title: Retrospective Investigation of a Lead Poisoning Outbreak from the Consumption of an Ayurvedic Medicine: Durban, South Africa.
abstract: Ayurvedic medicines have been gaining in popularity around the world in recent decades, but have also been associated with lead contamination and poisoning. In 2012 in Durban, South Africa, a lead poisoning outbreak among adolescents was associated with the consumption of an Ayurvedic medicine for the treatment of skin conditions. In 2014 eight individuals (out of 12 affected) were traced and interviewed. Questionnaires were administered; blood samples were taken for lead content analysis; and medical records were reviewed. Samples of the implicated medicines were analyzed to determine lead levels. Blood lead levels during the acute phase ranged from 34 to 116 µg/dL; and during the current study (two years later) from 13 to 34 µg/dL. The implicated lead capsules had a lead content of 125,235 µg/g. Participants suffered a wide range of non-specific ill health symptoms; and there was a significant delay in the diagnosis of lead poisoning. This study highlights the potential for lead poisoning outbreaks from the consumption of Ayurvedic medicines in African settings. There were weaknesses with regard to the diagnosis of and response to the outbreak, for which measures need to be put in place to ensure greater awareness of the role of Ayurvedic medicine in lead poisoning, and prompt diagnosis and treatment of future cases.
authors.affiliation: Environment & Health Research Unit, Medical Research Council, P.O. Box 87373, Houghton 2041, Johannesburg, Gauteng, South Africa. amathee@mrc.ac.za.|Faculty of Health Sciences, University of Johannesburg, P.O. Box 17011, Doornfontein 2018, Gauteng, South Africa. amathee@mrc.ac.za.|School of Public Health, University of the Witwatersrand, 27 St Andrews Road, Parktown 2193, Johannesburg, South Africa. amathee@mrc.ac.za.
authors.forename: Angela
authors.initials: A
authors.lastname: Mathee
authors.affiliation: Environment & Health Research Unit, Medical Research Council, P.O. Box 87373, Houghton 2041, Johannesburg, Gauteng, South Africa. nisha.naicker@mrc.ac.za.|School of Public Health, University of the Witwatersrand, 27 St Andrews Road, Parktown 2193, Johannesburg, South Africa. nisha.naicker@mrc.ac.za.
authors.forename: Nisha
authors.initials: N
authors.lastname: Naicker
authors.affiliation: Environment & Health Research Unit, Medical Research Council, P.O. Box 87373, Houghton 2041, Johannesburg, Gauteng, South Africa. june.teare@mrc.ac.za.
authors.forename: June
authors.initials: J
authors.lastname: Teare
mesh_terms: D000293:Adolescent; D004196:Disease Outbreaks; D005260:Female; D006801:Humans; D007407:Interviews as Topic; D007855:Lead Poisoning / Q000453:epidemiology*; D008297:Male; D008515:Medicine, Ayurvedic; D012189:Retrospective Studies; D012871:Skin Diseases / Q000188:drug therapy; D013019:South Africa / Q000453:epidemiology
keywords: Ayurvedic; South Africa; lead poisoning; traditional medicine