October 4, 2012 — At least four people have died and 30 others have been seriously injured by steroid injection shots that are contaminated with a rare type of meningitis. All of the people received steroid injections in their back, a common medical procedure. Because meningitis has an incubation period of up to four weeks, the number of cases will likely continue to grow.

Doctors are urging anyone who has had a spinal steroid injection in the last few months should seek emergency medical attention if they develop early symptoms of meningitis infection, which may include:

  • Severe or worsening headaches
  • Fever
  • Nausea
  • Difficulty with balance
  • Slurred speech

The products were shipped to 23 states. Five states have reported illnesses, including Tennessee, North Carolina, Florida, Virginia, and Maryland. The majority of the illnesses and two deaths have occurred in Tennessee, at one clinic — Saint Thomas Outpatient Neurosurgery Center in Nashville — that received more than 2,000 vials of the contaminated drug. The clinic has closed pending an investigation.

The outbreak was discovered about two weeks ago by Dr. April Pettit of Vanderbilt University, who noticed an unusual fungal infection in her patient’s spinal fluid. They immediately suspected that a spinal injection was to blame. After the clinic checked out, attention turned toward the steroid injection itself.

The company that sells the steroid injection is New England Compounding Center, a compounding pharmacy located in Farmingham, Massachusetts. Compounding pharmacies mix ingredients for clinics when the product is not commercially available. The company has stopped production and is working with investigators to find the source of the outbreak. On September 26, they issued a recall of three lots of the steroid (methylprednisolone acetate).

The Aspergillus type of meningitis is non-contagious, non-viral, and non-bacterial. It is created by a fungus found in leaf mold. Because fungal infections are notoriously difficult to treat, doctors must use powerful, high-dose, intravenous anti-fungal drugs. The people who have been hospitalized with this illness could need intensive care and up to six months of treatment.


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