A fungal meningitis outbreak linked to epidural steroid injections has sickened hundreds of people throughout the United States — including Maryland. The disease has been traced to an injectable medication that is commonly used to treat lower back pain in outpatient clinics. The Maryland Health Department, the Centers for Disease Control (CDC), and the Food and Drug Administration (FDA) are warning that anyone who has had an epidural steroid injection since May 21, 2012, should watch for symptoms of fungal meningitis.
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 Maryland, 23 people have been infected with meningitis, and 1 person has died.
November 5, 2012 — The number of infections in Maryland has grown to 23 people, and 1 person has 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. In Maryland, 19 people have fallen ill and 1 person has died. 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 — 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 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 — Nationwide, 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 Maryland, 17 people have fallen ill and 1 has 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 — 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 — 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 Maryland, 16 infections and 1 death 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 16 people have fallen ill and 1 person has died of fungal meningitis in Maryland. 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 15 illnesses and 1 death have been confirmed in Maryland. 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 — 14 illnesses and 1 death have been reported in Maryland. 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 — 13 illnesses and 1 death has been confirmed in Maryland. Nationwide, 170 people have been sickened and 14 have died.
October 9, 2012 — 8 illnesses and 1 death have been confirmed in Maryland. Nationwide, 119 people have been sickened and 11 people have died.
October 8, 2012 — The Maryland Department of Health has confirmed 5 illnesses and 1 death. The Centers for Disease Control (CDC) has confirmed a total of 105 illnesses and 8 deaths in 9 states. More than 17,000 vials of potentially contaminated steroid injections were sold to 75 clinics in 23 states. An estimated 13,000 people were exposed. The number of illnesses is expected to grow, because meningitis has an incubation period of up to one month. Click here to learn more from the Maryland Department of Community Health.
Maryland Meningitis Outbreak
Maryland Health Department has announced that the following facilities received recalled steroid injections and may have exposed patients:
- Baltimore Pain Management (Baltimore)
- Berlin Interventional Pain Management (Berlin)
- Box Hill Surgery Center (Abingdon)
- Greenspring Surgery Center (Baltimore)
- Harford County ASC, LLC (Edgewood)
- Pain Medicine Specialists (Towson)
- Surgcenter of Bel Air (Bel Air)
- Zion Ambulatory Center (Baltimore)
The Maryland Department of Health has contacted all of the facilities involved in the outbreak to ensure that the products are removed and to facilitate notification of patients who may have been exposed. The exposure period for the recalled products is May 21, 2012 until September 28, 2012, according to the Maryland Department of Health. The product have been traced to New England Compounding Center and the medicines have been recalled.
What is Fungal Meningitis?
Outbreaks of fungal meningitis are very rare. The disease occurs when fungal spores enter a person’s cerebrospinal fluid and cause an inflammation of the membrane around the spinal cord and brain (called the meninges). Sporadic cases of fungal meningitis usually occur in people with a weak immune system. The type of fungus implicated in this outbreak is called Aspergillus. It is not contagious, and is normally found in leaf mold. It was found in one patient involved in the outbreak.
Symptoms of Meningitis
Anyone who has recently had an epidural steroid injection and is concerned about meningitis should contact their physician for more information. Anyone who is experiencing symptoms of meningitis should seek emergency medical care immediately.
According to the Maryland Health Department, “Symptoms of meningitis can include but are not limited to fever, headache, neck stiffness, photophobia, nausea, or vomiting. Stroke symptoms can include but are not limited to double vision, slurred speech, weakness on one side of the body, or difficulty walking.”
In addition to these symptoms, the Centers for Disease Control (CDC) also warns about the following symptoms of fungal meningitis:
- Sudden worsening headache
- Pain or redness at the injection site
- Sensitivity to light
- And more