Shortage of calcium disodium versenate

The American Society of Health-System Pharmacists reports a shortage of calcium disodium versenate. "Approximately 250,000 U.S. children aged 1-5 years have blood lead levels greater than 10 micrograms of lead per deciliter of blood, the level at which CDC recommends public health actions be initiated." This chemical is used to remove lead from the blood and pass it out in the urine. There are still millions of housing units in the US with lead-based paint inside and/or outside. The old paint chips and children put a chip with milligram levels of lead in their mouth and can quickly build up blood levels in the micrograms as noted above. The house dust will also contain lead that can be breathed in, and exterior lead paint will contaminate the soil surrounding the building and be eaten in garden plants. Soil is still contaminated from the tetraethyllead that was found in gasoline for automobiles and that is still used in aviation gas. Likewise soil still contains lead from pesticides used before they were banned. Lead enters drinking water from the soil and from pipes that are joined with lead solder.

Adult exposure is almost always occupational, e.g., lead battery production and recycling, lead solder, firing range safety officers and instructors, smelter employees and people living near a smelter, factory workers who make radiation shields, etc.

Shortage of primaquine tablets

The American Society of Health-System Pharmacists has reported a shortage of primaquine phosphate tablets. Sanofi-Aventis, the only manufacturer, cannot provide a reason for this shortage. Two of the organisms which cause malaria, Plasmodium vivax and ovale, produce a dormant stage in the liver, appropriately named a hypnozoite (see photo).

Hypnozoites can only be killed by primaquine, and the various other malaria treatments will only affect the organisms in the blood. This will prevent the symptoms of the disease, but relapses will occur until the hypnozoites in the liver can be destroyed. The Centers for Disease Control have published treatment recommendations.

In the US, malaria prophylaxis and treatment are important to people who are traveling to areas of the world where malaria is active. Globally, the CDC is part of the World Health Organization's Roll Back Malaria campaign. As you can see from the map below, sub-Saharan Africa and southern Asia are the most affected. Worldwide, 85% (749,000) of the deaths due to malaria were children under five years old. This and other facts are available from the WHO.