FluTrackers Notes from CDC COCA Conference October 10, 2012

[sharon sanders]

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

Notes from conference:


On CDC conferece call now regarding #USA recalled steroid injections. Now speaking: Melissa K. Schaefer, MD - #meningitis #stroke #fb

About 13,000 injections from 3 recalled lots. As of now there are 12 known deaths & 137 cases. #meningitis #stroke #fb

Referring everyone to CDC website http://www.cdc.gov/hai/outbreaks/meningitis.html ? #meningitis #stroke #fb

All patients who received injection from any of 3 recalled lots after May 21 should b contacted 2 determine status #meningitis #stroke #fb

Investigation is evolving. Please check website frequently for most recent guidance etc. http://www.cdc.gov/hai/outbreaks/meningitis.html ? #meningitis #stroke #fb

New Update re: Case Definitions for #Meningitis and Septic Arthritis here: http://www.cdc.gov/HAI/outbreaks/cli..._outbreak.html ? #stroke #fb

Now speaking: Tom Chiller, MD, MPH Medical Epidemiologist Division of Foodborne, Waterborne & Environmental Diseases #meningitis #stroke #fb

Clinical info is being evolved as patients are being discovered. Most patients presenting w/headache. #meningitis #stroke #fb

1/3 w/neck stiffness & pain Many cases r "mild".Anyone who has abnormal white blood csf count >5 is to b evaluated. #meningitis #stroke #fb

Updated Clinician Guidance here: http://www.cdc.gov/hai/outbreaks/clinicians/index.html ? #meningitis #stroke #fb

Interim Treatmnt 4 CNS &/or Parameningeal Infections Assoc w/Injection of Contaminated Steroid http://www.cdc.gov/hai/outbreaks/cli...dance_cns.html ? #meningitis #stroke #fb

At this time, CDC does not recommend initiation of antifungal prophylaxis in exposed patients who are asymptomatic. #meningitis #stroke #fb

Now discussing meds: voriconazole, liposomal amphotericin B, Please see site: http://www.cdc.gov/hai/outbreaks/cli...dance_cns.html ? #meningitis #stroke #fb

Adequate duration of antifungal treatment is unknown but likely will require prolonged therapy (e.g., months). #meningitis #stroke #fb

Incubation period appears to be 1-4 weeks, but also shorter & longer too. Patients are not "safe" after 4 weeks. #meningitis #stroke #fb

Exserohilum is a black mold and evaluating further for recommendations for treatment. #meningitis #stroke #fb

Most deaths were from stroke. In 1 case exserohilum was directly invading into tissue causing stroke. #meningitis #stroke #fb

Some reports of incubation of 40 days and beyond. Still an unknown. #meningitis #stroke #fb

1 emergency room doctor n Tenn reports that he has seen 65 patients in last few days-all have presented w/headaches. #meningitis #stroke #fb

This concludes today's COCA conference with over 2000 listeners.