Multi state meningitis outbreak due to contaminated medicine

Via the New York Times, but also visible pretty much at any other news source you might look at, a report about an outbreak in 5 states of meningitis with 4 deaths and at least 30 illnesses, and it is expected to grow. Meningitis is actually a diagnosis more than a disease, and the inflammation of the central nervous system observed during meningitis can be caused by a wide variety of etiologic agents. The pathogen in this outbreak is actually a fungus called Aspergillus, which you may recall was put for in the last BONUS melee by Mackenzie. Mackenzie correctly stated that the major human disease due to Aspergillus is a toxemia due to the presence of aflatoxin, which typically causes moderate to severe liver damage.

In the current outbreak we have significantly different situation. The outbreak has been traced back by the Centers for Disease Control and Prevention to the administration of steroid injections in the treatment of back pain, a procedure that is done by orthopedists millions of times a year in the United States. The source appears to be from a preparation of methylprednisolone produced by a pharmacy supplier in New England, and the potentially contaminated medicine appears to have been shipped to at least 23 states.

In this procedure, medicine is injected into the fluid that sheathes the spinal cord in the lower back, and injection of microorganisms allows them to have easy access to all parts of the central nervous system. Procedures similar to the one in the outbreak are carried out on a routine basis in essentially all hospitals around the world, as it is a standard way of administering anesthetics for surgery, and it carries with it a not insignificant risk for a complicating infection.

Since this is a fungal infection, the only effective antibiotics are those that are effective against fungi. Systemic infections such as these are typically significantly more difficult to treat and routinely require a long regimen of antibiotics in order to effect a cure. Infectious disease specialists close to the case indicate that current patients may require 6 months to a year of antibiotics in order to eliminate the microorganism. The CDC is closely monitoring the outbreak and is trying to identify and recall all suspect vials of the contaminated methylprednisolone. Symptoms associated with this infection include: slurred speech, fever, severe and worsening headaches, and loss of balance. Because meningitis can be caused by many agents, and can have a very rapid progression, it is critical to identify the etiologic agent and immediately administer the appropriate treatment for the disease.


About ycpmicro

My name is David Singleton, and I am an Associate Professor of Microbiology at York College of Pennsylvania. My main course is BIO230, a course taken by allied-health students at YCP. Views on this site are my own.

Posted on October 7, 2012, in Danger danger danger!, Microbes in the News. Bookmark the permalink. 1 Comment.

  1. A comment from someone on the Internet said:

    I’d like to know when (date) this medication was shipped to California, I have had strange symptoms and wonder if there could be any connection

    This is not a medical blog, but my advice would be that if you had any medications administered via injection into the back by an orthopedic clinic recently, and if you have any symptoms including headache, vision problems, unexpected fever, or any of the other ones indicated in the summary above, to seek the opinion of your doctor immediately. Meningitis is not a trivial disease, and if it is related to this outbreak, medical treatment is critical. Good Luck!

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