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Industrial Solvent Identified as Cause of 22 Deaths in Panama, and not lisinopril as originally thought
A tainted generic cough syrup has been identified as the culprit in a rash of mysterious deaths in Panama. The toxic ingredient, diethylene glycol, is well known for its harmful effects. Was this an error? Was it deliberate? No one knows yet.
Authorities confirmed Tuesday that diethylene glycol, an industrial solvent and antifreeze prohibited for medicinal use, was present in the cough syrup, as well as in other medicines and even a lotion, all manufactured by the laboratory belonging to the state Social Security Fund (CSS).
Of the 51 people who have fallen ill, 22 have died of kidney failure.
Since September patients have been trickling in to public hospitals complaining of nausea, vomiting, diarrhoea and general weakness of the limbs, progressing to the point where they were unable to pass water. On Oct. 1, the authorities met to study the situation.
On Oct. 3, the Ministry of Health and CSS announced that "the national system of epidemiological surveillance had detected an unusual increase in the number of cases of acute renal insufficiency." The patients were mostly over 60, with a history of high blood pressure, diabetes and kidney problems.
Fearing an outbreak of a contagious disease, the Pan American Health Organisation and U.S. Centres for Disease Control and Prevention (CDC) were asked for help. A local interdisciplinary team of doctors was formed to supervise patient treatment.
Panama's Gorgas Memorial Institute joined the investigation effort, and carried out tests for dengue, influenza A and B, West Nile virus, equine encephalitis and enterovirus, all of which proved negative.
"Our concern was that it might be an emerging infectious disease that could spread rapidly through the population. But when we put all the pieces together we saw that they didn't match this picture. Some patients lived in houses where there were up to 10 children, all crowded together, and only one person was affected. Doctors and nurses who were treating the patients were not infected either," Dr. Jorge Motta, director of the Gorgas Institute, told IPS.
Investigators then started looking for a toxin that might have caused the disease. "When we looked at the medicines the patients were taking and those they told us about, we found 35 percent were on lisinopril," Motta said.