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The death of a 23-year-old Chinese construction worker in southern Israel from refractory metabolic acidosis after presenting symptoms of edema and loss of sensation in his legs raised the suspicion of Beriberi disease. As thiamine deficiency was suspected, two other Chinese workers from the same construction site, who also complained of pain and swelling in their legs were tested and found to have a significant deficiency. In addition 56.5% of 46 Chinese workers at the site were found to have a thiamine deficiency without any significant clinical symptoms. A nutritional evaluation demonstrated a lack of thiamine in the workers diet due to a limited variety of food, their dietary preferences, and cooking style. There was also a lack of attention given to providing essential nutrients including thiamine by their employees. Clinicians must be aware that thiamine deficiency and beriberi disease may be common in this apparently healthy population.