• Development: 8 seconds of peace before agony arrived
• Duration: 45-60 minutes
• Location: it was unescapably everywhere
• Feeling: very very sharp heat
• Intensity: the hottest pepper in the world—I agree.

Dr. Hack is chief of the division of medical toxicology and vice chair for research at East Carolina University in Greenville, North Carolina.

References

1. Barboza GE, García CC, et al. An amazing new Capsicum (Solanaceae) species from the Andean-Amazonian piedmont. PhytoKeys. 2020;167:13-29.
2. Guzmán I, Bosland PW. Sensory properties of chile pepper heat – and its importance to food quality and cultural preference. Appetite. 2017;117:186-190.
3. Rosenbaum T, Simon SA. Chapter 5. TRPV1 receptors and signal transduction. In: Liedtke WB, Heller S, eds. TRP ion channel function in sensory transduction and cellular signaling cascades. Boca Raton (FL): CRC Press/Taylor & Francis; 2007. Available from: https://www.ncbi.nlm.nih.gov/books/NBK5260/. Accessed March 26, 2024.
4. Shuba YM. Beyond neuronal heat sensing: diversity of TRPV1 heat-capsaicin receptor-channel functions. Front Cell Neurosci. 2021;14:612480.
5. Sharma SK, Vij AS, et al. Mechanisms and clinical uses of capsaicin. Eur J Pharmacol. 2013;720(1-3):55-62.
6. Weinberg RB. Hunan hand. N Engl J Med. 1981;305(17):1020.
7. Gummin DD, Mowry JB, et al. 2022 annual report of the National Poison Data System® (NPDS) from America’s Poison Centers®: 40th annual report. Clin Toxicol (Phila). 2022;61(10): 717-939.
8. Arens A, Ben-Youssef L, et al. Esophageal rupture after ghost pepper ingestion. J Emerg Med. 2016;51(6):e141-e143.
9. Healy VO. Orland Park man credits hot sauce with saving his life. Chicago Tribune. March 13, 2015. Available at: https://www.chicagotribune.com/2015/03/13/ orland-park-man-credits-hotsauce-with-saving-his-life/. Accessed March 26, 2024.
10. Boddhula SK, Boddhula S, et al. An unusual cause of thunderclap headache after eating the hottest pepper in the world – “The Carolina Reaper”. 2018. BMJ Case Rep. 2018:bcr-2017- 224085.
11. Wikipedia contributors. One Chip Challenge. Wikipedia, The Free Encyclopedia. Available at: https://en.wikipedia.org/wiki/One_Chip_Challenge. Last updated March 22, 2024. Accessed March 26, 2024.
12. Kearney T, Hiatt P, et al. Pepper spray injury severity: ten-year case experience of a poison control system. Prehosp Emerg Care. 2014;18(3):381-6.
13. Catalfamo LM, Marrone G, et al. The utility of Capsicum annuum L. in Internal Medicine and In Dentistry: A Comprehensive Review. Int J Environ Res Public Health. 2022;19(18):11187.