Meningitis Outbreak: What You Need to Know

October 8, 2012

By Nicole Mayer:

As of October 10, 2012, 137 people have been affected by the fungal meningitis outbreak in ten states, and at least twelve have died.

Health officials estimate that 13,000 people have been exposed to lots of an epidural steroid, which must be injected.

Growing Concern

On October 6, 2012, Massachusetts-based pharmacy, The New England Compounding Center (NECC) expanded its recall of products potentially linked to the recent fungal meningitis outbreak.

On October 4, 2012,  The Center for Disease Control (CDC) and the FDA previously recommended that health care professionals cease use of any products produced by NECC.  Initially, only three lots of injected steroids were recalled.

Now, in what it is referring to as an abundance of caution, NECC is recalling  all of its other products as well.

A full list of the products recalled by NECC is now posted in a 71-page document titled “list of all products manufactured since January 2012.”   While most items on the list have complex pharmaceutical-sounding names, some items have much more common names, such as certain types of “Magic Mouthwash.”

Who’s Affected?

The CDC, reporting on the outbreak, updates its website daily to reflect new cases.  As of October 10, 2012, the 137 cases and 12 deaths reported were found in the following states:

Tennessee – 44 cases, including 6 deaths

Michigan – 29 cases, including 3 deaths

Virginia – 27 cases, including 1 death

Indiana -15 cases

Maryland – 9 cases, including 1 death

Florida – 6 cases, 1 death

Minnesota – 3 cases

North Carolina – 2 cases

New Jersey – 2 cases

Ohio – 1 case

Of the states with confirmed cases, the following are the locations of facilities known to be affected, as reported by each state’s health department:

The Tennessee Department of Health reports three facilities with cases associated with epidural steroid injections provided at three facilities: (1) PCA Pain Center in Oak Ridge, (2) Saint Thomas Outpatient Neurosurgery Center in Nashville, (3) Specialty Surgery Center in Crossville.  You may call the Tennessee Poison Control Center at 1-800-222-1222 with questions about the outbreak.

The Michigan Department of Health  reports four affected facilities but the list of the facility names was not immediately located on its website. The Detroit Associated Free Press reports the affected facilities as: (1) Michigan Neurosurgical Institute in Grand Blanc; (2) Michigan Pain Specialists in Brighton; (3) Neuromuscular & Rehabilitation in Traverse City; and (4) Southeast Michigan Surgical Hospital in Warren.

The Virginia Department of Health  reports two affected medical facilities: (1) Insight Imaging in Roanoke, which already contacted more than 600 of its patients and (2) New River Valley Surgery Center in Christiansburg, which contacted less than 30 patients.  Individuals with questions may call their local health department or 211.

The Indiana State Department of Health reports the following six health care facilities known to have received the infected lots: (1) Ambulatory Care Center, LLP, Evansville; (2) Ft. Wayne Physical Medicine, Ft. Wayne; (3) OSMC Outpatient Surgery Center, Elkhart; (4) South Bend Clinic, South Bend; (5) Union Hospital, Terre Haute; (6) Wellspring, Columbus. Patients who have received steroid injections at these facilities since July 1, 2012, and who are experiencing symptoms of meningitis may contact Ken Severson at (317) 233-7104 or via email at kseverson@isdh.in.gov.

The Florida Department of Health reports six facilities in Florida received products from the contaminated steroid lots which are leading to meningitis cases: (1) Florida Pain Clinic, Ocala; (2) Marion Pain Management Center, Ocala; (3) Orlando Center for Outpatient Surgery, Orlando; (4) Pain Consultants of West Florida, Pensacola; (5) Surgery Center of Ocala, Ocala; (6) Surgical Park Center, Miami. If you received back or joint injections there since May 21, 2012, it is advised that you watch for symptoms.

The Minnesota Department of Health reports usage of the implicated drugs at: (1) Medical Advance Pain Specialists (MAPS) in Edina, Fridley, Shakopee and Maple Grove; (2) Minnesota Surgery Center (MSC) in Edina and maple Grove.   It is estimated that approximately 950 patients were treated with the implicated steroid product and the facilities contacted those individuals over this past weekend.  For more information, residents may call Buddy Ferguson at (651) 201-4997.

The Maryland Department of Health and Mental Hygiene reports  receipt of the affected product at seven facilities: (1) Berlin Interventional Pain Management, Berlin; (2) Box Hill Surgery Center, Abingdon; (3) Greenspring Surgery Center, Baltimore; (4) Harford County Ambulatory Surgery Center, Edgewood; (5) Maryland Pain Specialists, Towson; (6) SurgCenter of Bel Air, Bel Air; (7) Zion Ambulatory Center, Baltimore.

The North Carolina Department of Health and Human Services reports three clinics having received the recalled products. The first two used the lots for spinal injections: (1) High Point Surgery Center, High Point; (2) Surgical Center of Wilson, Wilson. All 94 patients who were exposed at these clinics have been notified. The third clinic (3) North Carolina Orthopaedic Clinic, Durham, used the product for joint injections to relieve pain. The clinic is working to contact all those potentially exposed.

The Ohio Department of Health reports that the tainted medication was sent to the following four Ohio healthcare facilities: (1) Marion Pain Clinic, Marion; (2) BKC Pain Specialists, Marion; (3) Cincinnati Pain Management, Dublin; (4) Ortho-Spine Rehab Center, Dublin.

The New Jersey Department of Health reports that the following six facilities have now removed the tainted medication from their inventory: (1) Central Jersey Orthopedics Specialists, PC in South Plainfield; (2) Edison Surgical Center, Edison; (3) IF Pain Associates/Isaiah Florence, Teaneck; (4) Premier Orthopaedic Associates, Vineland; (5) Comprehensive Pain Management, Sparta; (6) South Jersey Healthcare, Elmer and Vineland.

Other States Affected

Other states that received the implicated products, but that have no confirmed cases reported, include: California; Connecticut; Georgia, Idaho; Illinois; New Hampshire; Nevada; New York; Pennsylvania; Rhode Island; South Carolina; Texas; and West Virginia.  If you live in any of these states and have questions, you may want to contact your state’s health department to see if it has a list of facilities that received the affected products.

Symptoms

The CDC reports that the potentially contaminated injections were given starting May 21, 2012.  Those who think they may have been affected are advised to look for symptoms such as: fever, new or worsening headache, neck stiffness, sensitivity to light, new weakness or numbness, increasing pain, redness or swelling of the injection site.

The type of meningitis caused by the affected products is fungal meningitis and is NOT contagious.

In just the past four days, the number of cases reported has increased 114% (from 64 cases to 137 cases) and the number of deaths reported went up by 41% (from 7 to 12).