The pronunciation  and the associated spelling "haitch" is often considered to be h-adding and is considered non-standard in England. It is, however, a feature of Hiberno-English, and occurs sporadically in various other dialects. The perceived name of the letter affects the choice of indefinite article before initialisms beginning with H: for example "an H-bomb" or "a H-bomb". The pronunciation /heɪtʃ/ may be a hypercorrection formed by analogy with the names of the other letters of the alphabet, most of which include the sound they represent.The haitch pronunciation of h has spread in England, being used by approximately 24% of English people born since 1982, and polls continue to show this pronunciation becoming more common among younger native speakers. Despite this increasing number, the pronunciation without the /h/ sound is still considered to be standard in England, although the pronunciation with /h/ is also attested as a legitimate variant. In Northern Ireland, the pronunciation of the letter has been used as a shibboleth, with Catholics typically pronouncing it with the /h/ and Protestants pronouncing the letter without it.Authorities disagree about the history of the letters name. The Oxford English Dictionary says the original name of the letter was [ˈaha] in Latin; this became [ˈaka] in Vulgar Latin, passed into English via Old French [atʃ], and by Middle English was pronounced [aːtʃ]. The American Heritage Dictionary of the English Language derives it from French hache from Latin haca or hic.
Jamaican vomiting sickness, also known as toxic hypoglycemic syndrome (THS), acute ackee fruit intoxication, or ackee poisoning, is an acute illness caused by the toxins hypoglycin A and hypoglycin B, which are present in fruit of the ackee tree. While in the fully ripened arils, hypoglycin A is at levels of less than 0.1 ppm, in unripe arils it can be over 1000 ppm and can cause vomiting and even death. Some countries in the Caribbean and Western Africa experience frequent cases. Presentation
Abdominal discomfort begins two to six hours after eating unripe ackee fruit, followed by sudden onset vomiting. In severe cases, profound dehydration, seizures, coma, and death may ensue. Children and those who are malnourished are more susceptible to the disease. Pathophysiology
When ingested, hypoglycin A is metabolized to produce methylenecyclopropylacetic acid (MCPA). MCPA acts to inhibit the beta-oxidation of fatty acids in two ways. First, it interferes with the transport of long-chain fatty acids into the mitochondria. Also, it inhibits acyl-CoA dehydrogenases, so that only unsaturated fatty acids can be fully oxidized. Fatty acids accumulate in the liver in a microvesicular pattern that can be seen on biopsy. In the absence of fatty acid metabolism, the body becomes dependent on glucose and glycogen for energy. Octreotide can be used to reduce the secretion of insulin by the pancreas, thereby preventing severe hypoglycemia.Inhibition of beta-oxidation of fatty acids, however, also depletes a necessary cofactor for gluconeogenesis.