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US - CDC reports 63 dead, 749 infected with fungal meningitis in 20 states (Update Aug 5, 2013)

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  • US - CDC reports 63 dead, 749 infected with fungal meningitis in 20 states (Update Aug 5, 2013)

    Source: http://www.bizjournals.com/nashville...own-saint.html


    Meningitis outbreak shuts down Saint Thomas clinic
    Nashville Business Journal by Eric Snyder, Assistant Managing Editor
    Date: Monday, October 1, 2012, 1:21pm CDT - Last Modified: Monday, October 1, 2012, 1:53pm CDT


    The Saint Thomas Outpatient Neurosurgery Center outpatient clinic has been shut down following an apparent outbreak of meningitis.

    According to a news release from the Tennessee Department of Health and the Centers for Disease Control and Prevention, 11 patients treated at the clinic have contracted meningitis. Two of the patients have died...
    Last edited by Emily; November 7th, 2012, 03:40 PM. Reason: Updated case counts in title.

  • #2
    Re: TN: Meningitis outbreak shuts down Saint Thomas clinic

    Source: http://vitals.nbcnews.com/_news/2012...to-fungus?lite

    2 dead in Tenn. meningitis outbreak tied to fungus
    By JoNel Aleccia, NBC News

    A dozen people have been sickened and two have died after an outbreak of fungal meningitis tied to injections given at outpatient surgical centers in Tennessee and North Carolina, health officials said.

    At least 737 people who received lumbar epidural steroid injections between July 30 and Sept. 20 have been notified of the cluster of rare aspergillus meningitis infections, which attack the central nervous system, said Curtis Allen, a spokesman for the Centers for Disease Control and Prevention.

    Aspergillus is a mold present in the environment, and the meningitis is not related to the more common bacterial or viral types of meningitis...

    Comment


    • #3
      Re: TN: Meningitis outbreak shuts down Saint Thomas clinic

      Source: http://www.wdef.com/news/state/story...qbKimySqA.cspx


      2 more meningitis cases linked to Nashville clinic
      Updated: 6:16 pm

      NASHVILLE, Tenn. (AP) — Tennessee health officials have identified two more patients who contracted meningitis after getting steroid injections for back pain at a Nashville clinic.

      That raises the number of people who developed fungal meningitis after the injections to 14. One was in North Carolina and the rest are in the Nashville area. Two patients have died...

      Comment


      • #4
        Re: TN: Meningitis outbreak shuts down Saint Thomas clinic

        Meningitis Cases Are Linked to Steroid Injections in Spine

        By DENISE GRADY

        Published: October 2, 2012

        Dr. April Pettit, an infectious diseases specialist at Vanderbilt University, was worried about her patient. He had been ill with meningitis for two weeks, he was not getting better, and she could not figure out why. Antibiotics, the usual treatment, were not helping. Bacteria, the usual suspects, could not be found.

        A culture of the patient’s spinal fluid had revealed a fungus, Aspergillus.
        More: NYT
        “Addressing chronic disease is an issue of human rights – that must be our call to arms"
        Richard Horton, Editor-in-Chief The Lancet

        ~~~~ Twitter:@GertvanderHoek ~~~ GertvanderHoek@gmail.com ~~~

        Comment


        • #5
          Re: TN: Meningitis outbreak shuts down Saint Thomas clinic

          Health Department: Five New Cases Of Fungal Meningitis Reported

          Oct 03, 2012

          NASHVILLE, Tenn. – On Wednesday, the Tennessee Department of Health said five new cases of fungal meningitis have been reported in the last 24 hours, bringing the total number of cases to 18.

          Two of the new cases were patients who received lumbar epidural steroid injections from the Specialty Surgery Center in Crossville. The rest of the victims had received the injections at Saint Thomas Outpatient Neurosurgery Center in Nashville.

          More: http://www.newschannel5.com/story/19...gitis-reported
          “Addressing chronic disease is an issue of human rights – that must be our call to arms"
          Richard Horton, Editor-in-Chief The Lancet

          ~~~~ Twitter:@GertvanderHoek ~~~ GertvanderHoek@gmail.com ~~~

          Comment


          • #6
            Re: TN: Meningitis outbreak shuts down Saint Thomas clinic

            Is it going national?

            Oct 3, 2012

            Four dead, 26 sick from suspected fungal meningitis as outbreak worsens

            By Maggie Fox, NBC News

            Four people have died and 22 more made sick by meningitis linked to a rare fungal infection blamed on contaminated steroids, health officials said on Wednesday. They are “almost certain” more will be identified before it’s over.

            The 26 cases include 18 people in Tennessee, one in North Carolina, two in Florida, three in Virginia and two in Maryland, the U.S. Centers for Disease Control and Prevention reported. Two of the deaths were in Tennessee, one in Virginia and one in Maryland.

            More: NBC News
            “Addressing chronic disease is an issue of human rights – that must be our call to arms"
            Richard Horton, Editor-in-Chief The Lancet

            ~~~~ Twitter:@GertvanderHoek ~~~ GertvanderHoek@gmail.com ~~~

            Comment


            • #7
              Re: Four dead, 26 sick from suspected fungal meningitis as outbreak worsens

              Mass. firm tied to outbreak suspends operations

              October 3, 2012 06:41 PM EST |


              FRAMINGHAM, Mass. — A Massachusetts specialty pharmacy suspected as the source of a steroid that has been linked to an outbreak of a deadly form of meningitis says it has voluntarily suspended operations.

              In a statement Wednesday, the New England Compounding Center said it was working closely with the Massachusetts Department of Public Health and other regulators to identify the source of infection.

              The company said that immediately after it was notified about the infections it initiated a voluntary recall Sept. 26.

              Health officials say the outbreak has sickened 26 people in five states who received steroid injections. Four people have died.

              Eighteen of the cases are in Tennessee, where a Nashville clinic received the largest shipment of the steroid from the Framingham-based company.http://www.huffingtonpost.com/huff-w...break-company/
              CSI:WORLD http://swineflumagazine.blogspot.com/

              treyfish2004@yahoo.com

              Comment


              • #8
                Re: Four dead, 26 sick from suspected fungal meningitis as outbreak worsens

                NASHVILLE, Tenn. (AP) -- An outbreak of a rare and deadly form of meningitis has now sickened 26 people in five states who received steroid injections mostly for back pain, health officials said Wednesday. Four people have died, and more cases are expected.

                Eighteen of the cases of fungal meningitis are in Tennessee where a Nashville clinic received the largest shipment of the steroid suspected in the outbreak. The drug was made by a specialty pharmacy in Massachusetts that issued a recall last week. Investigators, though, say they are still trying to confirm the source of the infections.http://hosted.ap.org/dynamic/stories...10-03-16-19-43
                CSI:WORLD http://swineflumagazine.blogspot.com/

                treyfish2004@yahoo.com

                Comment


                • #9
                  Re: Four dead, 26 sick from suspected fungal meningitis as outbreak worsens

                  A few additional details in this article from WebMD.

                  "...So far there are 26 known cases in five states: Tennessee (18 cases, two deaths), North Carolina (one case, no deaths), Florida (two cases, no deaths), Virginia (three cases, one death), and Maryland (two cases, one death).

                  ...One <sic> Sept. 26, the NECC recalled three suspect lots of the medication. The action was not made public, but clinics that ordered the steroid were notified."



                  "What information consumes is rather obvious: it consumes the attention of its recipients. Hence a wealth of information creates a poverty of attention, and a need to allocate that attention efficiently among the overabundance of information sources that might consume it." - Herbert Simon

                  "The benefits of education and of useful knowledge, generally diffused through a community, are essential to the preservation of a free government." - Sam Houston

                  Comment


                  • #10
                    Re: Four dead, 26 sick from suspected fungal meningitis as outbreak worsens

                    [Source: Massachusetts Department of Health, full page: (LINK). Edited.]
                    For Immediate release - October 03, 2012

                    Statement from the Department of Public Health



                    BOSTON — The Massachusetts Department of Public Health (DPH) today released a statement regarding the investigation of the national meningitis outbreak:

                    “The Massachusetts Department of Public Health is collaborating with the CDC, FDA, and other state public health officials to identify the cause of an outbreak of more than 25 suspected cases of aspergillus (fungal) meningitis under investigation in Florida, Maryland, North Carolina, Tennessee and Virginia.

                    ‘’The cause for this cluster of cases is not yet known.

                    ‘’There are four products common to all of these cases. One medication, Methylprednisolone Acetate, a steroid, was prepared at the New England Compounding Center, Inc (NECC), a pharmacy in Framingham, Massachusetts. It has been recalled and quarantined as a precaution. NECC is voluntarily recalling all similar medications. In addition, at the request of DPH, NECC has agreed to voluntarily surrender their license to operate until this investigation is complete.

                    ‘’The form of fungal meningitis in these patients is not transmitted from person to person. There are no known cases in the Commonwealth.”


                    # # #
                    -
                    ------

                    Comment


                    • #11
                      Re: Four dead, 26 sick from suspected fungal meningitis as outbreak worsens

                      Originally posted by Giuseppe Michieli View Post

                      ...‘’There are four products common to all of these cases. One medication, Methylprednisolone Acetate, a steroid, was prepared at the New England Compounding Center, Inc (NECC), a pharmacy in Framingham, Massachusetts.

                      NBC News
                      lists 2 of the other products in common:

                      "Patients were also treated with injections of lidocaine and a povidone iodine skin preparation solution, the CDC said. "



                      "What information consumes is rather obvious: it consumes the attention of its recipients. Hence a wealth of information creates a poverty of attention, and a need to allocate that attention efficiently among the overabundance of information sources that might consume it." - Herbert Simon

                      "The benefits of education and of useful knowledge, generally diffused through a community, are essential to the preservation of a free government." - Sam Houston

                      Comment


                      • #12
                        Re: Four dead, 26 sick from suspected fungal meningitis as outbreak worsens

                        http://www.digtriad.com/news/article...pnews|bc|large
                        Fifth Person Dies From Meningitis, 35 Have It, CDC Says
                        3:45 PM, Oct 4, 2012
                        Liz Szabo, USA TODAY
                        [snip]
                        Inspectors from the Food and Drug Administration found fungus growing in sealed containers of the medication, preservative-free methylprednisolone acetate. Inspectors also found foreign material in other products, but haven't yet had time to test them to see what those materials are, Bernstein said.

                        "There is a possibility that it (fungal contamination) could be elsewhere, not just in this product, but in other products they made," Bernstein said.

                        Patients who received the injections also should call their doctors if they have a new or worsening headache or nausea, Park says. Symptoms similar to a stroke also could indicate this type of fungal infection...
                        http://www.pennlive.com/newsflash/in...d25bb486025625
                        FDA: Avoid drugs from company tied to meningitis
                        Oct. 4, 2012, 3:01 p.m. EDT
                        AP

                        NEW YORK (AP) — The government is warning doctors and hospitals not to use any product from the specialty pharmacy that made the steroid suspected in a meningitis outbreak...
                        “‘i love myself.’ the quietest. simplest. most powerful. revolution ever.” ---- nayyirah waheed
                        Avatar: Franz Marc, Liegender Hund im Schnee 1911 (My posts are not intended as advice or professional assessments of any kind.)

                        Comment


                        • #13
                          USA - CDC issues Health Advisory for Meningitis &amp; Stroke Associated with New England Compounding Center located in Framingham, MA


                          This is an official
                          CDC HEALTH ADVISORY

                          Distributed via the CDC Health Alert Network
                          October 4, 2012, 17:05 ET (5:05 PM ET)
                          CDCHAN-00327


                          Meningitis and Stroke Associated with Potentially Contaminated Product

                          Summary

                          The Centers for Disease Control and Prevention (CDC) and the Food and Drug Administration (FDA) are coordinating a multi-state investigation of fungal meningitis among patients who received an epidural steroid injection. Several of these patients also suffered strokes that are believed to have resulted from their infection. As of October 4, 2012, five deaths have been reported. Fungal meningitis is not transmitted from person to person. These cases are associated with a potentially contaminated medication. Investigation into the exact source is ongoing; however, interim data show that all infected patients received injection with preservative-free methylprednisolone acetate (80mg/ml) prepared by New England Compounding Center, located in Framingham, MA.

                          Background
                          On September 21, 2012, CDC was notified by the Tennessee Department of Health of a patient with the onset of meningitis approximately 19 days following epidural steroid injection at a Tennessee ambulatory surgery center (ASC). Initial cultures of cerebrospinal fluid (CSF) and blood were negative; subsequently, Aspergillus fumigatus was isolated from CSF by fungal culture. On September 28, investigators identified a case outside of Tennessee, possibly indicating contamination of a widely distributed medication. As of October 4, a total of 35 cases* in the following six states have been identified with a clinical picture consistent with fungal infection: Florida (2 cases), Indiana (1 case), Tennessee (25 cases, including 3 deaths), Maryland (2 cases, including 1 death), North Carolina (1 case), and Virginia (4 cases, including 1 death). Fungus has been identified in specimens obtained from five patients, one of whom also had Propionobacterium acnes, of unclear clinical significance, isolated from a post-mortem central nervous system specimen.
                          Infected patients have presented approximately 1 to 4 weeks following their injection with a variety of symptoms, including fever, new or worsening headache, nausea, and new neurological deficit (consistent with deep brain stroke). Some of these patients’ symptoms were very mild in nature. CSF obtained from these patients has typically shown elevated white cell count (with a predominance of neutrophils), low glucose, and elevated protein.

                          Recommendations
                          On September 25, 2012, the New England Compounding Center located in Framingham, MA voluntarily recalled the following lots of methylprednisolone acetate (PF) 80mg/ml:
                          • Methylprednisolone Acetate (PF) 80 mg/ml Injection, Lot #05212012@68, BUD 11/17/2012
                          • Methylprednisolone Acetate (PF) 80 mg/ml Injection, Lot #06292012@26, BUD 12/26/2012
                          • Methylprednisolone Acetate (PF) 80 mg/ml Injection, Lot #08102012@51, BUD 2/6/2013

                          On October 3, 2012, the compounding center ceased all production and initiated recall of all methylprednisolone acetate and other drug products prepared for intrathecal administration.
                          Physicians should contact patients who have had an injection (e.g., spinal, joint) using any of the three lots of methylprednisolone acetate listed above to determine if they are having any symptoms. Although all cases detected to date occurred after injections with products from these three lots, out of an abundance of caution, CDC and FDA recommend that healthcare professionals cease use of any product produced by the New England Compounding Center until further information is available.
                          For patients who received epidural injection and have symptoms of meningitis or basilar stroke, a diagnostic lumbar puncture (LP) should be performed, if not contraindicated. Because presenting symptoms of some patients with meningitis have been mild and not classic for meningitis (e.g., new or worsening headache without fever or neck stiffness), physicians should have a low threshold for LP. While CDC is aware of infections occurring only in patients who have received epidural steroid injections, patients who received other types of injection with methylprednisolone acetate from those three lots should also be contacted to assess for signs of infection (e.g., swelling, increasing pain, redness, warmth at the injection site) and should be encouraged to seek evaluation (e.g., arthrocentesis) if such symptoms exist.
                          For guidance on diagnostic testing that should be performed on patient specimens, physicians can go to http://www.cdc.gov/hai/outbreaks/meningitis.html. State health departments should be informed of patients undergoing evaluation. Clinicians should report any suspected adverse events following use of these products to FDA's MedWatch program at 1-800-332-1088 or www.fda.gov/medwatch.
                          *Case Definition
                          1: A person with meningitis1 of sub-acute onset (1-4 weeks) following epidural injection after July 1, 2012.
                          2: A person, who has not received a lumbar puncture, with basilar stroke 1-4 weeks following epidural injection after July 1, 20122.
                          3. A person with evidence of spinal osteomyelitis or epidural abscess at the site of an epidural injection diagnosed 1-4 weeks after epidural injection after July 1, 2012.
                          <sup>1</sup>clinically diagnosed meningitis meaning 1 or more of the following symptoms: headache, fever, stiff neck, or photophobia and a CSF profile consistent with meningitis (elevated protein/low glucose/pleocytosis)
                          <sup>2</sup>These people, if possible, should have an LP.
                          The Centers for Disease Control and Prevention (CDC) protects people's health and safety by preventing and controlling diseases and injuries; enhances health decisions by providing credible information on critical health issues; and promotes healthy living through strong partnerships with local, national, and international organizations.




                          http://emergency.cdc.gov/HAN/han00327.asp

                          Comment


                          • #14
                            Re: Five dead, 35 sick from suspected fungal meningitis as outbreak worsens

                            Rare Fungal Meningitis Outbreak Spreads To Six States

                            <!-- END CLASS="STORYTITLE" -->by Richard Knox
                            07:51 pm
                            October 4, 2012

                            It's a troubling story authorities think will unfold over the next month or so. An untold number of Americans who got steroid injections in their spine to relieve back pain may end up with a rare fungal meningitis. The drug was contaminated with the spores of a common leaf mold — nobody knows how.
                            ...
                            So far, the Centers for Disease Control and Prevention has recorded 35 cases of the fungal meningitis in six states: Tennessee, North Carolina, Florida, Virginia, Maryland and Indiana. Five patients have died.

                            The CDC conducted a joint media teleconference with the Food and Drug Administration Thursday, and has made the audio of the meeting available.

                            The potential problem is much bigger than the cases recorded so far. The contaminated drug, called methylprednilosone acetate, has been shipped to 75 hospitals and clinics in 23 states.
                            ...
                            Compounding pharmacies, which provide up to 10 percent of U.S. pharmaceuticals, are more loosely regulated than traditional drug companies. As is common, NECC is licensed by a state pharmacy board, which doesn't have the staff to conduct regular inspections. The company has been cited for contamination problems in the past, as the Boston Globe reports.
                            ...

                            Full text:
                            http://www.npr.org/blogs/health/2012...-to-six-states
                            "Safety and security don't just happen, they are the result of collective consensus and public investment. We owe our children, the most vulnerable citizens in our society, a life free of violence and fear."
                            -Nelson Mandela

                            Comment


                            • #15
                              Re: Five dead, 35 sick from suspected fungal meningitis as outbreak worsens

                              Breaking: FDA, CDC Says Don't Use Any Product From New England Compounding Center »

                              New England Compounding Center
                              697 Waverly St Framingham, MA 01702
                              www.​neccrx.​com/


                              Credit Tony Wilson
                              More photos:
                              http://framingham.patch.com/listings...#photo-2449589

                              New England Compounding Center is a medical compound-only pharmacy located on Waverly Street. It provides customized medications for patients based on what they need. It makes its own compounds, allowing practitioners to get compound medications that are no longer manufactured or are on constant back order due to shortages...

                              http://framingham.patch.com/listings...ounding-center
                              -------------------------------------------------------------------------------------------------------
                              New England Compounding Center Website

                              This website is temporarily unavailable.
                              http://www.neccrx.com/
                              ----------------------------------------------------------------------------------------------------------
                              October 04, 2012 05:06 PM Eastern Daylight Time

                              Statement from New England Compounding Center

                              FRAMINGHAM, Mass.--(BUSINESS WIRE)--The following is a statement from New England Compounding Center:
                              “New England Compounding Center (NECC) is working closely with the Massachusetts Board of Pharmacy, the Centers for Disease Control and the U.S. Food and Drug Administration on their investigation into the cause of infection in patients who received injections of methylprednisolone acetate. As part of this process, NECC has initiated a series of recalls encompassing all methylprednisolone acetate products - as well as other injectable medications - distributed from our facility in Framingham, Massachusetts. We also understand the FDA – as a precautionary measure - has suggested to medical professionals that they do not use any NECC products at this time,...

                              http://www.businesswire.com/news/rxt...ounding-Center
                              "Safety and security don't just happen, they are the result of collective consensus and public investment. We owe our children, the most vulnerable citizens in our society, a life free of violence and fear."
                              -Nelson Mandela

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