Fungal meningitis cases continue to climb, more local patients notified
Nationwide infections and fatalities from fungal meningitis continued to climb Tuesday as doctors at a local clinic notified more patients who received a possibly tainted steroid linked to the outbreak.
What is fungal meningitis?
Fungal meningitis is not contagious. It is also very rare. Viral and bacterial meningitis are more common. Fungal meningitis usually occurs in people whose immune systems are not functioning properly.
Symptoms include fever, new or worsening headache, neck stiffness, sensitivity to light, new weakness or numbness, increasing pain and redness or swelling of a spinal steroid injection site.
Centers for Disease Control and Prevention
The number of area patients potentially affected by the situation grew to 257 on Tuesday, up from 189 on Friday. Intervene MD physicians had contacted 246 of them and enlisted the help of the state health department in an effort to reach the others, clinic spokeswoman Cheryl Smithem said.
Steroids for pain relief
Spinal (epidural) steroid injections are a common treatment for many forms of low-back and leg pain. At times the injection alone is sufficient to provide relief, but commonly an epidural steroid injection is used in combination with a rehabilitation program.
Steroid injections also can be used to relieve pain in other areas, such as the neck and shoulders.
spine-health.com and webmd.com
“The good news is that the doctors have been able to speak with people and answer their concerns,” she said.
So far, 119 cases of the rare infection have been reported in 10 states, none in South Carolina. Eleven of the patients have died. The Tuesday count added 14 more infected people and three more fatalities, the Centers for Disease Control and Prevention reported.
Intervene MD of Mount Pleasant is the only South Carolina clinic on the CDC list of 76 health care facilities that received the potentially contaminated steroid methylprednisolone acetate made at New England Compounding Center. The drug, injected into the spine for pain relief, has been recalled.
The situation has hit home for some area residents who received spinal steroid injections for pain in recent months.
“I’m just worried about it,” said James Lemaster of Summerville.
Family members are concerned about him as well.
“My mom is real worried about it. Everyone is calling her right now. She’s a nervous wreck,” he said.
Starting in August, Lemaster, 38, said he had four spinal steroid injections for leg and back pain related to a car accident in June. The last injection was Sept. 13. Because of his concern about fungal meningitis, he contacted his doctor for more information. He did not recall the name of the steroid he received at a clinic that was not part of the steroid recall.
The CDC said the situation is of concern to patients who received the potentially fungus-tainted steroid by spinal injection after May 21, much earlier than previously suspected. As many as 13,000 patients may have been exposed to the drugs recalled from the Massachusetts firm, officials said.
People who have received spinal steroid injections for pain relief within the past four months are not at potential risk unless the steroid was manufactured at NECC.
The U.S. Food and Drug Administration said it has observed fungal contamination in a sealed vial of methylprednisolone acetate collected from NECC. The FDA is conducting microbial testing to confirm the species of fungus.
In addition to being rare, fungal meningitis is not contagious. It usually is seen in people whose immune systems are not functioning properly, such as an HIV-positive person or a cancer patient receiving chemotherapy.
Out of an abundance of caution, all of the drugs manufactured by NECC are being recalled. They include the steroid betamethasone, which was used at Intervene MD. Both recalled drugs have been replaced with medications from a different manufacturer, Smithem said.
Information was not available Tuesday on the number of patients, if any, who received a spinal injection of betamethasone at Intervene MD, she said.
Three lots of methylprednisolone acetate were recalled on Sept. 26 because of concerns about sterility and a connection to the outbreak of fungal meningitis.
The CDC advised Intervene MD that all infections detected as of Monday have occurred after injections with methylprednisolone acetate products from the three recalled lots. The illness takes from one week to one month to develop.
“We immediately removed all vials of the medication from use and returned them to the manufacturer. It is a relief that none of our patients are showing any signs and symptoms of meningitis,” the clinic said in a prepared statement.