel: Children Hospitalized After Trip to Egypt
Within ten days, two children who returned from Egypt developed acute anemia due to rapid red blood cell breakdown. Their families, aware of G6PD deficiency (favism), were unaware that Egyptian falafel, or 'ta'amiya,' is made entirely from fava beans, leading to an unintended medical emergency.
For most Israelis, falafel is a staple of local cuisine, but crossing the southern border brings changes not only to the landscape and language but also to recipes. In the case of falafel, this culinary shift can pose a significant health risk.
Within ten days, two children returning from vacations in Egypt were treated by Dr. Reizi Gruda-Zusman, a senior physician in the pediatric hemato-oncology department at Rambam Hospital, after developing acute anemia caused by the rapid breakdown of red blood cells.
In both instances, the children—who have no connection to one another—suffered from this condition after eating Egyptian falafel, known as 'ta'amiya,' a dish traditionally based on fava beans. The children's families, who were aware of a history of G6PD deficiency (sometimes called 'fava bean sensitivity'), were unaware of the dish's primary ingredient and inadvertently placed the children in danger.
'About a week and a half ago, a 12-year-old child who returned from Egypt arrived at Rambam,' says Dr. Gruda-Zusman. 'He suffered from jaundice, dark urine, and a significant drop in hemoglobin. The family knew about the G6PD deficiency in their family history, but the child's own sensitivity was unknown. They insisted they hadn't eaten fava beans, but the clinical picture was very clear.'
Dr. Gruda-Zusman described the situation: 'He arrived with acute red blood cell breakdown and very low hemoglobin. We checked all other possibilities, and then I asked him what he ate. The family insisted they hadn't been exposed to fava beans, but mentioned eating falafel. A quick check confirmed that Egyptian falafel is made entirely of fava beans, with no chickpeas at all. The family simply didn't know.'
Just days later, Dr. Gruda-Zusman treated an 8-year-old child who had also returned from Egypt suffering from acute hemolysis after eating the Egyptian version of the dish.
'In the second case, the family knew the child was sensitive to fava beans and was very careful,' says Dr. Gruda-Zusman. 'But they didn't know that the 'ta'amiya' they ate in Egypt was made of fava beans. They thought they were avoiding the trigger, but in practice, they were consuming it without knowing.'
The first child required several days of hospitalization for monitoring. The second child required a blood transfusion. His two-year-old brother, who had only a small portion, also arrived with lower-than-normal hemoglobin levels but did not require hospitalization due to the small amount consumed.
Why are fava beans dangerous?
The G6PD enzyme protects red blood cells from oxidative damage. In individuals with a deficiency, exposure to certain triggers, including fava beans, can cause hemolysis—a rapid breakdown of red blood cells. This results in acute anemia, jaundice, and dark urine.
The reaction can be particularly severe in young children, requiring hospitalization, supervision, and sometimes blood transfusions. While most cases resolve with appropriate treatment, serious complications can occur.
'It is very surprising to treat two such cases in such a short period,' notes Dr. Gruda-Zusman. 'It is vital to know the ingredients of our food, especially when a known sensitivity puts us at risk. This applies to trips to Egypt and to our daily lives in Israel.'
