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Lead Poisoning from Mexican Folk Remedies -- California

In May 1982, a 15-month-old California child and his 3-year-old sibling were treated in Mexico with multiple doses of azarcon (lead tetroxide) for chronic diarrhea that had been unsuccessfully treated with ampicillin. In June, the children were taken to a San Diego hospital where the younger child was found to have a blood lead level measurement of 124 ug/dl; the 3-year-old expired with seizures. It was not known whether an autopsy was performed, but azarcon-induced lead encephalopathy was suspected as a cause of death.

Because of these cases, in June 1982, the Los Angeles County Department of Health Services surveyed residents of six predominantly Hispanic, geographically representative census tracts in an attempt to estimate exposure to and knowledge of azarcon and greta (lead oxide). A total of 545 systematically selected households were included. Familiarity with the substances was greatest among Mexican-Hispanics, and prior use was exclusive to this group. Respondents in approximately one-quarter of Mexican-Hispanic households were familiar with one or both of the substances by means other than media announcements. An estimated 7.2%-12.1% of Mexican-Hispanic families admitted prior use from "years ago" to within the past month. One respondent provided interviewers with azarcon from the family medicine cabinet. Since investigators noted a reluctance to admit using azarcon or greta, the incidence of ingestion might have been greater than results of the survey indicated.

A Colorado survey in June-September 1982 among Texas farm workers showed that 7.0% of 100 migrant children under 12 years of age had been treated with substances called azarcon or greta at some time for gastrointestinal illness. Other states with migrant populations, such as Arizona, New Mexico, and Texas, are presently investigating the problem. Reported by T Sankury, MD, Northridge, D Cooper, MD, R Bradley, Los Angeles County-USC Medical Center, S Fong-Huie, MPH, A Guzman, L Habel, MPH, W Janer, L Lieb, MPH, A Martinez, MPH, L Portigal, MS, G Ramirez, F Sorvillo, MPH, B Weiss, MPH, Los Angeles County Dept of Health Svcs, D Dassey, MD, Riverside County Health Dept, T Kearney, PharmD, Regional Poison Center, M Ginsberg, MD, San Diego County Health Dept, R Schlag, R Murray, DrPh, J Chin, MD, State Epidemiologist, California Dept of Health Svcs; A Ackerman, PhD, Sunrise Community Health Center, Colorado; W Meister, MD, West Michigan Poison Control Center, J Miller, Migrant and Rural Health Association, Michigan; V Boersma, MD, D Bol, Holland Migrant Health Clinic, L Truskowski, K Higgins, A Scheit, L del Rio, Kenosha Health Dept, Wisconsin; R Trotter, PhD, Pan American University, IG Gosset, MD, Pan American Health Organization, El Paso, Texas; HF Newman, MD, US Food and Drug Administration, Texas; R Tyler, Women and Infant Care Program, Dept of Health and Human Svcs, Chicago, Illinois.

Editorial Note

Editorial Note: In summer 1981, the first cases of lead poisoning associated with the Mexican folk remedy, azarcon, were identified in Los Angeles, California, and Colorado (1,2). Since that time, nine additional confirmed cases associated with the ingestion of azarcon or the related remedy, greta, have been reported in California. In addition, five cases have been reported from Michigan and Wisconsin.

Greta and azarcon are fine powders with total lead contents varying from 70% to greater than 90%. As powder, they provide a large surface area for potential absorption. These remedies apparently are most often administered to infants and children, who are the most susceptible in terms of clinical impact and the capacity to absorb lead.

With the identification of multiple cases of lead poisoning and indication of significant exposure, major media efforts publicizing the dangers of azarcon and greta have been directed at Hispanic communities in California. Until recently, these substances were available at herb shops and from folk healers on both sides of the Mexican-American border. The U.S. Food and Drug Administration (FDA) has initiated a national recall of greta, and a reported 25 pounds of the substance was recently seized in southern Texas. The FDA is currently investigating the sale of greta in the Yakima Valley of Washington State. Mexican health authorities have reportedly instituted recall efforts in Baja California, Mexico. Mexican-American border. The U.S. Food and Drug Administration (FDA) has initiated a national recall of greta, and a reported 25 pounds of the substance was recently seized in southern Texas. The FDA is currently investigating the sale of greta in the Yakima Valley of Washington State. Mexican health authorities have reportedly instituted recall efforts in Baja California, Mexico.

Health professionals are urged to report cases of azarcon- or greta-associated lead poisonings and to promote educational programs in their Hispanic communities regarding the dangers of these folk remedies. Health education material in Spanish and English is available from the State of California and Los Angeles County Departments of Health Services and from the Sunrise Community Health Center, P.O. Box 245, Greely, Colorado 80632.

References

  1. CDC. Use of lead tetroxide as a folk remedy for gastrointestinal illness. MMWR 1981;30:546-7.

  2. CDC. Lead poisoning from lead tetroxide used as a folk remedy--Colorado. MMWR 1981;30:647-8.

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