International Notes
Eosinophilia-Myalgia Syndrome -- Canada
As of May 14, 1990, 10 confirmed cases of eosinophilia-myalgia
syndrome (EMS) in Canada have been reported to the Laboratory
Centre for Disease Control (LCDC), and other possible cases are
under investigation. All 10 cases have been linked to use of
L-tryptophan (LT)-containing pills. Eight of the confirmed cases
are in females. Eight patients used single-ingredient dietary
supplements purchased in the United States; one of the remaining
patients obtained LT compounded from an unspecified bulk material
at a Canadian pharmacy, and the other had obtained
nonprescription LT manufactured in the United States and
distributed illegally in Canada.
In Canada, single-ingredient LT products have been required to
be sold by prescription since 1985. The prescription drug
Tryptan*, manufactured by ICN Canada Ltd., is the only
single-ingredient LT product legally available in Canada. No EMS
cases have been directly linked to Tryptan.
Laboratory and epidemiologic investigations of EMS are under
way. Physicians in Canada should report any cases meeting the
case definition (1) to the Acting Director, Bureau of Chronic
Disease Epidemiology, LCDC, Health and Welfare Canada, Ottawa,
K1A 0L2 (telephone (613) 957-0329; FAX (613) 952-7009).
Adapted from: Canada Diseases Weekly Report 1990;16:69-70, as
reported by: K Wilkins, MSc, D Wigle, MD, Bur of Chronic Disease
Epidemiology, Laboratory Centre for Disease Control, Health and
Welfare Canada, Ottawa, Ontario.
Editorial Note
Editorial Note: As of May 11, 1990, 1500 EMS cases have been
reported to CDC from state and territorial health departments in
the United States. A total of 23 persons who had been taking LT
before their illness have died.
Reference
CDC. Eosinophilia-myalgia syndrome--New Mexico. MMWR
1989;38:765-7.
*Use of trade names is for identification only and does not imply
endorsement by the Public Health Service or the U.S. Department
of Health and Human Services.
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