Safety of Hydroxychloroquine and Chloroquine

The COVID-19 pandemic has many people searching for remedies to prevent or treat the disease. In particular, recent media coverage of clinical trials of hydroxychloroquine (brand name Plaquenil, among others) and a similar medication called chloroquine (brand name Aralen) have led some people to take these without a doctor’s prescription, or to take a higher dose than what they have been prescribed. 

In the United States, hydroxychloroquine is approved for the treatment of malaria, systemic lupus erythematosus, and rheumatoid arthritis. Chloroquine is approved for the treatment of malaria. While they can be very effective in the treatment of certain conditions, side effects and toxicity can occur at even regularly prescribed doses.  

Hydroxychloroquine and chloroquine toxicity can involve almost every organ system. Effects may include headache, vision or hearing changes, low blood potassium, and changes in heartbeat. If used without a doctor’s supervision, in combination with other medications, or by someone with underlying medical problems, side effects can include irregular heartbeat (arrhythmia), seizures, and heart failure leading to death. 

The Food and Drug Administration (FDA) recommends no one take hydroxychloroquine or chloroquine to prevent or treat COVID-19 outside of a clinical trial because of the risk of heart failure.  This medication and substances related to it (including those found in fish tank additives) should never be taken without a physician’s approval. 

If you have taken hydroxychloroquine or chloroquine and are concerned about the possibility of side effects, call your doctor or the Poison Control hotline at 1-800-222-1222.  For more information, see the Blue Ridge Poison Center’s article on hydroxychloroquine.

Safe Use of Household Cleaners

Because of COVID-19, many people are wondering how they can clean surfaces in their household to reduce the risk of spreading the disease.  The Centers for Disease Control has guidance on how to clean and what products will kill the COVID-19 virus. While cleaning can help the spread of illnesses, even regular household cleaners can be dangerous if they aren’t used properly.

Follow these guidelines for safety:

  1.  Don’t mix different cleaners together.  Chemicals in different cleaners can react to produce irritating or even poisonous gases. Don’t reuse bottles.
  2. Follow the directions on the bottle.  Store the cleaner in its original bottle, and make sure the label can be read. Some cleaners can cause skin and eye burns, so be sure you are wearing gloves and eye protection if recommended.  Some cleaners are not intended to be used on food contact surfaces.
  3. Don’t get the cleaner on your skin or in your mouth.  Even relatively mild cleaners can cause skin irritation if allowed to stay on the skin and vomiting if swallowed.  Stronger cleaners can cause severe burns.  Follow the directions on the bottle if the cleaner gets in your mouth or on your skin. If the label says to get medical help, call 911.  If you aren’t sure what to do, call the Poison Control hotline at 1-800-222-1222.
  4. Store cleaners out of the reach of children and pets.  They should be stored in a locked cabinet or in a high place where children can’t reach and they can’t accidentally fall out. Teach children not to touch cleaners until they are old enough to clean safely.

FDA Review Finds No Link Between Cell Phones and Cancer

Since cell phones began to be used widely, some people have been concerned about the potential for radiofrequency radiation (RFR) from cell phones to cause cancer. The federal Food and Drug Administration (FDA) recently released the results of a comprehensive review of scientific studies published from January 1, 2008 to May 8, 2018 on RFR and human health effects, looking for any possible causal relationship between RFR and cancer.  Their conclusion was that there was no measurable risk:   

Based on the FDA’s ongoing evaluation, the available epidemiological and cancer incidence
data continues to support the Agency’s determination that there are no quantifiable adverse
health effects in humans caused by exposures at or under the current cell phone exposure limits.

The full FDA report can be read here.

Use of Unregulated Supplements Can Cause Harm

In August 2019, the Blue Ridge Poison Control Center received a call regarding a patient who experienced hypoglycemia (low blood sugar) after using the supplement pill “V8”, which had been purchased at a gas station.  Over the next month, 12 additional cases were reported from hospitals.  An investigation by the Central Virginia Health District and the University of Virginia discovered that the supplement, which had been sold at several gas stations and convenience stores, contained a medicine used to treat diabetes.  VDH worked to remove the V8 pills from stores where they were known to be sold, to prevent future exposures.

One risk of using unregulated supplements is that they may include unlabeled ingredients, which can be harmful. If you suspect that you are experiencing health effects due to poisoning, or have questions regarding this incident, call 1-800-222-1222.

October 26 is Prescription Drug Take Back Day

October 26, 2019 is the National Prescription Drug Take Back Day.  Follow this link to find a collection site near you for an opportunity safely and anonymously turn in prescription drugs.  This can prevent drug addiction and overdose deaths, and can also prevent accidental poisoning to children or pets.  Turning in prescription drugs is a safe alternative to flushing drugs into public wastewater systems, which can end up in drinking water and pollute the environment.

If you cannot attend this event, contact your local police department about future events, or follow the EPA’s recommendations.

New Fish Consumption Advisory for the Nottoway River

The Virginia Department of Health (VDH) has issued an advisory on blue catfish consumption due to elevated mercury in blue catfish caught in the Nottoway River.

Recent fish tissue sample results from the Nottoway River in 2017 and 2018 show mercury levels in blue catfish exceed the amount considered safe for long-term human consumption.

More information is available in the press release for this advisory. Information on fish consumption advisories across the state can be found at http://fishadvisories.vdh.virginia.gov/.

Vaping and Lung Disease

Vaping and Lung Disease

Recently CDC has started investigating 450 possible cases across multiple states of a lung disease associated with vaping. As of September 5, six confirmed cases have been reported in Virginia. Information on this illness in Virginia can be found on the Virginia Department of Health page on Severe Lung Illness Associated with Vaping. No specific product has been identified as the cause yet, although many people affected report vaping THC oil.
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Pool Chemical Injuries

Treating pools with chemicals is important to prevent the spread of disease.  However, improper storage or use of these chemicals can cause injury.  Most chemicals used to treat pools contain chlorine or bromine, which can irritate the skin, eyes, mucous membranes, and respiratory tract.  Treatment primarily consists of removal from the source and supportive care

Most of these injuries take place at private residences, so it is important to use pool chemicals properly and keep them safely stored away from children and pets.  For more information, visit the Blue Ridge Poison Control Center website: https://med.virginia.edu/toxicology/wp-content/uploads/sites/268/2019/06/Jun19-PoolChemicals.pdf

Lead and Firing Ranges

Target Shooting and Lead

People who routinely go target shooting are at increased risk for exposure to lead. When a gun is fired, lead dust and vapors are released and can be breathed in or settle on the skin, hair, or clothes. Lead has no biological role in the body, and no level of lead is known to be safe. Lead is especially harmful to children, and can contribute to learning disabilities or ADHD.

Protect Your Child from Lead

It only takes a small amount of lead to raise a child’s blood lead level. Lead dust brought home from a shooting range on shoes or clothing can settle on floors, then be picked up on objects or a child’s hands, and from there taken to a child’s mouth. After going shooting, wash your hands, arms, and face to remove lead from your skin. Change your clothes when you get home and wash them separately. Keep down the amount of lead dust in the home through regular wet cleaning of floors. If you shoot regularly and have a child who is less than 6 years old, talk to your child’s doctor about lead poisoning and whether your child should be tested.

For more information for indoor gun range owners, employees, and customers, please see our handout on Lead and Firing Ranges fact sheet.

Kratom

What is kratom?

Kratom is an herbal extract made from the leaves of a tropical evergreen tree. It is sold as a herbal supplement in the United States. Kratom has some properties similar to opiates, but also can act as a mild stimulant. Some people take kratom to reduce opiate cravings or treat pain. Others take it recreationally, believing it helps improve mood.

Why am I hearing so much about kratom lately?

Kratom was first introduced into the US in the late 1990s and for years its use was very limited. In recent years kratom use has become much more common, possibly because of the opiate epidemic and people trying to use kratom to reduce their dependence on opiates. A new study on Poison Control Center calls related to kratom found they’ve become much more common in the past few years. In 2011 Poison Control Centers received 13 calls about kratom. This rose to 682 in 2017, and two-thirds of the 1807 kratom-related calls between 2011–2017 happened in 2016 and 2017.

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