CullmanTimes.com - Cullman, Alabama

Health

October 4, 2012

Rare US meningitis outbreak grows; 4 dead, 22 sick

NASHVILLE — An outbreak of a rare form of meningitis is likely to grow after sickening 26 people in five states, including four who died, health officials warned.

All received steroid injections, mostly for back pain, a fairly typical treatment. The drug was made by a specialty pharmacy in Massachusetts that issued a recall last week and has shut down operations.

The type of meningitis involved is not contagious like the more common forms. This type is caused by a fungus often found in leaf mold and which health officials suspect may have been in the steroid.

Eighteen of the cases are in Tennessee, where a Nashville clinic received the largest shipment of the steroid.. Investigators, though, say they are still trying to confirm the source of the infection.

Three cases have been reported in Virginia, two in Maryland, two in Florida and one in North Carolina. Two of the deaths were in Tennessee, and Virginia and Maryland had one each, said officials at the Centers for Disease Control and Prevention.

More new cases are almost certain to appear in the coming days, said Tennessee Department of Health Commissioner John Dreyzehner. Five new cases were confirmed over the past 24 hours, he said Wednesday, calling the situation a “rapidly evolving outbreak.”

But federal health officials weren’t clear about whether new infections are occurring. They are looking for — and increasingly finding — illnesses that occurred in the past two or three months.

Meningitis is an inflammation of the lining of the brain and spinal cord. Symptoms include severe and worsening headache, nausea, dizziness and fever. Some of the patients also experienced slurred speech, and difficulty walking and urinating, Tennessee health officials said.

“Some are doing well and improving. Some are very ill — very, very seriously ill and may die,” Tennessee health official Dr. David Reagan said of the state’s patients.

The incubation period is estimated at anywhere from two to 28 days, so some people may not have fallen ill yet, Tennessee health officials said. At three clinics in Tennessee, officials are contacting the more than 900 people who received the steroid in the past three months.

Investigators also have been looking into the antiseptic and anesthetic used during the injections. Neither has been ruled out. However, the primary suspicion is on the steroid medication. Steroid shots are common for back pain, often given together with an anesthetic.

The Food and Drug Administration identified the maker of the steroid as New England Compounding Center, a specialty pharmacy in Framingham, Mass. Last week, the company issued a recall of three lots of the steroid — methylprednisolone acetate. In a statement, the company said it had voluntarily suspended operations and was working with regulators to identify the source of the infection.

Compounding pharmacies mix ingredients for customized medicines that generally aren’t commercially available. They are regulated by states.

The outbreak was discovered about two weeks ago when Vanderbilt University’s Dr. April Pettit was treating a patient who was not doing well for reasons doctors did not understand.

When the lab found the fungus in the patient’s spinal fluid, Pettit began asking questions and learned the patient recently had steroid injections in his spine, according to Dr. William Schaffner, who chairs Vanderbilt’s Department of Preventive Medicine.

“When it became clear that the infection-control practices at the clinic were up to par, the steroid medication became implicated,” Schaffner said.

Federal officials did not release condition reports or details on all the patients in the five states. Fungal meningitis is treated with high-dose antifungal medications, usually given intravenously in a hospital.

Seventeen of the Tennessee cases were treated at the Saint Thomas Outpatient Neurosurgery Center in Nashville. It had 2,000 vials of the suspect lots, the largest number. That clinic voluntarily closed last month to deal with the investigation.

 

1
Text Only
Health
  • COMMENTARY: An alternative diagnosis to ADHD: Schoolchildren need more time to move

    The Centers for Disease Control and Prevention tells us that in recent years, there has been a jump in the percentage of young people diagnosed with attention deficit and hyperactivity disorder, commonly known as ADHD: 7.8 percent in 2003 to 9.5 percent in 2007 to 11 percent in 2011.

    July 18, 2014

  • Guideline: Most healthy women can skip pelvic exam

    No more dreaded pelvic exam? New guidelines say most healthy women can skip the yearly ritual.

    July 1, 2014

  • Sanofi targets fake Viagra market with non-prescription Cialis

    Sanofi sees an attractive opportunity in the rampant market for counterfeit Viagra: luring men away from dodgy online pharmacies with an over-the-counter version of a competing erection drug.

    June 5, 2014

  • Hospital charges to treat chest pain jump 10 percent in a year

    The charge to treat Medicare patients with chest pain at U.S. hospitals rose 10 percent to $18,568 in just a year, the biggest rise seen among the most common inpatient procedures, according to federal data.

    June 2, 2014

  • Study: Both men and women feel less stress at work than at home

    In a newly released study in the Journal of Science and Medicine, researchers carefully examined the levels of the stress hormone, cortisol, of a variety of workers throughout the day. The data clearly showed that both men and women are significantly less stressed out at work than they are at home.
     And the women they studied said they were happier at work. While the men said they felt happier at home.

    May 26, 2014

  • Jobless contend with weight gain as they search for work

    A subject long ignored by policymakers, and one that unemployment counselors are too sheepish to raise with job seekers, the link between bulging waistlines and joblessness is now of intense interest to researchers studying the long-term effects of the country's economic malaise.

    May 12, 2014

  • COMMENTARY: Helmets won't protect your kids from concussions

    When I was a kid, helmets were for motorcyclists. Now I see children wearing helmets when they're scooting down sidewalks, skating, skiing, sledding and playing soccer. Last week one of my friends saw a helmeted kid power-walking in Prospect Park. You can even buy $40 baby helmets on Amazon, because, according to the product description, "babies will always fall taking their first steps."

    May 2, 2014

  • 400px-Cannabis_Plant.jpg How bad is marijuana for your health?

    The Journal of Neuroscience recently published a study linking recreational marijuana use to subtle changes in brain structure. The researchers, led by Jodi Gilman of Massachusetts General Hospital, identified increased gray matter density in the left nucleus accumbens and some bordering areas.

    May 1, 2014 1 Photo

  • American sunscreens need an upgrade

    The last time a new sunscreen ingredient came on the U.S. market, the Y2K bug was threatening to destroy our way of life. Intel had just introduced the Pentium III processor, featuring an amazing 500 MHz of computing power.

    April 24, 2014

  • Cuba is running out of condoms

    The newest item on Cuba's list of dwindling commodities is condoms, which are now reportedly in short supply. In response, the Cuban government has approved the sale of expired condoms.

    April 23, 2014