Health and Fitness

UPDATE: Multistate Meningitis Outbreak Investigation, October 9, 2012


Atlanta, GA—(ENEWSPF)–October 9, 2012 10:45 AM EDT

At-A-Glance

Current Situation

  • CDC is aware that New England Compounding Center (NECC) has voluntarily expanded its recall to include all products currently in circulation that were compounded at and distributed from its facility in Framingham, Massachusetts.
  • CDC’s guidance to patients has not changed as a result of this voluntary recall. Patients who feel ill and are concerned about whether they received a medication from NECC at one of the affected facilities should contact their physicians.
  • Clinicians should actively contact patients who have received medicines associated with three lots of preservative-free methylprednisolone acetate (80mg/ml) recalled on September 26. The potentially contaminated injections were given starting May 21, 2012.
  • Patients have had symptoms generally starting from 1 to 4 weeks after their injection. Not all patients who received the medicine will become sick. Symptoms that should prompt patients to seek medical care include: fever, new or worsening headache, neck stiffness, sensitivity to light, new weakness or numbness, increasing pain, redness or swelling of the injection site.

CDC Responds to Multistate Meningitis Outbreak:

The Centers for Disease Control and Prevention (CDC) and the Food and Drug Administration (FDA) are currently coordinating a multistate investigation of fungal meningitis among patients who received an epidural steroid injection with a potentially contaminated product. This form of meningitis is not contagious. Several of these patients also suffered strokes that are believed to have resulted from their infection.

General Information:

Is the source of the outbreak known?
CDC is investigating medications and products that are associated with this outbreak of meningitis. At this point, there is not enough evidence to determine the original source of the outbreak, however there is a link to an injectable steroid medication.  The lots of medication that were given to patients have been recalled by the manufacturer.

What are the states that received the implicated product?
California, Connecticut, Florida, Georgia, Idaho, Illinois, Indiana, Maryland, Michigan, Minnesota, North Carolina, New Hampshire, New Jersey, Nevada, New York, Ohio, Pennsylvania, Rhode Island, South Carolina, Tennessee, Virginia, Texas, and West Virginia

What is meningitis?
Meningitis refers to inflammation of the protective membranes covering the brain and spinal cord known as the meninges. The inflammation is usually caused by an infection frequently with a bacteria or virus, but meningitis can also be caused by less common pathogens such as fungi. The severity of illness and the treatment for meningitis differ depending on the cause. Thus, it is important to know the specific cause of meningitis.

What is fungal meningitis?
Fungal meningitis occurs when the protective membranes that cover the brain and spinal cord are infected with a fungus.  Fungal meningitis can develop after a fungus spreads through the bloodstream from somewhere else in the body, as a result of the fungus being introduced directly into the central nervous system, or by direct extension from an infected body site next to the central nervous system.  

Is fungal meningitis common after epidural injections?
Epidural injections are generally very safe procedures, and complications are rare.  Fungal meningitis is an extremely rare cause of meningitis overall, including after epidural injections. The type of epidural medication given to patients affected by this outbreak is not the same type of medication as that given to women during childbirth.

What are the symptoms of fungal meningitis?
Symptoms of fungal meningitis are similar to symptoms of other forms of meningitis, however they often appear more gradually and can be very mild at first.  In addition to typical meningitis symptoms, like headache, fever, nausea, and stiffness of the neck, people with fungal meningitis may also experience confusion, dizziness, and discomfort from bright lights. Patients might just have one or two of these symptoms.

Multi-State Meningitis Outbreak – Current Case Count

October 8, 2012 2:00 PM EDT

Persons with Meningitis Linked to Epidural Steroid Injections, by State

Persons by State with Meningitis Linked to Epidural Steroid Injections, as of October 8, 2012

State Case Count Deaths
Florida (FL) 4
Indiana (IN) 11
Maryland (MD) 5 1
Michigan (MI) 21 2
Minnesota (MN) 3
North Carolina (NC) 2
Ohio (OH) 1
Tennessee (TN) 35 4
Virginia (VA) 23 1
TOTALS 105 8

Map of Healthcare Facilities which Received Three Lots* of Methylprednisolone Acetate (PF) Recalled from New England Compounding Center on September 26, 2012

October 8, 2012 5:45 PM EDT

* Lot #05212012@68, BUD 11/17/2012; Lot #06292012@26, BUD 12/26/2012; Lot #08102012@51, BUD 2/6/2013
** All vials of Methylprednisolone Acetate that were sent to Nevada were recalled prior to use.

List of Healthcare Facilities which Received Lots of Methylprednisolone Acetate (PF) Recalled from New England Compounding Center on September 26, 2012

CYPRESS SURGERY CENTER DBA 559 740 4094 VISALIA CA
ENCINO OUTPATIENT SURGICENTER 818-986-1037 ENCINO  CA
UKIAH VALLEY MEDICAL CENTER 707 463 7345 UKIAH CA
UNIVERSAL PAIN MANAGEMENAT 661-267-6876 x166 PALMDALE CA
INTERVENTIONAL SPINE AND SPORTS MED 203 598 7246 MIDDLEBURY CT
FLORIDA PAIN CLINIC 352-237-5906 OCALA FL
INTERVENTIONAL REHAB CENTER 850 484 8800 PENSACOLA FL
MARION PAIN MANAGEMENT CENTER 352 622 1845 OCALA FL
NORTH COUNTY SURGICENTER 561 626 6446 PALM BEACH GARDENS FL
ORLANDO CENTER FOR OUTPATIENT SURGERY 407-426-8331 ORLANDO FL
PAIN CONSULTANTS OF WEST FLORIDA 850 494 0000 PENSACOLA FL
SURGERY CENTER OF OCALA 352-237-5906 OCALA FL
SURGICAL PARK CENTER 305-271-9100 x226 MIAMI FL
FORSYTH STREET AMBULATORY SURG. CTR. 478-749-1610 MACON GA
PAIN SPECIALISTS OF IDAHO 208 522 7246 IDAHO FALLS ID
WALTER KNOX MEMORIAL HOSPITAL 208-365-3561 x3342 EMMETT ID
APAC CENTERS FOR PAIN MANAGEMENT 708-483-7007 WESTCHESTER IL
APAC CENTERS FOR PAIN MANAGEMENT- 773-935-2760 CHICAGO IL
THOREK MEMORIAL HOSPITAL 773 975-6734 CHICAGO IL
AMBULATORY CARE CENTER LLC 812 475 1800 EVANSVILLE IN
FORT WAYNE PHYSICAL MEDICINE 260-436-9337 FORT WAYNE IN
OSMC OUTPATIENT SURGERY CENTER 574-266-4173 ELKHART IN
SOUTH BEND CLINIC 574-237-9372 SOUTH BEND IN
UNION HOSPITAL– 812 238 4964 TERRE HAUTE IN
WELLSPRING 812-376-0700 COLUMBUS IN
BALTIMORE PAIN MANAGEMENT 410 682-5040 BALTIMORE MD
BERLIN INTERVENTIONAL PAIN MANAGEMENT 410 641 3759 BERLIN MD
BOX HILL SURGERY CENTER 410 877 8141 ABINGDON MD
GREENSPRING SURGERY CENTER 410 653 0077 BALTIMORE MD
HARFORD COUNTY ASC, LLC 410 538 7000 EDGEWOOD MD
PAIN MEDICINE SPECIALISTS 410 825 6945 TOWSON MD
SURGCENTER OF BEL AIR 410 638 5523 BEL AIR MD
MICHIGAN NEUROSURGICAL INST. 810 606 7112 GRAND BLANC MI
MICHIGAN PAIN SPECIALISTS 734 995 7246 BRIGHTON MI
NEUROMUSCULAR & REHABILITATION 231 935 0860 TRAVERSE CITY MI
SOUTHEAST MICHIGAN SURGICAL HOSPITAL 586-427-1000 WARREN MI
MAPS-EDINA MEDICAL PAIN CLINIC 763 537 6000 MINNEAPOLIS MN
MAPS-MEDICAL ADVANCED PAIN 763 537 6000 FRIDLEY MN
MEDICAL ADVANCED PAIN SPECIALISTS* 763-537-6000 x238 SHAKOPEE MN
MEDICAL ADVANCED PAIN SPECIALISTS. 763 537 6000 MAPLE GROVE MN
MINNESOTA SURGERY CENTER 763-767-7139 EDINA MN
MINNESOTA SURGERY CENTER- 763 537 6000 MAPLE GROVE MN
HIGH POINT SURGERY 336 878 6048 HIGH POINT NC
NORTH CAROLINA ORTHOPAEDIC CLINIC 919 403 5148 DURHAM NC
SURGERY CENTER OF WILSON 252-237-5649 WILSON NC
DR. O’CONNELL’S PAIN CARE CTR 603-335-5070 MERRIMACK NH
DR. O’CONNELL’S PAINCARE CENTERS, INC 603 692 3166 SOMERSWORTH NH
CENTRAL JERSEY ORTHOPEDICS SPECIALISTS PC 908 561 2122 SOUTH PLAINFIELD NJ
EDISON SURGICAL CENTER 732 452 0123 EDISON NJ
IF PAIN ASSOCIATES / ISAIAH FLORENCE 201 287 1100 TEANECK NJ
PREMIER ORTHOPEDICS SURG. ASSOC., LLC 856 690 1750 VINELAND NJ
Comprehensive Pain Management 973 796 5216 SPARTA NJ
SOUTH JERSEY HEALTH CARE 856 363 1558 ELMER NJ
SOUTH JERSEY HEALTHCARE 856-641-7557 VINELAND NJ
SAHARA SURGERY CENTER 702-362-7874 LAS VEGAS NV
BUTANI, SUNIL H. PHYSICIAN PC 516 747 5042 MINEOLA NY
OBOSA MEDICAL SERVICES 914-530-2323 MOUNT VERNON NY
ROCHESTER BRAIN AND SPINE 585 334 5560 ROCHESTER NY
BKC PAIN SPECIALISTS,LLC 740-387-7246 MARION OH
CINCINNATI PAIN MANAGEMENT 513 891 0022 CINCINNATI OH
MARION PAIN CLINIC 740-375-0200 MARION OH
ORTHO-SPINE REHAB. CENTER, INC. DUBLIN OH
ALLEGHENY PAIN MANAGEMENT 814-940-2000 ALTOONA PA
SOUTH HILLS PAIN & REHAB ASSOC. 412 469 7722 JEFFERSON HILLS PA
NEW ENGLAND ANESTHESIOLOGY (NEA) 401-490-7530 WARWICK RI
OCEAN STATE PAIN MANAGEMENT 401 766 7700 WOONSOCKET RI
OCEAN STATE PAIN MANAGEMENT- 401 884 6070 EAST GREENWICH RI
INTERVENE MD 843-216-4844 MOUNT PLEASANT SC
PCA PAIN CARE CENTER- 865 835 5196 OAK RIDGE TN
SPECIALTY SURGERY CENTER 931-484-2500 x125 CROSSVILLE TN
ST. THOMAS OUTPATIENT NEUROSURGIACL 615 341 3433 NASHVILLE TN
DALLAS BACK PAIN MANAGEMENT 214 445 5077 DALLAS TX
HARRIS METHODIST SOUTHLAKE CENTER 817 748 8778 SOUTHLAKE TX
INSIGHT IMAGING-ROANOKE 540 581 0882 ROANOKE VA
NEW RIVER VALLEY SURGERY CENTER 540 639 5888 CHRISTIANSBURG VA
PARS INTERVENTIONAL PAIN 304 865 7277 PARKERSBURG WV

Source: cdc.gov


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