HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Full Text (PDF) Submit a response View Shopping Cart Alert me when this article is cited Alert me when eLetters are posted Alert me if a correction is posted Services Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Blank, S Articles by Falk, H Search for Related Content PubMed PubMed Citation Articles by Blank, S Articles by Falk, H

An outbreak of hypervitaminosis D associated with the overfortification of milk from a home-delivery dairy.

S Blank, K S Scanlon, T H Sinks, S Lett and H Falk

Epidemic Intelligence Service, Centers for Disease Control and Prevention, Atlanta, Ga, USA.

OBJECTIVES. The purpose of the study was to identify cases of hypervitaminosis D caused by the inadvertent overfortification of milk from a home-delivery dairy and to identify risk factors for this illness. METHODS. Hospital discharge, laboratory, and state health department data were used to define, identify, and describe cases of hypervitaminosis D diagnosed in the exposed communities between January 1, 1985, and June 30, 1991. To identify disease risk factors, community-based sex- and age-matched controls were used in a case-control study. RESULTS. Of the 56 case patients identified, at least 41 were hospitalized; 2 died. The study included 33 case patients and 93 control subjects. Nineteen of the 33 case patients had been customers of the implicated dairy. Risk of illness rose with increasing consumption of the dairy's milk and was also associated with vitamin D supplement use, sunburn susceptibility, and cancer history. Accounting for these factors did not alter the association between drinking the dairy's milk and developing hypervitaminosis D. CONCLUSIONS. Overfortification of milk with vitamin D can lead to hypervitaminosis D, manifested by severe illness and death. The episode highlights the need for monitoring the fortification process and enforcing the upper limit for vitamin D addition to milk.

This article has been cited by other articles:

				R. Joshi Hypercalcemia due to Hypervitaminosis D: Report of Seven Patients J Trop Pediatr, December 1, 2009; 55(6): 396 - 398. [Abstract] [Full Text] [PDF]

				G. Jones Pharmacokinetics of vitamin D toxicity Am. J. Clinical Nutrition, August 1, 2008; 88(2): 582S - 586S. [Abstract] [Full Text] [PDF]

				G. Schwalfenberg Response Can Fam Physician, September 1, 2007; 53(9): 1435 - 1435. [Full Text] [PDF]

				J. N Hathcock, A. Shao, R. Vieth, and R. Heaney Risk assessment for vitamin D Am. J. Clinical Nutrition, January 1, 2007; 85(1): 6 - 18. [Abstract] [Full Text] [PDF]

				R. Vieth Critique of the Considerations for Establishing the Tolerable Upper Intake Level for Vitamin D: Critical Need for Revision Upwards J. Nutr., April 1, 2006; 136(4): 1117 - 1122. [Abstract] [Full Text] [PDF]

				F. Barrueto Jr,, H. H. Wang-Flores, M. A. Howland, R. S. Hoffman, and L. S. Nelson Acute Vitamin D Intoxication in a Child Pediatrics, September 1, 2005; 116(3): e453 - e456. [Abstract] [Full Text] [PDF]

				A. H. Lichtenstein and R. M. Russell Essential Nutrients: Food or Supplements?: Where Should the Emphasis Be? JAMA, July 20, 2005; 294(3): 351 - 358. [Abstract] [Full Text] [PDF]

				D.N.S Kerr Hypercalcemia and metastatic calcification Cardiovasc Res, December 1, 1997; 36(3): 293 - 297. [Full Text] [PDF]