Arsenic - A Fatal Complication for Pandemic Flu - MUST READ

[Emily]

Here's a Woods Hole press release that might explain the cluster of deaths in Mexico.

http://www.mbl.edu/news/press_releases/2009_pr_05_18.html

Scientists Link Influenza A (H1N1) Susceptibility to Common Levels of Arsenic Exposure

MBL, WOODS HOLE, MA—"The ability to mount an immune response to influenza A (H1N1) infection is significantly compromised by a low level of arsenic exposure that commonly occurs through drinking contaminated well water, scientists at the Marine Biological Laboratory (MBL) and Dartmouth Medical School have found.

Joshua Hamilton, the MBL's Chief Academic and Scientific Officer and a senior scientist in the MBL's Bay Paul Center; graduate student Courtney Kozul of Dartmouth Medical School, where the work was conducted; and their colleagues report their findings this week in the journal Environmental Health Perspectives.

"When a normal person or mouse is infected with the flu, they immediately develop an immune response," says Hamilton, in which immune cells rush to the lungs and produce chemicals that help fight the infection. However, in mice that had ingested 100 ppb (parts per billion) arsenic in their drinking water for five weeks, the immune response to H1N1 infection was initially feeble, and when a response finally did kick in days later, it was "too robust and too late," Hamilton says. "There was a massive infiltration of immune cells to the lungs and a massive inflammatory response, which led to bleeding and damage in the lung." Morbidity over the course of the infection was significantly higher for the arsenic-exposed animals than the normal animals.

Respiratory infections with influenza A virus are a worldwide health concern and are responsible for 36,000 deaths annually. The recent outbreak of the influenza A H1N1 substrain ("swine flu")--which is the same virus that Hamilton and his colleagues used in their arsenic study--to date has killed 72 people in Mexico and 6 in the United States.

"One thing that did strike us, when we heard about the recent H1N1 outbreak, is Mexico has large areas of very high arsenic in their well water, including the areas where the flu first cropped up. We don't know that the Mexicans who got the flu were drinking high levels of arsenic, but it's an intriguing notion that this may have contributed," Hamilton says."
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Whole article here: Low Dose Arsenic Compromises the Immune Response to Influenza A Infection in vivo

http://www.mbl.edu/news/press_releases/pdf/h1n1_arsenic.pdf

[Shiloh]

Discussion - Arsenic, A Fatal Complication for Pandemic Flu?

Source: http://momento24.com/en/2009/07/01/a...lu-infections/

Featured
Argentina has the world?s highest rate of deaths associated with swine flu infections
Posted on 01 July 2009 at 11:47

The National Government despite the alarming figures, refused to declare a national health emergency.

So far 16 provinces including Buenos Aires took their own healthcare decisions individually, to extend the winter break to about a month.

Schools which serve meals will have them available for pupils to pick them up and take them home every day during the emergency.

Parents are advised not to let their children go to crowded public places.

So far, 38 were killed by H1N1 virus, and world agencies believe the number of deaths is unusually large considering the total number of infections (1,587).

It is believed that the actual number of infections reaches 15,000 with 43 deaths.
The deceased by province are:
Province of Buenos Aires : 29
Buenos Aires City: 6
Santa Fe: 5
Corrientes: 2
Misiones: 1
? ? ? ? ? ? ?.
Total: 43

These figures suggest the official information does not entirely reflect the actual situation of the pandemic in the country.

All this leads to misinformation as well as fear in most of the population, while some are not aware of the real situation and consider it common seasonal flu.

Unfortunately, some authorities reacted a little late regarding preventive measures, declaring that the strain of H1N1 virus circulating in our country was a ?weakened? version of the illness, while figures seem to indicate it is a very aggressive and dangerous strain.

Health centers, collapsed, and when a patient arrived with flu symptoms, was sent him home and told to return only if 48 hours later the symptoms persisted. Despite the cold, parents had to take their children with a fever of 38 ?C or more out in the cold and wait in a crowded hospital lobby for long hours among hundreds of patients affected by all kind of diseases. This when the WHO said treatment with antiviral drugs such as, Tamiflu is most effective within the first 48 hours of infection.

Meanwhile, Chief of Cabinet Sergio Massa, said that from now on health authorities will change their current procedures and provide treatment right away to every patient suspected of being infected.

According to Massa, the government has a stock of two million treatments of Tamiflu, so he would be prepared for a resurgence of the epidemic, which according to many experts, could take place in the next two weeks.

Schools are closed but Dr. Carlos Bergallo, Chief of the Infectious Diseases of ?Cordoba? Hospital and ?Allende? Sanatorium said: ?They did not close the malls or movie theaters or places of that kind, so if the kids get together in leisure centers rather than in a classroom, this measures are useless. ?

The infectologist was concerned over the increase in cases of pneumonia treated at his hospital, and warned of the possibility that the H1N1 virus mixed with that of seasonal influenza.

?The virus may have mutated, and we do not know it. Small genetic changes can make it more aggressive.?

According to the doctor, the seriousness of swine flu, is that, unlike the seasonal version which mainly affecting young children and the elderly, this new disease attacks with particular virulence young adults, and develops unusually quickly.

[sharon sanders]

Re: Argentina has the world?s highest rate of deaths associated with swine flu infections

Arsenic concentration in water and bovine milk in Cordoba, Argentina. Preliminary results

<hr><table align="top" border="0" width="95%"><tbody><tr valign="top"><td>Alejo P?rez-Carrera ^a1 and Alicia Fern?ndez-Cirelli ^a1^c1
^a1 Centro de Estudios Transdisciplinarios del Agua, Facultad de Ciencias Veterinarias, Universidad de Buenos Aires, Av. Chorroar?n N? 280 C1427CWO, Ciudad de Buenos Aires, Argentina

</td><td align="right" bgcolor="#ddddff" valign="top"><table><tbody><tr><td align="right">Article author query</td></tr> <tr><td align="right" nowrap="nowrap">perez-carrera a [PubMed] [Google Scholar] </td></tr> <tr><td align="right" nowrap="nowrap">fernandez-cirelli a [PubMed] [Google Scholar] </td></tr></tbody></table></td></tr></tbody></table>The Chaco Pampean Plain of central Argentina constitutes one of the largest regions of high arsenic (As) groundwaters known, covering around 1?10⁶ km² (Smedley & Kinniburg, 2002; Far?as et al. 2004).
(Received January 5 2004)
(Accepted July 17 2004)

[sharon sanders]

Re: Woods Hole Scientists Link Influenza A (H1N1) Susceptibility to Arsenic Exposure

http://www.who.int/mediacentre/factsheets/fs210/en/

WHO Document last updated 2001 - obviously a long standing problem -

Arsenic in drinking water

Arsenic may be found in water which has flowed through arsenic-rich rocks. Severe health effects have been observed in populations drinking arsenic-rich water over long periods in countries world-wide.
Source

• Arsenic is widely distributed throughout the earth's crust.
• Arsenic is introduced into water through the dissolution of minerals and ores, and concentrations in groundwater in some areas are elevated as a result of erosion from local rocks.
• Industrial effluents also contribute arsenic to water in some areas.
• Arsenic is also used commercially e.g. in alloying agents and wood preservatives.
• Combustion of fossil fuels is a source of arsenic in the environment through disperse atmospheric deposition.
• Inorganic arsenic can occur in the environment in several forms but in natural waters, and thus in drinking-water, it is mostly found as trivalent arsenite (As(III)) or pentavalent arsenate (As (V)). Organic arsenic species, abundant in seafood, are very much less harmful to health, and are readily eliminated by the body.
• Drinking-water poses the greatest threat to public health from arsenic. Exposure at work and mining and industrial emissions may also be significant locally.

Effects

• Chronic arsenic poisoning, as occurs after long-term exposure through drinking- water is very different to acute poisoning. Immediate symptoms on an acute poisoning typically include vomiting, oesophageal and abdominal pain, and bloody "rice water" diarrhoea. Chelation therapy may be effective in acute poisoning but should not be used against long-term poisoning.
• The symptoms and signs that arsenic causes, appear to differ between individuals, population groups and geographic areas. Thus, there is no universal definition of the disease caused by arsenic. This complicates the assessment of the burden on health of arsenic. Similarly, there is no method to identify those cases of internal cancer that were caused by arsenic from cancers induced by other factors.
• Long-term exposure to arsenic via drinking-water causes cancer of the skin, lungs, urinary bladder, and kidney, as well as other skin changes such as pigmentation changes and thickening (hyperkeratosis).
• Increased risks of lung and bladder cancer and of arsenic-associated skin lesions have been observed at drinking-water arsenic concentrations of less than 0.05 mg/L.
• Absorption of arsenic through the skin is minimal and thus hand-washing, bathing, laundry, etc. with water containing arsenic do not pose human health risk.
• Following long-term exposure, the first changes are usually observed in the skin: pigmentation changes, and then hyperkeratosis. Cancer is a late phenomenon, and usually takes more than 10 years to develop.
• The relationship between arsenic exposure and other health effects is not clear-cut. For example, some studies have reported hypertensive and cardiovascular disease, diabetes and reproductive effects.
• Exposure to arsenic via drinking-water has been shown to cause a severe disease of blood vessels leading to gangrene in China (Province of Taiwan), known as 'black foot disease'. This disease has not been observed in other parts of the world, and it is possible that malnutrition contributes to its development. However, studies in several countries have demonstrated that arsenic causes other, less severe forms of peripheral vascular disease.
• According to some estimates, arsenic in drinking-water will cause 200,000 -- 270,000 deaths from cancer in Bangladesh alone (NRC, 1998; Smith, et al, 2000).

Measurement

• Accurate measurement of arsenic in drinking-water at levels relevant to health requires laboratory analysis, using sophisticated and expensive techniques and facilities as well as trained staff not easily available or affordable in many parts of the world.
• Analytical quality control and external validation remain problematic.
• Field test kits can detect high levels of arsenic but are typically unreliable at lower concentrations of concern for human health. Reliability of field methods is yet to be fully evaluated.

Prevention and control

The most important remedial action is prevention of further exposure by providing safe drinking- water. The cost and difficulty of reducing arsenic in drinking-water increases as the targeted concentration lowers. It varies with the arsenic concentration in the source water, the chemical matrix of the water including interfering solutes, availability of alternative sources of low arsenic water, mitigation technologies, amount of water to be treated, etc.
Control of arsenic is more complex where drinking-water is obtained from many individual sources (such as hand-pumps and wells) as is common in rural areas. Low arsenic water is only needed for drinking and cooking. Arsenic-rich water can be used safely for laundry and bathing. Discrimination between high-arsenic and low-arsenic sources by painting the hand-pumps (e.g. red and green) can be an effective and low cost means to rapidly reduce exposure to arsenic when accompanied by effective health education.
Alternative low-arsenic sources such as rain water and treated surface water may be available and appropriate in some circumstances. Where low arsenic water is not available, it is necessary to remove arsenic from drinking-water:

• The technology for arsenic removal for piped water supply is moderately costly and requires technical expertise. It is inapplicable in some urban areas of developing countries and in most rural areas world-wide.
• New types of treatment technologies, including co-precipitation, ion exchange and activated alumina filtration are being field-tested.
• There are no proven technologies for the removal of arsenic at water collection points such as wells, hand-pumps and springs.
• Simple technologies for household removal of arsenic from water are few and have to be adapted to, and proven sustainable in each different setting.
• Some studies have reported preliminary successes in using packets of chemicals for household treatment. Some mixtures combine arsenic removal with disinfection. One example, developed by the WHO/PAHO Pan American Center of Sanitary Engineering and Environmental Sciences in Lima, Peru (CEPIS), has proven successful in Latin America.

WHO's activities on arsenic

WHO's norms for drinking-water quality go back to 1958. The International Standards for Drinking-Water established 0.20 mg/L as an allowable concentration for arsenic in that year. In 1963 the standard was re-evaluated and reduced to 0.05 mg/L. In 1984, this was maintained as WHO's "Guideline Value"; and many countries have kept this as the national standard or as an interim target. According to the last edition of the WHO Guidelines for Drinking-Water Quality (1993):

• Inorganic arsenic is a documented human carcinogen.
• 0.01 mg/L was established as a provisional guideline value for arsenic.
• Based on health criteria, the guideline value for arsenic in drinking-water would be less than 0.01mg/L.
• Because the guideline value is restricted by measurement limitations, and 0.01 mg/L is the realistic limit to measurement, this is termed a provisional guideline value.

The WHO Guidelines for Drinking-water Quality is intended for use as a basis for the development of national standards in the context of local or national environmental, social, economic, and cultural conditions.
The summary of an updated International Programme on Chemical Safety Environmental Health Criteria Document on Arsenic published by WHO is available at http://www.who.int/pcs/pubs/pub_ehc_num.html. It addresses all aspects of risks to human health and the environment. The full text will be published in late 2001.
A UN report on arsenic in drinking-water has been prepared in cooperation with other UN agencies under the auspices of an inter-agency coordinating body (the Administrative Committee on Coordination's Sub-committee on Water Resources. It provides a synthesis of available information on chemical, toxicological, medical, epidemiological, nutritional and public health issues; develops a basic strategy to cope with the problem and advises on removal technologies and on water quality management. The draft of the report is available at http://www.who.int/water_sanitation_...q/arsenic3/en/
Information on arsenic in drinking-water on a country-by-country basis is being collected and will be added to the UN report and made available on the web site.
As part of WHO's activities on the global burden of disease, an estimate of the disease burden associated with arsenic in drinking-water is in preparation. A report entitled "Towards an assessment of the socioeconomic impact of arsenic poisoning in Bangladesh" was released in 2000.
A United Nations Foundation grant for 2.5 million approved in July 2000, will enable UNICEF and WHO to support a project to provide clean drinking-water alternatives to 1.1 million people in three of the worst affected sub-districts in Bangladesh. The project utilizes an integrated approach involving communication, capacity building for arsenic mitigation of all stakeholders at subdistrict level and below, tube-well testing, patient management, and provision of alternative water supply options.
Urgent requirements

• Large-scale support to the management of the problem in developing countries with substantial, severely affected populations.
• Simple, reliable, low-cost equipment for field measurement.
• Increased availability and dissemination of relevant information.
• Robust affordable technologies for arsenic removal at wells and in households.

Global situation

The delayed health effects of exposure to arsenic, the lack of common definitions and of local awareness as well as poor reporting in affected areas are major problems in determining the extent of the arsenic-in-drinking-water problem.
Reliable data on exposure and health effects are rarely available, but it is clear that there are many countries in the world where arsenic in drinking-water has been detected at concentration greater than the Guideline Value, 0.01 mg/L or the prevailing national standard. These include Argentina, Australia, Bangladesh, Chile, China, Hungary, India, Mexico, Peru, Thailand, and the United States of America. Countries where adverse health effects have been documented include Bangladesh, China, India (West Bengal), and the United States of America. Examples are:

• Seven of 16 districts of West Bengal have been reported to have ground water arsenic concentrations above 0.05 mg/L; the total population in these seven districts is over 34 million (Mandal, et al, 1996) and it has been estimated that the population actually using arsenic-rich water is more than 1 million (above 0.05 mg/L) and is 1.3 million (above 0.01 mg/L) (Chowdhury, et al, 1997).
• According to a British Geological Survey study in 1998 on shallow tube-wells in 61 of the 64 districts in Bangladesh, 46% of the samples were above 0.010 mg/L and 27% were above 0.050 mg/L. When combined with the estimated 1999 population, it was estimated that the number of people exposed to arsenic concentrations above 0.05 mg/l is 28-35 million and the number of those exposed to more than 0.01 mg/l is 46-57 million (BGS, 2000).
• Environment Protection Agency of The United States of America has estimated that some 13 million of the population of USA, mostly in the western states, are exposed to arsenic in drinking- water at 0.01 mg/L, although concentrations appear to be typically much lower than those encountered in areas such as Bangladesh and West Bengal. (USEPA, 2001)

Arsenic in Bangladesh

In Bangladesh, West Bengal (India) and some other areas, most drinking-water used to be collected from open dug wells and ponds with little or no arsenic, but with contaminated water transmitting diseases such as diarrhoea, dysentery, typhoid, cholera and hepatitis. Programmes to provide "safe" drinking-water over the past 30 years have helped to control these diseases, but in some areas they have had the unexpected side-effect of exposing the population to another health problem - arsenic.
Arsenic in drinking-water in Bangladesh is attracting much attention for a number of reasons. It is a new, unfamiliar problem to the population, including concerned professionals. There are millions of people who may be affected by drinking arsenic-rich water. Last, but not least, fear for future adverse health effects as a result of water already consumed.
Background

• In recent years, extensive well drilling programme has contributed to a significant decrease in the incidence of diarrhoeal diseases.
• It has been suggested that there are between 8-12 million shallow tube-wells in Bangladesh. Up to 90% of the Bangladesh population of 130 million prefer to drink well water. Piped water supplies are available only to a little more than 10% of the total population living in the large agglomerations and some district towns.
• Until the discovery of arsenic in groundwater in 1993, well water was regarded as safe for drinking.
• It is now generally agreed that the arsenic contamination of groundwater in Bangladesh is of geological origin. The arsenic derives from the geological strata underlying Bangladesh.

Situation

• The most commonly manifested disease so far is skin lesions. Over the next decade, skin and internal cancers are likely to become the principal human health concern arising from arsenic.
• According to one estimate, at least 100,000 cases of skin lesions caused by arsenic have occurred and there may be many more (Smith, et al, 2000).
• The number of people drinking arsenic-rich water in Bangladesh has increased dramatically since the 1970s due to well-drilling and population growth.
• The impact of arsenic extends from immediate health effect to extensive social and economic hardship that effects especially the poor. Costs of health care, inability of affected persons to engage in productive activities and potential social exclusion are important factors.
• The national standard for drinking-water in Bangladesh is 0.05 mg/L, same as in India.
• District and sub-district health officials and workers lack sufficient knowledge as to the identification and prevention of arsenic poisoning.
• The poor availability of reliable information hinders action at all levels and may lead to panic, exacerbated if misleading reports are made. Effective information channels have yet to be established to those affected and concerned.

Remedial actions

• Within Bangladesh, a number of governmental technical and advisory committees have been formed and a co-ordinating mechanism established among the interested external support agencies. These committees include the Governmental Arsenic Co-ordinating Committee headed by the Minister of Health & Family Welfare (MHFW) and several technical committees. One of the positive outcomes of this collaboration (including work with local institutes) has been the testing of new types of treatment technologies.
• So far, many initiatives have focused on water quality testing and control with a view to supplying arsenic-free drinking-water, thereby reducing the risk of further arsenic-related disease. The amount of testing required and the need to provide effective feedback to those using well water, suggest use of field testing kits.
• Only a few proven sustainable options are available to provide safe drinking-water in Bangladesh. These include: obtaining low-arsenic groundwater through accessing safe shallow groundwater or deeper aquifers (greater than 200 m); rain water harvesting; pond-sand-filtration; household chemical treatment; and piped water supply from safe or treated sources.

[Shannon Bennett]

Re: Argentina has the world?s highest rate of deaths associated with swine flu infections

This answers one pressing question but opens the door for others. What did two of three of the highest concentration of flu fatalities have in common. Is there a high concentration of naturally occurring arsenic in the water in Manitoba? I will have to check on that one. Perhaps there are two (or more) scenarios resulting in very high CFR's,
one is the relatively high arsenic level,
the second is lowered immunity in indigenous populations,
the third is low vitamin D levels.

The other question is why does a small increase in arsenic result in a significantly higher CFR?

[sharon sanders]

Re: Woods Hole Scientists Link Influenza A (H1N1) Susceptibility to Arsenic Exposure

Arsenic contamination of groundwater

From Wikipedia, the free encyclopedia

Jump to: navigation, search
<!-- start content --> Main article: Water pollution

Arsenic contamination of groundwater is a natural occurring high concentration of arsenic in deeper levels of groundwater, which became a high-profile problem in recent years due to the use of deep tubewells for water supply in the Ganges Delta, causing serious arsenic poisoning to large numbers of people. A 2007 study found that over 137 million people in more than 70 countries are probably affected by arsenic poisoning of drinking water.<sup id="cite_ref-0" class="reference">[1]</sup> Arsenic contamination of ground water is found in many countries throughout the world, including the USA. <sup id="cite_ref-1" class="reference">[2]

</sup> Approximately 20 incidents of groundwater arsenic contamination have been reported from all over the world. <sup id="cite_ref-2" class="reference">[3]</sup> Of these, four major incidents were in Asia, including locations in Thailand, Taiwan, and Mainland China.<sup id="cite_ref-unesco_planet_3-0" class="reference">[4]</sup> <sup id="cite_ref-chowdhury_4-0" class="reference">[5]</sup> South American countries like Argentina and Chile have also been affected. There are also many locations in the United States where the groundwater contains arsenic concentrations in excess of the Environmental Protection Agency standard of 10 parts per billion adopted in 2001.

Arsenic is a carcinogen which causes many cancers including skin, lung, and bladder as well as cardiovascular disease.

Some research concludes that even at the lower concentrations, there is still a risk of arsenic contamination leading to major causes of death. A study was conducted in a contiguous six-county study area of southeastern Michigan to investigate the relationship between moderate arsenic levels and twenty-three selected disease outcomes. Disease outcomes included several types of cancer, diseases of the circulatory and respiratory system, diabetes mellitus, and kidney and liver diseases. Elevated mortality rates were observed for all diseases of the circulatory system. The researchers acknowledged a need to replicate their findings.<sup id="cite_ref-5" class="reference">[6]

</sup> A study preliminarily shows a relationship between arsenic exposure measured in urine and Type II diabetes. The results supported the hypothesis that low levels of exposure to inorganic arsenic in drinking water may play a role in diabetes prevalence.<sup id="cite_ref-6" class="reference">[7]

</sup> Arsenic in drinking water may also compromise immune function <cite style="font-style: normal;" class="web">"Scientists link influenza A (H1N1) susceptibility to common levels of arsenic exposure". http://www.eurekalert.org/pub_releas...-sli052009.php.</cite> .

[St Michael]

Re: Argentina has the world?s highest rate of deaths associated with swine flu infections

in mice that had ingested 100 ppb (parts per billion) arsenic in their drinking water for five weeks, the immune response to H1N1 infection was initially feeble, and when a response finally did kick in days later, it was "too robust and too late," Hamilton says. "There was a massive infiltration of immune cells to the lungs and a massive inflammatory response, which led to bleeding and damage in the lung." Morbidity over the course of the infection was significantly higher for the arsenic-exposed animals than the normal animals.

The Chaco Pampean Plain of central Argentina constitutes one of the largest regions of high arsenic (As) groundwaters known

This is truly fascinating, and an incredible piece of scientific detective work!

I wonder if common water filters such as the Big Berkey remove arsenic from drinking water?

Google search "arsenic+water+filter"

[Shannon Bennett]

Re: Argentina has the world?s highest rate of deaths associated with swine flu infections

Here is an interesting article on influenza susceptibility and arsenic.

http://www.ehponline.org/members/2009/0900911/0900911.pdf

Low Dose Arsenic Compromises the Immune Response to Influenza A Infection in vivo
Courtney D. Kozul, Kenneth H. Ely, Richard I. Enelow, and Joshua W. Hamilton

[sharon sanders]

Re: Woods Hole Scientists Link Influenza A (H1N1) Susceptibility to Arsenic Exposure

Arsenic round the world: a review

http://www.sciencedirect.com/science?_ob=ArticleURL&_udi=B6THP-461XPC1-4&_user=10&_rdoc=1&_fmt=&_orig=search&_sort=d&_docanchor=&view=c&_searchStrId=945274995&_rerunOrigin=google&_acct=C000050221&_version=1&_urlVersion=0&_userid=10&md5=8b6c3b4806cd65ac5e3f7d7f169dee99

Badal Kumar Mandal and Kazuo T. Suzuki^,
<!-- authorsNoEnt --> Graduate School of Pharmaceutical Sciences, Chiba University, Chiba 263-8522, Japan

<!-- authorsNoEnt -->
<!-- articleText -->
Received 7 December 2001;
<!-- articleText -->revised 8 February 2002.
<!-- articleText -->Available online 12 June 2002.
<!-- articleText -->
<!-- articleText --> Abstract

This review deals with environmental origin, occurrence, episodes, and impact on human health of arsenic. Arsenic, a metalloid occurs naturally, being the 20th most abundant element in the earth's crust, and is a component of more than 245 minerals. These are mostly ores containing sulfide, along with copper, nickel, lead, cobalt, or other metals. Arsenic and its compounds are mobile in the environment. Weathering of rocks converts arsenic sulfides to arsenic trioxide, which enters the arsenic cycle as dust or by dissolution in rain, rivers, or groundwater. So, groundwater contamination by arsenic is a serious threat to mankind all over the world. It can also enter food chain causing wide spread distribution throughout the plant and animal kingdoms. However, fish, fruits, and vegetables primarily contain organic arsenic, less than 10% of the arsenic in these foods exists in the inorganic form, although the arsenic content of many foods (i.e. milk and dairy products, beef and pork, poultry, and cereals) is mainly inorganic, typically 65?75%. A few recent studies report 85?95% inorganic arsenic in rice and vegetables, which suggest more studies for standardisation. Humans are exposed to this toxic arsenic primarily from air, food, and water. Thousands and thousands of people are suffering from the toxic effects of arsenicals in many countries all over the world due to natural groundwater contamination as well as industrial effluent and drainage problems. Arsenic, being a normal component of human body is transported by the blood to different organs in the body, mainly in the form of MMA after ingestion. It causes a variety of adverse health effects to humans after acute and chronic exposures such as dermal changes (pigmentation, hyperkeratoses, and ulceration), respiratory, pulmonary, cardiovascular, gastrointestinal, hematological, hepatic, renal, neurological, developmental, reproductive, immunologic, genotoxic, mutagenetic, and carcinogenic effects. Key research studies are needed for improving arsenic risk assessment at low exposure levels urgently among all the arsenic research groups.

<!-- articleText --> Author Keywords: Arsenic; Chronic arsenic toxicity; Carcinogenic effects

<!-- articleText --> Article Outline

<dl><dt>1. Introduction</dt><dt>2. Occurrence</dt><dl><dt>2.1. Natural sources</dt><dl><dt>2.1.1. Earth crusts</dt><dt>2.1.2. Soil and sediment</dt><dl><dt>2.1.2.1. Soil</dt><dl><dt>2.1.2.1.1. Background values of arsenic</dt><dt>2.1.2.1.2. Arsenic in soil</dt><dt>2.1.2.1.3. Sediment</dt></dl></dl><dt>2.1.3. Water</dt><dt>2.1.4. Air</dt><dt>2.1.5. Living organisms</dt><dl><dt>2.1.5.1. Plants</dt><dt>2.1.5.2. Animals and human beings</dt></dl></dl><dt>2.2. Anthropogenic sources</dt><dl><dt>2.2.1. Man made sources</dt><dt>2.2.2. Insecticides</dt><dt>2.2.3. Herbicides</dt><dt>2.2.4. Desiccants and wood preservatives</dt><dt>2.2.5. Feed additives</dt></dl><dt>2.3. Drugs</dt><dt>2.4. Poison</dt></dl><dt>3. Metabolisms and toxicity of arsenic</dt><dl><dt>3.1. Metabolisms</dt><dt>3.2. Toxicity</dt><dl><dt>3.2.1. Respiratory effects</dt><dt>3.2.2. Pulmonary effects</dt><dt>3.2.3. Cardiovascular effects</dt><dt>3.2.4. Gastrointestinal effects</dt><dt>3.2.5. Hematological effects</dt><dt>3.2.6. Hepatic effects</dt><dt>3.2.7. Renal effects</dt><dt>3.2.8. Dermal effects</dt><dt>3.2.9. Neurological effects</dt><dt>3.2.10. Developmental effects</dt><dt>3.2.11. Reproductive effects</dt><dt>3.2.12. Immunologic effects</dt><dt>3.2.13. Genotoxic effects</dt><dt>3.2.14. Mutagenetic effects</dt><dt>3.2.15. Carcinogenic effects</dt><dt>3.2.16. Diabetes mellitus</dt><dt>3.2.17. Biochemical effects</dt></dl></dl><dt>4. Arsenic episodes round the world</dt><dl><dt>4.1. Natural groundwater arsenic contamination</dt><dl><dt>4.1.1. Taiwan incident</dt><dt>4.1.2. Antofagasta, Chile incident</dt><dt>4.1.3. West Bengal-India incident</dt><dt>4.1.4. Mexico incident</dt><dt>4.1.5. Argentina incident</dt><dt>4.1.6. Millard County, Utah, USA incident</dt><dt>4.1.7. Lane County, Western Oregon, USA incident</dt><dt>4.1.8. Lessen County, California, USA incident</dt><dt>4.1.9. Ontario, Canada incident</dt><dt>4.1.10. Nova Scotia, Canada incident</dt><dt>4.1.11. Hungary incident</dt><dt>4.1.12. New Zealand incident</dt><dt>4.1.13. Poland incident</dt><dt>4.1.14. Fairbanks, Alaska incident</dt><dt>4.1.15. Srilanka incident</dt><dt>4.1.16. Spain incident</dt><dt>4.1.17. China incident</dt><dt>4.1.18. Northern India incident</dt><dt>4.1.19. Bangladesh incident</dt><dt>4.1.20. Fallon, Nevada Incident</dt><dt>4.1.21. Fukuoka Prefecture, Japan incident</dt><dt>4.1.22. New Hampshire, USA incident</dt><dt>4.1.23. Vietnam incident</dt></dl><dt>4.2. Arsenic contamination from industrial sources</dt><dl><dt>4.2.1. Ronphibun, Thailand incident</dt><dt>4.2.2. Mindanao Island, Philippines incident</dt><dt>4.2.3. Nakajo, Japan incident</dt><dt>4.2.4. Toroku and Matsuo, Japan incident</dt><dt>4.2.5. Other incidents in Japan</dt><dt>4.2.6. P.N. Mitra Lane, Behala, Calcutta, India incident</dt><dt>4.2.7. Rajnandgaon district, Madhya Pradesh, India incident</dt><dt>4.2.8. Australia incident</dt><dt>4.2.9. Czechoslovakia incident</dt><dt>4.2.10. Toronto, Ontario, Canada incident</dt><dt>4.2.11. Greece incident</dt><dt>4.2.12. Ghana incident</dt><dt>4.2.13. USA incident</dt><dt>4.2.14. British incident</dt><dt>4.2.15. Southern Rhodesia incident</dt><dt>4.2.16. Torreon, Mexico incident</dt><dt>4.2.17. Northern Sweden incident</dt><dt>4.2.18. Armadale, central Scotland incident</dt><dt>4.2.19. Srednogorie, Bulgaria incident</dt></dl><dt>4.3. Arsenic contamination from food and beverage</dt><dl><dt>4.3.1. Soyasauce incident in Japan</dt><dt>4.3.2. Powdered milk incident in Japan</dt><dt>4.3.3. Wine incident in Manchester, England</dt><dt>4.3.4. Wine Incident in Germany</dt><dt>4.3.5. Guizhou Province, China Incident</dt><dt>4.3.6. Yunan Incident, China</dt></dl></dl><dt>Acknowledgements</dt><dt>References</dt></dl>

[St Michael]

Re: Argentina has the world?s highest rate of deaths associated with swine flu infections

This answers one pressing question but opens the door for others. What did two of three of the highest concentration of flu fatalities have in common. Is there a high concentration of naturally occurring arsenic in the water in Manitoba? I will have to check on that one. Perhaps there are two (or more) scenarios resulting in very high CFR's,
one is the relatively high arsenic level,
the second is lowered immunity in indigenous populations,
the third is low vitamin D levels.

The other question is why does a small increase in arsenic result in a significantly higher CFR?

I think you're onto something here:

Fiziol Zh Im I M Sechenova. 1994 Jul;80(7):88-98.Links
[The metabolism of heavy metals depends on the vitamin-D status of the body]
[Article in Russian]

Babarykin DA, Bauman VK.

Latvian Medical Academy, Riga.

The effect of vitamin D3 and its two metabolites 1,25(OH)2D3 and 24,25(OH)2D3 on the metabolism of heavy metals--Sr, Pb and Cd was studied. The experiments were carried out on chickens, the heavy metals were added to the chicken's ration. The results obtained demonstrated that vitamin D3 caused accumulation of those metals in tissues and their toxicity in organisms. When increasing the vitamin dose from 200 to 500 IU on 1 kg of ration that tendency was being heightened. On the three steroids which had been studied the metabolite 1,25(OH)2D3 displayed the greatest activity in accumulating metals in tissues, Pb in particular. The effect of 24,25(OH)2D3 on the indices being studied was comparable with that of vitamin D3.

Does vitamin D explain the role of vaccines, mercury, and heavy metals?

Vitamin D's role in increasing glutathione levels may explain the link between mercury and other heavy metals, oxidative stress, and autism. For example, activated vitamin D lessens heavy metal induced oxidative injuries in rat brain. The primary route for brain toxicity of most heavy metals is through depletion of glutathione. Besides its function as a master antioxidant, glutathione acts as a chelating (binding) agent to remove heavy metals such as mercury. Autistic individuals have difficulty excreting heavy metals like mercury. If brain levels of activated vitamin D are too low to employ glutathione properly, and thus unable to remove heavy metals, they may be damaged by heavy metal loads normal children easily excrete. That is, the mercury in Thiomerosol vaccines may have injured vitamin D deficient children while normal children would have easily bound the mercury and excreted it. These studies offer further hope that sun-exposure or vitamin D supplements may help autistic children by increasing glutathione and removing heavy metals. Not only do we have more clues that vitamin D is involved in autism, the vitamin D theory just did something else: it explained two other theories of autism, the mercury accumulation theory and the oxidative stress theory. Lin AM, Chen KB, Chao PL. Antioxidative effect of vitamin D3 on zinc-induced oxidative stress in CNS. Ann N Y Acad Sci. 2005 Aug;1053:319?29. Valko M, Morris H, Cronin MT. Metals, toxicity and oxidative stress. Curr Med Chem. 2005;12(10):1161?208. Kern JK, Jones AM. Evidence of toxicity, oxidative stress, and neuronal insult in autism. J Toxicol Environ Health B Crit Rev. 2006 Nov?Dec;9(6):485?99.

It bears repeating that the amount of activated vitamin D in the brain directly depends on the amount of vitamin D made in the skin, or ingested orally.

Arsenic
Arsenic is the most common cause of acute heavy metal poisoning in adults and is number 1 on the ATSDR's "Top 20 List." Arsenic is released into the environment by the smelting process of copper, zinc, and lead, as well as by the manufacturing of chemicals and glasses. Arsine gas is a common byproduct produced by the manufacturing of pesticides that contain arsenic. Arsenic may be also be found in water supplies worldwide, leading to exposure of shellfish, cod, and haddock. Other sources are paints, rat poisoning, fungicides, and wood preservatives. Target organs are the blood, kidneys, and central nervous, digestive, and skin systems (Roberts 1999; ATSDR ToxFAQs for Arsenic).

[Shannon Bennett]

Re: Argentina has the world?s highest rate of deaths associated with swine flu infections

http://www.preparedplanet.com/Berkey-Water-Filters.html

Apparently, you have to add a component to a Big Berkey to lower but not eliminate arsenic.

[St Michael]

Re: Woods Hole Scientists Link Influenza A (H1N1) Susceptibility to Arsenic Exposure

Some southeast Asian countries, including Vietnam and Cambodia, have very high levels of arsenic in their ground waters. It seems to me they also had very high levels of H5N1 mortality?

[Shannon Bennett]

Re: Argentina has the world?s highest rate of deaths associated with swine flu infections

If arsenic plays an active role in CFR rates then it seems to me that people living in other areas with relatively high concentrations of arsenic in the water will be the first to have exploding death rates. To prevent that people need to find out now what their arsenic levels are and, to start a chelation process if they are elevated.

[St Michael]

Re: Argentina has the world?s highest rate of deaths associated with swine flu infections

-EPA review of the various treatment technologies for arsenic removal from water http://www.epa.gov/ogwdw000/ars/treat.html
-EPA - ARSENIC IN DRINKING WATER Treatment Technologies for Arsenic Decision Tree, Variances and Exemptions. http://www.epa.gov/ogwdw000/ars/trtmt.html
-A table of the basic types of treatment for arsenic and their effectiveness - http://www.dainichi-consul.co.jp/eng...enic/treat.htm
-Finland compares carbon, ion exchange, and alumina for arsenic removal. http://www.gsf.fi/info/tr141abse.html
-State of Maine, Arsenic in well water information sheet. http://mainegov-images.informe.org/d...s/ASBROCH3.pdf
-New Hampshire Dept. of Enviro. Services - "Arsenic in Drinking Water" Lists source, treatment, health effects, oriented toward well owners. http://www.des.state.nh.us/ws-3-2.htm

[Shannon Bennett]

Re: Argentina has the world?s highest rate of deaths associated with swine flu infections

More on what the effect of arsenic and immune response and chelation.

http://www.sciencedirect.com/science?_ob=ArticleURL&_udi=B6T99-4GDK8YF-1&_user=10&_rdoc=1&_fmt=&_orig=search&_sort=d&_docanchor=&view=c&_searchStrId=945294060&_rerunOrigin=scholar.google&_acct=C000050221&_version=1&_urlVersion=0&_userid=10&md5=b855b6a77878dfcc75c84bde751075fb

Arsenic induced blood and brain oxidative stress and its response to some thiol chelators in rats <!-- articleText -->


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<!-- refMsg -->Swaran J.S. Flora^a^,^,, Smrati Bhadauria^a, Satish C. Pant^a and Ram K. Dhaked^b

<!-- authorsNoEnt -->^aDivision of Pharmacology and Toxicology, Defence Research and Development Establishment, Jhansi Road, Gwalior-474 002, India
^bDivision of Biotechnology, Defence Research and Development, Establishment, Jhansi Road, Gwalior-474 002, India

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Received 25 November 2004;
<!-- articleText -->accepted 6 April 2005.
<!-- articleText -->Available online 16 June 2005.
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<!-- articleText -->Abstract

Chronic arsenic toxicity is a widespread problem, not only in India and Bangladesh but also in various other regions of the world. Exposure to arsenic may occur from natural or industrial sources. The treatment that is in use at present employs administration of thiol chelators, such as meso 2,3-dimercaptosuccinic acid (DMSA) and sodium 2,3-dimercaptopropane 1-sulfonate (DMPS), which facilitate its excretion from the body. However, these chelating agents are compromised with number of limitations due to their lipophobic nature, particularly for their use in cases of chronic poisoning. During chronic exposure, arsenic gains access into the cell and it becomes mandatory for a drug to cross cell membrane to chelate intracellular arsenic. To address this problem, analogs of DMSA having lipophilic character, were examined against chronic arsenic poisoning in experimental animals. In the present study, therapeutic efficacy of meso 2,3-dimercaptosuccinic acid (DMSA), sodium 2,3-dimercaptopropane 1-sulfonate (DMPS), monoisoamyl DMSA (MiADMSA) were compared in terms of reducing arsenic burden, as well as recovery in the altered biochemical variables particularly suggestive of oxidative stress. Adult male Wistar rats were given 100-ppm arsenic for 10 weeks followed by chelation therapy with the above chelating agents at a dose of 50 mg/Kg (orally) once daily for 5 consecutive days. Arsenic exposure resulted in marked elevation in reactive oxygen species (ROS) in blood, inhibition of ALAD activity and depletion of GSH. These changes were accompanied by significant decline in blood hemoglobin level. MiADMSA was the most effective chelator in reducing ROS in red blood cells, and in restoring blood ALAD compared to two other chelators. Brain superoxide dismutase (SOD) and glutathione peroxidase (GPx) decreased, while ROS and TBARS increased significantly following arsenic exposure. There was a significant increase in the activity of glutathione-S-transferase (GST) with a corresponding decline in its substrate i.e. glutathione. Among all the three chelators, MiADMSA showed maximum reduction in the level of ROS in brain. Additionally, administration of MiADMSA was most effective in counteracting arsenic induced inhibition in brain ALAD, SOD and GPx activity. Based on these results and in particular higher metal decorporation from blood and brain, we suggest MiADMSA to be a potential drug of choice for the treatment of chronic arsenic poisoning. However, further studies are required for the choice of appropriate dose, duration of treatment and possible effects on other major organs.

<!-- articleText -->Keywords: Arsenic poisoning; Oxidative stress; Arsenic concentration; DNA damage; Biochemical recovery

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<dl><dt>Introduction </dt><dt>Materials and methods </dt><dl><dt>Chemicals </dt><dt>Animals and treatments</dt></dl><dt>Biochemical assay </dt><dl><dt>Blood and brain δ-aminolevulinic acid dehydratase (ALAD) </dt><dt>Brain δ-aminolevulinic acid synthase (ALAS) </dt><dt>Blood glutathione (GSH) </dt><dt>Brain glutathione (GSH) </dt><dt>Brain superoxide dismutase (SOD)</dt></dl><dt>Clinical hematological variables </dt><dl><dt>Thiobarbituric acid reactive substances (TBARS) </dt><dt>Brain glutathione peroxidase (GPx) </dt><dt>Brain glutathione-S-transferase (GST) </dt><dt>Reactive oxygen species (ROS)</dt></dl><dt>DNA damage studies </dt><dt>Arsenic estimation </dt><dt>Statistical analysis </dt><dt>Results </dt><dt>Discussion </dt><dt>Acknowledgements </dt><dt>References</dt></dl>
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<table><tbody><tr><td width="10%"></td></tr></tbody></table>Fig. 1. Denaturing poly acrylamide gel electrophoresis of total DNA isolated from brain of chronic arsenic exposed rats with and without chelation therapy (Lane 1—normal rat brain, lane 2—arsenic exposed, lane 3—arsenic exposed rats treated with DMSA, lane 4—arsenic exposed rats treated with DMPS and lane 5—arsenic exposed rats treated with MiADMSA).

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<table><tbody><tr><td width="10%"></td></tr></tbody></table>Fig. 2. Arsenic concentration in blood and brain of rats exposed to arsenic and treated with thiol chelators. One unit corresponds to arsenic concentration nanograms 100 ml^{− 1} for blood and micrograms per gram for brain tissue. Values are mean &#177; S.E.; n = 5; *^{,†,‡,&#167;}Differences between values with matching symbol notation within each figure are not statistically significant at 5% level of probability.

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Table 1. Efficacy of some thiol chelators on biochemical variables indicative of oxidative stress and altered heme biosynthesis in rats

Units: ALAD-δ-aminolevulinic acid dehydratase as nanomole per minute per milliliter erythrocytes; GSH—glutathione as milligrams per milliliter; Hb—hemoglobin as grams per deciliter; ROS—total reactive oxygen species nanomoles of DCF formed per minute per milliliter of RBC.
Values are mean &#177; S.E.; n = 5; *^,†,‡Differences between values with matching symbol notation within each row are not statistically significant at the 5% level of probability.

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Table 2. Effects of arsenic on some hematological parameters and their response to administration of some thiol chelators in exposed rats

Abbreviation and units: WBC—white blood cells as 10³ μl^{− 1}; RBC—red blood cells as 10⁶ μl^{− 1}; Hct—hematocrit as percent; MCV—mean cell volume as FL; MCH—mean cell hemoglobin as picogram and MCHC—mean cell hemoglobin concentration as grams per deciliter.
Values are mean &#177; S.E.; n = 5; *^,†,&#167;Differences between values with matching symbol notation within each row are not statistically significant at the 5% level of probability.

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Table 3. Effect of thiol chelators on arsenic induced brain oxidative stress in rats

Abbreviation and units: ROS—reactive oxygen species as nanomoles of DCF formed per minute per milligram protein; TBARS—thiobarbituric acid reactive substances as micrograms per gram and SOD—superoxide dismutase as units per milligram protein.
Values are mean &#177; S.E.; n = 5; *^,†,‡Differences between values with matching symbol notation within each row are not statistically significant at the 5% level of probability.

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Table 4. Effect of some thiol chelators on biochemical variables indicative of oxidative stress (GSH metabolism) and alteration in heme biosynthetic pathway in whole brain of arsenic exposed rats

Abbreviation and units: ALAD-δ-aminolevulinic acid dehydratase as nanomoles per minute per milligram protein; ALAS-δ-aminolevulinic acid synthatase as nanomoles per minute per milligram protein; GSH—glutathione as milligrams per gram tissue; GPx—micrograms per minute per milligram protein; GST—glutathione-S-transferase as nanomole conjugate per minute per milligram protein and SOD—superoxide dismutase as units per minute per milligram protein.
Values are mean &#177; S.E.; n = 5; *^,†Differences between values with matching symbol notations within each row are not statistically significant at the 5% level of probability.

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Corresponding author. Tel.: +91 751 2341848x365; fax: +91 751 2341148.