Hong Kong health care and hospitals

Hong Kong health authorities probe digestion drug after cancer patient’s medication found to be contaminated with mould

Discovery of Monascus mould on Indonesian-made Enzyplex tablets was ‘incidental’ finding when Queen Mary Hospital reviewed deceased woman’s case

PUBLISHED : Friday, 22 June, 2018, 7:02am
UPDATED : Friday, 22 June, 2018, 7:07am

Hong Kong’s Department of Health is investigating a drug used to aid digestion after the medication taken by a cancer patient was found to be contaminated with a type of mould.

The move follows the recent death of a lymphoma patient in her 30s at Queen Mary Hospital who had been taking Indonesian-made Enzyplex tablets for digestive disorders.

The Hospital Authority said on Thursday evening that the discovery of the Monascus mould on the tablet was an “incidental” finding when the hospital’s microbiology department reviewed the deceased woman’s case.

“The patient passed away recently due to her underlying disease,” an authority spokesman said.

Top microbiologist Professor Yuen Kwok-yung from the University of Hong Kong, who was involved in the review, said they decided to check all the oral medication taken by the patient, due to past incidents when contaminated drugs caused outbreaks of fungal infections. He said the patient’s stool also contained another kind of mould, Mucor.

Yuen said that in testing 16 drugs taken by the patient, 15 did not grow any bacteria or mould.

“Only the Enzyplex tablet grew Monascus which is different from the Mucor from the patient,” he said.

Monascus, which exists in the daily environment, would not cause any health hazard to a healthy person.

While Yuen said there was no proof that the woman’s Mucor infection was because of the drug, he suggested not giving the medication to patients with weaker immune systems.

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“It is reasonable to stop giving Enzyplex to any patient with underlying immunosuppressed diseases such as lymphoma, leukaemia and cancer while on chemotherapy,” he said.

An urgent meeting of the authority’s Central Committee on Infectious Disease and Emergency Responses would be held on Friday. Related clinical experts would assess the possible risk factors of the drug concerned and the prescription arrangements.

The health department said it was analysing samples of Enzyplex to determine if it exceeded specific standards on mould and yeast content. This would take between five and seven days.

The authority, which manages the city’s 43 public hospitals, said there had been no reported case of Monascus-related infection over the past five years but it had alerted frontline staff to pay special attention to the possible risk of infection among patients with a weaker immune system.

According to local supplier Unam Corporation, the product was manufactured in Indonesia and imported to Hong Kong. It was supplied to the authority, the department’s clinics, local private doctors, pharmacies and medicine stores, and also re-exported to Macau.

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The department has also instructed Unam to ask the manufacturer in Indonesia to conduct an investigation and submit a report.

William Chui Chun-ming, president of the Society of Hospital Pharmacists of Hong Kong, said the manufacturing process or raw materials might contribute to contamination of the drug.

But before the level of the fungi the drug contained was identified, Chui said patients should not stop using the medicine.