35 have been diagnosed with meningitis, five of which have died. Health officials are trying to get in touch with all who had a recent injection for their lower back pain.The deaths took place in Tennessee, Virginia and Maryland. The remaining diagnosed patients have recieved a steroid solution distributed by NEEC. Recalls have been made for all products coming from the New England Compounding Center (NECC).
"Unfortunately, despite the current recall, we expect to see additional cases as this investigation unfolds. However, it is possible if patients are identified soon and started on appropriate antifungal therapy some of the unfortunate consequences may be averted," Dr. Benjamin Park of the U.S. Centers for Disease Control and Prevention.
"Infected patients have presented approximately one to four weeks following their injection with a variety of symptoms including fever, new or worsening headache, nausea and our new symptoms consistent with a stroke," Park stated. "Some of these patients symptoms were very mild in nature. Cerebrospinal fluid obtained from these patients has shown findings consistent with meningitis. It is important to note that this type of meningitis is not transmissible from person-to-person."
The following 23 states have gotten NECC's medication: 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 (infectioncontroltoday.com).
"On Sept. 21, 2012, the CDC was notified by the Tennessee Department of Health of a patient with the onsite of meningitis approximately 19 days following epidural steroid injection at a Tenneessee ambulatory surgery center. All initial cultures of cerebral-spinal fluid and blood were negative for any potential infection. Subsequently, the patient had a fungus isolated from the cerebral-spinal fluid by fungal culture. On Sept. 28, 2012, investigators identified a case outside of Tennessee, possibly indicating contamination of a widely distributed medication. To date, a total of 35 cases in six states have been identified with a clinical picture consistent with fungal infection. Tragically, at least five deaths have been reported. Fungus has been identified in specimens that came from a total of five patients thus far. While investigation into the exact source of these infections is ongoing, all infected patients received preservative-free methylprednisolone acetate from among the three lots voluntarily recalled by the New England Compounding Center (NECC) in Framingham, Mass. on Sept. 25, 2012. "
"Looking under microscopic examination, it was identified as a fungal contaminant. For the sake of time, because we -- everything is unraveling and unfolding very quickly, we have not been able to further microbial testing of additional vials and what is necessary. So, right now, we can only say that it is a foreign material," FDA's Dr. Ilisa Bernstein said.
"Currently, we think that this type of meningitis is quite severe as we have been describing here. The antifungal treatment for this is intravenous antifungal treatment and requires initial hospitalization. But the duration of antifungal therapy could be prolonged possibly on the order of months," Park continued.
Medical personnel are trying to prevent the spreading of the outbreak. More information can be read on infectioncontroltoday.com
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