Health officials trying to contact four people at possible risk for fungal meningitis

Four people who received spinal injections of possibly contaminated steroids at a local clinic that could put them at risk of developing a potentially deadly case of fungal meningitis still have not been located, a health official said Wednesday.

Law enforcement, neighbors, family and landlords have been enlisted in the search for the patients who received the pain treatment at Intervene MD, said Dr. Kathryn Arden, regional medical director for the state Department of Health and Environmental Control.

Arden said a plan has been developed to track down three of the four individuals who have yet to be contacted. Officials are still working on a strategy to find the remaining patient, she said.

The four patients, whose identities are protected under privacy laws, are part of a group of more than 200 people who received injections of methylprednisolone acetate at Intervene MD. Twelve of them were referred for a lumbar puncture to have spinal fluid tested for the presence of fungal meningitis, Arden said.

No one has been diagnosed with fungal meningitis as a result of receiving a spinal injection of the suspect medicine at Intervene MD, which is the only clinic in the state affected by the Sept. 26 national recall of 5,000 unused single or multidose vials of the steroid. Intervene MD has offices in Mount Pleasant and North Charleston.

The Centers for Disease Control and Prevention on Wednesday reported 137 cases of fungal meningitis in 10 states, up from 119 cases on Tuesday. Another fatality from the rare infection was reported Wednesday, bringing the death toll to 12.

All fungal meningitis infections detected as of Monday have occurred after injections with methylprednisolone acetate manufactured by New England Compounding Center, according to the CDC.

The U.S. Food and Drug Administration is investigating to determine the extent of fungal contamination in 17,700 vials of methylprednisolone acetate made at NEEC in Framingham, Mass. More than 13,000 people could be affected nationwide, including 257 patients at Intervene MD, Arden said.

“It’s a disturbing situation but so far we think it’s going very well,” Arden said.

Fungal meningitis is not a risk to the general public because it is not contagious, she said.

The FDA has reported observing “fungal contamination by direct microscopic examination of foreign matter taken from a sealed vial of methylprednisolone acetate collected from the New England Compounding Center.”

The fungal meningitis incubation period is thought to be one to four weeks but in one patient it occurred 42 days after receiving a spinal injection of methylprednisolone acetate. Patients who received the possibly contaminated steroid injections for pain will be monitored for 90 days, she said.

She and other health officials are awaiting a report from the FDA that will provide more details on the situation ,such as the degree of fungal contamination in the three lots of steroid product.

Information on the incidence of fungal meningitis is scant because health care providers are not required to report a case of the disease to state or local authorities, Arden said.

Kate Jerdan of Ridgeville said she was alarmed when she heard about the steroid recall because her son Philip Jerdan receives spinal steroid injections for foot pain related to a car accident.

“We were awfully concerned about that fungal meningitis,” she said.

Jerdan said she called her son’s doctor and was reassured that he was not affected because the steroids used to treat him were from a different company.

Meningitis is caused by inflammation of the protective membranes covering the brain and spinal cord.

The inflammation usually is caused by an infection of the fluid surrounding the brain and spinal cord.

Viral and bacterial meningitis are more common than fungal meningitis. Although anyone can get fungal meningitis, people with weak immune systems, like those with AIDS or cancer, are at higher risk, according to the Centers for Disease Control.