2012 – Fungal Meningitis Outbreak due to tainted steroid injections — 64

— 64  CDC. “Multistate Outbreak of Fungal Meningitis and Other Infections.” 10-23-2013.[1]

— 29  Burgamy, Kenny. “395 Fungal Meningitis Case, 29 Deaths.” 11-5-2012, 13WMAZ.com

— 28  ABC News (Kate Moisse). “Meningitis Outbreak: 386 Cases, 28 Deaths.” 11-1-2012.

— 14  Fox, Maggie (NBC News). “Fungal meningitis cases grow to 185 in outbreak.” 10-12-2012

— 14  Karnowski, Steve (AP). “Minn. Lawsuit…litigation…tainted steroid injections.” 10-12-12

 

Florida            (  7)

—  7  CDC. “Multistate Outbreak of Fungal Meningitis and Other Infections.” 10-23-2013.

 

Indiana           (11)

— 11  CDC. “Multistate Outbreak of Fungal Meningitis and Other Infections.” 10-23-2013.

 

Maryland       (  3)

—  3  CDC. “Multistate Outbreak of Fungal Meningitis and Other Infections.” 10-23-2013.

 

Michigan        (19)

— 19  CDC. “Multistate Outbreak of Fungal Meningitis and Other Infections.” 10-23-2013.

 

Minnesota      (  1)

—  1  CDC. “Multistate Outbreak of Fungal Meningitis and Other Infections.” 10-23-2013.

 

No. Carolina  (  1)

—  1  CDC. “Multistate Outbreak of Fungal Meningitis and Other Infections.” 10-23-2013.

 

Ohio                (  1)

—  1   CDC. “Multistate Outbreak of Fungal Meningitis and Other Infections.” 10-23-2013.

 

Tennessee       (16)

— 16  CDC. “Multistate Outbreak of Fungal Meningitis and Other Infections.” 10-23-2013.

 

Virginia          (  5)

—  5  CDC. “Multistate Outbreak of Fungal Meningitis and Other Infections.” 10-23-2013.

—  2  ABC News (Kate Moisse). “Meningitis Outbreak: 386 Cases, 28 Deaths.” 11-1-2012.

 

Narrative Information

 

ABC News: “Nine more people have been diagnosed with fungal meningitis in an outbreak linked to tainted steroid injections, health officials reported today.  The U.S. Centers for Disease Control and Prevention has increased the tally of cases to 386 in 19 states: 377 cases of fungal meningitis and nine joint infections. The agency also dropped the death toll for the outbreak from 29 to 28, noting that Virginia is now reporting two deaths instead of three.

 

“The outbreak has been linked to contaminated vials of methylprednisolone acetate, an injectable steroid used to treat back and joint pain. Sealed vials of the steroid, made by the New England Compounding Center in Framingham, Mass., contained exserohilum rostratum, a fungus found in soil and plants.

 

“It’s not clear how the fungus landed in the pharmacy’s ostensibly sterile vials, some of which were shipped to clinics without sterility testing, according to an inspection by the Massachusetts Department of Public Health. Floor mats near sterile drug-mixing areas were “visibly soiled with assorted debris,” and a leak from a nearby boiler created an “environment susceptible to contaminant growth,” according to the report.

 

“Sealed vials of two other drugs made by the pharmacy contained bacteria, the U.S. Food and Drug Administration reported today. The drugs were the steroid betamethasone and a cardioplegic solution that paralyzes the heart during open heart surgery. The pharmacy has recalled all of its products and shut down operations.

 

“Ameridose, a sister company of the New England Compounding Center, also recalled all drugs Wednesday, citing sterility concerns, according to the FDA. Neither Ameridose nor the FDA have received any complaints or identified any impurities in those drugs.

 

“Meningitis affects the membranous lining of the brain and spinal cord. Early symptoms of fungal meningitis — including headache, fever, dizziness, nausea, sensitivity to light, stiff neck, weakness or numbness, slurred speech and pain, and redness or swelling at the injection site — can take more than a month to appear.

 

“The longest duration from the time of injection to the onset of symptoms in the current outbreak is six weeks, according to the CDC. The tainted steroids were recalled five weeks ago.

 

“Fungal meningitis is diagnosed through a spinal tap, which draws cerebrospinal fluid from the spine that can be inspected for signs of the disease. Once detected, it can be treated with high doses of intravenous antifungal medications.

 

“Unlike bacterial meningitis, fungal meningitis is not transmitted from person to person and only people who received the steroid injections are thought to be at risk.” (ABC News (Kate Moisse). “Meningitis Outbreak: 386 Cases, 28 Deaths.” 11-1-2012.)

 

Burgamy:  “More than 400 infections have now been tied to an outbreak linked to contaminated steroid shots from the New England Compounding Center, the Centers for Disease Control and Prevention announced Friday.

“As of Nov. 2, 395 people have developed fungal meningitis, including 29 deaths. Another nine patients have fungal joint infections from steroid injections they may have received in areas such as the knee, hip, shoulder and elbow.

“The ongoing 19-state outbreak of fungal meningitis has been linked back to three lots of methylprednisolone acetate (MPA) steroid injections made by the Compounding Center of Framingham, Mass. The injections were shipped to 23 states and officials have said up to 14,000 patients may have received the contaminated shots, mostly for back pain treatments.”  (Burgamy, Kenny. “395 Fungal Meningitis Case, 29 Deaths.” 11-5-2012, 13WMAZ.com. Cal.)

 

CDC: “In September 2012, the Centers for Disease Control and Prevention (CDC), in collaboration with state and local health departments and the Food and Drug Administration (FDA), began investigating a multistate outbreak of fungal meningitis and other infections among patients who received contaminated preservative-free MPA steroid injections from the New England Compounding Center in Framingham, Massachusetts. The investigation includes fungal meningitis (a form of meningitis that is not contagious), localized spinal or paraspinal infections, such as epidural abscess and arachnoiditis, and infections associated with injections in a peripheral joint space, such as a knee, shoulder, or ankle. The predominant fungus identified in patients is Exserohilum rostratum. One patient, the index case, had a laboratory-confirmed Aspergillus fumigatus infection. These fungi are common in the environment, however fungal infections are not transmitted from person to person.” (Centers for Disease Control and Prevention. Healthcare-associated Infections (HAIs). “Multistate Outbreak of Fungal Meningitis and Other Infections.” Atlanta, GA: CDC, 10-23-2013 update.)

 

Sources

 

ABC News (Kate Moisse). “Meningitis Outbreak: 386 Cases, 28 Deaths.” 11-1-2012. Accessed 11-4-2012: http://abcnews.go.com/Health/meningitis-outbreak-386-cases-28-deaths/story?id=17620484#.UJcdDWcmQqg

 

Burgamy, Kenny. “395 Fungal Meningitis Case, 29 Deaths,” 11-5-2012, 13WMAZ.com. Cal. Accessed 11-5-2012: http://www.13wmaz.com/news/national/article/202869/28/395-Fungal-Meningitis-Cases-29-Deaths–

 

Centers for Disease Control and Prevention. Healthcare-associated Infections (HAIs). “Multistate Outbreak of Fungal Meningitis and Other Infections.” Atlanta, GA: CDC, 10-23-2013 update. Accessed 10-16-2015 at: http://www.cdc.gov/hai/outbreaks/meningitis.html

 

Fox, Maggie (NBC News). “Fungal meningitis cases grow to 185 in outbreak.” 10-12-2012. Accessed 10-12-2012: http://vitals.nbcnews.com/_news/2012/10/12/14397656-fungal-meningitis-cases-grow-to-185-in-outbreak?lite

 

Karnowski, Steve (Associated Press). “Minn. Lawsuit at front of expected flood of litigation over tainted steroid injections.” 10-12-2012. Accessed 10-12-2012 at: http://www.startribune.com/local/173932141.html?refer=y

 

 

 

 

[1] From chart: “Cases and Deaths with Fungal Infections Linked to Steroid Injections.”