October 11, 2012 — An outbreak of fungal meningitis linked to tainted steroid shots continues to grow. Today the Centers for Disease Control and Prevention (CDC) reported 170 have fallen ill and 14 people have died in an outbreak across 11 states. One case involves a man who received a steroid shot in his ankle and now has an infection. It is the first injury linked to steroid shots in joints, as opposed to epidural shots for back pain.
The CDC reported the following statistics today:
- Florida: 7 cases, 2 deaths
- Idaho: 1 case
- Indiana: 21 cases, 1 death
- Maryland: 13 cases, 1 death
- Michigan: 39 cases, 3 deaths
- Minnesota: 3 cases
- New Jersey: 2 cases
- North Carolina: 2 cases
- Ohio: 3 cases
- Tennessee: 49 cases, 6 deaths
- Virginia: 30 cases
The CDC also increased the estimated number of people who have been exposed — approximately 14,000, instead of 13,000. Around 12,000 people have already been notified, and health departments are working to notify the rest.
Laboratory tests from people who have fallen ill have also identified two different funguses in the outbreak — Aspergillus in one patient, and Exserohilum in 10 patients. These two funguses are not contagious and rarely cause diseases, except in people with very weak immune systems. They usually grow in rotting plant matter, leaves, grass, and soil.
The outbreak has also been linked to New England Compounding Center. At least 50 vials of medicine from the facility have tested positive for the funguses. The facility is located next to a recycling and waste management facility in Massachusetts, and has faced accusations of tainted medicines in the past. The facility voluntarily recalled all medicines on October 5, rescinded their pharmacy license, and have shut down.
Government officials are investigating whether the company violated their license by mass-producing steroid shots, which are also commercially available from drug companies, and then selling the products across state lines. New England Compounding Center is a compounding pharmacy. Traditionally, compounding pharmacies were small-scale operations that mixed custom drugs (for example, turning a sold medication to a liquid for a patient who can’t swallow). However, an increasing number of compounding pharmacies are operating like mini drug companies, mass-producing medications much more cheaply than pharmaceutical companies, and with far less government oversight.
The CDC has made several recommendations for people who are concerned about exposure to the tainted steroid shots since May 21, 2012. Patients should contact the physician who performed the injection to find out whether the shot was recalled. If the patient has been exposed, he or she should be vigilant for symptoms of meningitis or stroke. Symptoms may be very mild. Patients who show symptoms should seek emergency medical attention. A spinal tap is necessary to diagnose fungal meningitis.
According to the CDC, symptoms of fungal meningitis include:
- Stiff neck
- Nausea and vomiting
- Photophobia (light sensitivity)
- Altered mental status
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