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dc.contributor.authorCarmichael, Wayneen_US
dc.contributor.authorM.F.O Azevedo, Sandraen_US
dc.contributor.authorAn, Jien_US
dc.contributor.authorJ.R. Molica, Renatoen_US
dc.contributor.authorM. Jochimsen, Eliseen_US
dc.contributor.authorLau, Sharonen_US
dc.contributor.authorL.Rinehart, Kennethen_US
dc.contributor.authorR. Shaw, Glenen_US
dc.contributor.authorK. Eaglesham, Geoffen_US
dc.date.accessioned2017-04-24T08:02:07Z
dc.date.available2017-04-24T08:02:07Z
dc.date.issued2001en_US
dc.date.modified2009-11-02T05:18:09Z
dc.identifier.issn00916765en_US
dc.identifier.doihttp://www.ehponline.org/realfiles/members/2001/109p663-668carmichael/carmichael-full.htmlen_AU
dc.identifier.urihttp://hdl.handle.net/10072/16884
dc.description.abstractAn outbreak of acute liver failure occurred at a dialysis center in Caruaru, Brazil (8౷' S, 35൸' W), 134 km from Recife, the state capital of Pernambuco. At the clinic, 116 (89%) of 131 patients experienced visual disturbances, nausea, and vomiting after routine hemodialysis treatment on 13-20 February 1996. Subsequently, 100 patients developed acute liver failure, and of these 76 died. As of December 1996, 52 of the deaths could be attributed to a common syndrome now called Caruaru syndrome. Examination of phytoplankton from the dialysis clinic's water source, analyses of the clinic's water treatment system, plus serum and liver tissue of clinic patients led to the identification of two groups of cyanobacterial toxins, the hepatotoxic cyclic peptide microcystins and the hepatotoxic alkaloid cylindrospermopsin. Comparison of victims' symptoms and pathology using animal studies of these two cyanotoxins leads us to conclude that the major contributing factor to death of the dialyses patients was intravenous exposure to microcystins, specifically microcystin-YR, -LR, and -AR. From liver concentrations and exposure volumes, it was estimated that 19.5 姯L microcystin was in the water used for dialysis treatments. This is 19.5 times the level set as a guideline for safe drinking water supplies by the World Health Organization. Key words: cyanobacteria, cyanotoxins, cylindrospermopsins, microcystins, toxins. Environ Health Perspect 109:663-668 (2001). [Online 20 June 2001] http://ehpnet1.niehs.nih.gov/docs/2001/109p663-668carmichael/abstract.htmlen_US
dc.description.peerreviewedYesen_US
dc.description.publicationstatusYesen_AU
dc.format.extent36963 bytes
dc.format.extent98683 bytes
dc.format.mimetypetext/plain
dc.format.mimetypeapplication/pdf
dc.languageEnglishen_US
dc.language.isoen_AU
dc.publisherNational Institute of Environmental Health Sciencesen_US
dc.publisher.placeWashington, D.C.en_US
dc.publisher.urihttp://www.ehponline.org/en_AU
dc.relation.ispartofpagefrom663en_US
dc.relation.ispartofpageto668en_US
dc.relation.ispartofissue7en_US
dc.relation.ispartofjournalEnvironmental Health Perspectivesen_US
dc.relation.ispartofvolume109en_US
dc.subject.fieldofresearchcode321201en_US
dc.titleHuman fatalities from cyanobacteria: Chemical and biological evidence for cyanotoxins.en_US
dc.typeJournal articleen_US
dc.type.descriptionC1 - Peer Reviewed (HERDC)en_US
dc.type.codeC - Journal Articlesen_US
gro.rights.copyrightCopyright remains with the authors2001. The attached file is reproduced here in accordance with the copyright policy of the publisher. For information about this journal please refer to the journal's website or contact the authors.en_AU
gro.date.issued2001
gro.hasfulltextFull Text


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