Toxic Waters

Now that high summer and higher temperatures have arrived, Harmful Algae Blooms (“HABs”) are an increasing threat to recreational and subsistence uses of bodies of fresh- and salt-water.  HABs can impact, sometimes fatally, harvesting of water- and shoreline-dwelling animals and plants, drinking, swimming, wading, and boating.  Pets and children are particularly vulnerable because they can rush into water before you even realize they’re out of the car.  The Oregon Health Authority advises,

“Don’t go into water that looks foamy, scummy, thick like paint, pea-green, blue-green or brownish red.  A good rule of thumb for you and your pet is: When in Doubt, Stay Out!”  (https://www.oregon.gov/OHA/PH/HealthyEnvironments/Recreation/HarmfulAlgaeBlooms/pages/index.aspx).

Bear in mind that most waters are not monitored for toxicity, so the lack of a warning sign is not enough to assure safe use.  The following websites provide information on identifying and responding to toxic waters and their impacts, and include alerts on the few, most popular, waters that are monitored and posted:

The Washington website is also available in Spanish, Somali, and Viet.  As an example of a posted warning, Odell Lake near Willamette Pass, between Eugene and Klamath Falls OR, has recently been posted; see the Oregon website above.

CDC HAN and FDA Warning re Hand Sanitizers

CDC has issued an HAN Health Advisory urging avoidance of Methanol-based hand sanitizers.  Methanol can cause blindness or death when absorbed through the skin.  CDC specifically indicates manufacturer Eskbiochem SA de CV, but the FDA lists many others (see below).  Find more details in the HAN at https://emergency.cdc.gov/han/2020/han00434.asp?deliveryName=USCDC_511-DM32445.

The FDA has found many hand sanitizers that are not labeled to contain Methanol but which testing has shown to be contaminated.  They have recently updated their Warning to include many other manufacturers and brands, all from Mexico.  Additional manufacturers include Grupo Insoma S.A.P.I de CV, Transliquid Technologies, Soluciones Cosmeticas SA de CV, and Tropicosmeticos SA de CV.  Brand names include Mystic Shield. Bersih, Britz, All-Clean, Esk Biochem, Lavar, The Good Gel, CleanCare NoGerm, Saniderm, and additional more generic names.

The FDA Warning advises “Consumers who have been exposed to hand sanitizer containing methanol and are experiencing symptoms should seek immediate treatment for potential reversal of toxic effects of methanol poisoning. Substantial methanol exposure can result in nausea, vomiting, headache, blurred vision, permanent blindness, seizures, coma, permanent damage to the nervous system or death.”  It particularly warns about accidental ingestion, which can be fatal, especially to children.

Find the updated FDA Warning at https://www.fda.gov/drugs/drug-safety-and-availability/fda-updates-hand-sanitizers-methanol.

CDC HAN on Chloroquine as Seen on TV

CDC has released a new HAN Health Alert Advisory on Severe Illness Associated with Using Non-Pharmaceutical Chloroquine Phosphate to Prevent and Treat COVID-19.  The Summary includes “Chloroquine phosphate, when used without a prescription and supervision of a healthcare provider, can cause serious health consequences, including death.  Clinicians and public health officials should discourage the public from misusing non-pharmaceutical chloroquine phosphate (a chemical used in home aquariums).  Clinicians should advise patients and the public that chloroquine, and the related compound hydroxychloroquine, should be used only under the supervision of a healthcare provider as prescribed medications.”  Find the CDC HAN at https://emergency.cdc.gov/han/2020/han00431.asp?deliveryName=USCDC_511-DM24285.

FDA Warning re Cipro et al and Blood Sugar

The FDA has required new label warnings about blood sugar and mental health side effects of fluoroquinolone antibiotic drugs.  The most common fluoroquinolones are Cipro (ciprofloxacin), Avelox (moxifloxacin), and Levaquin (levofloxacin), but there are many others, most of which end in -floxacin.  The new label has many specific warnings and recommendations for diabetics.  For full details see https://www.fda.gov/Safety/MedWatch/SafetyInformation/SafetyAlertsforHumanMedicalProducts/ucm612979.htm.

Sensipar Notice

The National Kidney Foundation® is partnering with Amgen, a pharmaceutical company, to provide important information on a medication you may be taking.  Please see the message below for details:

Visit www.fda.gov/medwatch or call 1-800-FDA-1088 (332-1088).
Please see accompanying Sensipar® full Prescribing Information. 

Copyright © 2017 National Kidney Foundation, Inc., All rights reserved.

CDC HAN re Hurricane Travelers

CDC has issued a bulletin to its Health Alert Network (HAN) recommending that healthcare providers be watchful for unusual infectious diseases in patients and others who visit Puerto Rico, the Virgin Islands, and other Caribbean hurricane-ravaged areas between September 2017 and March 2018, including leptospirosis, dengue, hepatitis A, typhoid fever, vibriosis, Zika, chikungunya, and influenza.  Also, visitors to flooded or contaminated areas of the Gulf and Atlantic Coasts could possibly return with necrotizing fasciitis, invasive fungi, Mycobacterium, LegionellaPseudomonas, or other water-associated Gram-negative bacteria.  The HAN, at https://emergency.cdc.gov/han/han00408.asp,  provides specific recommendations and reporting requirements dealing with these possibilities.

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 .