Man dies after ingesting aquarium product containing chloroquine: Hospital network - ABC News

Posted: 23 Mar 2020 07:38 PM PDT

The FDA is warning people not to self-medicate to avoid coronavirus

March 24, 2020, 2:35 AM

6 min read

A man reportedly died after ingesting a substance used to clean fish tanks that contains a form of chloroquine, a drug that President Donald Trump has claimed repeatedly could be a "game changer" in the fight against the novel coronavirus.

The man's wife also is in critical condition, the health care system Banner Health said in a statement, adding, "Within thirty minutes of ingestion, the couple experienced immediate effects requiring admittance to a nearby Banner Health hospital."

The additive ingested had the same active ingredient as the prescription drug chloroquine used to prevent and treat malaria, but it's formulated differently, according to Dr. Daniel Brooks, Banner Poison and Drug Information Center medical director.

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Trump has been publicly touting the prescription form of chloroquine in the fight against novel coronavirus despite repeated warnings from health officials that any suggestion that it works is purely anecdotal.

"Given the uncertainty around COVID-19, we understand that people are trying to find new ways to prevent or treat this virus, but self-medicating is not the way to do so," Brooks said in a statement.

The Centers for Disease Control and Prevention advises on its website that "there are no US Food and Drug Administration (FDA)-approved drugs specifically for the treatment of patients with COVID-19," and a vaccine is estimated to remain at least a year away.

The CDC notes that a study in China reported that COVID-19 patients treated with chloroquine "had clinical and virologic benefit versus a comparison group, and chloroquine was added as a recommended antiviral for treatment of COVID-19 in China."

Chloroquine has been approved to treat and prevent malaria since 1944. Because the drug is on the market, doctors already can use it for off-label purposes.

The FDA said it advises against taking any form of chloroquine unless it has been prescribed by a doctor and obtained from a legitimate source. It says it's been working with online sites to remove dangerous items.

"Products marketed for veterinary use or 'for research only,' or otherwise not for human consumption have not been evaluated for safety and should never be used," according to an agency statement.

"FDA is aware that chloroquine is marketed as an unapproved drug to treat external parasites in aquarium fish, but these products have not been evaluated by FDA to determine if they are safe, effective, properly manufactured, and adequately labeled," the agency said.

Trump said he thinks that because chloroquine has worked well against malaria, he thinks it will work well against COVID-19.

"We don't know, but there's a real chance that it could have a tremendous impact. It would be a gift from God if that worked. That would be a big game changer. So we'll see," Trump said.

When asked if the drug was promising last Friday, the government's top infectious disease expert, Dr. Anthony Fauci, standing next to Trump, said "the answer is no" because "the evidence you're talking about … is anecdotal evidence."

"The information that you're referring to specifically is anecdotal," he added. "It was not done in a controlled clinical trial. So, you really can't make any definitive statement about it."

Trump then stepped forward to add: "We'll see. We're going to know soon."

Trump isn't alone in sharing enthusiasm for at least wanting to try the drug, especially on the sickest of patients who have no other options.

New York Gov. Andrew Cuomo says the state has acquired 70,000 doses of hydroxycholoroquine, 750,000 doses of chloroquine and 10,000 doses of Zithromax -- an antibiotic -- to implement in drug trials starting Tuesday.

Several clinical trials of hydroxycholoroquine for preventing or treating the virus are planned in the U.S., according to CDC.

"The last thing that we want right now is to inundate our emergency departments with patients who believe they found a vague and risky solution that could potentially jeopardize their health," Brooks' said.

What to know about coronavirus:

New Research on an Important Little Fish - UConn Today

Posted: 24 Mar 2020 06:52 AM PDT

A slender little fish called the sand lance plays a big role as "a quintessential forage fish" for puffins, terns and other seabirds, humpback whales, and other marine mammals, and even bigger fish such as Atlantic sturgeon, cod, and bluefin tuna in the Gulf of Maine and northwest Atlantic Ocean. But scientists say right now they know far too little about its biology and populations to inform relevant management, climate adaptation and conservation efforts.

A collaborative team of 24 coauthors, including UConn Marine Sciences Professor Hannes Baumann and Professor Emeritus Peter Auster, who also serves as Senior Research Scientist at Mystic Aquarium, and led by first author and marine ecologist Michelle Staudinger at the University of Massachusetts Amherst's Northeast Climate Adaptation Science Center, this week is calling for increased focus on sand lance and their ecological role in the region's dynamic ecosystem, which is facing increased pressure and risks from climate change, fishing, and offshore wind energy development. Details are in the current issue of Fish and Fisheries.

Two species, American and Northern sand lance, are so streamlined that they can dive at swimming speed into the sandy sea floor, burrowing to escape predators. Staudinger explains, "They're unique among forage fish because of their elongate body shape and hiding behaviors. Their shape makes them very attractive to many predators because they're easy to swallow. Most marine predators don't chew their food, rather they swallow their food whole. It's like eating spaghetti instead of a meatball; there are no legs or spines to get caught in your mouth or throat. Even small seabird chicks can swallow large sand lance because they slide right down into the gullet."

Sand lance are an unmanaged forage fish in the region, so there is no priority for collecting data on abundance and how they are distributed. "Sand lance occur in large schools that make them tasty targets for large predators. They are high energy food. When populations decline, there are fewer schools and this requires predators to spend more time and energy searching. Switching to other less nutritious prey species can affect growth of predators, and have cascading effects through the ecosystem," said Auster. "Also, sand lance lay adhesive eggs that can anchor to the seafloor. Disturbances of eggs from storms and fishing gear may affect survival, but we have little concrete information in this regard."

This work represents the first comprehensive assessment of this important forage fish in the Northwest Atlantic, though similar efforts have been carried out in the Pacific Northwest and Europe. In the Atlantic, sand lance are observed to be a significant food source for the federally endangered Roseate tern, Atlantic sturgeon and cod, Harbor and Grey seals and Minke and Humpback whales. "This paper is a call to our peers and colleagues that there is a big gap in knowledge, and to bring more attention to these species as unmanaged forage fish," says Staudinger.

In addition to UMass Amherst's Northeast Climate Adaptation Science Center, the work was supported by Woods Hole Oceanographic Institution, the U.S. Fish and Wildlife Service, NOAA/Stellwagen Bank National Marine Sanctuary, National Marine Sanctuary Foundation, University of Connecticut, Boston University, the Northeast Regional Sea Grant Consortium, and others.

Overall, they report that 72 regional predators including 45 fish species, two squids, 16 seabirds, and nine marine mammals were found to consume sand lance. Staudinger adds that because sand lance are winter spawners, they are particularly vulnerable to warming ocean temperatures in Gulf of Maine waters, which are known as a global hotspot of warming. The eel-like fish may also be less adaptable than other fish species – they are very dependent on sandy bottom marine environments increasingly targeted by dredging for beach nourishment and siting of wind energy turbines.

Though more work needs to be done, this research creates a solid basis to build upon.

The researchers say, "We have identified several research priorities that include basic information on sand lance abundance, reproduction, their sensitivity to climate change, fishing and habitat disturbance. We also need extensive studies to understand how these small but important fish influence the food web, both their prey and their predators."

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