UPDATE: 10-7-12 2:00PM PST
The rising toll -- 7 dead, 57 ill and thousands potentially exposed -- has cast a harsh light on the loose regulations that legal experts say allowed a company to sell 17,676 vials of an unsafe drug to pain clinics in 23 states. Federal health officials said Friday that all patients injected with the steroid drug made by that company, the New England Compounding Center in Framingham, Mass., which has a troubled history, needed to be tracked down immediately and informed of the danger.
Read more: http://www.post-gazette.com/stories/news
The CDC is coordinating a multistate investigation of meningitis among patients who received epidural steroid injections (medication injected into the spine). Several of these patients have had strokes related to the meningitis.
In several patients, the meningitis was found to be caused by a fungus that is common in the environment but rarely causes meningitis. This form of meningitis is not contagious. The source of the fungus has not yet been identified, and the cause of infections in the other patients is still being assessed.
The states involved in the outbreak: Persons with meningitis linked to epidural steroid injections:
Florida: 2 cases
Indiana: 3 cases
Maryland: 2 cases, including 1 death
Michigan: 4 cases
North Carolina: 1 case
Tennessee: 29 cases, including 3 deaths
Virginia: 6 cases, including 1 death
Is the source of the outbreak known?
The CDC is investigating medications and products that are associated with this outbreak of meningitis. At this point, there is not enough evidence to determine the original source of the outbreak, however there is a link to an injectable steroid medication. The lots of medication that were given to patients have been recalled by the manufacturer. The manufacturer(s) was not named in the CDC report.
States that received the implicated medicine product
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
What are the symptoms of this form of meningitis?
Symptoms of fungal meningitis are similar to symptoms of other forms of meningitis, however they often appear more gradually and can be very mild at first. In addition to typical meningitis symptoms, like headache, fever, nausea, and stiffness of the neck, people with fungal meningitis may also experience confusion, dizziness, and discomfort from bright lights. Patients might just have one or two of these symptoms.
Drugs in short supply and custom-mixed medicines
The executive vice president of the International Academy of Compounding Pharmacists says, "Because of the incredible number of drugs that are out of stock or back-ordered, compounding pharmacies are working with local hospitals, clinics and physicians to fill that gap,” according to Fox News.
Steroid shots can be custom-mixed and have been a concern for a while. “These medicines are made in private and hospital pharmacies and are used to treat everything from cancer to menopause symptoms to vision loss.”
Splitting doses of brand named medicines into smaller doses or in combinations can lead to contamination if sterile conditions are not met.
A shortage of drugs has forced doctors to stretch supplies and seek custom-made alternatives if the first-choice treatment is not available. The steroid suspected in the current outbreak has been in short supply.