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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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  • #76
    Re: US - 8 dead, 105 sick from suspected fungal meningitis as outbreak worsens

    This is the first estimate of potential exposure that I've seen.

    "Fungal meningitis exposure may reach 13,000"

    "The number of people infected with a rare type of meningitis tied to contaminated steroid injections has climbed to 105, federal health officials said Monday. Eight people have died.

    The drugs were given starting May 21, much earlier than previously suspected, officials with the Centers for Disease Control and Prevention said. Infections and deaths have been reported in nine states. As many as 13,000 patients may have been exposed to the potentially contaminated drugs recalled from a Massachusetts compounding pharmacy, officials added."



    "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


    • #77
      Re: US - 8 dead, 105 sick from suspected fungal meningitis as outbreak worsens

      This is an official
      CDC HEALTH ADVISORY

      Distributed via Health Alert Network
      October 8, 2012, 13:10 ET (1:10 PM ET)
      CDCHAN-00328-2012-10-08-ADV-N

      Update: Multistate Outbreak of Meningitis and Stroke Associated with Potentially Contaminated Steroid Medication


      Summary
      The Centers for Disease Control and Prevention (CDC) and the Food and Drug Administration (FDA) continue to work closely with state public health departments on a multistate investigation of fungal meningitis among patients who received an epidural steroid injection. Some of these patients also suffered strokes that may have resulted from their infection. These cases are associated with a potentially contaminated steroid medication prepared by New England Compounding Center (NECC), located in Framingham, Mass. This HAN notice provides updated information about the investigation (including a change in the case definition*), laboratory findings, an expanded voluntary recall of products, and recommendations for clinicians


      Background
      CDC, in collaboration with FDA, state public health departments, and state boards of pharmacy, has been investigating an ongoing outbreak of meningitis associated with a potentially contaminated steroid medication, preservative-free methylprednisolone acetate (80mg/ml) prepared by New England Compounding Center, located in Framingham, Mass. CDC and state public health departments are actively coordinating outreach to patients who have been exposed to this potentially contaminated medication.
      As of October 8, 2012, a total of 105 cases, including 8 deaths, have been reported in 9 states: Florida (4 cases), Indiana (11 cases), Maryland (5 cases, including 1 death), Michigan (21 cases, including 2 deaths), Minnesota (3 cases), North Carolina (2 cases), Ohio (1 case), Tennessee (35 cases, including 4 deaths), and Virginia (23 cases, including 1 death). Fungus has been identified in specimens obtained from at least nine patients, one of whom also had Propionibacterium acnes, of unclear clinical significance, isolated from a post-mortem central nervous system specimen. In addition to an Aspergillus spp. isolated from a Tennessee patient, the fungus Exserohilum rostratum was identified in other patients, indicating the possibility of infections caused by multiple organisms. Fungal meningitis is not transmitted from person to person.
      The clinical presentation of infected patients remains consistent with the prior report: onset of symptoms is typically 1 to 4 weeks following 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. Cerebrospinal fluid (CSF) obtained from these patients has typically shown elevated white cell count (with a predominance of neutrophils), low glucose, and elevated protein. As of October 8, no infections resulting from injection into a peripheral joint space have been reported.


      Product Recall
      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

      All infections detected as of October 8 have occurred after injections with methylprednisolone acetate products from one of these lots. At this time, there is no evidence of infection related to other NECC products.
      The FDA investigation into the NECC facility is ongoing. On October 5, FDA reported observing “fungal contamination by direct microscopic examination of foreign matter taken from a sealed vial of methylprednisolone acetate collected from the New England Compounding Center.” Further analysis is ongoing. On October 6, NECC expanded its previous recalls to include all products currently in circulation that were compounded at and distributed from its facility in Framingham, Mass. More information about this recall is available at the FDA website.



      Recommendations
      • Physicians should contact (by phone or in person) any patient who had an injection (e.g., spinal, joint) after May 21, 2012, using any of the following three recalled lots of preservative-free methylprednisolone acetate (80mg/ml) produced by NECC, to determine if they are having symptoms:
        • Methylprednisolone Acetate (PF) 80mg/ml Injection, Lot# 05212012@68, BUD 11/17/2012
        • Methylprednisolone Acetate (PF) 80mg/ml Injection, Lot#06292012@26, BUD 12/26/2012
        • Methylprednisolone Acetate (PF) 80mg/ml Injection, Lot# 08102012@51, BUD 2/6/2013


      Symptoms that should prompt diagnostic evaluation include: fever, new or worsening headache, neck stiffness, sensitivity to light, new weakness or numbness, increasing pain, redness or swelling at injection site. Some of the symptoms of patients who have ultimately been diagnosed with meningitis have been mild and not classic for meningitis (e.g., new or worsening headache without fever or neck stiffness).

      *Case Definition (note: the initial date for an epidural/joint steroid injection has been revised from July 1, 2012, to May 21, 2012).
      1. A person with meningitis1 of sub-acute onset (1-4 weeks) following epidural injection after May 21, 2012.
      2. A person with basilar stroke 1-4 weeks following epidural injection after May 21, 20122, who has not received a diagnostic lumbar puncture.
      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 May 21, 2012.
      4. A person with septic arthritis3 diagnosed 1-4 weeks following steroid joint injection after May 21, 2012.
      _________
      1Clinically diagnosed meningitis meaning one or more of the following symptoms: headache, fever, stiff neck, or photophobia and a CSF profile consistent with meningitis (pleocytosis +/- low glucose, elevated protein).
      2These people, if possible, should have a lumbar puncture.
      3Clinically diagnosed septic arthritis meaning new or worsening pain with presence of effusion or new or worsening effusion.
      Additional Information

      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.

      Additional Resources










      http://emergency.cdc.gov/HAN/han00328.asp

      Comment


      • #78
        Re: US - 8 dead, 105 sick from suspected fungal meningitis as outbreak worsens

        October 8, 2012 7:17 PM

        Finding meningitis victims before it's too late

        ByJonathan LaPook
        ...
        Dr. William Schaffner, who has been tracking the outbreak at the Vanderbilt University Hospital in Nashville, Tenn., said the sooner they find the infected, the better the odds of recovery.

        "Whether each and every vial was contaminated is not known. But we have an increasing number of patients who are being infected," he said.
        ...
        The Centers for Disease Control believes the majority will not get sick; Dr. Schaffner agrees.

        "If there is a silver lining, it's that apparently many people were inoculated but the attack rate is very small," he said. "It's really about 1 percent or less. We hope that that continues."
        ...
        The typical incubation period is one to four weeks, but it is unclear how long patients who received the steroid injections will need to wait before they are considered out of the woods.

        It's also difficult to predict how many of the patients exposed to the vials will get sick, since doctors don't have a lot of experience dealing with meningitis victims with normal immune systems; usually patients get meningitis after having already compromised immune systems, whether it be from AIDS, cancer or another illness.

        Full text:
        http://www.cbsnews.com/8301-18563_16...-its-too-late/
        "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


        • #79
          Re: US - 8 dead, 105 sick from suspected fungal meningitis as outbreak worsens

          Saint Thomas Hospital
          4220 Harding Road
          Nashville, TN 37205

          Do you have concerns about meningitis?


          <IFRAME height=225 src="http://www.youtube.com/embed/OwuX1C9k1RQ" frameBorder=0 width=400></IFRAME>



          Page Last Updated: 10/8/12 4:00pm CSTSaint Thomas Hospital was NOT affected by the meningitis outbreak that involved some patients at the Outpatient Neurosurgery Center, which has been closed since September 20. Saint Thomas Hospital patients and prospective patients should NOT be concerned. If you are interested in the national outbreak that involved the Outpatient Neurosurgery Center, please read on.

          The Saint Thomas Outpatient Neurosurgery Center is working with Saint Thomas Hospital, the State of Tennessee Health Department, the Centers for Disease Control and Prevention and the Food and Drug Administration to identify the source of a cluster of meningitis first discovered at the Center.

          Saint Thomas Hospital is currently treating 25 patients associated with an outbreak of rare fungal meningitis first discovered at the Saint Thomas Outpatient Neurosurgical Center.

          Information For Patients

          If you received an epidural steroid injection at the Saint Thomas Outpatient Neurosurgery Center between July 1, 2012 and September 20, 2012, and have not already spoken with a representative of the Center, please call 615-341-3425. Some patients receiving the procedure during the time specified have developed a rare form of meningitis. The Centers for Disease Control and Prevention (CDC) is coordinating a multi-state investigation of meningitis among patients who have received epidural steroid injections using a specific and commonly used steroid. Some of these patients have also had strokes that are believed to have resulted from their infection. This form of meningitis is not transmitted from person to person and the specific cause for the illness is not yet known.

          We want to make sure that you are not having any problems related to your procedure. If you had an epidural steroid injection at the Saint Thomas Outpatient Neurosurgery Center and are experiencing any of the following symptoms, please contact us immediately or come directly to the Saint Thomas Hospital Emergency Department.



          The Tennessee Department of Health is encouraging patients who recieved an injection between July 1 and September 20 to continute to follow up with their physicians. If you did did recieve an epidural steroid injection within this window, please look for the following primary symptoms, in order of importance:
          • Headache
          • Fever
          • Nausea
          • Dizziness/unsteadiness
          • Worsening lower back pain
          • Weakness or numbness
          • Slurred speech
          • Sensitivity to Light
          • Difficulty waking
          • Stiff Neck
          Our utmost concern is your well-being. Please contact us at 615-341-3425 if you are experiencing symptoms or have questions.



          Facts About the Meningitis Outbreak
          • The CDC has identified 105 cases of fungal meningitis in nine states.
          • Of the 105 cases, eight patients have died as a result of the outbreak.
            • Four in Tennessee
            • Two in Michigan
            • One in Maryland
            • One in Virginia

          • The medication was produced at the New England Compounding Center in Massachusetts and the facility has recalled all batches of the medication. In addition, the facility voluntary closed and surrendered their pharmacy license.
          • The Food and Drug Administration is advising clinicians to discontinue the use of any materials associated with the New England Compounding Center (NECC) facility until further notice.
          • The Tennessee Department of Health says evidence points to this being a product issue. "There was no significant lapse in processes at any of the Tennessee clinics or centers who were impacted by the contaminated steroid."
          • The suspected medication responsible for the outbreak has been shipped to 23 states.
          • Seventy-five (75) centers across these 23 states have been confirmed as having received the steroid, according to the CDC and FDA.
          • The Tennessee Department of Health has identified a medication known as methylprednisolone acetate as a prime suspect in this outbreak, though the investigation is ongoing.
          • This form of meningitis is non-communicable, or cannot be passed from person to person.
          • Patient conditions range between stable to critical.
          • In Tennessee, patients have been exposed to methylprednisolone acetate in three facilities: the Saint Thomas Outpatient Neurosurgical Center in Nashville, the Specialty Surgery Center in Crossville and the PCA Pain Center in Oak Ridge.
          • Saint Thomas Hospital is currently treating 20 patients associated with an outbreak of rare fungal meningitis first discovered at the Saint Thomas Outpatient Neurosurgical Center.
          • As of Wednesday night, Oct. 3, the Saint Thomas emergency department screened more than 40 patients.
          • It is important to know that this type of meningitis is severe. If you have received an epidural steroid injection between July 1, 2012 and Sept. 20, 2012 at the Saint Thomas Outpatient Neurosurgical Center and are experiencing symptoms, please see a physician or visit the Saint Thomas Hospital Emergency Room at 4220 Harding Road in Nashville.
          • For patient inquiries, please contact the Saint Thomas Outpatient Neurosurgery Center at (615) 341-3425.
          Additional Resources For Information
          For updates from the Tennessee Department of Health, please visit www.tn.gov/health. For media inquiries, please contact Woody McMillin at (615) 714-3446 or woody.mcmillin@tn.gov.For information from the Centers for Disease Control and Prevention, please visit www.cdc.gov/meningitis/index.html. For media inquiries to the CDC, please contact Curtis Allen at (404) 639-3286 or media@cdc.gov.

          Media advisories from the Centers for Disease Control and Prevention can be found at www.cdc.gov/media/archives.htm

          Media Contact Information
          If you are a member of the media requesting additional information, please contact the Saint Thomas Health communications office at 615-284-6839.
          Robert Latham, M.D. is the Chief of Medicine, Medical Administrator for the Hospitalist Program and Director of Infectious Diseases Program at Saint Thomas Hospital in Nashville, Tenn.

          http://www.stthomas.org/meningitis
          "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


          • #80
            Re: US - 8 dead, 105 sick from suspected fungal meningitis as outbreak worsens

            Ninth person reported killed in meningitis outbreak
            October 8, 2012, 11:44 PM



            As many as 13,000 people received steroid shots suspected in a U.S. meningitis outbreak, health officials said Monday. But it's not clear how many are in danger.

            Officials don't how many of the shots may have been contaminated with meningitis-causing fungus tied to the outbreak. And the figure includes not only those who got them in the back for pain - who are most at risk - but also those who got the shots in other places, like knees and shoulders.

            Those injected in joints are not believed to be at risk for fungal meningitis, said Curtis Allen, a spokesman for the Centers for Disease Control and Prevention. He said there was no breakdown available of how many had the shots in the back or in joints... http://www.cbsnews.com/8301-201_162-...itis-outbreak/
            CSI:WORLD http://swineflumagazine.blogspot.com/

            treyfish2004@yahoo.com

            Comment


            • #81
              Re: US - 8 dead, 105 sick from suspected fungal meningitis as outbreak worsens

              [Source: Kentucky Department of Health, full page: (LINK). Edited.]
              Department for Public Health Update on Fungal Meningitis Investigation

              Press Release Date: Monday, October 08, 2012 / Revision Date: Monday, October 08, 2012 - Contact Information: Media Contact: Gwenda Bond or Beth Fisher (502) 564-6786


              Several Kentuckians treated in Tennessee affected, New England Compounding Center products recalled


              FRANKFORT, Ky. (Oct. 8, 2012) - The Kentucky Department for Public Health has been notified of five recent cases of fungal meningitis in Kentucky residents who received medical care in Tennessee. These cases of illness match the pattern associated with a multistate outbreak that has been linked to injections from three lots of steroid medications distributed by the New England Compounding Center, a compounding-only pharmacy. This type of fungal meningitis is not contagious.

              The New England Compounding Center has issued a voluntary recall of all products it has produced or distributed. Although none of the implicated lots of contaminated medication is known to have been distributed in Kentucky, other lots and types medicines from this company have been sent to Kentucky facilities. The U.S. Food and Drug Administration and KDPH recommend that pharmaceuticals manufactured by this company not be used for patients. More information on this recall is available at the FDA’s website.

              “The Department for Public Health is closely monitoring this situation as it evolves,” said Dr. Stephanie Mayfield, commissioner of the Department for Public Health. “We now know that several Kentuckians who received treatment out of state have been affected by this outbreak. We are working with our partners at local health departments and with the state health care associations to notify health care facilities that may have received medications included on the recall list to ensure that they are not used to treat Kentucky patients.”

              Kentuckians who have received epidural steroid injections since May 21 and have any of the following symptoms should talk to their health provider as soon as possible:
              • Worsening headache
              • Fever
              • Sensitivity to light
              • Stiff neck
              • New weakness or numbness in any part of your body
              • Slurred speech
              If Kentuckians have questions or concerns about steroid injections they have received, DPH recommends they contact their health care provider.

              Clinicians should immediately inform the state or local health department of any patients that are undergoing evaluation for suspected fungal infection related to this outbreak.


              For more information and national updates on the multistate outbreak, visit the Centers for Disease Control and Prevention website.


              ###
              -
              -------

              Comment


              • #82
                Re: US - 8 dead, 105 sick from suspected fungal meningitis as outbreak worsens

                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
                <table cellpadding="0" cellspacing="0"> <colgroup><col width="289"> <col width="120"> <col width="139"> <col width="66"> </colgroup><tbody><tr> <td width="289">CYPRESS SURGERY CENTER DBA</td> <td width="120">559 740 4094</td> <td width="139">VISALIA</td> <td width="66">CA</td> </tr> <tr> <td>ENCINO OUTPATIENT SURGICENTER</td> <td>818-986-1037</td> <td>ENCINO </td> <td>CA</td> </tr> <tr> <td>UKIAH VALLEY MEDICAL CENTER</td> <td>707 463 7345</td> <td>UKIAH</td> <td>CA</td> </tr> <tr> <td>UNIVERSAL PAIN MANAGEMENAT</td> <td>661-267-6876 x166</td> <td>PALMDALE</td> <td>CA</td> </tr> <tr> <td>INTERVENTIONAL SPINE AND SPORTS MED</td> <td>203 598 7246</td> <td>MIDDLEBURY</td> <td>CT</td> </tr> <tr> <td>FLORIDA PAIN CLINIC</td> <td>352-237-5906</td> <td>OCALA</td> <td>FL</td> </tr> <tr> <td>INTERVENTIONAL REHAB CENTER</td> <td>850 484 8800</td> <td>PENSACOLA</td> <td>FL</td> </tr> <tr> <td>MARION PAIN MANAGEMENT CENTER</td> <td>352 622 1845</td> <td>OCALA</td> <td>FL</td> </tr> <tr> <td>NORTH COUNTY SURGICENTER</td> <td>561 626 6446</td> <td>PALM BEACH GARDENS</td> <td>FL</td> </tr> <tr> <td>ORLANDO CENTER FOR OUTPATIENT SURGERY</td> <td>407-426-8331</td> <td>ORLANDO</td> <td>FL</td> </tr> <tr> <td>PAIN CONSULTANTS OF WEST FLORIDA</td> <td>850 494 0000</td> <td>PENSACOLA</td> <td>FL</td> </tr> <tr> <td>SURGERY CENTER OF OCALA</td> <td>352-237-5906</td> <td>OCALA</td> <td>FL</td> </tr> <tr> <td>SURGICAL PARK CENTER</td> <td>305-271-9100 x226</td> <td>MIAMI</td> <td>FL</td> </tr> <tr> <td>FORSYTH STREET AMBULATORY SURG. CTR.</td> <td>478-749-1610</td> <td>MACON</td> <td>GA</td> </tr> <tr> <td>PAIN SPECIALISTS OF IDAHO</td> <td>208 522 7246</td> <td>IDAHO FALLS</td> <td>ID</td> </tr> <tr> <td>WALTER KNOX MEMORIAL HOSPITAL</td> <td>208-365-3561 x3342</td> <td>EMMETT</td> <td>ID</td> </tr> <tr> <td>APAC CENTERS FOR PAIN MANAGEMENT</td> <td>708-483-7007</td> <td>WESTCHESTER</td> <td>IL</td> </tr> <tr> <td>APAC CENTERS FOR PAIN MANAGEMENT-</td> <td>773-935-2760</td> <td>CHICAGO</td> <td>IL</td> </tr> <tr> <td>THOREK MEMORIAL HOSPITAL</td> <td>773 975-6734</td> <td>CHICAGO</td> <td>IL</td> </tr> <tr> <td>AMBULATORY CARE CENTER LLC</td> <td>812 475 1800</td> <td>EVANSVILLE</td> <td>IN</td> </tr> <tr> <td>FORT WAYNE PHYSICAL MEDICINE</td> <td>260-436-9337</td> <td>FORT WAYNE</td> <td>IN</td> </tr> <tr> <td>OSMC OUTPATIENT SURGERY CENTER</td> <td>574-266-4173</td> <td>ELKHART</td> <td>IN</td> </tr> <tr> <td>SOUTH BEND CLINIC</td> <td>574-237-9372</td> <td>SOUTH BEND</td> <td>IN</td> </tr> <tr> <td>UNION HOSPITAL--</td> <td>812 238 4964</td> <td>TERRE HAUTE</td> <td>IN</td> </tr> <tr> <td>WELLSPRING</td> <td>812-376-0700</td> <td>COLUMBUS</td> <td>IN</td> </tr> <tr> <td>BALTIMORE PAIN MANAGEMENT</td> <td>410 682-5040</td> <td>BALTIMORE</td> <td>MD</td> </tr> <tr> <td>BERLIN INTERVENTIONAL PAIN MANAGEMENT</td> <td>410 641 3759</td> <td>BERLIN</td> <td>MD</td> </tr> <tr> <td>BOX HILL SURGERY CENTER</td> <td>410 877 8141</td> <td>ABINGDON</td> <td>MD</td> </tr> <tr> <td>GREENSPRING SURGERY CENTER</td> <td>410 653 0077</td> <td>BALTIMORE</td> <td>MD</td> </tr> <tr> <td>HARFORD COUNTY ASC, LLC</td> <td>410 538 7000</td> <td>EDGEWOOD</td> <td>MD</td> </tr> <tr> <td>PAIN MEDICINE SPECIALISTS</td> <td>410 825 6945</td> <td>TOWSON</td> <td>MD</td> </tr> <tr> <td>SURGCENTER OF BEL AIR</td> <td>410 638 5523</td> <td>BEL AIR</td> <td>MD</td> </tr> <tr> <td>MICHIGAN NEUROSURGICAL INST.</td> <td>810 606 7112</td> <td>GRAND BLANC</td> <td>MI</td> </tr> <tr> <td>MICHIGAN PAIN SPECIALISTS</td> <td>734 995 7246</td> <td>BRIGHTON</td> <td>MI</td> </tr> <tr> <td>NEUROMUSCULAR & REHABILITATION</td> <td>231 935 0860</td> <td>TRAVERSE CITY</td> <td>MI</td> </tr> <tr> <td>SOUTHEAST MICHIGAN SURGICAL HOSPITAL</td> <td>586-427-1000</td> <td>WARREN</td> <td>MI</td> </tr> <tr> <td>MAPS-EDINA MEDICAL PAIN CLINIC</td> <td>763 537 6000</td> <td>MINNEAPOLIS</td> <td>MN</td> </tr> <tr> <td>MAPS-MEDICAL ADVANCED PAIN</td> <td>763 537 6000</td> <td>FRIDLEY</td> <td>MN</td> </tr> <tr> <td>MEDICAL ADVANCED PAIN SPECIALISTS*</td> <td>763-537-6000 x238</td> <td>SHAKOPEE</td> <td>MN</td> </tr> <tr> <td>MEDICAL ADVANCED PAIN SPECIALISTS.</td> <td>763 537 6000</td> <td>MAPLE GROVE</td> <td>MN</td> </tr> <tr> <td>MINNESOTA SURGERY CENTER</td> <td>763-767-7139</td> <td>EDINA</td> <td>MN</td> </tr> <tr> <td>MINNESOTA SURGERY CENTER-</td> <td>763 537 6000</td> <td>MAPLE GROVE</td> <td>MN</td> </tr> <tr> <td>HIGH POINT SURGERY</td> <td>336 878 6048</td> <td>HIGH POINT</td> <td>NC</td> </tr> <tr> <td>NORTH CAROLINA ORTHOPAEDIC CLINIC</td> <td>919 403 5148</td> <td>DURHAM</td> <td>NC</td> </tr> <tr> <td>SURGERY CENTER OF WILSON</td> <td>252-237-5649</td> <td>WILSON</td> <td>NC</td> </tr> <tr> <td>DR. O'CONNELL'S PAIN CARE CTR</td> <td>603-335-5070</td> <td>MERRIMACK</td> <td>NH</td> </tr> <tr> <td>DR. O'CONNELL'S PAINCARE CENTERS, INC</td> <td>603 692 3166</td> <td>SOMERSWORTH</td> <td>NH</td> </tr> <tr> <td>CENTRAL JERSEY ORTHOPEDICS SPECIALISTS PC</td> <td>908 561 2122</td> <td>SOUTH PLAINFIELD</td> <td>NJ</td> </tr> <tr> <td>EDISON SURGICAL CENTER</td> <td>732 452 0123</td> <td>EDISON</td> <td>NJ</td> </tr> <tr> <td>IF PAIN ASSOCIATES / ISAIAH FLORENCE</td> <td>201 287 1100</td> <td>TEANECK</td> <td>NJ</td> </tr> <tr> <td>PREMIER ORTHOPEDICS SURG. ASSOC., LLC</td> <td>856 690 1750</td> <td>VINELAND</td> <td>NJ</td> </tr> <tr> <td>Comprehensive Pain Management</td> <td>973 796 5216</td> <td>SPARTA</td> <td>NJ</td> </tr> <tr> <td>SOUTH JERSEY HEALTH CARE</td> <td>856 363 1558</td> <td>ELMER</td> <td>NJ</td> </tr> <tr> <td>SOUTH JERSEY HEALTHCARE</td> <td>856-641-7557</td> <td>VINELAND</td> <td>NJ</td> </tr> <tr> <td>SAHARA SURGERY CENTER</td> <td>702-362-7874</td> <td>LAS VEGAS</td> <td>NV</td> </tr> <tr> <td>BUTANI, SUNIL H. PHYSICIAN PC</td> <td>516 747 5042</td> <td>MINEOLA</td> <td>NY</td> </tr> <tr> <td>OBOSA MEDICAL SERVICES</td> <td>914-530-2323</td> <td>MOUNT VERNON</td> <td>NY</td> </tr> <tr> <td>ROCHESTER BRAIN AND SPINE</td> <td>585 334 5560</td> <td>ROCHESTER</td> <td>NY</td> </tr> <tr> <td>BKC PAIN SPECIALISTS,LLC</td> <td>740-387-7246</td> <td>MARION</td> <td>OH</td> </tr> <tr> <td>CINCINNATI PAIN MANAGEMENT</td> <td>513 891 0022</td> <td>CINCINNATI</td> <td>OH</td> </tr> <tr> <td>MARION PAIN CLINIC</td> <td>740-375-0200</td> <td>MARION</td> <td>OH</td> </tr> <tr> <td>ORTHO-SPINE REHAB. CENTER, INC.</td> <td> </td> <td>DUBLIN</td> <td>OH</td> </tr> <tr> <td>ALLEGHENY PAIN MANAGEMENT</td> <td>814-940-2000</td> <td>ALTOONA</td> <td>PA</td> </tr> <tr> <td>SOUTH HILLS PAIN & REHAB ASSOC.</td> <td>412 469 7722</td> <td>JEFFERSON HILLS</td> <td>PA</td> </tr> <tr> <td>NEW ENGLAND ANESTHESIOLOGY (NEA)</td> <td>401-490-7530</td> <td>WARWICK</td> <td>RI</td> </tr> <tr> <td>OCEAN STATE PAIN MANAGEMENT</td> <td>401 766 7700</td> <td>WOONSOCKET</td> <td>RI</td> </tr> <tr> <td>OCEAN STATE PAIN MANAGEMENT-</td> <td>401 884 6070</td> <td>EAST GREENWICH</td> <td>RI</td> </tr> <tr> <td>INTERVENE MD</td> <td>843-216-4844</td> <td>MOUNT PLEASANT</td> <td>SC</td> </tr> <tr> <td>PCA PAIN CARE CENTER-</td> <td>865 835 5196</td> <td>OAK RIDGE</td> <td>TN</td> </tr> <tr> <td>SPECIALTY SURGERY CENTER</td> <td>931-484-2500 x125</td> <td>CROSSVILLE</td> <td>TN</td> </tr> <tr> <td>ST. THOMAS OUTPATIENT NEUROSURGIACL</td> <td>615 341 3433</td> <td>NASHVILLE</td> <td>TN</td> </tr> <tr> <td>DALLAS BACK PAIN MANAGEMENT</td> <td>214 445 5077</td> <td>DALLAS</td> <td>TX</td> </tr> <tr> <td>HARRIS METHODIST SOUTHLAKE CENTER</td> <td>817 748 8778</td> <td>SOUTHLAKE</td> <td>TX</td> </tr> <tr> <td>INSIGHT IMAGING-ROANOKE</td> <td>540 581 0882</td> <td>ROANOKE</td> <td>VA</td> </tr> <tr> <td>NEW RIVER VALLEY SURGERY CENTER</td> <td>540 639 5888</td> <td>CHRISTIANSBURG</td> <td>VA</td> </tr> <tr> <td>PARS INTERVENTIONAL PAIN</td> <td>304 865 7277</td> <td>PARKERSBURG</td> <td>WV</td> </tr> </tbody></table>
                Contact Us:

                • Centers for Disease Control and Prevention
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                  TTY: (888) 232-6348
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                Comment


                • #83
                  Re: US - 8 dead, 105 sick from suspected fungal meningitis as outbreak worsens

                  Tennessee -

                  TDH Update on Outbreak of Infections Associated with Epidural Steroid Injections

                  Monday, October 08, 2012 | 05:35 pm

                  NASHVILLE – Tennessee Health Commissioner John Dreyzehner, MD, MPH, has provided an update on the investigation of infections associated with epidural steroid injections. His statements from today’s media briefing are included below.

                  Dreyzehner has activated the State Health Operations Center in response to the multi-state outbreak of infections first identified September 18, 2012. TDH will staff the SHOC daily, and an on-call physician will answer calls after hours.

                  The outbreak has been linked to patients receiving spinal steroid injections, a common treatment for back pain, between June 27 and September 28, 2012 in Nashville and between July 1 and September 28, 2012 in Crossville and Oak Ridge. The incubation period for onset of illness is estimated at two to 28 days. The steroid drugs believed to be responsible were compounded by the New England Compounding Center in Framingham, Mass. NECC has now voluntarily recalled all products compounded and distributed from its Massachusetts facility.

                  TDH will provide new information on this investigation to media in a briefing via telephone on Tuesday, October 9 at 1 p.m. Central time. Media members may participate in the briefing by calling 1-888-757-2790, passcode 781337.

                  Statement by Commissioner Dreyzehner October 8, 2012:

                  Good afternoon. I want to thank you for being with us. We appreciate the public health value of your continuing coverage.

                  Before I go into details about activities and facts, I want to again offer our sympathy to the people whose lives have been significantly impacted by this very tragic situation. To those whose families or circle of friends have been affected, please know we keep you in our thoughts and prayers.

                  Today we confirm three new cases and one additional death. The total number of cases in Tennessee is now 35 and the number of deaths is four. Friday we opened the State Health Operations Center here in the Cordell Hull Building and four regional health operations centers.

                  These are our emergency operations centers, allowing a network of professionals to rapidly exchange information and data. At the conclusion of this news briefing, those of you who want to see the center here will have that opportunity.

                  Local health department teams in many areas of the state worked tirelessly over the weekend, making personal contact with approximately 66 at-risk patients who we previously had not been able to verify were contacted with the latest information. In many cases, that meant knocking on doors and asking and answering questions.

                  This Saturday, the New England Compounding Center announced a voluntary recall of all products compounded and distributed from its Massachusetts facility.

                  We issued a Tennessee Health Alert Network message to state clinicians two days before, on Thursday afternoon, directing them to not use any NECC products. To reinforce that message, we sent another alert via THAN his morning.

                  It is important to be clear our colleagues at the CDC and FDA have not found any problems with any of the multiple other products they have identified as coming from NECC. But we believe they should not be used in Tennessee as long as we, the CDC and the FDA lack assurance that no other product is contaminated.

                  We understand NECC has committed to fax notices of the recall to every practice location where their products have been sent. We are carefully double-checking to identify which practice locations might have used these NECC products. That work will continue until we know where every product went and if it was used, and we will work to assure that staff at every practice location that received recalled products from NECC are aware of the message to not use those products. We are also sharing information through our network of health departments, our website, and through all of you in the media.

                  Based on their analysis of cases nationally, the CDC has expanded the case definition for patients included in this outbreak, and we are following the expanded definitions in Tennessee. The new date is June 27 in Tennessee. This is in contrast to the national date of May 21 and our June 27 date reflects when materials were actually received in Tennessee.

                  Our goal is to continue to identify at-risk patients as soon as possible, knowing early recognition can benefit treatment results. Because of the aggressive follow-up of involved clinics and other efforts, patients are now being identified earlier in the course of their illness, when treatment is expected to be more effective.

                  One of the challenges for clinicians in Tennessee known to have possibly used contaminated methylprednisolone acetate has been the demanding process of assuring that all patients potentially at risk have up-to-date information.

                  As you know our team here at TDH identified the outbreak and also that methylprednisolone acetate was the primary suspect, and we have modified our messages as our scientific investigation has led to new findings. As the situation has evolved, our outreach efforts have also evolved in concert with our scientific investigation. Our regional county leaders, county health directors and public health nurses have been instrumental in this effort.

                  At present our plans include partnering with the clinics to assure regular person-to-person contact with each of the at-risk patients, for as long as deemed necessary. We will continue to cooperate with the staff of the affected clinics and to provide ongoing information and evaluation to those who were possibly exposed to contaminated medication.

                  We are cautiously optimistic that many of the efforts to reach patients and clinicians with information about this outbreak are succeeding in allowing earlier recognition of infection and earlier institution of treatment. We appreciate your reporting and helping to inform the public about the evolving developments and uncertainties in this outbreak.

                  https://news.tn.gov/node/9714
                  "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


                  • #84
                    Re: US - 8 dead, 105 sick from suspected fungal meningitis as outbreak worsens

                    Posted on Tuesday, 10.09.12

                    Gov says 4 confirmed meningitis cases in Fla

                    The Associated Press
                    ...<!-- end /production/story/credit_line_format.comp -->
                    Scott said Tuesday that all four cases are related to the same facility in Marion County. He says that as of Monday authorities had contacted nearly 700 of the 1,185 patients linked to facilities that got tainted medicine in Marion, Miami-Dade, Orange and Escambia counties.
                    ...

                    "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


                    • #85
                      A nationally recognized media person says on twitter a few minutes ago:

                      Dr. Sanjay Gupta ‏@sanjayguptaCNN
                      just spoke to #CDC. fungal #meningitis numbers continue to grow. 119 people ill -- 11 have died. I am in mass investigating

                      Comment


                      • #86
                        Re: US - 11 dead, 119 sick from suspected fungal meningitis as outbreak worsens

                        Meningitis outbreak: 11 dead, 119 infected
                        More than 100 infected by rare fungal meningitis


                        Eleven people have died so far from an outbreak of a rare non-contagious fungal meningitis, an inflammation of membranes surrounding the brain and spinal cord.

                        MENINGITIS: WHAT YOU NEED TO KNOW

                        Find out what you need to know about meningitis and the deadly outbreak that's now spread to seven states.

                        MORE
                        The discovery of the outbreak, linked to an injectable steroid the patients were getting to treat pain, was first reported late last week by Centers for Disease Control and Prevention in Atlanta.

                        On Tuesday the CDC said 119 people had been infected, and warned that the number will likely rise. Fungal meningitis is very rare and, unlike viral and bacterial meningitis, is not contagious.



                        Read more: http://www.wpbf.com/news/health/Meni...#ixzz28pGJ2EBS
                        CSI:WORLD http://swineflumagazine.blogspot.com/

                        treyfish2004@yahoo.com

                        Comment


                        • #87
                          Re: US - 11 dead, 119 sick from suspected fungal meningitis as outbreak worsens

                          Deaths rise to 11, with 119 sickened in rare meningitis outbreak
                          By the CNN Wire Staff
                          updated 1:47 PM EDT, Tue October 9, 2012


                          CNN) -- A rare, noncontagious form of meningitis has claimed 11 lives and sickened 119 people, an increase from the eight deaths and 105 illnesses previously reported, the Centers for Disease Control and Prevention said Tuesday.
                          The outbreak is linked to contaminated steroid injections, and as many as 13,000 people may have received the medicine between May 21 and September 24, the CDC said.
                          The number of reported cases grew significantly in recent days as federal and state authorities continued to investigate the outbreak.
                          Tennessee is the hardest-hit state, with 35 infections and four deaths, according to the CDC.http://www.cnn.com/2012/10/09/health...ure/index.html
                          CSI:WORLD http://swineflumagazine.blogspot.com/

                          treyfish2004@yahoo.com

                          Comment


                          • #88
                            Re: US - 11 dead, 119 sick from suspected fungal meningitis as outbreak worsens

                            Multi-State Meningitis Outbreak - Current Case Count

                            October 9, 2012 1:45 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 9, 2012

                            <table style="background-color: #d4eeb6; border: 1px solid #6aad29; border-collapse: collapse; width: 400px; margin-left: auto; margin-right: auto;"> <tbody><tr><th scope="col" style="background-color: #609c25; border: 1px solid #6aad29; text-align: left; padding: 8px;">State</th> <th scope="col" style="background-color: #609c25; border: 1px solid #6aad29; padding: 8px;">Case Count</th> <th scope="col" style="background-color: #609c25; border: 1px solid #6aad29; padding: 8px;">Deaths</th> </tr> <tr><td scope="row" style="border: 1px solid #6aad29; padding: 5px;">Florida (FL)</td> <td style="border: 1px solid #6aad29; text-align: center; padding: 5px;">4</td> <td style="border: 1px solid #6aad29; text-align: center; padding: 5px;">
                            </td> </tr> <tr><td scope="row" style="border: 1px solid #6aad29; padding: 5px;">Indiana (IN)</td> <td style="border: 1px solid #6aad29; text-align: center; padding: 5px;">12</td> <td style="border: 1px solid #6aad29; text-align: center; padding: 5px;">
                            </td> </tr> <tr><td scope="row" style="border: 1px solid #6aad29; padding: 5px;">Maryland (MD)</td> <td style="border: 1px solid #6aad29; text-align: center; padding: 5px;">8</td> <td style="border: 1px solid #6aad29; text-align: center; padding: 5px;">1</td> </tr> <tr><td scope="row" style="border: 1px solid #6aad29; padding: 5px;">Michigan (MI)</td> <td style="border: 1px solid #6aad29; text-align: center; padding: 5px;">25</td> <td style="border: 1px solid #6aad29; text-align: center; padding: 5px;">3</td> </tr> <tr><td scope="row" style="border: 1px solid #6aad29; padding: 5px;">Minnesota (MN)</td> <td style="border: 1px solid #6aad29; text-align: center; padding: 5px;">3</td> <td style="border: 1px solid #6aad29; text-align: center; padding: 5px;">
                            </td> </tr> <tr><td scope="row" style="border: 1px solid #6aad29; padding: 5px;">New Jersey (NJ)</td> <td style="border: 1px solid #6aad29; text-align: center; padding: 5px;">1</td> <td style="border: 1px solid #6aad29; text-align: center; padding: 5px;">
                            </td> </tr> <tr><td scope="row" style="border: 1px solid #6aad29; padding: 5px;">North Carolina (NC)</td> <td style="border: 1px solid #6aad29; text-align: center; padding: 5px;">2</td> <td style="border: 1px solid #6aad29; text-align: center; padding: 5px;">
                            </td> </tr> <tr><td scope="row" style="border: 1px solid #6aad29; padding: 5px;">Ohio (OH)</td> <td style="border: 1px solid #6aad29; text-align: center; padding: 5px;">1</td> <td style="border: 1px solid #6aad29; text-align: center; padding: 5px;">
                            </td> </tr> <tr><td scope="row" style="border: 1px solid #6aad29; padding: 5px;">Tennessee (TN)</td> <td style="border: 1px solid #6aad29; text-align: center; padding: 5px;">39</td> <td style="border: 1px solid #6aad29; text-align: center; padding: 5px;">6</td> </tr> <tr><td scope="row" style="border: 1px solid #6aad29; padding: 5px;">Virginia (VA)</td> <td style="border: 1px solid #6aad29; text-align: center; padding: 5px;">24</td> <td style="border: 1px solid #6aad29; text-align: center; padding: 5px;">1</td> </tr> <tr><td scope="row" style="border: 1px solid #6aad29; font-weight: bold; background-color: #aede7b; padding: 8px;">TOTALS</td> <td style="border: 1px solid #6aad29; text-align: center; font-weight: bold; background-color: #aede7b; padding: 8px;">119</td> <td style="border: 1px solid #6aad29; text-align: center; font-weight: bold; background-color: #aede7b; padding: 8px;">11</td> </tr> </tbody></table>
                            Case Count Maps by Date




                            Contact Us:

                            • Centers for Disease Control and Prevention
                              1600 Clifton Rd
                              Atlanta, GA 30333
                            • 800-CDC-INFO
                              (800-232-4636)
                              TTY: (888) 232-6348
                            • New Hours of Operation
                              8am-8pm ET/Monday-Friday
                              Closed Holidays
                            • cdcinfo@cdc.gov






                            http://www.cdc.gov/hai/outbreaks/meningitis-map.html

                            Comment


                            • #89
                              Re: US - 11 dead, 119 sick from suspected fungal meningitis as outbreak worsens

                              Join us for an upcoming COCA Conference Call, where CDC subject matter experts will discuss topics of interest to clinicians. If you have questions or trouble accessing this COCA Call/Webinar, please
                              e-mail coca@cdc.gov.

                              Multistate Meningitis Outbreak Investigation: Information and Guidance for Clinicians

                              = No Continuing Education

                              Date: Wednesday, October 10, 2012 - TOMORROW
                              Time: 2:00 - 3:00 pm (Eastern Time)

                              Join by Phone:
                              Dial-In Number: 888-790-6180
                              Passcode: COCA
                              Overview:

                              The Centers for Disease Control and Prevention (CDC) and the Food and Drug Administration (FDA) continue to work closely with state public health departments on a multistate investigation of fungal meningitis among patients who received an epidural steroid injection. These cases are associated with a potentially contaminated steroid medication prepared by New England Compounding Center (NECC), located in Framingham, Mass. During this COCA Call, CDC subject matter experts will review current epidemiology of the outbreak, describe clinical presentation and features of fungal meningitis, and review CDC’s recommended treatment guidance.

                              Presenter(s):

                              Melissa K. Schaefer, MD
                              Medical Officer
                              Division of Healthcare Quality Promotion
                              National Center for Emerging and Zoonotic Infectious Diseases
                              Centers for Disease and Control and Prevention

                              Tom Chiller, MD, MPH
                              Medical Epidemiologist
                              Division of Foodborne, Waterborne & Environmental Diseases
                              National Center for Emerging and Zoonotic Infectious Diseases
                              Centers for Disease and Control and Prevention

                              This is an audio only call. There are no slides or handouts for this call. The recorded call audio and transcript will be available a few days after the live call. To view the record call materials please visit the call webpage at http://emergency.cdc.gov/coca/calls/...nfo_101012.asp

                              Comment


                              • #90
                                Re: US - 11 dead, 119 sick from suspected fungal meningitis as outbreak worsens

                                This is not included in the fatality count of today's CDC update.

                                "First Fungal Meningitis Death in Florida in Outbreak: State Health Officials"

                                "State health officials on Tuesday confirmed the first fungal meningitis death in Florida in the recent nationwide outbreak.

                                A 70-year-old Marion County man died in July, before the discovery of the contaminated lots of the steroid methylprednisolone acetate from the New England Compounding Center, the Florida Department of Health said.

                                The steroid is injected into the spine to relieve back pain.

                                The Department of Health said there have been six cases of fungal meningitis in the state, all in Marion County. One of them is a 78-year-old man who contracted the disease after getting a contaminated back steroid injection, the department said.

                                "We are saddened by this news and share our condolences with his family and friends," said Florida's Secretary of Health and Surgeon General, Dr. John Armstrong, in a statement. "Our disease investigation process discovered the link between this individual's death and a contaminated steroid injection. We will continue to work closely with our health partners to ensure that individuals who may have received the contaminated medicine are treated, and we have ensured that no medications from NECC, steroid or otherwise, are available in Florida."

                                Health officials said they have visited 78 facilities in Florida to urge them to stop using any products they received from the New England Compounding Center since Jan. 1."



                                "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

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