Human fatalities from cyanobacteria: Chemical and biological evidence for cyanotoxins.

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Title Human fatalities from cyanobacteria: Chemical and biological evidence for cyanotoxins.
Author Carmichael, Wayne W; Azevedo, Sandra M.F.O; An, Ji Si; Molica, Renato J.R.; Jochimsen, Elise M.; Lau, Sharon; Rinehart, Kenneth L.; Shaw, Glendon Reginald; Eaglesham, Geoff K.
Journal Name Environmental Health Perspectives
Year Published 2001
Place of publication Washington, D.C.
Publisher National Institute of Environmental Health Sciences
Abstract An outbreak of acute liver failure occurred at a dialysis center in Caruaru, Brazil (8°17' S, 35°58' W), 134 km from Recife, the state capital of Pernambuco. At the clinic, 116 (89%) of 131 patients experienced visual disturbances, nausea, and vomiting after routine hemodialysis treatment on 13–20 February 1996. Subsequently, 100 patients developed acute liver failure, and of these 76 died. As of December 1996, 52 of the deaths could be attributed to a common syndrome now called Caruaru syndrome. Examination of phytoplankton from the dialysis clinic's water source, analyses of the clinic's water treatment system, plus serum and liver tissue of clinic patients led to the identification of two groups of cyanobacterial toxins, the hepatotoxic cyclic peptide microcystins and the hepatotoxic alkaloid cylindrospermopsin. Comparison of victims' symptoms and pathology using animal studies of these two cyanotoxins leads us to conclude that the major contributing factor to death of the dialyses patients was intravenous exposure to microcystins, specifically microcystin-YR, -LR, and -AR. From liver concentrations and exposure volumes, it was estimated that 19.5 μg/L microcystin was in the water used for dialysis treatments. This is 19.5 times the level set as a guideline for safe drinking water supplies by the World Health Organization. Key words: cyanobacteria, cyanotoxins, cylindrospermopsins, microcystins, toxins. Environ Health Perspect 109:663–668 (2001). [Online 20 June 2001]
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Copyright Statement Copyright remains with the authors2001. The attached file is reproduced here in accordance with the copyright policy of the publisher. For information about this journal please refer to the journal's website or contact the authors.
Volume 109
Issue Number 7
Page from 663
Page to 668
ISSN 0091-6765
Date Accessioned 2006-07-20
Language en_AU
Faculty Griffith Health Faculty
Subject PRE2009-Environmental and Occupational Health and Safety
Publication Type Journal Articles (Refereed Article)
Publication Type Code c1x

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