An outbreak of fungal meningitis has been linked to contaminated epidural steroid injections that are commonly used to treat back pain. In 2012, at least 750 people were infected in 20 states, and 64 died. Fungal meningitis is not contagious, but outbreaks are long-lasting because the disease has a prolonged incubation period. Fungal meningitis can also cause strokes and fungal joint infections.
Meningitis Lawsuits Centralized in MDL
February 10, 2015 — Two years after a deadly outbreak of fungal meningitis, lawsuits against clinics and doctors who administered tainted steroid injections have been centralized in a federal Multi-District Litigation (MDL) in Massachusetts. Click here to read more.
December 17, 2014 — The co-founders and 12 employees of New England Compounding Pharmacy (NECC) were arrested early this morning in connection with an outbreak of fungal meningitis in 2012, which killed 64 people and injured 750 in 20 states. Click here to read more.
December 30, 2013 — The bankrupt owners of New England Compounding Center (NECC) have established a $100 million compensation fund to pay off creditors, including hundreds of people who filed fungal meningitis lawsuits. Click here to read more.
October 7, 2013 — A woman in Tennessee has relapsed after she was supposedly cured of her fungal meningitis infection. In June, the NEJM reported a fungal meningitis relapse in an 80 year-old man who was also infected last year. Click here to read more.
May 24, 2013 — An outbreak of fungal meningitis has been linked to contaminated injections manufactured by Main Street Family Pharmacy in Tennessee. At least seven (7) people have been sickened in Illinois and North Carolina. Click here to read more.
January 3, 2013 — At least 30 individuals and families have filed lawsuits against Insight Imaging, a Virginia clinic that administered tainted medicines from NECC. The lawsuits allege that Insight Imaging misrepresented the safety of the medicine by reporting it as Depo-Medrol on bills instead of the generic medicine from NECC. Click here to read more.
January 2, 2013 — At least 620 people have fallen ill and 39 have died. NECC has filed for bankruptcy and will seek to establish a compensation fund for the victims. Click here to read more.
December 6, 2012 — Massachusetts Department of Health sends “cease and desist” orders to 3 more compounding pharmacies in the state after finding safety violations during surprise inspections.
November 29, 2012 — Consumer advocacy group Public Citizen calls on FDA to re-inspect 16 compounding pharmacies that received warning letters after 2003. Click here to read more.
November 26, 2012 — The CDC is reporting that 490 people have been diagnosed with meningitis, 12 people have been diagnosed with peripheral joint infections, and 34 people have died in 19 states. Most new cases since November 4 have involved non-meningitis fungal infections. Click here to read more.
November 13, 2012 — FDA expected to request greater authority to regulate compounding pharmacies. Click here to read more.
November 12, 2012 — NECC has expressed support for centralization of nationwide fungal meningitis lawsuits into one court. The CDC reports 438 people have fallen ill and 32 have died in 19 states. Click here to read more.
November 8, 2012 — The 42-day incubation period for fungal meningitis has ended, but new cases continue to trickle in. Click here to read more.
November 5, 2012 — 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.
New England Compounding Center Recalls All Medicines
The fungal meningitis outbreak has been linked to medications from New England Compounding Center. Most of the illnesses have been linked to epidural steroid injections (steroid shots), which are commonly used to treat back pain at outpatient clinics. However, illnesses have also been linked to other medications from New England Compounding Center.
On September 26, the company recalled three lots of methylprednosolone acetate, which were sent to 75 facilities in 23 states. On October 5, the company recalled all lots of all medications. Several illnesses have been linked to other medications from the company — including eye injections and medicines used during heart surgery.
The outbreak of fungal meningitis was first discovered by Dr. April Pettit, of Vanderbilt University, who treated a sick patient with an unusual fungal infection in her spine. Doctors immediately suspected that the patient’s recent epidural steroid injection was to blame. Investigators ruled out the clinic where she was injected.
The source of the outbreak was traced to New England Compounding Center, a compounding pharmacy, which mixes custom medications. The company has ceased production pending an investigation.
More Medications Linked to Infections
The majority of people who have fallen ill with fungal meningitis were treated with methylprednisolone acetate, a type of epidural steroid injection. Soon after the New England Compounding Center recalled this medication, they recalled all other medications for potential fungal contamination. The FDA has received reports of people getting infections from other medications sold by NECC. The other medications of greatest concern include:
- Cardioplegic solution (used in open heart surgery)
- Opthalmic drugs (used in eye surgery)
- Triamcinolone acetonide (epidural steroid injection)
Symptoms of Fungal Meningitis
- Worsening headache
- Neck stiffness
- Muscle weakness or numbness
- Pain or swelling at the injection site
- Difficulty balancing
- Slurred speech
- Sensitivity to light
- Personality changes
- Confusion, hallucinations
What is Fungal Meningitis?
Fungal meningitis is an inflammation of the lining of the brain and spinal cord (the meninges) caused by a fungus in cerebrospinal fluid. It is not contagious, because it occurs when a person ingests fungal spores from the environment. It is far less common than bacterial or viral meningitis.
If an epidural needle is contaminated with meningitis, the fungus can easily travel through the spinal cord to the brain and cause severe, life-threatening meningitis.
The type of funguses associated with this outbreak are Exserohilum and Aspergillus, which are found in rotting plant matter. Meningitis often causes severe, life-threatening illness. Hospitalization and intensive care are often necessary. Treatment involves intravenously delivering powerful anti-fungal drugs, and the patient may need care for up to six months. Unfortunately, even with treatment, many people with fungal meningitis suffer permanent neurological impairment or death.