Meningitis is making an unwelcome comeback in the United States as several recent cases linked to steroid spinal injections have killed 14 people and sickened at least 170 others in 10 states. Officials with the CDC say that the infections were passed through steroid drug injections containing a fungus known as Aspergillus. So the infection is not believed to be transferred from person-to-person or canine-to-canine. The incubation period ranges from a few days to four weeks after injection.
The contaminated drug is said to have been shipped to 75 hospitals and clinics in 23 states, with cases reported so far in Tennessee (which, with 26, has the most cases), North Carolina, Florida, Michigan, Virginia and Maryland. Infected patients had each received a treatment for back pain called a lumbar epidural steroid injection. Ouch. Sounds painful!
An infectious disease expert at Vanderbilt University, Dr. William Schaffner, had this to say about expectations about the infections this year: “I’m afraid we’re going to see many more cases spread across the country.”
Labeled Methylprednisolone Acetate, the solution was produced by the New England Compounding Center in Massachusetts. The lot numbers of the potentially contaminated drug include: 05212012@68,06292012@26, and 08102012@51.
Doctors urge anyone who has undergone spinal epidural injection treatment during the past few months to seek immediate medical attention if they suspect they are suffering any symptoms. Caused by a fungus normally found in leaf mold, Fungal Meningitis can cause mild stroke-like symptoms, including slurred speech and difficulty walking and urinating. Other symptoms include worsening and severe headache, nausea, dizziness and fever. And here I didn’t even know you had to scrub leaves as well as bathroom tile to keep mold at bay!
Treatment includes high-dose antifungal medications, usually administered intravenously in a hospital, with success tied closely to the speed of diagnosis and treatment. The outbreak has raised concerns about the safety of a method used by millions to offset severe back pain. Sterile drugs and equipment are essential for the procedure because epidural injections involve inserting a needle directly into a part of the body that is an avenue for efficient germ delivery directly to the brain. That doesn’t sound good.
- One clinic in Tennessee, where most of that state’s patients in the outbreak so far were infected, had received 2,000 vials of the drug.
- Also in Tennessee, some hospitalized patients are recovering and walking the halls, while others are severely ill and in intensive care units,
- In reaction to one verified infection, the North Carolina Board of Pharmacy suspended one company’s business permits.
- Although the New England Center has not yet responded to the story, information about the steroids previously available on their website no longer appears.
- Fungal infections are notoriously stubborn and hard to treat, requiring powerful drugs that can produce harsh side effects. Cats are also notoriously stubborn, by the way.
- Most patients will need six months to a year of treatment to eliminate the infection.
“Given the severity of illness,” said director of the FDA office of compliance, we believe precautionary measures are warranted to protect public health.”
Unless you have recently undergone spinal injection therapy for chronic acute back pain, you will likely easily avoid this particular outbreak of Fungal Meningitis. However, according to the Meningitis Foundation of America, there are essentially two distinct types of Meningitis: aseptic and bacterial. And, unfortunately, meningitis cases are not delivered exclusively by contaminated epidural injections. To avoid contracting meningitis of any kind, observe these safety precautions:
1. Practice good hygiene!
- Don’t share food, glasses, water bottles, water bowls or eating utensils.
- Don’t share tissues, handkerchiefs, towels or bones.
- Don’t share lip balm, lip gloss, lipstick or jerky treats.
- Wash your hands or paws often with soap and hot water.
2. Beef up your immune system.
- Eat a well-balanced diet rich in lean proteins, complex carbohydrates and fresh fruits and vegetables.
- Exercise on a regular basis. I like taking long walks.
- Get plenty of sleep. You don’t have to tell me twice!
- Don’t smoke, drink or use drugs.
3. Seek medical advice about whether your children ages 11-12 are good candidates for vaccine. (Generally, vaccines are only necessary and effective if a teenager is exposed to meningitis during an outbreak, is traveling or living where a meningococcal disease is common, if the child is a military recruit, or if your son or daughter has an immune disorder or a damaged or missing spleen.)
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