Medicine Chest News - Part 145

Diethylene Glycol Deaths 2On Monday morning, June 24, the CDC contacted officials in the Office of Emergency Operations at the FDA about the Haitian crisis. Over the course of the week, the FDA worked with the Haitian press to fax “Alert Bulletins” to 24-hour French and Creole radio stations, service agencies, nurses’ associations, and other Haitian organizations. On Wednesday afternoon, the FDA issued an Import Bulletin (#60B02). Photographs of the Valodon and Afebril labels were distributed to US postal and Customs officials, who were instructed to be alert for these products entering the US. The FDA screened all liquid medications imported into the US from Haiti, while computer searches assured the agency that no acetaminophen shipments from Haiti had been imported in the past year. By the end of the week, FDA officials felt certain that the contaminated Haitian acetaminophen would not create a problem in the US. Read the rest of this entry »

Epidemiologic InvestigationAlthough CDC epidemiologists had generated a long list of possible causes of the epidemic before arriving in Haiti (including infectious agents, ingestible substances, and toxins), the initial phases of the investigation yielded some important clues. Pathology reports had initially suggested a toxic exposure, and the duration of the epidemic suggested an ongoing exposure rather than a single point source. The patients were young, which suggested to the researchers either a unique exposure of some kind (for example, bottles, pacifiers, or baby food), a disease manifestation unique to children, or a dose-response relationship that would render young children most susceptible. Moreover, the presence of a fever in almost all of the presenting cases suggested an infection or other predisposing illness for which a medication or herbal remedy might have been used. Read the rest of this entry »

HealthPublic health politics in Haiti have been dominated for decades by the Boulos family. The patriarch of this influential and wealthy family, Carlos Boulos, MD, founded a nonprofit organization known by its initials CDS (in English: the Center for Develop ment and Health) in the 1970s. Adroitly securing funding from diverse sources such as the WHO and the US Agency for International Development, CDS became an important public health and primary care organization serving the poorest of the poor in Haiti. Johns Hopkins professor Neal Halsey s work in Haiti was largely conducted under the auspices of CDS.

Carlos Boulos had three sons. Reginald ran CDS after his father’s death, and it was he who supported and collaborated with Halsey on studies of new vaccines and HIV, among other projects. Reginald’s brother Rudy ran a pharmaceutical manufacturing company named Pharval. The youngest Boulos brother, Franz, ran a cosmetics firm. Read the rest of this entry »

Diethylene Glycol Deaths

Many illnesses and injuries go untreated in a country like Haiti, considered the poorest in the Western Hemisphere. The World Health Organization (WHO) estimates that only 50% of the Haitian population has access to primary health care services.1 In part, this is a distribution problem; 70% of health care providers work in the cities, while 70% of the population lives in the rural areas of the country.1 According to 1997 WHO figures, Haiti has only 1.2 doctors per thousand inhabitants and only one hospital bed per 1300 inhabitants.1 Pediatric deaths are tragically common. In the summer of 1996, however, a cluster of pediatric deaths due to acute renal failure attracted worldwide attention. Read the rest of this entry »

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