Title: |
Outbreak of Tattoo-Associated Nontuberculous Mycobacterial Skin Infections.
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Abstract: |
BACKGROUND: On April 29, 2015, the Florida Department of Health in
Miami-Dade County (DOH-Miami-Dade) was notified by a local dermatologist of
three patients with suspect nontuberculous mycobacterial (NTM) infection after
receiving tattoos at a local tattoo studio. CONCLUSIONS:
WGS and SNP analyses identified the tap water and the bottle of greywash tattoo
ink as the sources of the NTM infections. |
Industry Significance Rating: |
High - Industry alert, report has major implications related to health and safety.
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Publication: |
Clinical Infectious Diseases. 2018 Nov 17. doi: 10.1093/cid/ciy979. |
Authors: |
Griffin I, Schmitz A, Oliver C, Pritchard S, Zhang G, Rico E, Davenport E, Llau
A, Moore E, Fernandez D, Mejia-Echeverry A, Suarez J, Noya-Chaveco P, Elmir S,
Jean R, Pettengill JB, Hollinger KA, Chou K, Williams-Hill D, Zaki S,
Muehlenbachs A, Keating MK, Bhatnagar J, Rowlinson MC, Chiribau C, Rivera L. |
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Discussion: |
The authors report an extremely serious cluster of NonTuberculous Mycobacterial
infections among clients of a tattoo parlour, after the Florida Dept of Health
conducted an investigation it was discovered that "Thirty-eight
of 226 interviewed clients were identified as outbreak-associated cases"
and the likely sources of the infections were tap water and a bottle of greywash
tattoo ink.
Mycobacterium are a member of the genus of Actinobacteria which have over 190
species many of whom are pathogens capable of causing very serious diseases in
animals and humans including tuberculosis and leprosy. It would be of particular
concern to the tattoo industry that "M.
chelonae was isolated from five unopened bottles of greywash ink"
as M. chelonae is capable of causing skin infections such as rashes, cellulitis
and abscessus.
Purchasing tattoo inks from non-local suppliers can be problematic for health
authorities as offshore suppliers are likely to be outside of the regulatory
jurisdiction of local health authorities and this may hamper the ability to
identify the exact source of infections and or any problems with the
manufacturing and supply chain, tattoo technicians who import should also be
aware that depending on local laws the act of importation may place the impost
of product liability and compliance upon them.
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Recommendations: |
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Tap water should never be used to dilute tattoo inks as it is NOT STERILE and is likely to contain a wide range of microorganisms.
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It is advisable to restrict the purchase of tattoo inks to reputable sources that are able to provide all required information about the ingredients, sterility of the product, and the manufacturing processes.
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Legal, insurance and regulatory advice is recommended if tattoo inks are to be purchased from non local suppliers.
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Keywords: |
Scientific Report, Medical Report, Health Department, Infections, nontuberculous mycobacterial, tattoo, tap water.
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