A rare and deadly outbreak of non-contagious fungal meningitis has been linked to epidural steroid injections. Many of the illnesses and deaths have occurred in four clinics in Michigan. The Michigan Health Department and the Centers for Disease Control (CDC) are advising anyone who has recently had an epidural steroid injection (usually used to treat back pain) to watch for symptoms of meningitis. The earliest known exposure was on May 21, 2012.
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. More people have fallen ill in Michigan than in any other state. At least 164 people have been diagnosed with meningitis, 8 people have a peripheral joint infection, and 9 people have died.
November 5, 2012 — The number of infections in Michigan has grown to 119 people, including 6 fungal joint infections. Of these people, 7 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. In Michigan, the number of illnesses has grown to 82, and 5 people have 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 — In Michigan, 80 people have fallen ill and 5 have died in an outbreak of fungal meningitis. 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 Michigan has grown to 73, and 5 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 — In Michigan, the number of cases of fungal meningitis has grown to 68, including 5 deaths. 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 Michigan, 62 people have fallen ill and 5 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 — 53 people have been sickened and 5 people have died in an outbreak of fungal meningitis in Michigan. 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 Michigan, 49 people have been sickened in the outbreak of fungal meningitis and 4 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 Michigan, 48 infections and 3 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 47 people have fallen ill and 3 people have died of fungal meningitis in Michigan. 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 46 illnesses and 3 deaths have been confirmed in Michigan. 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 –– 41 illnesses and 3 deaths have been reported in Michigan. 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 — 39 illnesses and 3 deaths have been confirmed in Michigan. Nationwide, 170 people have been sickened and 14 have died.
October 9, 2012 — 25 illnesses and 3 death have been confirmed in Michigan. Nationwide, 119 people have been sickened and 11 people have died.
October 8, 2012 — The Michigan Department of Health is reporting 21 illnesses and 2 deaths. In total, at least 105 illnesses and 8 deaths in 9 states have been confirmed in the outbreak. Click here to learn more from the Michigan Department of Community Health.
Michigan Meningitis Outbreak
The following facilities are involved in the outbreak of fungal meningitis in Michigan:
- Michigan Neurosurgical Institute (Grand Blanc)
- Michigan Pain Specialists (Brighton)
- Neuromuscular & Rehabilitation (Traverse City)
- Southeast Michigan Surgical Center (Warren)
The contaminated injections were administered from May 2012 until September 2012. Clinics are currently in the process of notifying patients who may have been exposed. It is likely that the number of injuries will continue growing, because meningitis has an incubation period of up to 4 weeks.
Fungal Meningitis Outbreak
The outbreak of fungal meningitis has been linked to products sold by the New England Compounding Center. The company manufactures custom mixed medications for facilities when there are no commercially-available alternatives. The epidural steroid injections were sold without preservatives, which might have inhibited fungal growth.
More than 17,000 vials of the contaminated product were sold to 75 clinics in 23 states. Experts estimate that 13,000 people were exposed to the contaminated injections. The New England Compounding Center has recalled all medicines sold by their company. They have also voluntarily rescinded their license.
What is Fungal Meningitis?
Meningitis is a disease that occurs when the meninges (the protective membrane around the brain and spinal cord) becomes inflamed. It is a very serious illness that can cause permanent neurological impairment and death. Meningitis is usually caused by viruses or bacteria. It is rarely caused by fungus, and usually only in people with very weak immune systems.
Outbreaks of fungal meningitis can occur when injections are contaminated with fungal spores. The injection introduces the fungus directly into a person’s cerebrospinal fluid in the spinal cord. Once the fungus is in cerebrospinal fluid, it can easily travel to the brain and cause severe meningitis.
Treatment for fungal meningitis involves administering anti-fungal drugs, usually intravenously, but sometimes directly into the brain. A patient may require several months of treatment.
Symptoms of Fungal Meningitis
The Centers for Disease Control (CDC) guidance for patients is to contact a physician if they feel ill and are concerned about whether they received a medication from New England Compounding Center. The symptoms may not appear for up to four weeks after the patient receives an injection. Furthermore, symptoms may be relatively mild, and patients may only have one or two symptoms.
Fungal meningitis symptoms may include:
- Nausea, vomiting
- Redness, swelling at the injection site
- Stiffness in the neck
- New muscle weakness
- Headache that gets worse
- Slurred speech
- Trouble balancing
- Sensitivity to light
- And more