A southern Alberta couple who realized their infant had eaten raccoon feces found themselves racing against time to find a rare medication — and doctors and pharmacists across Western Canada mobilized to help them find it.
Ashley Haughton learned raccoon scat can be extremely dangerous when she found it in her yard in Lethbridge, Alta., and researched how to dispose of it safely.
Raccoons can carry a deadly form of roundworm called Baylisascaris procyonis, and the eggs live in their feces.
An extremely rare parasitic infection can occur if humans ingest the eggs, which hatch into larvae, travel through the body and invade organs, including the eyes and brain.
And so when her one-year-old son ate raccoon feces from a flower pot in the garden just over four weeks ago, Haughton knew to be alarmed: Symptoms of the infection include brain damage, blindness and coma.
It can also be deadly.
“They go through the stomach barrier, they infest your body … and essentially eat you from the inside out,” Jon Martin, the boy’s father, told Calgary Eyeopener, a CBC Radio morning show, on Thursday.
“And if you don’t treat them quickly enough, there isn’t really a way to reverse the effects, because they’ve literally eaten your tissue.”
Health Canada gave special authorization
Martin and Haughton immediately called their family doctor and the province’s Poison & Drug Information Service.
Both advised the parents to wait and see if their son — whom they didn’t want to name in order to protect his privacy — developed symptoms of infection.
Instead, the parents sought to have the feces tested for roundworm, and their veterinarian confirmed the worst: The sample was infested with so many eggs and larvae that they were unable to count them all.
After rushing their son to a hospital emergency room, they were prescribed albendazole, which needs to be taken within three days of exposure.
Special authorization to write the prescription was given by Health Canada, as its manufacturer has not filed a drug submission in Canada, the department told CBC News.
This signalled the delays to come.
“We started calling around … to try and track it down and then soon realized that it wasn’t available commonly at all,” Martin said.
‘I couldn’t imagine being in that situation’
When Lethbridge pharmacist Bryce Barry got the call that Martin was looking for albendazole and why, he immediately understood the dire predicament.
“I’ve got young kids, and I couldn’t imagine being in that situation,” said Barry, who works at Shoppers Drug Mart in Park Place Mall.
But when he checked his suppliers, Barry realized he couldn’t bring in the medication to his pharmacy. And when he discovered it’s not commercially available in Canada, he started contacting his network.
When a drug is not widely available, a compounding pharmacy can prepare personalized medications for patients by mixing individual ingredients together in the exact strength and dosage required.
Barry’s friend, Dawson Bremner, had opened a pharmacy in Vancouver that had many suppliers outside of Canada and was doing a lot of compounding — and might be able to order, or make, albendazole.
Bremner couldn’t do either, but instead he contacted his pharmaceutical representative, who mass-emailed clients across Western Canada.
Script Pharmacy in Calgary responded.
It had not compounded the anti-parasitic formula in more than a decade, but it had the medication and the ingredients needed to make it into a palatable liquid.
“When we first got that email … my technician took it very seriously,” said Script co-owner and pharmacist Aleem Datoo.
“[But] I don’t think we had the full sense of how [serious] the situation was until a few weeks later, when our provincial college called and verified that [the feces] did have this certain parasite.
“That’s when we really fully appreciated what had been done — but on our end, it had been a total team effort.”
Martin and Haughton, meanwhile, were preparing to drive to Montana to get the drug when they learned the Calgary pharmacy could make it.
“It was one of the happiest phone calls I think you can get in a situation like this,” Martin said.
“I mean, I kind of had a breakdown on the phone.”
‘Everybody came together’
Fifty-six hours after ingesting raccoon feces, Martin and Haughton’s son received his first dose of albendazole.
And from the hospital doctors to the veterinarian to a chain of pharmacists, the collaboration between so many people to acquire the drug struck Barry as incredible.
“Everybody came together, and some of us had pretty small parts … but we were proud to get it in time,” Barry said. “And I thought it was pretty neat.”
Since Martin and Haughton’s son was exposed to roundworm four weeks ago, it means he is outside of the usual window for symptoms of infection to appear.
And according to Martin, he seems just fine.
“He’s still doing all the wonderful things that the toddler is supposed to do,” Martin said. “You can’t really ask for much more.”