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.”

Posted by Randa Wagner on Oct 11 2012. You can follow any responses to this entry through the RSS Feed. Both comments and pings are currently closed.