Environmental Toxicology
Newsletter

"Published Occasionally at Irregular Intervals"
~ Dr. Arthur L. Craigmill  ~
Extension Toxicologist

Vol. 26 No. 2 -- July 2006

"IN THIS ISSUE"

   Introduction
    DPR Releases 2004 Pesticide Use Data
    Orf Virus Infection in Humans
    Animal Health and Consumer Protection
    Death of a Child After Ingestion of a Metallic Charm
    Pesticides in the Nation’s Streams and Ground Water
    "Top 10 Pesticide Blunders" provide cautionary tales
   Benzene in Soft Drinks
   Comprehensive Dietary Supplement Reports Issued

~~ TOXICOLOGY TIDBITS ~~

     Efficacy of Home Washing Methods in Controlling Surface Microbial Contamination on Fresh Produce  

    News from the California Department of Pesticide Regulation

     Health Canada Issues Chaparral Warning
    Petting Zoo Visits Linked to Fever and Diarrhea in Kids
    Cows' Ability to Break Down Perchlorate Documented
     LactMed: A New NLM Database on Drugs and Lactation
     New telephone line for antimicrobials
    Genistein & Soy Formula Expert Panel Reports
      FDA rejects green tea/cardiovascular health claim
     State Health Officer Cautions Californians About Ticks and Tick-Borne Diseases
     FDA/EPA Advisory on Seafood Consumption Still Current
     Mold Prevention Strategies and Possible Health Effects in the Aftermath of Hurricanes and Major Floods
 

    Veterinary Notes

                News from CAHFS
                 FDA Prohibits Extra-Label Use of Adamantine and Neuraminidase
                 International Workshop on Minor Use and Minor Species: A Global Perspective
                Ask CVM

 

Case 3. On July 28, 2004, a man aged 51 years from Sonoma County, California, was referred to an infectious diseases physician because of pruritic, painless vesicles on his left hand. He had onset of these lesions 10 days after shearing young sheep, which had been purchased recently at auction and vaccinated with the live orf vaccine. The patient noted that some of the sheep had ulcers on their oral mucosa. He also recalled cutting his skin on thistles and burs embedded in the sheep wool. He reported no constitutional symptoms. His physical examination was only remarkable for five bullae (vesicles >1 cm in diameter), 1.0-1.5 cm in diameter, on the back of both hands. Histopathology indicated nonspecific inflammation, but serologic evaluation revealed parapoxvirus, consistent with current or recent parapoxvirus infection. All lesions healed spontaneously within 2 weeks.

Case 4. On May 25, 2005, a girl aged 11 years was taken to her pediatrician in Nashville, Tennessee, with a 7-mm papulovesicular lesion on the fourth finger of her left hand. Ten days before this visit, her family had vaccinated their sheep against orf virus. Five days before her clinic visit, she had cut the same finger on a lamb harness. The remainder of her physical examination was unremarkable. CDC confirmed the presence of orf virus using both genus- and species-specific primers, and standard PCR assays were negative for both primer sets. The lesion healed spontaneously within 1 month. No other family members reported similar lesions to the attending physician.

Editorial Note:

Although orf virus infection is self-limiting in hosts with normal immune systems, it can resemble skin lesions associated with potentially life-threatening zoonotic infections such as tularemia, cutaneous anthrax, and erysipeloid; therefore, rapid and definitive diagnosis is critical. Tularemia and erysipeloid are generally associated with exposure to rabbits or New World sylvan rodents and swine, respectively. Both orf virus infection and naturally acquired anthrax in humans can result from exposure to domestic sheep and goats; thus, exposure history alone (i.e., animal contact) is insufficient to indicate etiology, necessitating laboratory evaluation. 

Transmission of orf virus to humans occurs after contact with infected or recently vaccinated animals and/or fomites in conjunction with skin trauma. Orf virus vaccine strains have been known to cause outbreaks among sheep, and three of the illnesses described in this report occurred soon after vaccination of the flock. Veterinary vaccines for orf virus use nonattenuated, live virus preparations and are intended to produce controlled infections in flocks. Recently vaccinated animals pose an occupational risk to humans. Infections in three of the four cases described in this report were temporally associated with orf virus vaccination; however, the vaccines used to inoculate the animals in question were not available for genetic comparison with patient isolates.

Three of the four cases described in this report were associated with concurrent skin trauma; orf virus infection is facilitated by skin trauma, and previous case series have associated skin trauma with orf virus infection. Trivial injury (e.g., pricks from thistle) or substantial trauma (e.g., bites) can facilitate transmission of orf virus. Therefore, barrier protection (e.g., nonporous gloves) and hand washing during the care of sheep and goats is recommended whenever feasible. These measures are especially important for any person with a compromised immune system or a chronic skin disorder (e.g., eczema) who has contact with overtly infected animals. Immunocompromised persons should discuss the risks of handling orf-infected animals and infection-prevention strategies with their primary-care physicians.

Human orf virus infection is a common yet preventable consequence of contact with sheep and goats. Persons who are most likely to be exposed to orf virus (e.g., farm workers) might be familiar with the infection and thus might not seek medical attention. As a result, clinicians might not be familiar with orf virus infections, leading to a delay in diagnosis and unnecessary antibiotic use. Public health personnel should be cognizant that orf virus infection is similar in appearance and risk factors to life-threatening infections such as cutaneous anthrax and that skin trauma is a predisposing factor to infection. In addition, immunocompromised patients can have progressive, destructive lesions requiring medical interventions such as antiviral therapy and surgical debridement. The relation between vaccination of sheep and goats for orf virus and subsequent human orf virus infection should be considered in future public health investigations. Barrier precautions and proper hand hygiene are recommended for the prevention of orf virus infection in humans. 

    Nearly a century ago, farmers had a medicine chest of products to "cure" their animals, with names such as Lee's Gizzard Capsules, Liquid Hog Medicine, and Kow-Kure. The gizzard capsules, made with nicotine, were advertised to get rid of worms in turkeys. Liquid Hog Medicine, which contained lye, was for treating diarrhea in pigs. And Kow-Kure, whose exact ingredients remain a mystery, purported to prevent miscarriages in cows.

    Such products went by the wayside as Congress passed stronger drug laws, and today, the regulation of animal drugs closely parallels the regulation of human drugs. Like human drugs, all animal drugs must be approved by the Food and Drug Administration before being allowed on the market. The FDA's Center for Veterinary Medicine (CVM) is responsible for regulating drugs and food additives used for animals-both food-producing animals and family pets.

    To date, the CVM has approved nearly 700 drug products for use in 97 million cattle, 59 million pigs, 8.8 billion chickens, 272 million turkeys, 7 million sheep, and millions of other food-producing animals in the United States. In addition, more than 700 approved drug products are available to maintain the health of America's 60 million pet dogs, 75 million pet cats, and 5 million horses.

To read the entire article link to:  http://www.fda.gov/

    Lead-based paint remains the most common source of lead exposure for children aged <6 years. However, one report determined that 34% of children aged <6 years with lead poisoning in Los Angeles County had been exposed to items containing lead that had been brought into the home. These items might include candy, folk and traditional medications, ceramic dinnerware, and metallic toys and trinkets. Exposures to some of these items can result in life-threatening BLLs of >100 µg/dL (elevated BLLs are >10 µg/dL for children and >25 µg/dL for adults). In 2004, a child in Oregon had a BLL of 123 µg/dL after ingesting a necklace with high lead content. The same year, the Consumer Product Safety Commission (CPSC) recalled 150 million pieces of imported metallic toy jewelry sold in vending machines. Some lead-contaminated items intended for use by children are manufactured in countries with limited government regulation of lead in consumer products. With the decline in BLLs in U.S. children, widespread education of the dangers of lead paint, and systematic reduction of lead hazards in U.S. housing, acute ingestion of lead-containing items has become increasingly more common as a source of life-threatening BLLs.

    This report describes the death of a child from acute lead poisoning caused by lead encephalopathy after ingestion of a heart-shaped metallic charm containing lead; the charm had been attached to a metal bracelet provided as a free gift with the purchase of shoes manufactured by Reebok International Ltd. On March 23, a voluntary recall of 300,000 heart-shaped charm bracelets was announced by CPSC and Reebok (see Figure below). Health-care providers should consider lead poisoning in young children with increased intracranial pressure, unexplained and prolonged gastric symptoms, or a history of mouthing or ingesting nonfood items. Health-care providers also should warn caregivers against allowing children to mouth any metal objects.

    In mid-February 2006, a boy aged 4 years with a previous medical history of microcephaly and developmental delay was brought to a hospital pediatric emergency department in Minneapolis, Minnesota, with a chief complaint of vomiting. Probable viral gastroenteritis was diagnosed, and the boy was administered ondansetron, an antiemetic; his parents were encouraged to increase his fluid intake, and he was released. He returned to the emergency department 2 days later with intractable vomiting, poor oral intake, "sore tummy," and listlessness. He was dehydrated and had normal blood sodium and elevated blood urea nitrogen levels. He received intravenous fluid replacement and was admitted to the hospital.

    The next day, about 10 hours after admission, the boy became agitated and combative and exhibited possible posturing. During transport to the radiology department, the boy suffered a respiratory arrest associated with seizure-type activity. He was resuscitated and placed on mechanical ventilation. He was administered a computer tomography (CT) scan of his head and of his chest and radiographs of his abdomen. The CT scan revealed diffuse cerebral edema, and the boy underwent emergent ventriculostomy and decompressive craniotomy. A heart-shaped object was observed on his abdominal radiographs but it was thought to be a radiopaque temperature probe on his body. When the radiographs were examined again, the object was recognized as a foreign body in his stomach, and testing for heavy metal levels was requested.

    The next day, a BLL of 180 µg/dL was reported; cerebral blood flow studies indicated no flow to the brain, and the boy met clinical brain death criteria. On the fourth day of hospitalization, the child was removed from life support and died. Upon autopsy, a heart-shaped charm imprinted with "Reebok" was removed from the child's stomach. The mother recognized the object as a charm that came with a pair of shoes belonging to another child whose home her son had visited. The mother was not aware that her son had ingested the charm, and he had no history of ingesting nonfood substances.

    Acid digestion testing performed on the ingested charm determined that the charm consisted of 99.1% lead. CPSC suggests that tests for leaching be conducted on those items containing more than 0.06% lead by weight. A charm similar in size and shape to the one ingested, with Reebok imprinted on it, was obtained by Minneapolis Department of Regulatory Services staff members at an athletic shoe store in Minneapolis and tested by the same laboratory using the same method. Results determined that the charm consisted of 67.0% lead by weight. The same staff member purchased another look-alike charm with a pair of athletic shoes from the Reebok Internet site; this charm was tested by the same Minneapolis laboratory using the same testing method and determined to contain only 0.07% lead by weight.

    In Atlanta, Georgia, CDC staff members purchased four pairs of athletic shoes of the same brand, including two pairs with look-alike charm bracelets and two pairs with both charm bracelets and shoelace charms, from local stores and from the company's Internet site; they also obtained a promotional charm bracelet from a different athletic shoe manufacturer. Acid digestion analyses were conducted and revealed lead contents ranging from 0.004% to 0.044% by weight.

    The variation in lead content revealed by the tests in Minneapolis and Atlanta is consistent with previous test results for small, inexpensive metallic jewelry. The variations in lead content of the charms purchased in Atlanta stores and from the company's Internet site were not as varied as those in Minneapolis, likely indicating different suppliers or production lots.

    As the variation in lead content in these products indicates, alternatives to lead are available. Restriction or elimination of nonessential uses of lead in consumer products should be part of a proactive strategy that prevents exposure to these products and is preferable to relying on case finding to identify lead exposure hazards.

REF: MMWR, March 23, 2006 / 55(Dispatch);1-2.

    The U.S. Geological Survey has released a report describing the occurrence of pesticides in streams and ground water during 1992-2001. The report concludes that pesticides are typically present throughout the year in most streams in urban and agricultural areas of the Nation, but are less common in ground water. The report also concludes that pesticides are seldom at concentrations likely to affect humans. However in many streams, particularly those draining urban and agricultural areas, pesticides were found at concentrations that may affect aquatic life or fish-eating wildlife.

    Dr. Robert Hirsch, Associate Director for Water, said, "While the use of pesticides has resulted in a wide range of benefits to control weeds, insects, and other pests, including increased food production and reduction of insect-borne disease, their use also raises questions about possible effects on the environment, including water quality." Hirsch also commented that "the USGS assessment provides the most comprehensive national-scale analysis to date of pesticide occurrence in streams and ground water. Findings show where, when, and why specific pesticides occur, and yield science-based implications for assessing and managing pesticides in our water resources."

    The USGS findings show strong relations between the occurrence of pesticides and their use, and point out that some of the frequently detected pesticides, including the insecticide diazinon and the herbicides alachlor and cyanazine, are declining.

    USGS has worked closely with the U.S. Environmental Protection Agency (EPA) during the 10-year study. EPA uses the data extensively in their exposure and risk assessments for regulating the use of pesticides. For example, EPA used USGS data in its risk assessments for the reevaluation of diazinon, chlorpyrifos, cyanazine and alachlor. Uses of three of these pesticides (diazinon, chlorpyrifos and cyanazine) have now been significantly limited, and usage of alachlor was voluntarily reduced and largely replaced by a registered alternative.

    The USGS report is based on analysis of data collected from 51 major river basins and aquifer systems across the Nation from Florida to the Pacific Northwest and including Hawaii and Alaska, plus a regional study in the High Plains aquifer system.

    Although none of the USGS stream sampling sites were located at drinking-water intakes, a screening-level assessment was done by USGS to provide an initial perspective on the relevance of the pesticide concentrations to human health. USGS measurements were compared to EPA drinking-water standards and guidelines. Concentrations of individual pesticides were almost always lower than the standards and guidelines, representing less than 10 percent of the sampled stream sites and about 1 percent of domestic and public-supply wells.

    However, pesticides may have substantially greater effects on aquatic ecosystems than on humans based on a screening-level comparison of USGS measurements to water-quality benchmarks for aquatic life and fish-eating wildlife. More than 80 percent of urban streams and more than 50 percent of agricultural streams had concentrations in water of at least one pesticide—mostly those in use during the study period—that exceeded a water-quality benchmark for aquatic life. Water-quality benchmarks are estimates of concentrations above which pesticides may have adverse effects on human health, aquatic life, or fish-eating wildlife.

    Insecticides, particularly diazinon, chlorpyrifos, and malathion frequently exceeded aquatic-life benchmarks in urban streams. Most urban uses of diazinon and chlorpyrifos, such as on lawns and gardens, have been phased out since 2001 because of use restrictions imposed by the EPA. The USGS data indicate that concentrations of these pesticides may have been declining in some urban streams even before 2001—benchmark exceedences in urban streams were least frequent late in the study. A case study of diazinon shows declining concentrations in several urban streams in the Northeast during 1998-2004.

    In agricultural streams, the pesticides chlorpyrifos, azinphos-methyl, p,p’-DDE, and alachlor were among those most often found at concentrations that may affect aquatic life, with each being most important in areas where its use on crops is or was greatest. According to senior author Robert Gilliom, however, "Pesticide use is constantly changing in response to such factors as regulations and market forces and findings from this decade-long study need to be examined in relation to changes in use during and after the study. For example, levels of the herbicide alachlor declined in streams in the Corn Belt (generally including Illinois, Indiana, Iowa, Nebraska, and Ohio, as well as parts of adjoining states) throughout the study period as its use on corn and soybeans declined, with no levels greater than its aquatic-life benchmark by the end of the study. In contrast, both the use and the levels of atrazine, the most heavily used herbicide in the Corn Belt region, remained relatively high throughout the study period."

    In addition, DDT, dieldrin, and chlordane—organochlorine pesticide compounds that were no longer in use when the study began—were frequently detected in bed sediment and fish in urban and agricultural areas. Concentrations of these compounds in fish declined following reductions in their use during the 1960s and elimination of all uses in the 1970s and 1980s, and continue to slowly decline. Just as notable as the declines, however, is the finding that these persistent organochlorine pesticides still occur at levels greater than benchmarks for aquatic life and fish-eating wildlife in many urban and agricultural streams across the Nation.

    The USGS study also reported that pesticides seldom occurred alone—but almost always as complex mixtures. Most stream samples and about half of the well samples contained two or more pesticides, and frequently more.

    Gilliom explained that "The potential effects of contaminant mixtures on people, aquatic life, and fish-eating wildlife are still poorly understood and most toxicity information, as well as the water-quality benchmarks used in this study, has been developed for individual chemicals. The common occurrence of pesticide mixtures, particularly in streams, means that the total combined toxicity of pesticides in water, sediment, and fish may be greater than that of any single pesticide compound that is present. Studies of the effects of mixtures are still in the early stages, and it may take years for researchers to attain major advances in understanding the actual potential for effects. Our results indicate, however, that studies of mixtures should be a high priority."

    FDA is committed to ensuring the safety of food and beverages consumed by Americans and providing timely and factual information when safety questions are raised. We are issuing this statement today to better describe the steps FDA is taking in response to reports that benzene has been found in some soft drinks.

    Benzene, a carcinogen, is found in the environment from natural and man-made sources. In November 2005, FDA received reports that benzene had been detected at low levels in some soft drinks containing benzoate salts (an antimicrobial agent) and ascorbic acid (Vitamin C), particularly under certain conditions of storage, shelf life and handling.

    FDA's Center for Food Safety and Applied Nutrition (CFSAN) initiated a survey of benzene levels in soft drinks following receipt of the November 2005 reports. This survey indicates that the vast majority of beverages sampled (including those containing both benzoate salts and ascorbic acid) contain either no detectable benzene levels or are well below the 5 parts per billion (ppb) U.S. water standard. The results of this survey, which will be released in the near future, indicate that the levels of benzene in these beverages do not pose a safety concern.

    FDA's Total Diet Study (TDS) results from 1995 to 2001, indicated benzene levels in soft drinks that were well above and inconsistent with CFSAN's more recent survey results. The TDS results were also well above and inconsistent with levels reported in previous and current peer-reviewed literature and with hundreds of recent domestic and international government and beverage industry results. We are working to determine the source of the differences. As with any data that appear to be inconsistent, FDA believes it is important to closely examine the reasons for such differences.

    The TDS is an ongoing FDA program that determines levels of various contaminants and nutrients in a wide variety of foods. The analytical procedures used in the TDS are designed to detect multiple pesticide residues, industrial chemicals, and toxic and nutrient elements in many foods, not just benzene in beverages. Ongoing investigations into the analytical method used by the TDS suggest that elevated benzene levels can be formed by the procedures used to analyze beverage samples. This raises major concerns about the reliability of the TDS data for benzene in beverages and could explain why these data indicate higher levels of benzene than the levels reported in the more recent surveys by CFSAN and others, as noted above. We are continuing our investigation of the TDS data for benzene, and will make the results available when the investigation is complete.

    FDA is also continuing to follow up with companies to ensure that processing conditions are established that will ensure that benzene formation is avoided or minimized.

    FDA believes that the results of CFSAN's recent survey indicate that the levels of benzene found in soft drinks do not pose a safety concern.

REF:  FDA News Digest, April 17, 2006, FDA website

The draft statement http://consensus.nih.gov/2006/MVMDRAFT051706.pdf was accompanied by a 321-page evidence report. http://www.ahrq.gov/downloads/pub/evidence/pdf/multivit/multivit.pdf A final statement is expected in July.

REF: Consumer Health Digest #06-21, May 23, 2006

 TOXICOLOGY TIDBITS

Efficacy of Home Washing Methods in Controlling
 Surface Microbial Contamination on Fresh Produce

    Much effort has been focused on sanitation of fresh produce at the commercial level; however, few options are available to the consumer. The purpose of this study was to determine the efficacy of different cleaning methods in reducing bacterial contamination on fresh produce in a home setting. Lettuce, broccoli, apples, and tomatoes were inoculated with Listeria innocua and then subjected to combinations of the following cleaning procedures: (i) soak for 2 min in tap water, Veggie Wash solution, 5% vinegar solution, or 13% lemon solution and (ii) rinse under running tap water, rinse and rub under running tap water, brush under running tap water, or wipe with wet/dry paper towel. Presoaking in water before rinsing significantly reduced bacteria in apples, tomatoes, and lettuce, but not in broccoli. Wiping apples and tomatoes with wet or dry paper towels showed lower bacterial reductions compared with soaking and rinsing procedures. Blossom ends of apples were more contaminated than the surface after soaking and rinsing; similar results were observed between the flower section and stem of broccoli. Reductions of L. innocua in both tomatoes and apples were more than in lettuce and broccoli when subjected to the same washing procedures. Reductions of surface contamination of lettuce after soaking in lemon or vinegar solutions were not significantly different from lettuce soaking in cold tap water. Therefore, educators and extension workers might consider it appropriate to instruct consumers to rub or brush fresh produce under cold running tap water before consumption. (Journal of Food Protection, Vol. 69, No. 2, pp. 330–334.)

REF: FSnet Feb. 15/06 -- II

News from the California Department of Pesticide Regulation

 

Health Canada issues chaparral warning

    Health Canada is warning consumers not to ingest the herb chaparral in the form of loose leaves, teas, capsules or bulk herbal products because of the risk of liver and kidney problems. Chaparral refers to three plant species: Larrea tridentata, Larrea divaricata and Larrea mexicana, which may also be called creosote bush, greasewood, or hediondilla. The shrub grows in the Western United States and parts of Mexico and is used traditionally by the indigenous people of these regions to treat such conditions as arthritis, cancer, tuberculosis, bowel cramps, diarrhea, venereal disease, colds and bronchitis. No chaparral-containing products are currently approved by Health Canada for any use. [Health Canada News release, Dec 21, 2005] http://www.inspection.gc.ca/english/corpaffr/recarapp/2005/20051222e.shtml

REF:  Consumer Health Digest, #06-08, February 21, 2006

Petting zoo visits linked to fever and diarrhea in kids

    Petting zoos at agricultural fairs, festivals, and zoos let kids interact with animals like goats, cows, sheep, and llamas. But few regulations exist to ensure that petting zoo animals are free of disease, and several nationwide outbreaks of E. coli infection have been linked to these attractions, say researchers from the Centers for Disease Control and Prevention (CDC) in Atlanta, Georgia.

During 2004 to 2005, petting zoo problems appeared in three states:

North Carolina: In October 2004, about 800,000 people attended the North Carolina State Fair, which provided two petting zoos for kids. At the end of October, the state health department received reports of hemolytic uremic syndrome (HUS, a condition that causes severe anemia and kidney damage) in three children who had visited the petting zoo. Local health departments later reported 108 cases of diarrhea (most in children) close to the time of the state fair, and 78% of the ill people had visited the state fair petting zoo. Almost 20% of them needed hospitalization for their illness, which included symptoms such as bloody diarrhea and fever. Samples taken from the fairgrounds showed that one of the two petting zoos was contaminated with E. coli, bacteria found in the feces (bowel movements) of people and animals that can make both kids and adults sick and is linked to HUS. Illness in kids was associated with:

• touching or stepping in manure
• falling or sitting on the ground by the petting zoo
• thumb-sucking or using a pacifier or sippy cup while in the petting zoo

Although having parents who were aware that animals can cause disease helped to protect kids from illness, using alcohol-based hand sanitizers didn't help reduce E. coli infection.

Florida: In March 2005, 63 people developed E. coli infections (and seven people developed HUS); most cases developed in children after they attended fairs and festivals in Florida that contained a farm animal petting zoo. At least half of those who became sick had touched at least one cow, sheep, or goat; stool (poop) samples from the animals and humans tested positive for E. coli. Having indirect animal contact (such as touching sawdust or shavings or visibly soiled clothes or shoes) was also associated with infection, which caused symptoms such as diarrhea, vomiting, abdominal cramps, and fever.

Arizona: In July 2005, the Arizona Department of Health Services received reports of two children who had been hospitalized for E. coli infection. Both kids had visited an Arizona zoo that contained a petting area. Although one child had directly touched the animals, the other had not - but both children played in an area right next to and downhill from the petting zoo facility. Stool samples from some of the petting zoo animals tested positive for E. coli, and health experts suspect that the play area close to the petting zoo became contaminated via drainage.

What This Means to You: The findings in this CDC report suggest that parents should be cautious about taking kids to petting zoos. Often, petting zoos aren't required to check for contamination, and kids may get sick even if they clean up afterward with hand sanitizers. If you do choose to visit a petting zoo with your child:

• Wash your child's hands well with soap and water immediately after coming in contact with the animals. All family members in the zoo area should wash their hands right away, too.
• Avoid playing in play areas or grass that's right next to or downhill from the zoo.
• Don't let your child use a pacifier, sippy cup, or other item that is placed in the mouth while in the petting zoo. Don't allow thumb-sucking or nail-biting while there, either.
• Don't lean against railings, fence posts, or other stationary objects by the petting zoo.
• Watch out for piles of manure or sawdust that may be contaminated with the animals' feces.
• If your child has diarrhea, belly pain, vomiting, or fever and you've visited a petting zoo recently, talk to your child's doctor.

Source: Morbidity and Mortality Weekly Report, December 23, 2005.
February 2006, Kids Health, http://www.kidshealth.com/research/petting_zoo.html

REF: FSnet, February 23, 2006

Cows' ability to break down perchlorate documented

    Dairy cows can break down up to 80 percent of perchlorate that they ingest, according to new research about this chemical (Proceedings of the National Academy of Sciences, volume 102, pages 16152-16157). The findings suggest that this natural "filtering" process may occur in the rumen, the second of four compartments in a cow's complex stomach.

    Perchlorate, which exists naturally in the environment, has shown up at very low levels in some milk. In this research, levels in the milk of cows given various doses of the compound increased slightly as the dosage increased. But the levels did not rise in direct proportion to the increased dosage, according to the ARS scientists at Beltsville, Md., who performed the study.

    Work by others has already shown that perchlorate does not accumulate in bovine tissue. (February 22, 2006, ARS Food and Nutrition Briefs, http://www.ars.usda.gov/is/np/fnrb/fnrb0106.htm)

REF: AnimalNet Feb. 23/06

LactMed: A New NLM Database on Drugs and Lactation

    LactMed, a free online database with information on drugs and lactation, is one of the newest additions to the National Library of Medicine's TOXNET system, a Web-based collection of resources covering toxicology, chemical safety, and environmental health.

    LactMed may be searched at http://toxnet.nlm.nih.gov/cgi-bin/sis/htmlgen?LACT

    Geared to the healthcare practitioner and nursing mother, LactMed contains over 450 drug records. It includes information such as maternal levels in breast milk, infant levels in blood, potential effects in breastfeeding infants and on lactation itself, the American Academy of Pediatrics category indicating the level of compatibility of the drug with breastfeeding, and alternate drugs to consider. References are included, as is nomenclature information, such as the drug's Chemical Abstract Service's (CAS) Registry number and its broad drug class.

    LactMed was developed by a pharmacist who is an expert in this subject. Three other recognized authorities serve as the database's scientific review panel. Ancillary resources, such as a glossary of terms related to drugs and lactation, and breastfeeding links are also offered.

    LactMed can be searched together with TOXNET's other databases in a multi-database environment, to obtain other relevant information about drugs. As a work in progress, LactMed will continue to expand with additional drugs and be enhanced with other substances, such as industrial chemicals and radiation.

REF:  TOXNET

New telephone line for antimicrobials

    The National Pesticide Information Center (NPIC) is now taking inquiries, via their telephone helpline, 1-800-858-7378, and web-based services, http://npic.orst.edu/, regarding antimicrobial pesticides and pesticide products. NPIC is a toll-free telephone service that provides objective, science-based information about a wide variety of pesticide-related subjects. The service is available daily, 6:30 a.m.- 4:30 p.m. (PT).

REF: Pesticide Notes, 25(3), 2006.

Genistein & Soy Formula Expert Panel Reports

    The Center for the Evaluation of Risks to Human Reproduction (CERHR) announces the availability of the Genistein & Soy Formula Expert Panel Reports and requests public comment. 

    The reports are available on the CERHR website (http://cerhr.niehs.nih.gov). Written public comments on these reports should be received by July 5, 2006. You may provide input to the NTP at:  http://ntp.niehs.nih.gov/go/27902

REF:  http://ntp.niehs.nih.gov

FDA rejects green tea/cardiovascular health claim

    The FDA has concluded that there is no credible scientific evidence that drinking green tea or green tea extract reduce the risk of heart disease. In rejecting a petition that sought to allow tea labels to make that claim, the agency said its review included 105 articles publications submitted with the petition but found "no credible evidence" to support the requested claims. [Schneeman B. Letter to Stanley F. Tarka, M.D. May 9, 2006] http://www.cfsan.fda.gov/~dms/qhcgtea2.html

REF:  Consumer Health Digest #06-20,  May 16, 2006.

State Health Officer Cautions Californians About Ticks and Tick-Borne Diseases

    As warmer spring temperatures attract Californians to outdoor activities, people must take precautions to prevent tick bites because some ticks carry germs that cause disease, including Lyme disease, State Public Health Officer Dr. Mark Horton advised today.

    "Californians should take measures to reduce their exposure to ticks when they venture outdoors to work in their yards and participate in recreational activities, including hiking and camping," Horton said.

    Ticks are small, insect-like creatures that are often found in naturally vegetated areas throughout California. They prefer cool, moist environments, shaded grasses, shrubs and leaf litter. Ticks attach to animals and feed on their blood over several days. 

    Individuals may become infected with the bacteria that cause Lyme disease when they are bitten by an infected western black-legged tick, the only tick that transmits Lyme disease.  The smaller, immature form of the tick known as a "nymph" is most active during the spring and early summer months.  Roughly the size of a poppy seed, nymphs are found on logs, tree trunks, fallen branches or tree limbs and among the damp leaves that accumulate under trees. Nymphs may attach to people as they gather or sit on logs or walk through leaf litter.  Because nymphs are so small, people may not notice if one attaches to them.

    Early symptoms of Lyme disease often include a spreading rash, which is usually accompanied by flu-like symptoms, such as fever and body aches.  Prompt treatment with antibiotics can cure the disease, particularly when it is diagnosed early.  If left untreated, symptoms can progress into arthritis, heart ailments or nervous system disorders.

    Ticks in California can carry other germs that cause diseases in humans, such as anaplasmosis, ehrlichiosis, Rocky Mountain spotted fever and babesiosis. The first line of defense against tick-borne diseases is taking proper personal protective measures to avoid tick bites. Horton offered the following steps to reduce exposure to tick bites:

1. Avoid areas where ticks live, such as trail margins, brushy and grassy areas, leaf litter in forests with oak and other hardwood trees.  Stay on trails and avoid contact with logs, tree trunks and fallen branches or tree limbs in forests.
2. When in areas where ticks can be found:

• Wear light-colored clothing so ticks can easily be seen.
• Wear long pants and long-sleeved shirts. Tuck pant legs into boots or socks and tuck shirts into pants. 
• Use a repellent registered for use against ticks.  Repellents with DEET are effective and can be applied to the skin. Repellents with permethrin are applied to clothing only. Always follow directions on the container and be especially careful when applying to children. 
• Inspect yourself frequently for ticks while in tick habitat

     3. When out of tick-infested areas:

• Conduct a check of your entire body, especially the hairline, armpit, back of knees and groin, each day for up to three days after returning from tick habitat. An additional tick check two or three days after exposure may reveal an engorged tick or a tick bite reaction that may not have been noticeable before.
• Parents should inspect their children, especially on the scalp and hairline, after activities in tick-infested areas.

    Individuals who discover a tick attached to their body should remove it as soon as possible to reduce the possibility of infection.  The sooner a tick is removed, the less likely you are to get sick from an infected tick bite. The tick should be removed by grasping it with fine-pointed tweezers and pulling it gently, but firmly, straight out.  Insecticides, lighted matches or gasoline are ineffective and should not be used to remove ticks.  Individuals are advised to wash their hands and apply antiseptic to the affected area. Individuals who develop a rash, fever or other symptoms within two to four weeks after being bitten by a tick should consult their physician immediately.

    Additional information is available on the California Department of Health Services’ Web site at http://www.dhs.ca.gov/ps/dcdc/disb/disbindex.htm or by calling (916) 552-9730.

REF:  CDHS News Release, May 15, 2006.

Youth Tobacco Surveillance United States, 2001--2002

    The National Youth Tobacco Survey (NYTS) and state youth tobacco surveys (YTS) were developed to provide states with data to support the design, implementation, and evaluation of comprehensive tobacco-control programs. This report summarizes data from the 2002 NYTS and the 2001 and 2002 YTS. Current use of any tobacco product ranged from 13.3% among middle school students to 28.2% among high school students. Exposure to secondhand smoke (i.e., environmental tobacco smoke) was high. Media and advertising influence was also noted. Health and education officials use YTS and NYTS data to plan, evaluate, and improve national and state programs to prevent and control youth tobacco use. States can use these data in presentations to their state legislators to demonstrate the need for funding comprehensive tobacco control programs including tobacco cessation and prevention programs for youth.

REF: MMWR, May 19, 2006.

FDA/EPA Advisory on Seafood Consumption Still Current

    In response to recent inquiries about the FDA/EPA consumer advisory, “What You Need to Know About Mercury in Fish and Shellfish,” FDA and EPA want to assure consumers that the advice contained in the 2004 advisory remains current and that FDA and EPA stand behind it. The advisory’s recommendations are specific to women who might become pregnant, women who are pregnant, nursing mothers, and young children.

    Fish and shellfish are an important part of a healthy diet and can contribute to heart health and children’s proper growth and development. Because of their many healthy benefits we recommend that women and young children include them as a regular part of their diet. However, nearly all fish and shellfish contain traces of mercury.

    By following 3 recommendations for selecting and eating fish or shellfish, women and young children will receive the benefits of eating fish and shellfish and be confident that they have reduced their exposure to the harmful effects of mercury.

1. Do not eat Shark, Swordfish, King Mackerel, or Tilefish because they contain high levels of mercury.
   
   
2. Eat up to 12 ounces (2 average meals) a week of a variety of fish and shellfish that are lower in mercury.
   
   
   • Five of the most commonly eaten fish that are low in mercury are shrimp, canned light tuna, salmon, pollock, and catfish.
   • Another commonly eaten fish, albacore (“white”) tuna has more mercury than canned light tuna. So, when choosing your two meals of fish and shellfish, you may eat up to 6 ounces (one average meal) of albacore tuna per week.
     
     
3. Check local advisories about the safety of fish caught by family and friends in your local lakes, rivers, and coastal areas. If no advice is available eat up to 6 ounces (one average meal) per week of fish you catch from local waters, but don’t consume any other fish during that week.

    Follow these same recommendations when feeding fish and shellfish to your young children but serve smaller portions.

    FDA continues to test fish and shellfish for mercury. Should there be a significant change in the underlying science regarding the risks from methylmercury or the benefits from fish, FDA and EPA will update the advisory to ensure that the public is informed when making choices about the amounts and types of fish to eat.

    The complete 2004 FDA/EPA advisory, “What You Need to Know About Mercury in Fish and Shellfish,” can be found at www.cfsan.fda.gov/~dms/admehg3.html.

REF: FDA website, June 6, 2006

Mold Prevention Strategies and Possible Health Effects in the Aftermath of Hurricanes and Major Floods

Summary
    Extensive water damage after major hurricanes and floods increases the likelihood of mold contamination in buildings. This report provides information on how to limit exposure to mold and how to identify and prevent mold-related health effects. Where uncertainties in scientific knowledge exist, practical applications designed to be protective of a person's health are presented. Evidence is included about assessing exposure, clean-up and prevention, personal protective equipment, health effects, and public health strategies and recommendations. The recommendations assume that, in the aftermath of major hurricanes or floods, buildings wet for >48 hours will generally support visible and extensive mold growth and should be remediated, and excessive exposure to mold-contaminated materials can cause adverse health effects in susceptible persons regardless of the type of mold or the extent of contamination.

    For the majority of persons, undisturbed mold is not a substantial health hazard. Mold is a greater hazard for persons with conditions such as impaired host defenses or mold allergies. To prevent exposure that could result in adverse health effects from disturbed mold, persons should 1) avoid areas where mold contamination is obvious; 2) use environmental controls; 3) use personal protective equipment; and 4) keep hands, skin, and clothing clean and free from mold-contaminated dust.

    Clinical evaluation of suspected mold-related illness should follow conventional clinical guidelines. In addition, in the aftermath of extensive flooding, health-care providers should be watchful for unusual mold-related diseases. The development of a public health surveillance strategy among persons repopulating areas after extensive flooding is recommended to assess potential health effects and the effectiveness of prevention efforts. Such a surveillance program will help CDC and state and local public health officials refine the guidelines for exposure avoidance, personal protection, and clean-up and assist health departments to identify unrecognized hazards.

REF:  MMWR, Recommendations and Reports, June 9, 2006 / 55(RR08);1-27.

Veterinary Notes

News from the UC Davis California Animal Health and Food Safety Laboratory System (CAHFS)

Cattle:
A group of cattle that were moved to a new pasture experienced sudden death in nine head, three to four days after the move. Rumen content from one of the animals was positive for lupanine, suggestive of lupine toxicosis. Ingestion of toxic amounts of this plant (especially seeds) can lead to a neurotoxic syndrome characterized by muscle tremors, labored breathing, convulsions, coma and death. Cattle were moved off the pasture, and no further deaths occurred.

Horses:
Two horses ingested a total of approximately six pounds of rat bait pellets containing diphacinone. Serum collected from both horses approximately 24 hours after exposure was positive by HPLC. Diphacinone is a second-generation, long-acting anticoagulant rodenticide that interferes with normal blood clotting as a result of reduced concentrations of clotting factors II, VII, IX, and X. The oral lethal dose for diphacinone in horses has not been reported in the literature. Both horses were monitored carefully, received vitamin K1 for 21 days and recovered completely.

Goats:
Lupine poisoning was diagnosed in a group of goats that were moved to a new field. Five goats died within four hours of being moved. Pathology findings in three goats included acsites in all and myocardial degeneration in two. No cardiotoxic compounds were detected in the rumen contents but alkaloids sparteine and lupanine were detected. These compounds are consistent with ingestion of lupine. Toxic amounts of this plant (especially seeds) in goats can lead to neurologic signs. The livers of all three goats had very low copper concentrations. The copper deficient state of these goats may have made them more susceptible to toxins to which goats are normally resistant.

Sheep:
Eleven sheep died acutely shortly after being turned out on a harvested broccoli field following a period of above-average rain and plant regrowth. No lesions were noted. Nitrate was detected in the aqueous humor fluid at 134 ppm (toxic >25 ppm), which is indicative of nitrate intoxication. Clinical signs of nitrate/nitrite intoxication include salivation, diarrhea, tremors, ataxia, tachycardia and seizures. Death often occurs within six to 24 hours of exposure.

Llamas:
Oleander poisoning resulted in a two-day history of depression, lethargy, anorexia, atazia, tremors, and recumbency in a 5-year-old llama. The nursing baby (cria) remained healthy. Necropsy revealed myocardial degeneration. Stomach content contained plant material that resembled parts of oleander (Nerium oleander). All parts of the plant oleander, dried and fresh, are highly toxic.

REF: CAHFS Lab Notes, Winter 2006.

FDA Prohibits Extra-Label Use of Adamantine and Neuraminidase

    The Food and Drug Administration (FDA) is issuing an order prohibiting the extralabel use of anti-influenza adamantane and neuraminidase inhibitor drugs in chickens, turkeys, and ducks. We are issuing this order based on evidence that extralabel use of these antiinfluenza drugs in chickens, turkeys, and ducks will likely cause an adverse event in humans.

    This rule becomes effective June 20, 2006.

REF: Federal Register, Vol. 71, No. 55 / Wednesday, March 22, 2006

International Workshop on  Minor Use and Minor Species: A Global Perspective

    The proceedings of this Workshop that was held on October 7, 2004 are available online at http://www.fda.gov/cvm/.

    This workshop was jointly sponsored by the Food and Drug Administration’s, Center for Veterinary Medicine and the US Department of Agriculture’s National Research Support Project No. 7, or NRSP-7.  The purpose of the workshop was to provide a global perspective on drug needs and drug approvals for minor species and minor uses. 

Ask CVM
(The Center for Veterinary Medicine)

• Are mail order pet medications the same as those I get directly from the veterinarian?
• I need a drug to treat my pet that you can’t buy in the United States, but it is available overseas. How can I get permission to import that drug?
• I found the same drug my veterinarian sells me, but for a much lower price in another country, and I can order it online.
• Do I need permission from FDA to import that drug?
• Do I contact CVM if I have a concern about my vet, such as his treating my dog with drugs not approved for dogs, or the fact that he makes me buy drugs from him because he won’t write a prescription the way my doctor will?
• Who in FDA should I notify if I think there is something wrong with my dog’s commercially made pet food?
• I’ve seen several food additive products that are supposed to make my dog feel better. Does CVM regulate these products?
• I read in a magazine that I can contact CVM for free health care advice about my pet. Who do I talk to?

For answers to these questions link to:  FDA Veterinarian.

REF: FDA Veterinarian, November/December 2005.

!! CLICK ON THE PIG !!

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