A rare outbreak of fungal meningitis has been linked to contaminated epidural steroid injections, which are commonly used to treat back pain at outpatient clinics. Tennessee is one of the hardest-hit states. Dozens of illnesses and several deaths have been confirmed. Several patients had strokes related to meningitis. The earliest known exposure occurred in May 2012, and experts are warning anyone who has had an epidural steroid injection since this date should be vigilant for symptoms of 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 Tennessee, the number of people who have fallen ill has grown to 82 people, of whom 13 have died.
November 5, 2012 — The number of infections in Tennessee has grown to 78 people, of whom 13 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 Tennessee, 74 people have fallen ill and 10 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 — 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 — In Tennessee, the number of cases of fungal meningitis has grown to 70, including 9 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 Tennessee, 69 people have fallen ill and 9 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 — 66 people have been sickened and 8 people have died in an outbreak of fungal meningitis in Tennessee. 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 Tennessee, 63 people have been sickened in the outbreak of fungal meningitis and 8 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 — Tennessee remains the hardest-hit state in a nationwide outbreak of fungal meningitis. The CDC has confirmed 61 infections and 8 deaths linked to the outbreak. 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 59 people have fallen ill and 6 people have died of fungal meningitis in Tennessee. 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 53 illnesses and 6 deaths have been confirmed in Tennessee. 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 — 50 illnesses and 6 deaths have been reported in Tennessee. 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 — 49 illnesses and 6 deaths has been confirmed in Tennessee. Nationwide, 170 people have been sickened and 14 have died.
October 9, 2012 –– 39 illnesses and 6 deaths have been confirmed in Tennessee. Nationwide, 119 people have been sickened and 11 people have died.
October 9, 2012 — St. Thomas Hospital is treating 25 people who were sickened with meningitis at St. Thomas Outpatient Neurosurgery Center. Click here to read more.
October 8, 2012 — The Tennessee Department of Health is aware of 35 illnesses and 4 deaths caused by fungal meningitis, abscess, or stroke associated with contaminated epidural steroid injections. Click here to learn more from the Tennessee Department of Health.
Tennessee Meningitis Outbreak
The outbreak of fungal meningitis in Tennessee has been linked to the following clinics, according to the Centers for Disease Control (CDC):
- PCA Pain Care Center: Oak Ridge, Tennessee
- Specialty Surgery Center: Crossville, Tennessee
- St. Thomas Outpatient Surgery Center: Nashville, Tennessee
The contaminated products were given beginning on May 21, 2012. As many as 13,000 people may have been exposed to the injections. Because fungal meningitis has an incubation period of up to 4 weeks, the number of cases is expected to continue growing.
Fungal Meningitis Outbreak
The Tennessee fungal meningitis outbreak was first identified in September, when Dr. April Pettit of Vanderbilt University treated a patient who had a fungal infection in her spine. Doctors immediately suspected the patient’s recent epidural spinal injection. Further investigation traced the outbreak to the company that created the epidural spinal medication.
The outbreak has been linked to the New England Compounding Center, a company that creates custom mixed medications that do not contain preservatives (which would inhibit fungal growth). The company has now recalled all products sold at their facility in an abundance of caution, although illnesses have only been linked to epidural steroid injections.
What is Fungal Meningitis?
Fungal meningitis is a non-contagious disease that occurs when fungal spores infect cerebrospinal fluid, and cause an inflammation of the meninges, which is the lining around the brain and spinal cord. In severe cases, the inflammation causes fluid to build up inside the brain, neurological impairment, and even death.
Fungal meningitis is very rare, and outbreaks are even more rare. The disease normally only occurs in people with weakened immune systems (such as those undergoing cancer therapy). However, large outbreaks can occur when many people receive injections that introduce fungal spores directly into their cerebrospinal fluid.
Treatment for fungal meningitis involves hospitalization, intensive care, and intravenous administration of anti-fungal drugs. Recovery can take up to six months.
Symptoms of Meningitis
Experts are recommending that anyone who has had an epidural steroid injection in the last few months should contact emergency medical attention immediately if they show symptoms of meningitis. These symptoms may include:
- Headache that gets worse
- Problems with speech / balance
- Stiffness in the neck
- Personality changes
- Sensitivity to light
- Redness or swelling of the injection site
- New weakness or numbness
- And more