An outbreak of fungal meningitis has been traced to epidural steroid injections from New England Compounding Center. Many illnesses have occurred in six clinics in Indiana. The Indiana Health Department recommends that anyone who has had an epidural steroid injection (commonly administered in outpatient clinics to treat back pain or joint pain) since May 21, 2012, should contact a physician if they are concerned about meningitis.
UPDATE
Click here to visit the CDC website for more information.
November 26, 2012 — The current case count from the CDC involves 490 cases of fungal meningitis, 12 peripheral joint infections, and 34 deaths in 19 states. In Indiana, 55 people have been diagnosed with meningitis and 5 people have died.
November 5, 2012 — The number of infections in Indiana has grown to 51 people, of whom 3 have died. The nationwide total is 419 illnesses (including 10 joint infections) and 30 deaths in 19 states. As the incubation period ends, it is likely that the number of new cases will taper off. However, people with the disease may continue to require treatment for several months or more.
October 26, 2012 — The outbreak of fungal meningitis continues to spread, with more cases of joint infections. The CDC reports a total of 338 infections, including 7 peripheral joint infections and 331 cases of meningitis, stroke, or central nervous system infection. Of these, at least 25 people have died in 18 states.
October 25, 2012 — In Indiana, the number of illnesses has grown to include 43 people, of whom 3 have died. Nationwide, the CDC is reporting 328 infections linked to contaminated medicines (including 5 peripheral joint infections and 323 cases of fungal meningitis, stroke, or infection) including 24 deaths in 18 states.
October 24, 2012 — The number of illnesses in Indiana has grown to 41, and 3 people have died. The CDC reports that, nationwide, 317 people have been infected (312 cases of fungal meningitis, stroke, or central nervous system infection, and 5 cases of peripheral joint infections), 24 people have died in 17 states. CDC is reporting that new cases are more mild. It has been more than 1 month since NECC medicines were recalled; fungal meningitis has an unknown incubation period and illnesses could continue.
October 23, 2012 — The CDC is reporting 308 cases (including 304 cases of fungal meningitis, stroke, or other central nervous system infection, and 4 cases of peripheral joint infections). Of these, 23 people have died in 17 states.
October 22, 2012 — In Indiana, 40 people have fallen ill and 2 have died in an outbreak of fungal meningitis. The CDC is reporting that the number of illnesses has grown to 297 (including 294 cases of fungal meningitis and 3 peripheral joint infections) and 23 deaths. The number of states involved remains at 16.
October 19, 2012 — 35 people have been sickened and 2 people have died in an outbreak of fungal meningitis in Indiana. The CDC is reporting that, nationwide, 271 people have fallen ill (including 268 cases of fungal meningitis or stroke, and 3 joint infections). Of these, at least 21 have died. 16 states are involved in the outbreak.
October 18, 2012 — In Indiana, 34 people have been sickened in the outbreak of fungal meningitis and 2 people have died. Nationwide, 257 people in 16 states have fallen ill (including 254 with fungal meningitis, stroke, or infection, and 3 with peripheral joint infections), and 20 people have died.
October 17, 2012 — In Indiana, 32 infections and 2 deaths have been linked to the outbreak of fungal meningitis. Nationwide, 247 people have fallen ill (including 245 cases of fungal meningitis, stroke, or other central-nervous system fungal infection; and 2 joint infections). Of these, 19 people have died in 15 states.
October 16, 2012 — The CDC is reporting that 30 people have fallen ill and 2 people have died of fungal meningitis in Indiana. Nationwide, 233 people have been infected — including 231 cases of fungal meningitis and 2 cases of joint infections. At least 15 people have died in 15 states.
October 15, 2012 — At least 28 illnesses and 2 deaths have been confirmed in Indiana. Nationwide, the CDC is reporting 214 illnesses (212 cases of fungal meningitis with 2 cases of joint infections) and 15 deaths in 15 different states.
October 12, 2012 — 24 illnesses and 1 death have been reported in Indiana. The CDC has confirmed 184 meningitis cases plus 1 case of joint infection. At least 14 people have died in 12 states.
October 11, 2012 — 21 illnesses and 1 death have been confirmed in Indiana. Nationwide, 170 people have been sickened and 14 have died.
October 9, 2012 — 12 illnesses have been confirmed in Indiana. Nationwide, 119 people have been sickened and 11 people have died.
October 8, 2012 — The Indiana Department of Health has reported 11 illnesses in the state. The nationwide total is 105 illnesses and 8 deaths in 9 states. Although meningitis is not contagious, the disease has a latency period of up to 4 weeks. The number of illnesses is expected to continue growing. Click here to learn more from the Indiana Department of Community Health.
Indiana Meningitis Outbreak
The outbreak of meningitis has been linked to the following facilities located in Indiana:
- Ambulatory Care Center (Evansville)
- Fort Wayne Physical Medicine (Fort Wayne)
- OSMC Outpatient Surgery Center (Elkhart)
- South Bend Clinic (South Bend)
- Union Hospital (Terre Haute)
- Wellspring (Columbus)
The Health Department in Indianapolis is working with the Centers for Disease Control (CDC) and the Food and Drug Administration (FDA) to investigate a multi-state outbreak of fungal meningitis linked to contaminated epidural steroid injections. Several patients have fallen ill with meningitis or suffered strokes due to meningitis.
The outbreak has been traced to preservative-free methylprednisolone acetate sold by New England Compounding Center, of Farmingham, Massachusetts. The company has recalled the steroid injection and all other medications sold at their facility.
The Indiana Health Department says that patients who were given injections will be contacted by the facility where they received the injection. According to the Health Department:
“Patients who have received a steroid injection since May 21, 2012, and are experiencing symptoms such as a new or worsening headache, fever, neck stiffness or pain at the injection site, should contact their physician to determine if they have received one of the recalled products and to receive further instruction.”
More than 17,000 vials of potentially contaminated steroid injections were distributed to 75 clinics in 23 states. An estimated 13,000 people have been exposed to the injections.
What is Fungal Meningitis?
Fungal meningitis (as opposed to viral or bacterial meningitis) is a life-threatening disease that occurs when fungal spores infect cerebrospinal fluid. The disease causes an inflammation of the meninges, which is the protective membrane around the brain and spinal cord.
Outbreaks of fungal meningitis are very rare. The disease normally only occurs in people who have a very weak immune system (for example, people undergoing cancer therapy, or people with HIV). If fungal spores are injected directly into a person’s cerebrospinal fluid, the spores can easily spread to the brain and cause meningitis.
Patients often must undergo aggressive treatment with anti-fungal medications, either intravenously or directly into the brain. Recovery can take up to six months.
Symptoms of Fungal Meningitis
Fungal meningitis often has mild symptoms early in the disease. Patients may only have one or two symptoms. Experts recommend that anyone who is concerned that they may have meningitis caused by epidural steroid injections should contact their physician to find out if they were exposed to the contaminated products. If meningitis is suspected, seek emergency medical attention.
Symptoms of fungal meningitis may include the following:
- Nausea
- Vomiting
- Sudden worsening headache
- Pain, swelling, redness at the injection site
- Stiffness in the neck
- Slurred speech
- Difficulty balancing
- Confusion
- Dizziness
- Light sensitivity
- And more