Fungal Meningitis case confirmed in Morrow County
Local Public Health Employees Go Door-To-Door To Reach Those Affected
The Ohio Department of Health (ODH) has linked two additional cases of meningitis to steroid injections produced at New England Compounding Center. This brings the total number of cases to three in Ohio: a male from Hamilton County; a female from Morrow County; and a female from Crawford County.
In Ohio, ODH, local health departments, the Association of Ohio Health Commissioners (AOHC) and the Ohio Public Health Association (OPHA), have mobilized community resources to ensure all patients of four Ohio healthcare facilities who received epidural injections with a potentially contaminated steroid linked to fungal meningitis are doing okay.
The outbreak is responsible for 14 deaths and more than 170 cases of fungal meningitis and stroke across 11 states. There have been no deaths related to this outbreak in Ohio.
Public Health officials in Morrow County are working closely with local providers, the infected patient, the Marion County Health Department, ODH, and the Centers for Disease Control and Investigation (CDC) to investigate and report this case as part of the ongoing fungal meningitis outbreak investigation
“Local health departments are our boots on the ground. Our public health nurses and health commissioners are mobilizing and some have even reached out to sheriffs’ offices and Emergency Medical Services to ensure that we hear back from every one of these patients,” said Beth Bickford, Executive Director for the Association of Ohio Health Commissioners. “If that means knocking on doors, then that’s what they will do.”
Knocking on doors is exactly what Morrow County Health Department staff did Sunday night. Health department nurses and sanitarians went out to homes to notify the Morrow County patients who were exposed and could not be reached by telephone. Those patients were educated about the recall, the disease, the symptoms of fungal meningitis, and the importance of getting immediate medical treatment for symptoms, even if the symptoms are mild.
“Because the symptoms of this type of fungal meningitis have been so subtle and because the disease can be so serious, we made numerous calls and visits to reach those who are at risk of infection,” said Angela Smith, Morrow County Health Commissioner. “This is public health, and it is what I would want someone to do for me.”
Smith clarified that the outbreak is not a danger to the general public because this type of meningitis does not spread from person to person. Because the FDA and CDC investigations have linked specific and traceable medication to the disease, the people who are at risk of infection could be identified and notified to ensure they would recognize illness and seek treatment early when it can be most successful.
“This outbreak affects only those patients who received epidural, or spinal, injections of specific lots of the recalled product,” said Smith. “Not everyone treated at these clinics is at risk, and not everyone who received an injection is at risk. We have spoken with all of the Morrow County residents matched to the product linked to this outbreak.”
ODH was informed by the four clinics in Ohio that received the possibly tainted drug that 422 patients received injections. Through aggressive outreach, 419 patients were reached and advised to monitor closely for a change in symptoms. All patients who received the injections in Morrow County have been directly contacted.
The medication at the center of the recall is a steroid medication often used to treat back pain which is administered by epidural (or back) injection. Certain lots of the medication made by the New England Compounding Center in Framingham, Mass. may be contaminated with a fungus which has caused some patients to develop a rare form of fungal meningitis (brain infection) and stroke. About 17,700 single-dose vials of the steroid were sent to 23 states. Inspectors found at least one sealed vial contaminated with fungus, and tests were being done on other vials.
On October 3, 2012, the company ceased all production and initiated recall of all methylprednisolone acetate (a steroid medication) and other drug products prepared for injections in and around the spinal cord (known as intrathecal administration).ODH alerted healthcare providers in Ohio to inform them of symptoms that could be caused by the tainted drug as well as update lists of recalled products.
Symptoms of fungal meningitis are similar to symptoms of other forms of meningitis; however they often appear more gradually and can be very mild at first. In addition to typical meningitis symptoms, like headache, fever, nausea, and stiffness of the neck, people with fungal meningitis may also experience confusion, dizziness, and discomfort from bright lights. Patients might just have one or two of these symptoms.
For more information on fungal meningitis, please contact a Public Health Nurse at the Morrow County Health Department at (419)947‑1545 or visit us on the web at www.MorrowCountyHealth.org. We are “Your Partner in Prevention and Preparedness.”