October 5, 2012
Health officials warn that a rare form of meningitis is
likely to continue to spread. This was reported
after four people died and 26 have fallen ill in five states.
All of those currently infected received steroid injections,
primarily for back pain. The steroid was
made by a specialty pharmacy located in Massachusetts. The pharmacy issued a recall on the drug last
week and has since shut down operations.
The type of meningitis is not a contagious one as the more
common forms are. This type is found in
leaf mold, which is what health officials suspect may have been in the steroid.
18 of the reported cases are in Tennessee, where a Nashville
clinic received the largest shipment of the steroid injections. Investigators are still trying to confirm the
source of the infection.
Three cases were reported in Virginia, two cases in
Maryland, two cases in Florida and one in North Carolina. Two of the four reported deaths were in
Tennessee. One death was reported in
Virginia and one in Maryland. The case
information has come from the Centers for Disease Control and Prevention.
In the coming days, it is feared that new cases will be
reported. The Tennessee Department of Health
Commissioner John Dreyzeher has confirmed 5 new cases on Wednesday and is
calling the situation, “a rapidly evolving outbreak.”
Although Tennessee is reporting this, the federal health
officials are not confirming that this is the case. They have found that the illness has been
occurring for the last two to three months.
Tennessee health officials have reported that some of the
affected patients have experienced slurred speech and difficulty walking and
urinating. Meningitis is inflammation of
the lining of the brain and spinal cord. Other symptoms of meningitis
include: severe and worsening headache,
dizziness, nausea, and fever. The incubation period is estimated to be anywhere
from 2 to 28 days, which means that people may not yet have fallen ill that
were exposed. Tennessee officials are
contacting over 900 patients that received the injections.
"Some are doing well and improving. Some are very ill —
very, very seriously ill and may die," Tennessee health official Dr. David
Reagan said of the state's patients.
Officials are also investigating the antiseptic and
anesthetic that is used along with the injections and has not yet ruled these
out. However, the main suspicion is the
steroid injection, which is commonly given for back pain and administered along
with anesthetic.
The Food and Drug Administration has identified the maker of
the steroid as the New England Compounding Center, a specialty pharmacy located
in Framingham, Massachusetts. The company issued a recall of three lots of the
steroid methylprednisolone acetate. The
company issued a statement saying that it had voluntarily suspended operations
and was working with regulators to locate the source of the infection. Specialty, compounding pharmacies, such as
the New England Compounding Center, mix ingredients for customized medications
that are not commercially available and are regulated by states individually.
The outbreak was uncovered about two weeks ago when Vanderbilt
University Dr. April Pettit was treating a patient who was not doing well and
doctors could not figure out why a patient was not doing well. The lab discovered the fungus when they
tested the patient’s spinal fluid and this caused Dr. Pettit to ask questions
and uncovered the patient’s steroid injection treatments.
"When it became clear that the infection-control
practices at the clinic were up to par, the steroid medication became
implicated," according to Dr. William Schaffner, chair of Vanderbilt’s
Department of Preventative Medicine.
Federal officials have not released details or the condition
of any of the patients. Fungal
meningitis is usually treated with intravenous anti-fungal medication. Of the 26 currently known cases, 17 were
treated at Saint Thomas Outpatient Neurosurgery Center in Nashville, TN. The clinic had 2,000 vials of the steroid and
voluntarily closed to handle the investigation.
For more information, you can look to the Centers for
Disease Control and Prevention: http://www.cdc.gov/meningitis/fungal.html
Adapted from: ABCNews.com, “Rare US
Meningitis Outbreak Grows; 4 Dead, 22 Sick.” Mike Stobbe and Travis Loller.
Nashville, Tenn. October 4, 2012.
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