Some tattoo inks are tainted with nontuberculous Mycobacteria which can cause serious infections, including lung diseases, eye problems, several organ infections, and infection of the joints, the US FDA (Food and Drug Administration) informed today. The Agency added that Mycobacteria-linked infections are not easy to diagnose and require treatment that may last over six months.

The FDA says it has received reports of serious infections which started coming in last year in at least four states. The Agency is calling on all personnel involved in the tattoo industry, including artists, manufacturers of tattoo ink, consumers, as well as health care professionals, public health officials to be aware of this potential infection risk.

Apart from pathogens from the nontuberculous Mycobacteria family, tattoo pigments and inks may also infect people with fungi and molds.

Linda Katz, M.D., M.P.H., director of FDA’s Office of Cosmetics and Colors, urges anybody involved in tattooing or its consequences, including health care professionals, to report any tattoo-linked complication to its MedWatch program. Doctors especially need to become aware of the signs and symptoms so that the risk of misdiagnosis may be reduced.

Tattoo artists need to be fully knowledgeable about this potentially serious complication. Even the most scrupulous tattoo artist who follows strict hygiene practices may not be aware that an ink or pigment is tainted. Katz informed that without proper equipment, it is often hard to tell whether there is contamination.

The FDA says that it has two priority objectives at the moment:

  • To encourage tattoo artists to take special precautions
  • Encourage tattoo customers to seek medical care immediately if any of the signs and symptoms associated with infection are detected

Katherine Hollinger, D.V.M., M.P.H., an epidemiologist who works at the Office of Cosmetics and Colors, said:

“Reporting an infection to FDA and the artist is important. Once the problem is reported, FDA can investigate, and the artist can take steps to prevent others from being infected.”

The FDA oversees the quality and safety of tattoo inks and pigments in the USA. When a safety issue comes to the Agency’s attention, it intervenes, as it is doing now.

An investigation started in January of this year, it was coordinated and initiated by the CORE (Coordinated Outbreak Response and Evaluation) network, part of the FDA. It was through its MedWatch reporting program that officials at the regulatory agency got to know about the problem. Seven tattoo customers in Monroe Country, New York, all of whom had used the same artist, had confirmed nontuberculous Mycobacteria infections. Soon after their tattoos had healed they noticed red bumps had appeared.

Not long afterwards, reports came in of another 12 clients with the same problem; they too had used the same artist as the seven others. All the 19 clients had used the same brand of tattoo ink. 14 of them were found to have exactly the same type of nontuberculous Mycobacteria infection. In an online communiqué, the FDA wrote “An NTM sample from a sealed container of the same type of ink used to tattoo the affected individuals was a perfect match to the NTM linked to these infections.”

The CDC (Centers for Disease Control and Prevention), FDA district offices as well as regional and local health departments liaised closely during the investigation.

Soon other states, including Colorado, Iowa and Washington started reporting similar infections among tattoo customers. It became apparent that this was not a case of one ink manufacturer and a single artist.

Tattoo artists can take measures to reduce the risk of infections by acquiring inks that are known not to be have been contaminated with pathogenic bacteria. They should make sure that only sterile water is used to dilute the inks. Distilled, filtered, bottled or tap water are examples of non-sterile water.

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Tattoo artists can take steps to reduce the risk of nontuberculous Mycobacteria infection

Written by Christian Nordqvist