90 Meningitis Cases, Outbreak Update Issued By The CDC

Date: Oct-08-2012So far, there have been at least 90 cases of meningitis and 7 deaths, the Centers for Disease Control and Prevention has informed in an update on this latest outbreak that has affected 7 US states.

Patients became ill with a potentially fatal form of meningitis after receiving injections in their spine with a preservative-free steroid methylprednisolone acetate - which were contaminated with fungi. The steroid is administered for the treatment of inflammation and pain.

The CDC informs that there have been reported cases in Florida, Indiana, Maryland, Michigan, North Carolina, Tennessee, and Virginia. In nine patients, laboratory tests have revealed the presence of Exserohilum and Aspergillus, two types of fungi.

The CDC says it is issuing an updated guidance to doctors and patients regarding contaminated drugs received from the New England Compounding Center in Framingham, Mass.

A range of symptoms linked to this latest outbreak have been reported, many of which are related to a rare form of fungal meningitis, as well as stroke.
The New England Compounding Center (NECC)
The New England Compounding Center (NECC), part of New England Compounding Pharmacy Inc., is the company that has produced and delivered the contaminated steroid injections.

NECC has announced a recall of all its products that are currently in circulation which were produced and delivered from its facility at Framingham, Mass. The company says that the recall is being taken out of "an abundance of caution due to the potential risk of contamination, and in cooperation with an investigation being conducted by the U.S. Food and Drug Administration, the Centers for Disease Control and Prevention and the Massachusetts Board of Registration in Pharmacy."

This PDF file contains a list of all medications which are subject to this recall.

NECC says it is contacting all of its customers by fax, including clinics, hospitals and healthcare providers. It is telling them to stop using the products immediately, to retain and secure them, and follow the instructions in the faxed letter.

State health departments and the CDC have released the names of about 75 healthcare facilities that have received tainted products.
Patients who were administered these drugs need to be located immediately
Benjamin Park, M.D., medical officer, Mycotic Diseases Branch, CDC, said:

"All patients who may have received these medications need to be tracked down immediately. Patients can find the names of the clinics that used these medications on the CDC website. It is possible that if patients with infection are identified soon and put on appropriate antifungal therapy, lives may be saved."

According to the CDC, signs and symptoms, which occur between one to four weeks following injection with the contaminated products include:

fever
new or worsening headache
nausea
new neurological deficit (consistent with deep brain stroke)

In many cases, signs and symptoms were mild. According to cerebrospinal fluid samples taken from these patients and sent to the lab for analysis, they had meningitis.

The following lots of methylprednisolone acetate (PF) 80mg/ml were recalled by NECC on September 26th, 2012:
Methylprednisolone Acetate (PF) 80 mg/ml Injection, Lot #05212012@68, BUD 11/17/2012
Methylprednisolone Acetate (PF) 80 mg/ml Injection, Lot #06292012@26, BUD 12/26/2012
Methylprednisolone Acetate (PF) 80 mg/ml Injection, Lot #08102012@51, BUD 2/6/2013

If you are a doctor and have administered patients with an injection using any of the lots mentioned above, you should contact them immediately to find out whether any of them are showing symptoms.

In a communiqué, the CDC and FDA (Food and Drug Administration) recommend that "healthcare professionals cease use of any product produced by the New England Compounding Center until further information is available."

If you have had an epidural steroid injection since July of this year, and experience any of the symptoms listed below, contact your doctor immediately:
Fever
Photophobia (sensitivity to light)
Stiff neck
Slurred speech
Abnormal weakness in any part of the body
Abnormal numbness in any part of the body
A headache that keeps getting worse

In order to maximize its response capabilities and to make sure that these recommendations reach as many people and places as possible, the CDC has activated its Emergency Operations Center.

Clinicians should check the following web page for guidance on diagnostic testing that should be done on patient specimens.

If you are a doctor, please inform your State health department of any patients undergoing evaluation for this infection, and report any suspected adverse events to www.fda.gov/medwatch, or telephone 1-800-332-1088.

Contaminated products have been shipped to the following states: California, Connecticut, Florida, Georgia, Idaho, Illinois, Indiana, Maryland, Michigan, Minnesota, North Carolina, New Hampshire, New Jersey, Nevada, New York, Ohio, Pennsylvania, Rhode Island, South Carolina, Tennessee, Virginia, Texas, and West Virginia.

Written by Christian Nordqvist

Copyright: Medical News Today

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