Thursday, October 11, 2012

Meningitis cases linked to steroids increase; no California cases so far

LAKE COUNTY, Calif. – A meningitis outbreak linked to epidural steroid injections that so far is affecting the eastern half of the United States is continuing to grow, with health officials continuing to monitor patients in the North Coast region who received the steroids.
On Monday, the Centers for Disease Control and Prevention in Atlanta reported that the outbreak of fungal meningitis cases linked to contaminated methylprednisolone acetate injectable steroids had grown to 105 cases across nine states, with eight deaths.
No cases have so far been reported in California, the agency said.
Affected states included Florida, Indiana, Maryland, Michigan, Minnesota, North Carolina, Ohio, Tennessee and Virginia, according to the CDC, which is coordinating the investigation into the outbreak.
The CDC said the manufacturer of the methylprednisolone acetate injections, New England Compounding Center located in Framingham, Mass., began a voluntary recall of the drugs on Sept. 26.
State and federal officials said 75 health care facilities in 23 states received the contaminated product.
In California, four health facilities received the drug, which is used as an epidural injection for chronic pain.
Among them was Ukiah Valley Medical Center, which last week sent out letters to patients notifying them of the issues, as Lake County News has reported.
Also receiving the compound in California were the Cypress Surgery Center in Visalia, the Encino Outpatient Surgical Center and Universal Pain Management in Palmdale, the CDC reported.
To date, no patients have been admitted to UVMC with meningitis-type symptoms as a result of receiving this compound, the hospital said Monday.
Meningitis is a swelling of the meninges, the protective covering of the brain and spinal cord.
The CDC said infected patients have developed a variety of symptoms approximately one to four weeks following their injection. The symptoms include fever, new or worsening headache and nausea. Some also have suffered strokes.
The CDC investigation thus far has revealed that the meningitis linked to the steroid injections was caused by a fungus that is common in the environment but rarely causes meningitis. The source of the fungus, however, has not been identified.
Officials said the fungal meningitis in this outbreak is not contagious.
Anyone who has had one of the epidural steroid injections since May 21 should talk to their doctor immediately if they experience a worsening headache, fever, sensitivity to light, stiff neck, new weakness or numbness in any part of your body or slurred speech, according to the CDC.
In a Monday statement, UVMC said it selected the New England Compounding Center in spite of a 75 percent higher cost for the compounded medication because the center is a specialized “compounding-only pharmacy” dedicated to providing medications and services to patients and prescribers.
“The team of registered pharmacists at UVMC did not choose the product based on price,” according to Heather Van Housen, UVMC’s patient care executive.
“The product was selected because it contains no preservatives or buffers that other pharmaceutical manufacturers offer that may cause higher risk of infection or other complications,” Van Housen said.

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