News & Analysis News From the Centers for Disease Control and Prevention Adults Are Making It Easier for Children “These data suggest it may be time to hishand.Hehadnofeverorchillsbutreported to Ingest Dangerous Drugs placegreateremphasisonencouragingadults beingunabletodrink.Hereceivedaprescrip- Whenchildrenaccidentallyswallowprescrip- to keep medicines in containers with child- tion steroid and was discharged. tion drugs, more than half the time it’s be- resistantfeatures,”seniorauthorDanielBud- cause an adult has removed the medication nitz, MD, MPH, of CDC’s Division of Health- from child-safe packaging, according to a care Quality Promotion, said in a statement. CDC study in the Journal of Pediatrics. Common reasons for removing drugs The 1970 passage of the Poison Preven- from child-safe packaging included moving tion Packaging Act, which required child- them to pill organizers that help people re- safe packaging for most prescription medi- member to take them or make traveling with cations, helped reduce unintentional child medicationseasier.Somedrugswereleftout poisonings, the authors wrote. But as medi- for someone else to take. cation use increased in the 2000s, so did “There is an opportunity here for inno- children’s exposures to those drugs. To learn vative medication container options that more about how children are getting ac- promote adult adherence and provide por- cess to medications, the study’s authors sur- tability and convenience, while maintain- veyed 4496 adults who called any of 5 US ing child safety,” Budnitz said. poison centers about an accidental expo- sure involving a child 5 years or younger be- Hundreds of Health Care Workers tween February and September 2017. Exposed to Rabies About half of the exposures to attention- A Utah man who became infected with ra- Two days later he returned to the hospi- bies after handling several bats potentially deficit/hyperactivity disorder medication tal with breathing difficulties and lighthead- and 42.6% of cases involving opioids oc- exposed 279 other people, most of them edness. After being transferred to 2 more health workers. curred when loose pills were left lying out, hospitals with worsening symptoms, he de- the study showed. In about 30% to 40% of ThecasewasfirstreportedtotheUtahDe- veloped a high fever and became coma- partmentofHealthonNovember3,2018,but children’s exposures to anticonvulsants, hy- tose. The man received steroids for pre- the55-year-oldman’ssymptomshadbegun18 poglycemics, or cardiovascular/antithrom- sumed autoimmune encephalitis. He was boticagents,themedicationhadbeentrans- daysearlier.Themaninitiallysoughtchiroprac- thentransferredtoafourthhospitalafterde- ticcareforarmandneckpainheattributedto ferredtoanothercontainer.Abouthalfofthe veloping seizures. An infectious disease spe- prescription drug exposures involved a drug apreviousinjury.Twodayslaterhewenttothe cialist there noted the man’s muscle spasms emergency department with ongoing pain, a intended for a parent, while 30.7% in- while swallowing could indicate rabies. volved drugs intended for a grandparent. burningsensationinhisarm,andnumbnessin After the man died, CDC testing con- firmed a rabies diagnosis. It was the first hu- manrabiesdeathinUtahsince1944.Hisfam- ilysaidthemanhadhandledseveralbatsthat entered his home’s attic and master bed- room, but they weren’t aware of the rabies risk associated with bats. Further investiga- tionidentified279people,mostlyhealthcare workers,whowerepotentiallyexposedtora- bies. More than 100 required postexposure prophylaxis, including 74 health workers. Public health workers distributed fliers and posters describing the rabies risk from bats. “Educatingthegeneralpublicabouttherisk of rabies through bat exposure and advising healthcareproviderstoconsiderrabiesinthe differential diagnosis of unexplained neuro- logicsymptomscouldreduceexposures,”the authors wrote. − Bridget M. Kuehn, MSJ Note: Source references are available through embedded hyperlinks in the article text online. jama.com (Reprinted) JAMA March 24/31, 2020 Volume 323, Number 12 1125 © 2020 American Medical Association. All rights reserved. Left, iStock.com/NoDerog; Right, iStock.com/ePhotocorp
JAMA – American Medical Association
Published: Mar 24, 2020
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