West Nile Virus

The numbers are not large, but deaths are being reported from West Nile Virus, with northern Los Angeles County reporting relatively more.  The CDC web page on West Nile includes mosquito reduction methods and links to EPA reviews of insecticides; find it at https://www.cdc.gov/westnile/ .  In most cases your state and county health departments also have their own pages on West Nile, with local instructions for reporting dead birds, which are markers for surveillance of the disease.

Warning: Kayexalate, Sodium Polystyrene Sulfonate

The FDA has published a safety communication on potassium-lowering drug Kayexalate and other brands of sodium polystyrene sulfonate because it has been found to bind to other oral medications, reducing their effectiveness.  The FDA recommends separating the dosing of sodium polystyrene sulfonate from other orally administered medicines by at least 3 hours.  They are updating sodium polystyrene sulfonate drug labels to include information about this dosing separation.  For details see https://www.fda.gov/Safety/MedWatch/SafetyInformation/SafetyAlertsforHumanMedicalProducts/ucm574763.htm .

CDC HAN on Seoul Virus

CDC has issued an HAN Health Alert on Seoul Virus, a hantavirus, which can be contracted from pet rates and can result in potentially fatal Hemorrhagic Fever with Renal Syndrome (HFRS).  The primary source of the Virus in the US is in the Midwest, but infected rats have been found in much of the US.

Seoul virus is transmitted from rats to people.  People who become infected with this virus often exhibit relatively mild or no symptoms, but some develop HFRS (https://www.cdc.gov/hantavirus/hfrs), which can result in death in approximately 1–2% of HFRS cases.  Symptoms include fever, severe headache, back and abdominal pain, chills, blurred vision, redness of the eyes, or rash.  HFRS is characterized by a prodromal phase with non-specific symptoms and can progress to hypotension, decreased urine output, and renal failure, which often resolves after a diuretic phase.  Coagulopathy and pulmonary edema are rare complications.  Laboratory findings include low platelets, elevated white blood cell counts, electrolyte abnormalities, elevated blood urea nitrogen (BUN) and creatinine, and proteinuria.  Find the HAN notice at https://emergency.cdc.gov/han/han00400.asp .

Warning: dm Meds Pioglitazone

The FDA has issued an expanded warning label about type 2 diabetes medications containing Pioglitazone, which includes Actos, Actoplus Met, Actoplus Met XR, Duetact, and Oseni.  The FDA has concluded that Pioglitazone does increase the risk of bladder cancer, and recommends that it not be prescribed for patients with bladder cancer, and that all others using it watch for blood or a red color in the urine, new or worsening urge to urinate, or pain when urinating, any of which could indicate possible bladder cancer.  For full details see http://www.fda.gov/Safety/MedWatch/SafetyInformation/SafetyAlertsforHumanMedicalProducts/ucm532772.htm .

FDA Warning: Hepatitis Medications

The FDA has warned that Direct-Acting Antivirals for Hepatitis C can in some cases encourage the growth or regrowth of Hepatitis B, possibly resulting in serious injury or death.  Find the Drug Safety Announcement, including a list of Direct-Acting Antivirals, at http://www.fda.gov/Drugs/DrugSafety/ucm522932.htm , and more information at http://www.fda.gov/Safety/MedWatch/SafetyInformation/SafetyAlertsforHumanMedicalProducts/ucm523690.htm .