Source:
https://www.animalpolitico.com/2022/11/casos-muertes-meningitis-durango-traramiento/
Source:
https://www.animalpolitico.com/2022/11/casos-muertes-meningitis-durango-traramiento/
There are 10 deaths from meningitis in Durango due to alleged irregular treatment; women with obstetric surgery, main victims
Health authorities have not given explanations about the cause of the problem, registered in Durango and with a total of 61 cases. Among the hypotheses that are analyzed is the use of an apocryphal medication or needles in poor condition.
By
Marcela Christmas Eve
November 24, 2022
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The cases of meningitis in Durango are increasing and affecting to a greater extent women who had obstetric surgery, while the authorities still do not give an accurate explanation of the origin of the outbreak. At noon this Wednesday, the State Health Secretariat reported that so far 61 cases and 10 deaths have been recorded.
According to specialists, the hypotheses point to contamination in medication or needles. The Pisa pharmaceutical company asked to prevent the use of four batches of the anesthetic Bupivacaine, which correspond to more than a million and a half vials, in a preventive manner. The common factor among women diagnosed with meningitis is having received neuraxial anesthesia, known as spinal anesthesia.
"As a preventive measure during the course of the investigation, Cofepris calls on warehouses, hospitals, surgical units, distributors, warehouses of public and private health agencies and/or institutions that distribute medicines, as well as points of sale in the entities of the country to a quarantine and preventive isolation of batches B22M142, B22A263, B22E872 of heavy Bupivacaine and batch B20J500 of Bupivacaine, while the investigation of the root cause of the problem is carried out and concluded," says the information. issued by Pisa.
According to the doctor and researcher Alejandro Macías, who has followed up on the cases, it is unlikely that the original drug was contaminated since there are thousands of doses distributed in various countries and this would have already caused a larger outbreak —and so far only It has been presented in the city of Durango-, so the other possibility is that it is a question of light bulbs produced in an apocryphal way.
From his perspective, the contamination of all the original batches would have meant that hundreds of thousands of people were already infected, so there is not enough evidence so far that this is the reason. However, he believes that the health authority is right to prevent batches from being used until there is confirmation.
An official letter dated November 7, signed by Moisés Nájera Torres, commissioner for the Protection against Sanitary Risks of the state of Durango, requests "urgently" to refrain from using the drugs bupivacaine heavy batch no. B22M142 and B22E872, "this due to the adverse reactions presented".
“In the Santé Hospital, the operating rooms are closed because they have two registered patients with this problem that we have of aseptic meningitis. As our function is risk prevention, it has to be done. They referred to our reception centers, Hospital 450 and one of them to ISSSTE. The medication was immediately secured in all private hospitals until it was determined at our national level, which is Cofepris, if the medication was contaminated or not," Nájera Torres told the media when the first measures were taken.
On November 15, the federal Ministry of Health reported that a commission of experts from different areas of the agency works in coordination with local authorities to determine the causes, as well as to supervise medical care. According to the federal government, the Health Sector Operational Command, made up of various agencies, has implemented comprehensive actions for medical care, mental health, health regulation, and pharmacovigilance.
Until then, 95% of the cases corresponded to women who underwent obstetric surgical procedures. All cases had a history of having received a neuraxial block. The patients, who had mostly been treated in private hospitals, were later treated at the General Hospital 450 of the State Health Secretariat and at the General Hospital of Zone 1 of the IMSS.
According to what was reported by the federal authorities, samples of cerebrospinal fluid and isolates from patients with skin conditions who were given drugs against fungi were sent to the Epidemiological Diagnosis and Reference Institute (InDRE), which maintains communication with staff from the State Laboratory of Public Health (LESP) of Durango.
On the other hand, they assured that Cofepris verifies private health establishments and carries out pharmacovigilance, laboratory analysis and traceability of medicines and supplies. All of this resulted in the suspension of activities at a private hospital and two operating rooms at another for "critical irregularities." The samples are still being analyzed to determine the causes, so there is still no certainty about the causes.
How does aseptic meningitis manifest?
"Days after my sister's death, pain feels normal, courage increases," Alejandra Rojas shared on her social media. Maleny died after being hospitalized for 16 days at Hospital 450, after having a cesarean section on August 21 at the Del Parque private hospital, according to her sister's account.
Four days after the cesarean section, she began with symptoms of meningitis, which she was not diagnosed with at first. Later, already at Hospital 450, she was administered the indicated medicine when the doctors discovered that it was a fungus. Alejandra denounces that, when the medicine finished, she went without it for two days and, although it was later administered again, she died.
On November 21, her son turned three months old. “What was joy for us for having my nephew turned into pain for losing my sister because of a murderous hand that stole her life, because of a hospital that did not take care of her health, because of a system corrupt and inept health My nephews are not alone and they will not be, but they do not have her mother and they are going to need her all her life, ”Alejandra shared.
Specialists warn that the problem persists and more cases will be found every day, because it can take several weeks to develop symptoms. However, at this time, intense, intractable headaches with a history of neuraxial anesthesia are warning signs, mainly in private hospitals in Durango, although at least one case has already been reported in a public hospital.
"Despite adequate treatment with the antifungals liposomal amphotericin and voriconazole, mortality is and will be high because meningitis is a very serious disease," says specialist Isaac Chávez Díaz. He explains that the case of the needle hypothesis is difficult to corroborate, but it could be those that are intended for single use, which are subjected to conventional resterilization processes, without the process being appropriate or successful.
Meningitis is a disease in which the tissues covering the brain and spinal cord become inflamed. Viral or aseptic meningitis, the most common, is caused by infection with one or more types of viruses. The cases detected in Durango have been caused by a fungus. Its incubation is relatively slow.
The majority of cases focused on patients who underwent obstetric surgical processes is due to the fact that the drug enters directly into the central nervous system, so there is no defense. In most cases it is about cesarean sections and the concentration is in private hospitals in Durango. If a very strong headache or back pain is detected after this procedure, it is necessary to see a doctor immediately, specialists recommend.
According to the medical personnel who have monitored the cases of meningitis, national coordination is necessary to channel sufficient resources to Durango through health institutions, as well as to study and discover the true cause. "It's not a 100-meter race, it's a marathon," says Macías.
