A recent fungal meningitis outbreak has infected at least 170 people in 11 states. The death toll from the outbreak that has reportedly been linked to spinal steroid injections compounded at the New England Compounding Center (NECC) in Framingham, Massachusetts currently stands at 14. According to the nation's Centers for Disease Control and Prevention (CDC), as many as 14,000 patients in 23 states may have received a contaminated steroid injection. NECC has reportedly stopped all of its manufacturing processes and recalled all of the company's products, including three batches of allegedly tainted steroid injections sent to 75 medical facilities.
Fungal meningitis is a rare infection that can cause the membranes which surround the brain and spinal cord to swell. Although other forms of meningitis are contagious, fungal meningitis cannot be transmitted from one person to another. In order to become infected, a person must have the fungus injected into their central nervous system. Symptoms of infection may include fever, muscle weakness, light sensitivity, headaches, back pain, and a stiff neck. The incubation period for fungal meningitis is normally one to four weeks. Still, the CDC has stated patients may have begun receiving contaminated injections as early as May 21, 2012.
The exact cause of the fungal meningitis outbreak is currently under investigation by the CDC, United States Food and Drug Administration (FDA), and the Massachusetts Department of Public Health. Investigators have reportedly linked the current outbreak to a preservative-free steroid, methylprednisolone acetate, commonly used to relieve back pain. At least 50 vials of the drug have allegedly tested positive for the fungus.
NECC and other compounding facilities are used to alter a drug manufacturer's product in an effort to meet the needs of each specific patient. The facilities often change the dosage or physical form of a drug. They also commonly provide drugs that are not commercially available. Compounding facilities are reportedly popular with small clinics and private medical practices because they offer a more affordable alternative to purchasing large quantities of drugs from the manufacturer. Although the FDA oversees pharmaceutical drug manufacturers in the U.S., it apparently does not have equivalent regulation authority over drug compounders.
In the State of Indiana, at least six health care facilities dispensed steroid injections from the three batches of drugs that are suspected of being contaminated with fungal meningitis. State health officials have asked clinics and other health care providers who used the products to warn patients who may have received the allegedly contaminated injections of the potential risks. Additionally, at least one patient who was injected with a contaminated shot at an Indiana health care facility has died.
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Meningitis outbreak: Some questions and answers, by Amina Khan, Los Angeles Times
Meningitis outbreak growing, 14 people dead, by Lauran Neergaard and Mike Stobbe, Chicago Sun-Times
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