All affected infants had received parenteral nutrition therapy, in addition to other supportive measures and therapeutic interventions common to the care of low-birthweight infants. Both outbreaks ceased shortly after use of E-Ferol was discontinued. In collaboration with the state health departments, CDC is conducting ongoing epidemiologic investigations at both institutions. FDA and the distributor have initiated a voluntary recall of the product. Other vitamin E preparations are available for enteral, subcutaneous, and intramuscular administration.
Vitamin E is a component, at lower concentrations, of multivitamin preparations for intravenous use.
Use of these alternative vitamin E preparations has not been temporally associated with the severe clinical syndrome described above. Vitamin E and the neonate. Hittner HM, Godio LB, Rudolph AJ, et al. Conjugated hyperbilirubinemia in infancy associated with parenteral alimentation. Lipson AH, Pritchard J, Thomas G. Thrombocytopenia after intralipid infusion in a neonate.