624
COMPOSITION OF SOME ANALGESIC PRODUCTS AND AN ANTIDIARRHOEAL AGENT BEFORE (1982) AND AFTER (1991) ESSENTIAL DRUGS DECREE IN NIGERIA
be deceived too; ’Panadol’ is the most prescribed brand of paracetamol and 85% of kaolin prescriptions studied were for ’Diapec’ not "kaolin suspension". Among the analgesics, ’Daga’ (Hoechst), ’Cafenol’ (Sterling Products), ’Phensic’ (Beecham), and ’PR’ (Boots) remain popular
for self-medication. These were all fixed-ratio combinations before
the essential drugs decree but manufacturers have kept on the old brand names. Patients now pay more for single active ingredients and the drug companies spend less on production. Furthermore the number of branded products of paracetamol in the two pharmacies studied were seventeen while aspirin brands numbered eight. Before the essential drugs programme there had been only six and
four, respectively.
implementation of an essential drugs in programme Nigeria drug companies will have to be compelled to For the successful
produce low-cost generics. Department of Pharmaceutics, Faculty of Pharmaceutical Sciences, University of Nigeria, Nsukka, Nigeria
M. U. ADIKWU
Isolation of Latin American epidemic strain of Vibrio cholerae O1 from US Gulf Coast SIR,-In January, 1991, cholera caused by toxigenic Vibrio cholerae 01 reappeared in Peru after being absent from South America for more than a century. An epidemic rapidly spread throughout Peru and into Ecuador, Colombia, Brazil, Chile, Mexico, Guatemala, Bolivia, Panama, and El Salvador. Cholera cases have also come into the USA from this epidemic. More than 300 000 cases with about 3000 deaths have been reported.1 Since 1973, another cholera strain had been implicated in about 65 cholera cases that have been associated with consumption of seafood from the US Gulf Coast. The single toxigenic V cholerae 01 1 strain linked to all these cases is designated the Gulf Coast strain. This strain is distinguishable from other epidemic strains, including the 7th pandemic isolates and those currently being isolated from Latin America.2 Although cholera caused by the Gulf Coast strain has usually been associated with seafood consumption, that strain is rarely isolated from seafood or environmental samples. While investigating the ecology of vibrios in Mobile Bay on the US Gulf Coast, US Food and Drug Administration researchers unexpectedly isolated V cholerae 01 serotype Inaba, biotype El Tor, from oysters and intestinal contents of fish collected on July 2, 1991. An intensive sampling programme was implemented, and V cholerae 01 1 was isolated from three additional Mobile Bay oyster samples (two harvested on July 22 and one on September 16,1991 ). All isolates were toxigenic, as determined by DNA probe, enzyme-linked immunosorbent assay, and tissue culture (Chinese hamster ovary). All the Mobile Bay isolates were indistinguishable from each other and clearly differed from the previously described Gulf Coast strain. The Mobile Bay isolates were similar to the Latin American epidemic strains by serotype, biotype, phage type, and multilocus enzyme electrophoresis type, and when the strains were characterised by pulse field gel electrophoresis of DNA restriction
fragments and Southern blots of restricted genomic DNA probed for rRNA or cholera toxin genes. These recent environmental isolates have not been implicated in US-acquired cholera, which has been historically associated with consumption of seafood from the Gulf Coast. The only US cases caused by the Latin American strain were in small outbreaks resulting from importation of crabs from South America for personal consumption.3 The strains were isolated over a short period, and whether the organism has established an ecological niche on the Gulf Coast remains to be established. There is public health concern because the Latin American clone has the proven ability to cause widespread epidemic disease. By contrast, the Gulf Coast strain has caused only sporadic disease or small outbreaks with no secondary spread along the Gulf Coast. This apparent difference in epidemic potential may be attributable to variation in host susceptibility or strain virulence, or environmental colonising ability. Differences in food handling and eating habits, or quality of water and sewage treatment may also play a part in the ability of these strains to cause an epidemic. No human disease has been reported despite increased surveillance for cholera. The organism may have entered Mobile Bay through environmental contamination from any of a number of sources. Biological Hazards Branch, Division of Seafood Research, Office of Seafood, Food and Drug Administration, Dauphin Island, Alabama 36528, USA
ANGELO DEPAOLA GESA M. CAPERS MILES L. MOTES
Atlanta, Georgia
ORJAN OLSVIK PATRICIA I. FIELDS JOY WELLS I. KAYE WACHSMUTH
Division of Microbiology, Center for Food Safety and Applied Nutrition, Food and Drug Administration, Washington DC
THOMAS A. CEBULA WALTER H. KOCH FARUKH KHAMBATY MAHENDRA H. KOTHARY W. LES PAYNE BARRY A. WENTZ
Enteric Disease Branch, Division of Bacterial and Mycotic Diseases, Center for Infectious Diseases, Centers for Disease Control,
1. Centers for Disease Control. Update: cholera: western hemisphere, and recommendations for treatment of cholera. MMWR 1991; 40: 562-65 2. Wachsmuth K, Bopp CA, Fields PI, Carrillo C. Differences between toxigenic Vibrio cholerae O1 from South America and US Gulf Coast. Lancet 1991, 337: 1097-98. 3. Centers for Disease Control. Cholera: New York, 1991. MMWR 1991; 40: 516-18.
Toxigenic Vibrio cholerae O1 and cargo ships entering Gulf of Mexico SIR,-In January, 1991, epidemic cholera surfaced in Peru; the disease has since spread to Ecuador, Columbia, Guatemala, Brazil, Bolivia, Chile, Panama, Mexico, El Salvador, Honduras, Nicaragua, and Venezuela, as reported to the Pan American Health Organisation (Dec 5,1991). The agent in this epidemic is toxigenic Vibrio cholera 01, biotype El Tor, serotype Inaba.’ In July and September, 1991,toxigenic V cholerae 01 resembling the Latin American strain was recovered from seafoods collected
COMPOSITION OF SOME ANALGESIC PRODUCTS AND AN ANTIDIARRHOEAL AGENT BEFORE (1982) AND AFTER (1991) ESSENTIAL DRUGS DECREE IN NIGERIA
be deceived too; ’Panadol’ is the most prescribed brand of paracetamol and 85% of kaolin prescriptions studied were for ’Diapec’ not "kaolin suspension". Among the analgesics, ’Daga’ (Hoechst), ’Cafenol’ (Sterling Products), ’Phensic’ (Beecham), and ’PR’ (Boots) remain popular
for self-medication. These were all fixed-ratio combinations before
the essential drugs decree but manufacturers have kept on the old brand names. Patients now pay more for single active ingredients and the drug companies spend less on production. Furthermore the number of branded products of paracetamol in the two pharmacies studied were seventeen while aspirin brands numbered eight. Before the essential drugs programme there had been only six and
four, respectively.
implementation of an essential drugs in programme Nigeria drug companies will have to be compelled to For the successful
produce low-cost generics. Department of Pharmaceutics, Faculty of Pharmaceutical Sciences, University of Nigeria, Nsukka, Nigeria
M. U. ADIKWU
Isolation of Latin American epidemic strain of Vibrio cholerae O1 from US Gulf Coast SIR,-In January, 1991, cholera caused by toxigenic Vibrio cholerae 01 reappeared in Peru after being absent from South America for more than a century. An epidemic rapidly spread throughout Peru and into Ecuador, Colombia, Brazil, Chile, Mexico, Guatemala, Bolivia, Panama, and El Salvador. Cholera cases have also come into the USA from this epidemic. More than 300 000 cases with about 3000 deaths have been reported.1 Since 1973, another cholera strain had been implicated in about 65 cholera cases that have been associated with consumption of seafood from the US Gulf Coast. The single toxigenic V cholerae 01 1 strain linked to all these cases is designated the Gulf Coast strain. This strain is distinguishable from other epidemic strains, including the 7th pandemic isolates and those currently being isolated from Latin America.2 Although cholera caused by the Gulf Coast strain has usually been associated with seafood consumption, that strain is rarely isolated from seafood or environmental samples. While investigating the ecology of vibrios in Mobile Bay on the US Gulf Coast, US Food and Drug Administration researchers unexpectedly isolated V cholerae 01 serotype Inaba, biotype El Tor, from oysters and intestinal contents of fish collected on July 2, 1991. An intensive sampling programme was implemented, and V cholerae 01 1 was isolated from three additional Mobile Bay oyster samples (two harvested on July 22 and one on September 16,1991 ). All isolates were toxigenic, as determined by DNA probe, enzyme-linked immunosorbent assay, and tissue culture (Chinese hamster ovary). All the Mobile Bay isolates were indistinguishable from each other and clearly differed from the previously described Gulf Coast strain. The Mobile Bay isolates were similar to the Latin American epidemic strains by serotype, biotype, phage type, and multilocus enzyme electrophoresis type, and when the strains were characterised by pulse field gel electrophoresis of DNA restriction
fragments and Southern blots of restricted genomic DNA probed for rRNA or cholera toxin genes. These recent environmental isolates have not been implicated in US-acquired cholera, which has been historically associated with consumption of seafood from the Gulf Coast. The only US cases caused by the Latin American strain were in small outbreaks resulting from importation of crabs from South America for personal consumption.3 The strains were isolated over a short period, and whether the organism has established an ecological niche on the Gulf Coast remains to be established. There is public health concern because the Latin American clone has the proven ability to cause widespread epidemic disease. By contrast, the Gulf Coast strain has caused only sporadic disease or small outbreaks with no secondary spread along the Gulf Coast. This apparent difference in epidemic potential may be attributable to variation in host susceptibility or strain virulence, or environmental colonising ability. Differences in food handling and eating habits, or quality of water and sewage treatment may also play a part in the ability of these strains to cause an epidemic. No human disease has been reported despite increased surveillance for cholera. The organism may have entered Mobile Bay through environmental contamination from any of a number of sources. Biological Hazards Branch, Division of Seafood Research, Office of Seafood, Food and Drug Administration, Dauphin Island, Alabama 36528, USA
ANGELO DEPAOLA GESA M. CAPERS MILES L. MOTES
Atlanta, Georgia
ORJAN OLSVIK PATRICIA I. FIELDS JOY WELLS I. KAYE WACHSMUTH
Division of Microbiology, Center for Food Safety and Applied Nutrition, Food and Drug Administration, Washington DC
THOMAS A. CEBULA WALTER H. KOCH FARUKH KHAMBATY MAHENDRA H. KOTHARY W. LES PAYNE BARRY A. WENTZ
Enteric Disease Branch, Division of Bacterial and Mycotic Diseases, Center for Infectious Diseases, Centers for Disease Control,
1. Centers for Disease Control. Update: cholera: western hemisphere, and recommendations for treatment of cholera. MMWR 1991; 40: 562-65 2. Wachsmuth K, Bopp CA, Fields PI, Carrillo C. Differences between toxigenic Vibrio cholerae O1 from South America and US Gulf Coast. Lancet 1991, 337: 1097-98. 3. Centers for Disease Control. Cholera: New York, 1991. MMWR 1991; 40: 516-18.
Toxigenic Vibrio cholerae O1 and cargo ships entering Gulf of Mexico SIR,-In January, 1991, epidemic cholera surfaced in Peru; the disease has since spread to Ecuador, Columbia, Guatemala, Brazil, Bolivia, Chile, Panama, Mexico, El Salvador, Honduras, Nicaragua, and Venezuela, as reported to the Pan American Health Organisation (Dec 5,1991). The agent in this epidemic is toxigenic Vibrio cholera 01, biotype El Tor, serotype Inaba.’ In July and September, 1991,toxigenic V cholerae 01 resembling the Latin American strain was recovered from seafoods collected
