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.
CDC has issued a Health Alert Network or HAN bulletin on the Rising Numbers of Deaths Involving Fentanyl and Fentanyl Analogs, Including Carfentanil, and Increased Usage and Mixing with Non-opioids. Find the bulletin at https://content.govdelivery.com/accounts/USCDC/bulletins/1fde19f.
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.
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, Legionella, Pseudomonas, 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.
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.
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 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 .
The FDA has issued a warning about malfunction of Implantable Infusion Pumps that are, or have been, exposed to high-EMF environments such as MRI machines. For details see http://www.fda.gov/Safety/MedWatch/SafetyInformation/SafetyAlertsforHumanMedicalProducts/ucm536526.htm .
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 .