Epidemiologic Notes and Reports
Update: Eosinophilia-Myalgia Syndrome Associated with
Ingestion of L-Tryptophan -- United States, as of January 9,1990
As of January 9, 1046 eosinophilia-myalgia syndrome (EMS) cases
have been reported to CDC from 49 states, the District of
Columbia, and Puerto Rico (Figure 1) (1-3). Only Alaska has
reported no cases (Figure 1). Seven deaths have been reported in
patients who met the surveillance case definition and who used
L-tryptophan (LT).
As of January 9, CDC has received completed report forms from
38 states and Puerto Rico with information about 429 cases
fitting the case definition. Ages of these patients ranged from
11 years to 84 years (median: 48 years); 96% of patients were
non-Hispanic white, 2% were Hispanic, and 1% were black. Three
hundred sixty (84%) were female. Four hundred nineteen (98%) had
histories of LT ingestion preceding onset of symptoms; dosage
ranged from 26 mg to 15,000 mg per day (median: 1500 mg per day).
Three hundred seventy-two (87%) reported onset of symptoms during
or after July 1989 (Figure 2). Of the EMS patients reported thus
far, 139 (32%) have required hospitalization.
Physicians report suspected cases to state and local health
departments, and information is recorded on a standardized
case-report form. Total numbers of EMS cases are telephoned
weekly to CDC by health departments, and case-report forms mailed
when completed; this results in a timely accumulation of total
numbers but a lag in availability of detailed data.
Reported by: State and territorial health departments. Div of
Environmental Hazards and Health Effects, Center for
Environmental Health and Injury Control, CDC.
CDC. Eosinophilia-myalgia syndrome and L-tryptophan-containing
products--New Mexico, Minnesota, Oregon, and New York, 1989. MMWR
1989;38:785-8.
CDC. Update: eosinophilia-myalgia syndrome associated with
ingestion of L-tryptophan--United States. MMWR 1989;38:842-3.
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