The Centers for Disease Control and Prevention (CDC) and the Food and Drug Administration (FDA) are coordinating a multi-state investigation of fungal meningitis cases among patients who received an injection with a potentially-contaminated steroid medication. The medication linked to this outbreak was produced by the New England Compounding Center (NECC) in Framingham, Massachusetts. None of the three medication lots that have been linked to this outbreak were distributed to health care providers in Utah.
Even so, Utah residents who received any epidural injection or joint injection within the past few months are asked to be vigilant and watch for any signs or symptoms of illness, especially those consistent with meningitis. Meningeal signs and symptoms being seen as part of this outbreak include the following: headache, neck pain, neck stiffness, fever, nausea, vomiting, and in some cases, weakness or numbness (in any part of the body), and sensitivity to light. In the current outbreak, most patients have begun experiencing symptoms one to four weeks after their epidural injection.
Three lots of the preservative-free methylprednisolone acetate were voluntarily recalled in the latter part of September by NECC because of potential contamination. A total of 75 facilities/clinics in 23 states received product from the three recalled lots. A list of the facilities can be found on the CDC’s website at http://www.cdc.gov/hai/outbreaks/meningitis-facilities-map.html.
Facilities in Idaho and Nevada are among those that received medication from the three recalled lots. However, none of the recalled medication was administered to patients in Nevada before being pulled from use. The possibility of exposure does exist for any Utah residents who received an epidural injection treatment within the past couple of months at a clinic/facility in Idaho named in the above-mentioned list.
On October 6, 2012, NECC expanded its previous recalls to include all products currently in circulation that were produced at and distributed from its facility in Framingham, Massachusetts. This was done from an abundance of caution by NECC and none of the products included in this expanded recall have been linked to this current outbreak of meningitis. Some clinics/facilities in Utah did receive epidural medications and other medications produced and distributed by NECC that are included in the expanded recall. As stated above, no facilities in Utah received any of the medications from the three lots initially recalled by NECC that have been tied to the outbreak.
As of October 10, 137 cases have been reported and there have been 12 deaths associated with the outbreak. All of the cases have occurred in patients who received an epidural injection using methylprednisolone acetate from the three lots of medication included in the initial recall by NECC. All cases have occurred in the following 10 states, Florida, Indiana, Maryland, Michigan, Minnesota, New Jersey, North Carolina, Ohio, Tennessee and Virginia. The CDC has set up a website with updated information regarding this outbreak at http://www.cdc.gov/hai/outbreaks/meningitis.html. The website has current case counts, deaths, and those states affected, as well as patient and clinician information.
The Utah Department of Health is closely monitoring the outbreak and distributing information to clinicians and other public health partners.