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Steroid Injections Cause Meningitis Outbreak

Tyler Neilsen, Staff Writer
October 16, 2012
Filed under News

On October 4th, the Center for Disease Control (CDC) announced an outbreak of fungal meningitis. The outbreak was found to be caused by a strain of mold that has never been known to cause meningitis. As of October 12th, 185 cases and 14 deaths have been reported.

This particular strain of fungal meningitis has been linked to three batches of epidural steroid injections made in the New England Compounding Center (NECC), a special pharmacy in Massachusetts. Methylprednisolone acetate is a steroid used to treat back pain. Cases have been reported in a dozen states including Florida, Indiana, Maryland, Michigan, Minnesota, New Jersey, North Carolina, Ohio, Pennsylvania, Tennessee, and Virginia.

Researchers have identified two different types of mold as the culprits—exserohilum and aspergillus. Exserohilum is a common mold found in soil and on plants, especially grasses. Aspergillus is an even more common mold that grows both indoors and outdoors. Although it can cause lung infections, most people are exposed to aspergillus on a daily basis and are unaffected.
Meningitis is an inflammation of the spinal cord and the brain fluid. Fungal meningitis is a non-contagious fungal infection that spreads through the bloodstream as a result of a fungus that has been introduced directly into the central nervous system or an infected body site near the central nervous system. It can also develop after taking medications that weaken the immune system, such as steroid injections.

Fungal meningitis is diagnosed by collecting blood and spinal fluid samples that are typed in a laboratory. Symptoms include fever, headache, stiff neck, nausea, vomiting, phototobia (light sensitivity), and an altered mental status. Treatment includes hospitalization with long courses of antifungal medications administered through an IV. It is estimated that over 13,000 patients received the injections.

Diagnosis and treatment of meningitis are extremely invasive. In fact, the drugs that the CDC has recommended are toxic. Voriconazole and lipsomal amphotericin B are antifungal drugs that can damage the kidneys as well as produce other toxic side effects.

For this reason, the CDC has recommended that only patients exhibiting symptoms should be treated.  The CDC and NECC have recommended that anyone who received a spinal or neck steroid injection between May 21 and September of this year keep an eye out for symptoms. The CDC warns that it can take up to four weeks for patients to exhibit symptoms.

Case counts are expected to continue to grow as the 14,000 plus patients who received the vaccination are contacted. It is estimated that nearly 18,000 contaminated vials were distributed. Federal lawsuits against the NECC are in process and a case action is expected to be filed.

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