Tennessee - Outbreak of fungal meningitis and associated infections: 124 cases, 14 deaths

[Catbird]

Today's update from TN Health Commissioner John Dreyzehner.
https://news.tn.gov/node/9724

"...Since our report 24 hours ago, four additional patients have been identified in Tennessee, bringing our total to 39. We also sadly report two additional confirmed deaths, bringing our state total to six.

...We have five key messages we?d like to make in today?s briefing. These are:

1. Our ongoing investigation indicates Exserohilum is the primary fungal infection affecting patients in Tennessee, a fungus so rare that most physicians never see it in a lifetime of practicing medicine.

2. We are continuing to work with the CDC on recommendations for treatment and we expect additional information soon.

3. We have evidence the incubation period may be longer than previously reported, possibly up to three months.

4. Patients who received methylprednisolone acetate should continue to be vigilant for symptoms.

5. Efforts to increase awareness about the need for patients to seek clinical evaluation are proving beneficial.

We?ll now address each of these points in greater detail.

First, Exserohilum rarely causes human infections. We appreciate the CDC?s work in convening national experts in fungal infections and anticipate forthcoming guidance. The currently recommended anti-fungal treatment medications are active against Exserohilum.

Second, because we are dealing with an exceptionally rare disease, the CDC is working with us and other state health departments across the U.S. with treatment recommendations. We will provide the latest information concerning recommended treatment protocols to clinicians via the Tennessee Health Alert Network.

Third, we have evidence the incubation period may be longer than previously reported. Our earliest estimate was in the range of two to 28 days. Based on the analysis of additional case studies, a more accurate range appears to be six to 42 days for our patients. Some experts believe vigilance for up to three months will be necessary. We are investigating this carefully and will be keeping in touch with those patients who may be at risk for infection until we have evidence that the incubation period is passed. It is important to understand the incubation period is an outer limit, based on the best available science, and that opinions and science could change as more information is gathered. Please note the average incubation period in Tennessee cases thus far is 16 days.

Fourth, patients who received injections from potentially contaminated lots of methylprednisolone acetate from New England Compounding Center should pay close attention to any new symptoms of headache (either new or worsening), fever, painful or stiff neck, dizziness or falling, worsening back pain at the injection site, or other unexpected pain or numbness. It is very important for these patients and their family members to remain vigilant for signs and symptoms.

Fungal meningitis can be extremely difficult to detect early in some patients. For that reason, we strongly recommend patients and families keep alert to signs of illness. We will be issuing additional messages to clinicians through the Tennessee Health Alert Network, reinforcing the need for maintained observation and caution for at-risk patients.

Fifth, the efforts to increase awareness about the need for at-risk patients to come in for clinical evaluations are proving beneficial. We will continue to work with the CDC, the FDA, other state health departments and a variety of subject matter experts on the scientific investigation.

Our next news briefing will be via conference call this Friday at 1 p.m., using the same number. If we have significant new information to provide earlier, we will of course convene again before then. We will post updates on cases and/or deaths at 1 p.m. Central time daily to the TDH website."

 

[sharon sanders]

Re: Tennessee - Outbreak of fungal meningitis: 6 deaths, 39 cases

Re: Tennessee - Outbreak of fungal meningitis: 6 deaths, 39 cases

Thanks Catbird. I think we should have a thread per state starting today. The state health department notices, news, etc. can be posted on these threads.

:tiphat:

 

[Catbird]

Re: Tennessee - Outbreak of fungal meningitis: 6 deaths, 39 cases

Re: Tennessee - Outbreak of fungal meningitis: 6 deaths, 39 cases

Thanks Sharon. I think it's a good idea as it will make it easier to keep track of the various hotline numbers and State Health Advisories, etc.

 

[Pathfinder]

Re: Tennessee - Outbreak of fungal meningitis: 6 deaths, 39 cases

Re: Tennessee - Outbreak of fungal meningitis: 6 deaths, 39 cases

TDH Update on Outbreak of Infections Associated with Recalled Methylprednisolone Acetate

Wednesday, October 10, 2012 | 02:00 pm

NASHVILLE ? As of 1 p.m. Central time Oct. 10, 2012, the Tennessee Department of Health is aware of 44 patients with meningitis, epidural abscess or posterior stroke associated with epidural steroid injections provided between July 1 and Sept. 28, 2012 at these three facilities: PCA Pain Center in Oak Ridge, Saint Thomas Outpatient Neurosurgery Center in Nashville and the Specialty Surgery Center in Crossville. The number of confirmed deaths in this situation remains at six.

Individuals who have had an epidural steroid injection at one of these facilities during that time should contact their health care provider for an assessment. Tennesseans wanting to ask questions about the outbreak may contact the Tennessee Poison Control Center at 1-888-222-1222.

The symptoms of infection associated with this outbreak vary from mild to severe, and may include worsening to severe headache; fever; stiff neck; unsteadiness or falling; back pain; dizziness; slurred speech and other unusual or abnormal symptoms.

TDH will provide new information on this investigation in a media briefing on Friday, Oct. 12, at 1 p.m. Central time. Media members may participate in the briefing via telephone by calling 1-888-757-2790, passcode 781337.

The mission of the Tennessee Department of Health is to protect, promote and improve the health and prosperity of people in Tennessee. For more information about TDH services and programs, visit http://health.state.tn.us/.

https://news.tn.gov/node/9731

 

[Catbird]

Re: Tennessee - Outbreak of fungal meningitis: 6 deaths, 44 cases

Re: Tennessee - Outbreak of fungal meningitis: 6 deaths, 44 cases

Live blog of today's conference with TN Dept. of Health. The official update hasn't been released yet but I will post it when it comes out. Hopefully, it will offer some clarification about a possible 2nd shipment of contaminated vials that may have affected an additional 111 people.


From The Tennessean (Adam Tamburin reporting):


Adam Tamburin:
Dr. John Dreyzehner, Tennessee's health commissioner has started the briefing.
1:02


Adam Tamburin:
A physician who has treated a large number of fungal meningitis patients is also involved in the call.
1:02


Adam Tamburin:
Fifty cases reported in Tennessee, one more than yesterday. Still six deaths.
1:04


Adam Tamburin:
Dreyzehner: A shipment of possibly tainted steroid injections was sent to Tennessee in early June. The state is now working to contact patients who were exposed to that shipment.
1:06

Adam Tamburin:
Health Department workers will be available for one-on-one interviews next week.
1:08

Adam Tamburin:
Dr. Robert Latham has been involved with the care of 31 outbreak patients at St. Thomas. Two St. Thomas patients have died, one went home, the rest remain at the hospital.
1:12

Adam Tamburin:
Latham: The patient who went home with intravenous treatment was treated with antifungals.
1:13

Adam Tamburin:
Dreyzehner on the June shipment of epidural steroid injections: "We can't assure that that product was not one of the recalled lots."
1:15

Adam Tamburin:
A number of those exposed to the June injections also received injections within the already existing window of concern. 111 separate patients were exposed to the earlier shipment.
1:17

Adam Tamburin:
To clarify: 111 additional patients were exposed to the earlier treatment, in addition to the ones who were exposed to both the earlier shipment and the later shipment of contaminated steroids.
1:23

Adam Tamburin:
Dreyzehner: It can take a couple of weeks for fungi to grow when testing is done to determine if it is present in the steroid injections.
1:24

Adam Tamburin:
Latham: As treatment continues, they are determining the appropriate levels of antifungals to use.
1:25

Adam Tamburin:
"Somewhere around four to six weeks of intravenous medications is probably what we're going to be shooting for."
1:26

Adam Tamburin:
An average of two weeks in the hospital could be expected, based on existing cases at St. Thomas.
1:28

Adam Tamburin:
Dr. David Reagan: Five percent of those exposed to contaminated steroids in Tennessee have gotten sick so far.
1:29

Adam Tamburin:
10 of 50 patients in the outbreak have had strokes, Dr. Marion Kainer said.
1:30

Adam Tamburin:
One particular lot of medication seems to be the culprit in most of the Tennessee cases. Three lots are suspected of contamination.
1:32

Adam Tamburin:
Fifteen new cases of fungal meningitis nationwide were reported today in the outbreak, bringing the overall total to 184, according to the CDC.
1:36

Adam Tamburin:
Dreyzehner: Evidence suggests the June shipment probably didn't affect any new patients.
1:38

Adam Tamburin:
2,520 vials of potentially contaminated steroids were sent to Tennessee, not counting the June shipment. 447 were not used, Kainer said.

Adam Tamburin:
Everyone infected was injected with a compounded version of methylprednisolone acetate from the New England Compounding Center. Most of those injections were administered in the back.
1:43

Adam Tamburin:
Nationwide, at least one person seems to have developed a fungal joint infection after having it administered near the ankle.
1:45

Adam Tamburin:
No joint infections have been reported in Tennessee so far, though.
1:47

Adam Tamburin:
The briefing is over

 

[Catbird]

Re: Tennessee - Outbreak of fungal meningitis: 6 deaths, 44 cases

Re: Tennessee - Outbreak of fungal meningitis: 6 deaths, 44 cases

Latest update from the TN Dept. of Health.

TDH Update on Outbreak of Infections Associated with Recalled Methylprednisolone Acetate-October 12, 2012

Friday, October 12, 2012 | 05:51 pm

NASHVILLE ? Tennessee Health Commissioner John Dreyzehner, MD, MPH, has provided an update on the investigation of infections associated with recalled methylprednisolone acetate. His statements from today?s media briefing are included below. Dreyzehner was joined today by Robert Latham, MD, chief of medicine and infectious disease specialist at Saint Thomas Hospital in Nashville; his statements are also included below.

As of 1 p.m. Central time Oct. 12, 2012, the Tennessee Department of Health is aware of 50 patients with meningitis, epidural abscess or posterior stroke associated with epidural steroid injections provided between July 1 and Sept. 28, 2012 at these three facilities: PCA Pain Center in Oak Ridge, Saint Thomas Outpatient Neurosurgery Center in Nashville and the Specialty Surgery Center in Crossville. The number of confirmed deaths in this situation remains at six.

Individuals who have had an epidural steroid injection at one of these facilities during that time should contact their health care provider for an assessment. Tennesseans wanting to ask questions about the outbreak may contact the Tennessee Poison Control Center at 1-800-222-1222.

Separately, the Tennessee Board of Pharmacy has called a meeting for Monday, October 15, 2012 at 11 a.m. Central time. The meeting will take place at Heritage Place, 227 French Landing in Nashville in the Poplar Room. The meeting notice may be viewed online at https://apps.tn.gov/pmn/sitemap/notice/1546.html.

Statement by Commissioner Dreyzehner October 12, 2012:

Good afternoon and thank you for your participation in today?s press briefing. We continue to appreciate the media?s important role in disseminating important public health information.

We begin by again extending our sympathy to those most affected by this tragic outbreak: families who have lost loved ones and individuals who are now struggling to recover, or those dealing with worry about the uncertainty of this evolving situation and the imperfect scientific understanding about some important details. They are in our thoughts and prayers as the work continues.

We invited the clinician who has cared for the most patients impacted by this outbreak to attend today?s briefing. So, I?m joined by Dr. Robert Latham, who will discuss his work treating patients associated with this outbreak. He will be discussing that with you in a few moments, and then be available to answer questions. Also on the call are two key Tennessee Department of Health leaders: Dr. David Reagan, our Chief Medical Officer, and Dr. Marion Kainer, who supervises our Healthcare Associated Infections & Antimicrobial Resistance Program.

Today, we sadly report one additional person in Tennessee has been identified as infected associated with the outbreak, since our 1 p.m. update yesterday, bringing the total number to 50 in Tennessee. The number of deaths stands at six.

We said in our first press briefing Oct. 1, this is an evolving situation. As our investigative and outreach work goes on, what we know continues to improve, allowing us to know and share greater information than we could previously. Additional understanding about the incubation period, risk factors, attack rate and the cause or causes of the illnesses and other factors in the outbreak itself will probably change or come to light as time passes, new observations are made and the scientific understanding evolves. That is the nature of outbreak investigations, generally and particularly in the setting of uncharted territory as we have here.

Maintaining our commitment to transparency, we want to report an issue we believe will not result in new infections but warrants public information. Thanks to the very alert staff at Saint Thomas, we have learned an order of methylprednisolone acetate from a possibly contaminated lot was shipped to Tennessee in early June and was used for treatment of patients. We are working to confirm the lot number associated with this delivery from the New England Compounding Center.

Saint Thomas has identified every patient who received injections from this shipment, which we believe, but cannot yet assure, is different from the recalled lots. Out of an abundance of caution, we are now working to contact every person treated with this material. In many cases, those who were treated in this earlier time were also treated later, so many have already been contacted.

Some of you have likely been following national discussions about a second firm whose products are now a subject of inquiry by the CDC and FDA. We are having conversations with the CDC and the FDA about Ameridose products. At this time we have no information about identification or confirmation of any problems associated with Ameridose products. If we learn of any issues potentially affecting public health, we will respond rapidly and appropriately.

Some of you have asked about regulatory action regarding NECC. As you know, TDH, without waiting for regulatory action, issued two alerts via the Tennessee Health Alert Network for clinicians in Tennessee to not use any products produced or distributed by NECC. The first of these messages went out Oct. 4, two days before the expanded voluntary recall of all NECC products. While we had no knowledge of any other NECC product contamination, we did this out of an abundance of caution to offer protection to the people of Tennessee.

We want to emphasize the cooperation we?ve received from the healthcare community and our public health partners on a most important part of this outbreak: treatment of infected patients. We also want to acknowledge the work of clinicians who have been most helpful and continue to work tirelessly.

Our focus has been and will continue to be on the protection of the people of Tennessee. Our early actions protected people in Tennessee from further exposure to contaminated products from NECC. Regulatory action was not necessary to accomplish this.

With us today is Dr. Robert Latham, who has himself worked tirelessly throughout this outbreak, and as one of the clinicians who initially reported early cases, allowing our team, led by Dr. Kainer, to connect the dots and alert the CDC and FDA of what we initially saw as a very unusual cluster of stroke and meningitis, as early as September 20. We?re grateful for his efforts and pleased to have him here with us.

Statement by Robert Latham, MD, October 12, 2012:

Thank you Dr. Dreyzehner. I am very pleased to be here this afternoon. As most of you know, I have been very involved with the care of the 31 patients admitted to Saint Thomas Hospital for treatment of the fungal infection resulting from receiving an epidural injection of a contaminated steroid preparation. Thus, I am uniquely positioned to speak about the status of these patients, their care at our hospital and the burden this medical accident has placed on the patients and their families. To date, we had two patients die of their infection; 28 remain in stable condition; two are critically ill in our intensive care unit; and one went home. Most of those in stable condition are showing signs of improvement, some at a faster pace than others.

My involvement with these patients has also made me a key eyewitness to another extraordinary story: one of selfless sacrifice and caring among nurses, associates and physicians who have come forward to help in ways that I never imagined. Most notable has been our ER nurses and physicians. We have seen 330 patients in our emergency department since Oct. 1 who have been extensively evaluated after being notified as potentially receiving the contaminated medication; 275 have required lumbar punctures, an often tedious and difficult procedure, to sample their cerebrospinal fluid to allow clear distinction between the presence or absence of any infection.

Finally, the Saint Thomas Hospital operators have been answering calls around the clock from worried members of the community, directing them where to seek assistance and, I have to add, finding me when I need to be somewhere I am not.

We appreciate the media assistance in continuing to provide the public with information. We continue to ask your assistance is assuring the public that the only center that received the tainted steroids was the ninth-floor Outpatient Neurosurgery Center, which is separate from the hospital or any other outpatient center on the Saint Thomas campus. I must emphasize that I am not affiliated with the center nor perform epidural injections; questions you have regarding either of those topics, I cannot answer. However, I am very willing to take questions about these patients, their infections and the tremendous outpouring of assistance I have witnessed among my fellow Saint Thomas workers.

 

[Catbird]

Re: Tennessee - Outbreak of fungal meningitis: 6 deaths, 50 cases

Re: Tennessee - Outbreak of fungal meningitis: 6 deaths, 50 cases

Update from TN Dept. of Health.

TDH Update on Outbreak of Infections Associated with Recalled Methylprednisolone Acetate-October 14, 2012

Sunday, October 14, 2012 | 01:59 pm

NASHVILLE ? As of 1 p.m. Central time Oct. 14, 2012, the Tennessee Department of Health is aware of 53 patients with meningitis, epidural abscess or posterior stroke associated with epidural steroid injections provided at these three facilities: PCA Pain Center in Oak Ridge, Saint Thomas Outpatient Neurosurgery Center in Nashville and the Specialty Surgery Center in Crossville. The number of confirmed deaths in this situation in Tennessee remains at six.

Individuals who have had an epidural steroid injection at one of these facilities provided between July 1 and Sept. 28, 2012 should contact their health care provider for an assessment. Tennesseans wanting to ask questions about the outbreak may contact the Tennessee Poison Control Center at 1-800-222-1222.

TDH has confirmed that an additional lot of methylprednisolone acetate shipped to Tennessee in early June and used for treatment of patients was not one of the recalled lots of material from New England Compounding Center.

Separately, the Tennessee Board of Pharmacy has called a meeting for Monday, October 15, 2012 at 11 a.m. Central time. The meeting will be held at Heritage Place, 227 French Landing in Nashville in the Poplar Room. The meeting notice may be viewed online at https://apps.tn.gov/pmn/sitemap/notice/1546.html.

 

[Pathfinder]

Re: Tennessee - Outbreak of fungal meningitis: 6 deaths, 50 cases

Re: Tennessee - Outbreak of fungal meningitis: 6 deaths, 50 cases

At center of meningitis scare, Nashville hospital battles to save lives

Published: Sunday, 14 Oct 2012 | 5:25 PM ET
...
Since the beginning of the month, some 330 patient have gone to the St. Thomas 29-bed emergency room, where the triage area is named after the mother of comedian, actress and star of "Laugh In" Lily Tomlin, whose family is from Nashville and donated privately to the facility.

But it is no laughing matter of late, as two people have died of meningitis at St. Thomas and the hospital has treated 33 of the 53 cases of meningitis in Tennessee, the hardest hit state.

While the hospital has not given patient names, one of the casualties at St. Thomas was Reba Temple, 80, of Centerville, Tennessee, according to a family friend. Temple herself was a former health director of Hickman County.
...
At one point 40 to 45 patients who had received injections were being treated at St. Thomas each day, officials said.

Of those who have survived so far, two remain in critical condition, 28 are in stable condition and on Friday the hospital sent the first of its victims home, where the patient will continue intravenous anti-fungal therapy.
"Our first case (of fungal meningitis) has been in the hospital for over four weeks on continuous anti-fungal therapy," Latham said.
...
Of the 17,676 vials of steroid suspected of being contaminated, 2,000 vials went to the ninth floor of the Nashville hospital, to St. Thomas Outpatient Neurosurgery Center, more than any other facility in the nation. The clinic is not affiliated with the hospital though it is on the property.
...
St. Thomas is not out of the woods yet. On Friday, officials confirmed another 111 patients of the Outpatient Neurosurgery Center in the building may have received tainted medicine from one of the lots as early as early June. Some of them may have to come in for tests.

Full text:
http://www.cnbc.com/id/49409614

 

[Pathfinder]

Re: Tennessee - Outbreak of fungal meningitis: 6 deaths, 53 cases

Re: Tennessee - Outbreak of fungal meningitis: 6 deaths, 53 cases

Meningitis outbreak: Even unclear answers bring some comfort

Tennessean hosts panel on outbreak

2:36 AM, Oct 16, 2012

Never before does Dr. David Reagan remember searching for a disease on MEDLINE and having the online biomedical literature catalog turn up zero results.

But that?s what happened several weeks ago when the Tennessee Department of Health?s chief medical officer searched for Exserohilum meningitis.

The disease is so rare that, before the current outbreak, there were no case reports. When that happens, Reagan said, there?s not a lot of precedent to go on: ?You have to learn from the situation itself.?

On Monday night, the learning continued as members of the local community gathered to participate in a meningitis roundtable discussion hosted by The Tennessean at the First Amendment Center. Reagan fielded questions as part of an expert panel that also included Woody McMillin, spokesman for the Tennessee Department of Health; local pharmacist John Hollis, who is former director for Nashville General Hospital; and Lisa Green, the Tennessean?s health editor.
...
Several questions focused on the effectiveness of diagnostic procedures other than a spinal tap, such as an MRI or blood test. In 50 meningitis patients tested, Reagan said, about ?half the time an MRI has shown some abnormality related to the infection.? He emphasized that the results of an MRI or blood test are still not as reliable as the currently recommended lumbar puncture.
...
Greg Clucker received shots from an infected lot in Nashville in August and came to the roundtable with a specific question regarding future vulnerability to the disease. He wondered, if he is healthy now, but several months down the road his immune system becomes compromised, if there?s a possibility that meningitis may appear then.

?The answer was he has no idea,? Clucker said. But even hearing that in person from the health professional on the front lines of the investigation was better than not being able to ask the question.
...

http://www.tennessean.com/article/2...break-Even-unclear-answers-bring-some-comfort

 

[Pathfinder]

Re: Tennessee - Outbreak of fungal meningitis: 6 deaths, 53 cases

Re: Tennessee - Outbreak of fungal meningitis: 6 deaths, 53 cases

FDA Issues Additional Patient Notification on NECC Product

Monday, October 15, 2012 | 03:15 pm

NASHVILLE - The Tennessee Department of Health and other state health departments across the United States today received information from the Food and Drug Administration that there is evidence indicating possible additional problems with products from the New England Compounding Center. To access the FDA announcement, please go to: http://www.fda.gov/Safety/MedWatch/SafetyInformation/SafetyAlertsforHumanMedicalProducts/ucm323946.htm

As the FDA launches a national effort to notify clinicians about the possibility of additional materials from NECC which may pose a risk to patients, the Tennessee Department of Health will support this effort through outreach. TDH urges all Tennesseans to be alert to messages from their physician concerning possible exposure to products from NECC.

FDA is advising a heightened awareness of any symptoms of infection in those persons who were exposed to NECC products.

The Tennessee Department of Health will use the Tennessee Health Alert Network and other avenues of communication to reach out to medical professionals statewide with this new information from FDA.

https://news.tn.gov/node/9758

 

[Pathfinder]

Re: Tennessee - Outbreak of fungal meningitis: 6 deaths, 53 cases

Re: Tennessee - Outbreak of fungal meningitis: 6 deaths, 53 cases

Meningitis outbreak: TN revokes compounding pharmacist's license

TN bans compounding pharmacy tied to meningitis

<?xml:namespace prefix = fb ns = "http://www.facebook.com/2008/fbml" /><fb:like class="fb_edge_widget_with_comment fb_iframe_widget" send="false" width="429" show_faces="false" font="" ref="artrectop" action="recommend" fb-xfbml-state="rendered" href=""></fb:like>2:28 AM, Oct 16, 2012
Written by Nate Rau

A compounding pharmacy that federal health officials linked to 15 fungal meningitis deaths nationwide surrendered its Tennessee license Monday, nearly a month after a Vanderbilt University doctor made the first connection between her dying patient and a tainted epidural steroid.

The surrender came as the U.S. Food and Drug Administration linked infections in two heart transplant patients to drugs from New England Compounding Center. Agency officials also said some of the compounding pharmacy?s drugs injected during eye surgery could cause infections, but they didn?t name those drugs.

More...
http://www.tennessean.com/article/2...mpounding-pharmacist-s-license?nclick_check=1

--------------------------------------------------------------------------------------

October 15, 2012 Board action concerning New England Compounding Center

http://health.state.tn.us/boards/pharmacy/PDFs/NewEnglandCompounding101512.pdf

http://health.state.tn.us/boards/pharmacy/index.shtml

 

[Pathfinder]

Re: Tennessee - Outbreak of fungal meningitis: 6 deaths, 59 cases

Re: Tennessee - Outbreak of fungal meningitis: 6 deaths, 59 cases

TDH Provides Support in Food and Drug Administration Alert Regarding NECC Products

Tuesday, October 16, 2012 | 03:16 pm

NASHVILLE ? The Tennessee Department of Health is supporting the Food and Drug Administration in an effort to alert patients who may have been treated in Tennessee with potentially unsafe products from New England Compounding Center. The FDA announced Monday, Oct. 15, its concerns about additional NECC products, including injectable ophthalmic drugs used in some eye surgeries and cardioplegic solution used in some heart surgeries after May 21, 2012.

None of these additional products should have been in use after Oct. 4, 2012, when the Tennessee Department of Health used the Tennessee Health Alert Network to notify clinicians to not use any NECC product. This action was followed by a voluntary recall of NECC products Oct. 6.
An earlier recalled NECC product, methylprednisolone acetate, is the primary suspect in a growing number of patients across the United States affected with meningitis, deep brain stroke and spinal abscesses after receiving an epidural steroid injection or steroid injection in a major joint.

The latest FDA alert focuses on other injectable products formulated by NECC which may be a factor in a recently discovered patient with meningitis.

As of 1 p.m. Central time Oct. 16, 2012, TDH is aware of 59 patients with illness associated with epidural steroid injections or steroid injections in a major joint provided at these three facilities: PCA Pain Center in Oak Ridge, Saint Thomas Outpatient Neurosurgery Center in Nashville and the Specialty Surgery Center in Crossville. The number of confirmed deaths in this situation remains at six.

The FDA has issued a MedWatch alert to healthcare providers across the nation who may have received the additional suspect NECC products so they, in turn, may contact their patients. The Tennessee Department of Health is now working with the FDA to identify every Tennessee medical facility that received the suspect materials and to conduct its own outreach efforts to assure all clinicians understand the possible risk to their patients. At this time, it appears less than 75 facilities in Tennessee received the materials now in question. Concerned individuals may obtain additional information by visiting www.fda.gov/Drugs/DrugSafety/ucm322735.htm.

?The FDA is providing information about shipments of the new suspect materials from NECC to us and other health departments across the country, and we?ve already started work on sorting out which Tennessee facilities received these,? said TDH Chief Medical Officer David Reagan, MD, PhD. ?As we identify facilities and clinicians who have received the questionable NECC products, we?ll reach out to them and confirm FDA?s guidance about alerting their patients.?

?Within a few hours of receiving notification from FDA about the potential problem with other NECC products, we asked for and received support from many health and medical organizations across the state,? said TDH Commissioner John Dreyzehner, MD, MPH. ?Those agreeing to provide assistance thus far are the Tennessee Hospital Association, the Tennessee Medical Association, the Tennessee Pharmacy Association, AmSurg Corp. and others. It?s gratifying to see how quickly our state?s health and medical communities can respond to address significant issues affecting Tennesseans.?

The mission of the Tennessee Department of Health is to protect, promote and improve the health and prosperity of people in Tennessee. For more information about TDH services and programs, visit http://health.state.tn.us/.

https://news.tn.gov/node/9766

 

[Pathfinder]

Re: Tennessee - Outbreak of fungal meningitis: 6 deaths, 59 cases

Re: Tennessee - Outbreak of fungal meningitis: 6 deaths, 59 cases

Saint Thomas Hospital -

Do you have concerns about meningitis?

Page Last Updated: 10/16/12 4:25pm CST
...
Saint Thomas Hospital is currently treating 31 patients associated with an outbreak of rare fungal meningitis first discovered at the Saint Thomas Outpatient Neurosurgical Center.

The Saint Thomas emergency department has screened more than 300 patient since Oct. 1, 2012 and performed 275 lumbar punctures.

It is important to know that this type of meningitis is severe. If you have received an epidural steroid injection between June 27, 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.
...

http://www.stthomas.org/meningitis

 

[Catbird]

Re: Tennessee - Outbreak of fungal meningitis: 6 deaths, 59 cases

Re: Tennessee - Outbreak of fungal meningitis: 6 deaths, 59 cases

TDH Update on Outbreak of Infections Associated with Recalled Products from NECC

"Wednesday, October 17, 2012 | 12:10 pm

NASHVILLE ? The Tennessee Department of Health has now confirmed that 74 healthcare facilities in Tennessee have received suspect material from New England Compounding Center that may pose a risk to some patients. The Food and Drug Administration has characterized the notification effort as recommended ?out of an abundance of caution.?

How those facilities were identified:
The evening of Monday, Oct. 15, the FDA provided TDH a list of more than 131,000 shipping invoices for NECC materials that went to medical facilities across the U.S. TDH staff members began work immediately to identify which NECC invoices were for materials going to Tennessee. On Oct. 16, TDH staff members were able to confirm where the majority of shipments had gone and today continue combing the invoices for additional data.

The process to notify patients:
Also on the evening of Oct. 15, TDH asked for and received cooperative assistance from the Tennessee Hospital Association, the Tennessee Medical Association, the Tennessee Pharmacy Association, AMSURG and other healthcare organizations. Through a cooperative effort, TDH and its partners began contacting healthcare facilities today, providing information to help each facility with an action plan for contacting their patients. The facilities are being urged to identify which patients received potentially unsafe NECC products during heart or eye surgeries and to then contact their patients to provide information about the risk for infection. TDH anticipates some patients will begin receiving contacts as early as this week.

TDH and its partners are working with healthcare providers on the important patient identification and contact efforts. To allow time for these facilities to put their notification plans in place, TDH and its partners are providing assistance with necessary processes at all facilities. TDH estimates this work will occur very rapidly. The department respects and appreciates care providers? desires to be the first to contact their patients about the potential risk as an important part of their clinician-patient relationship.

As of 11 a.m. Central time Oct. 17, 2012, the Tennessee Department of Health is aware of 61 patients with meningitis, epidural abscess or posterior stroke associated with epidural steroid injections or steroid injections in a major joint using products from New England Compounding Center. Of those cases, eight have resulted in death of the patients.

Tennesseans wanting to ask questions about the outbreak may contact the Tennessee Poison Control Center at 1-800-222-1222.

TDH will continue to post updated information on this outbreak investigation online at http://news.tn.gov/taxonomy/term/30. The Centers for Disease Control and Prevention also has information on the investigation available online at www.cdc.gov/HAI/outbreaks/meningitis.html.

The mission of the Tennessee Department of Health is to protect, promote and improve the health and prosperity of people in Tennessee. For more information about TDH services and programs, visit http://health.state.tn.us/."

 

[Catbird]

Re: Tennessee - Outbreak of fungal meningitis: 61 cases, 8 deaths

Re: Tennessee - Outbreak of fungal meningitis: 61 cases, 8 deaths

"Meningitis outbreak: TN illness count rises to 63"

"The number of patients in Tennessee who have been diagnosed with fungal meningitis from a tainted steroid has jumped yet again, going from 61 to 63, according to state health officials.

State Health Department spokesman Woody McMillin said Thursday that there has been no increase in the number of deaths in the state from the outbreak. The total now stands at eight.

"Work continues on all fronts. We expect the seven-day work weeks to continue indefinitely for those in the State Health Operations Center," McMillin said.

The spokesman said the agency was not aware of any patients affected by other tainted drugs that may have come from the Massachusetts drug compounding firm that produced the tainted epidural steroid. "

 

[Catbird]

Re: Tennessee - Outbreak of fungal meningitis: 63 cases, 8 deaths

Re: Tennessee - Outbreak of fungal meningitis: 63 cases, 8 deaths

TDH Update on Outbreak of Infections Associated with Recalled Products from NECC

"Thursday, October 18, 2012 | 11:40 am

NASHVILLE ? As of 11 a.m. Central time Oct. 18, 2012, the Tennessee Department of Health is aware of 63 patients with meningitis, epidural abscess or posterior stroke associated with epidural steroid injections or steroid injections in a major joint using products from New England Compounding Center. The number of confirmed deaths in this situation remains at eight.

Tennesseans wanting to ask questions about the outbreak may contact the Tennessee Poison Control Center at 1-800-222-1222. "

 

[Pathfinder]

Re: Tennessee - Outbreak of fungal meningitis: 63 cases, 8 deaths

Re: Tennessee - Outbreak of fungal meningitis: 63 cases, 8 deaths

Two TN meningitis victims identified

Both women received steroid injections

<?xml:namespace prefix = fb ns = "http://www.facebook.com/2008/fbml" /><fb:like class="fb_edge_widget_with_comment fb_iframe_widget" href="" action="recommend" ref="artrectop" fb-xfbml-state="rendered" font="" show_faces="false" width="429" send="false"></fb:like>4:45 AM, Oct 19, 2012

One was Earline Williams, 72, a longtime librarian at Stratford High School, who died Monday at Baptist Hospital. She had been treated with the steroid methylprednisolone acetate at Saint Thomas Outpatient Surgical Center, according to longtime friend Liz Allison of Cookeville, Tenn.

?She got an epidural steroid injection and she had a severe reaction. It?s terrible,? Allison said.

?It was just a few weeks ago that she was watching her granddaughter play baseball.?
...
Jean Cloonan of Franklin, another friend of Mrs. Williams, said the retired librarian had gone to the emergency room about a week before her death.
...
Born in Sugar Grove, Ky., Mrs. Williams was survived by her son, Matthew, and granddaughter, Sydney.

The other victim was Margaret Bryant, 74, of McMinnville, who died on Sept. 18, a month and a day after she received a steroid injection at Saint Thomas Outpatient Neurosurgical Center, according to a lawsuit filed Thursday in Davidson Circuit Court in Nashville.

Her husband, Bertram Bryant, referred questions to his attorney, Michael Galligan, who could not be reached for comment.
...

Full text:
http://www.tennessean.com/article/20121019/NEWS07/310190089/Two-TN-meningitis-victims-identified

 

[Catbird]

Re: Tennessee - Outbreak of fungal meningitis: 63 cases, 8 deaths

Re: Tennessee - Outbreak of fungal meningitis: 63 cases, 8 deaths

TDH Update on Outbreak of Infections Associated with Recalled Products from NECC-October 20, 2012

"Saturday, October 20, 2012 | 11:35 am

NASHVILLE ? As of 11 a.m. Central time Oct. 20, 2012, the Tennessee Department of Health is aware of 69 patients with meningitis, epidural abscess or posterior stroke associated with epidural steroid injections or steroid injections in a major joint using products from New England Compounding Center. Of those cases, nine have resulted in death of the patients.

Tennesseans wanting to ask questions about the outbreak may contact the Tennessee Poison Control Center at 1-800-222-1222..."

 

[Shiloh]

Re: Tennessee - Outbreak of fungal meningitis: 69 cases, 9 deaths

Re: Tennessee - Outbreak of fungal meningitis: 69 cases, 9 deaths

Source: http://www.wdef.com/news/state/stor...n-Tenn-rises-to-9/BYcG-k1L30eislOous3Zug.cspx


Meningitis death toll in Tenn. rises to 9
Updated: 7:07 pm

NASHVILLE, Tenn. (AP) ? The death toll from meningitis cases in Tennessee has risen to 9 while state Department of Health officials report 69 total cases across the state...

 

[Pathfinder]

Re: Tennessee - Outbreak of fungal meningitis: 69 cases, 9 deaths

Re: Tennessee - Outbreak of fungal meningitis: 69 cases, 9 deaths

FDA Withdraws List of Facilities Receiving NECC Materials Due to Incorrect Data

Tuesday, October 23, 2012 | 10:07 am

NASHVILLE ? The Food and Drug Administration has posted a message to its website citing some technical problems and incorrect data with a list of facilities earlier believed to have received suspect medication from the New England Compounding Center.

That list had been used by the Tennessee Department of Health and other state health departments to notify health care facilities they had received potentially unsafe injectable medications used in some eye and heart surgeries.

The FDA said it is working to correct the list and will repost it to the FDA website when staff members are sure it is accurate. The Tennessee Department of Health used the FDA-supplied information to identify 74 facilities in the state receiving suspect materials. TDH withdrew that information from its website today, and is now waiting to receive corrected information. If corrected information reveals facilities in Tennessee need to be notified, TDH will do so promptly. TDH believes the corrected list will identify significantly fewer Tennessee facilities affected by the recall.

The mission of the Tennessee Department of Health is to protect, promote and improve the health and prosperity of people in Tennessee. For more information about TDH services and programs, visit http://health.state.tn.us/.

https://news.tn.gov/node/9806