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Author Topic: US Meningitis Outbreak Grows; (From Steroid Injections ?) 700 Cases, 51 dead  (Read 73352 times)
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« on: October 04, 2012, 11:34:15 AM »

http://abcnews.go.com/Health/wireStory/dead-rare-meningitis-cases-expected-17393781#.UG2XhK7BnIU
Rare US Meningitis Outbreak Grows; 4 Dead, 22 Sick
October 4, 2012

 An outbreak of a rare form of meningitis is likely to grow after sickening 26 people in five states, including four who died, health officials warned.

All received steroid injections, mostly for back pain, a fairly typical treatment. The drug was made by a specialty pharmacy in Massachusetts that issued a recall last week and has shut down operations.

The type of meningitis involved is not contagious like the more common forms. This type is caused by a fungus often found in leaf mold and which health officials suspect may have been in the steroid.
 ::snipping2::
 More new cases are almost certain to appear in the coming days, said Tennessee Department of Health Commissioner John Dreyzehner. Five new cases were confirmed over the past 24 hours, he said Wednesday, calling the situation a "rapidly evolving outbreak."

But federal health officials weren't clear about whether new infections are occurring. They are looking for — and increasingly finding — illnesses that occurred in the past two or three months.
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« Reply #1 on: October 04, 2012, 01:29:10 PM »

http://www.medpagetoday.com/Neurology/GeneralNeurology/35125
Steroid 'Prime Suspect' in Meningitis Cases
By Michael Smith, North American Correspondent, MedPage Today
October 4, 2012

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« Reply #2 on: October 04, 2012, 02:03:37 PM »

http://www.usatoday.com/story/news/nation/2012/10/04/meningitis-outbreak-medicines/1613093/
Meningitis puts spotlight on compound medicines
October 4, 2012

11:17AM EST October 4. 2012 - NASHVILLE -- The fungal meningitis outbreak centered on Nashville has renewed debate over who should regulate specialty pharmacies that compound medicines.

While they fall under the purview of state pharmacy boards, critics contend those state agencies are often too understaffed and underfunded to adequately monitor such facilities. They want the U.S. Food and Drug Administration to take a greater regulatory role.

But the FDA has said it will do that only on a case-by-case basis -- such as the meningitis outbreak that surfaced in Nashville and has since spread to four other states.

Authorities said all of those infected with fungal meningitis received spinal injections of a steroid solution sold by New England Compounding Center, a specialty pharmacy in Framingham, Mass. It and similar facilities combine, mix and/or alter active ingredients to make custom medications, much like early pharmacists.

These modern-day apothecaries now are supplying a greater share of the medicines Americans take, driven by the surge in outpatient procedures, development of bio-engineered drugs and a push for more individualized treatment, experts say.
 ::snipping2::
His group and others have pushed for greater FDA oversight, citing recent outbreaks linked to compounded medications as evidence of the need. Among them:

-- A bacterial infection that killed nine people in two Birmingham, Ala.-area hospitals in early 2011. Another 10 people were sickened by the Serratia marcescens bacteria, which was in an intravenous nutritional supplement prepared by a local compounding pharmacy, the New York Times reported.

-- Bacteria-tainted Avastin injections that caused eye infections in four patients at the Veterans Affairs' Nashville hospital in March 2011. The hospital had compounded the Avastin for eye injections from packaging intended for intravenous use.

-- A fungal endophthalmitis outbreak that struck 33 people in seven states who underwent eye surgery between November 2011 and April 2012, causing vision loss and blindness in some. It was linked to an injectable dye produced by a Florida compounding pharmacy, the FDA said.

The same Florida company, Franck's Lab, also made an injectable supplement that killed 21 polo horses in April 2009, the Associated Press reported. In that case, Franck's won a federal court ruling that said the FDA had no jurisdiction over compounding of veterinary medicines given to non-food animals.

But the agency acted against the company again after the endophthalmitis outbreak earlier this year, saying in a July 9 warning letter that "environmental sampling revealed the presence of microorganisms and fungal growth in the clean room where sterile products were prepared."

As a result, Franck's stopped selling sterile products -- including methylprednisolone, the drug implicated in the Tennessee outbreak -- in May, well before the current outbreak, according to FDA records.

Despite those and other high-profile cases, advocates have made little progress in gaining greater federal oversight of compounding pharmacies, Vaida said. The Nashville meningitis outbreak could help change that.
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« Reply #3 on: October 04, 2012, 02:07:08 PM »

http://www.nytimes.com/2012/10/04/health/meningitis-outbreak-grows-with-cases-in-5-states.html?_r=0
In Outbreak, Meningitis Is Reported in 5 States
October 3, 2012

An outbreak of a rare type of meningitis, linked to spinal injections for back pain, is growing and has killed four people and sickened at least 30 others in five states, health officials said on Wednesday. New cases are appearing every day.
 The patients are thought to have been infected by a steroid drug contaminated with a fungus, Aspergillus. The drug may have been shipped to 23 states, a spokesman for the Centers for Disease Control and Prevention said. This type of meningitis does not spread from person to person.

So far, cases have appeared in Tennessee, North Carolina, Florida, Virginia and Maryland. All the patients had received a treatment for back pain called a lumbar epidural steroid injection.

The drug under suspicion is methylprednisolone acetate, and health officials confirmed on Wednesday that all the infected patients had been treated with a brand of it produced by the New England Compounding Center in Framingham, Mass. So far, the incubation period seems to be from a few days to four weeks after the injection.
 ::snipping2::
 The outbreak has also drawn attention to the potential threats posed by compounding pharmacies like the one in New England. These pharmacies prepare drug mixtures and solutions that are not routinely available from major manufacturers, and not subject to the same rigorous safety standards that the government imposes on big drug companies.

On Sept. 26, the New England center voluntarily recalled three lots of the drug after it was told of the problem, according to Erica Jefferson, a spokeswoman for the Food and Drug Administration. She did not know how many doses were in the lots or where they had been shipped, but the center’s Web site said New England Compounding was licensed in all 50 states. One clinic in Tennessee, where most of that state’s patients in the outbreak so far were infected, had received 2,000 vials of the drug.

On Wednesday, North Carolina’s board of pharmacy suspended the company’s permission to do business there. So far the state has had one case, and several clinics received the potentially contaminated drug, a health department spokeswoman said.
 ::snipping2::
 Some hospitalized patients are recovering and walking the halls, but others are severely ill and in intensive care units, said Dr. Robert H. Latham, an infectious diseases specialist at St. Thomas Hospital in Nashville.

Fungal infections are notoriously stubborn and hard to treat, requiring powerful drugs that can have harsh side effects. Dr. Latham predicted that these patients would need six months to a year of treatment to get rid of the infection.
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« Reply #4 on: October 04, 2012, 02:45:23 PM »

http://abcnews.go.com/Health/wireStory/dead-rare-meningitis-cases-expected-17393781
Rare US Meningitis Outbreak Grows, 5 Dead
October 4, 2012

Another fatality from a growing outbreak of a rare form of meningitis was reported Thursday, raising the death toll to five people, officials said.

In all, 35 people in six states have been sickened from a steroid that was distributed to 23 states
, the Centers for Disease Control and Prevention said.

All received steroid injections used mostly for back pain that have been traced back to a specialty pharmacy in Massachusetts. The pharmacy issued a recall last week and has shut down operations.
 ::snipping2::

2 Pgs.  - Video at Link
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« Reply #5 on: October 04, 2012, 03:31:23 PM »

http://abcnews.go.com/Health/wireStory/dead-rare-meningitis-cases-expected-17393781#.UG3iH67BnIU
FDA: Avoid Drugs From Company Tied to Meningitis
October 4, 2012

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« Reply #6 on: October 04, 2012, 04:29:34 PM »

http://www.nj.com/politics/index.ssf/2012/10/6_nj_facilities_received_drug.html
6 N.J. facilities received drug tied to meningitis outbreak
October 4, 2012

Six medical facilities in New Jersey received the steroid medication being investigated in a fungal meningitis outbreak that has claimed four lives in other states, health officials said today, as they began investigating whether anyone has been stricken by the illness in the state.

The six facilities that received the potentially tainted steroid are doctor's offices and pain management practices, Health Department Spokeswoman Donna Leusner said. Some patients have received injections from the supply.

There are no meningitis cases reported in New Jersey related to the questionable steroid, Leusner said.

"Patients who may have received an injection from these facilities are being contacted by the facilities," Leusner said. "The Department of Health has told the facilities to stop using the medication" and "the facilities are cooperating. The NJ Department of Health is working with the facilities to ensure that the medication is not used and to identify any illnesses or adverse events associated with the medication."

 ::snipping2::
Meningitis is an inflammation of the lining of the brain and spinal cord. Symptoms include severe and worsening headache, nausea, dizziness and fever. Some of the patients also experienced slurred speech, and difficulty walking and urinating, according to health officials in Tennessee, where the most cases have been reported.

Fungal meningitis, which is not contagious like more common forms, is treated with high-dose antifungal medications, usually given intravenously in a hospital.

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« Reply #7 on: October 05, 2012, 04:05:18 PM »

http://www.boston.com/news/local/massachusetts/2012/10/05/steroid-related-meningitis-cases-rise/4wg6sgooaYviqrjq9Vc6bO/story.html
Steroid-related meningitis cases rise to 47
October 5, 2012

NEW YORK (AP) — Health officials say the number of people sickened by a deadly meningitis outbreak has risen again. There are now 47 cases in seven states.

The number of deaths — five — has remained the same.

Tennessee, Virginia, Maryland, Florida, North Carolina and Indiana had previously reported cases. On Friday, Michigan joined the list, with four cases.
 ::snipping2::
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« Reply #8 on: October 05, 2012, 09:45:14 PM »

http://www.nytimes.com/2012/10/06/health/officials-seek-patients-exposed-to-tainted-back-pain-drug.html?_r=0
Officials Seek People Exposed to a Tainted Drug
October 5, 2012

As the case count continued to rise in a multistate outbreak of meningitis linked to a tainted drug, federal health officials emphasized on Friday that it was absolutely essential to find everyone who may have been exposed to the drug, which was used in spinal injections for back pain.

“All patients who may have received these medications need to be tracked down immediately,” Dr. Benjamin Park, a medical officer at the Centers for Disease Control and Prevention, said in a statement. “It is possible that if patients with infection are identified soon and put on appropriate antifungal therapy, lives may be saved.”

Health officials said they were concerned that some patients who initially had mild symptoms did not realize they needed medical attention. But this type of meningitis, caused by a fungus, can become very severe, so there is an urgent need for early treatment.

Doctors urged anyone who had a spinal injection for pain in the last few months to contact a doctor if they became ill, particularly with symptoms that include a new or worsening headache, fever, stiff neck, sensitivity to light, nausea, slurred speech or loss of balance. The medical name for the injections is a lumbar epidural steroid injection.

Fungal meningitis does not spread from person to person.
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« Reply #9 on: October 06, 2012, 02:25:00 PM »

http://www.cdc.gov/hai/outbreaks/meningitis.html
Multistate Meningitis Outbreak Investigation
October 6, 2012
This information will be updated daily at 2pm EST
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« Reply #10 on: October 06, 2012, 03:15:00 PM »

http://www.cbsnews.com/8301-204_162-57527391/meningitis-outbreak-death-toll-rises-to-7/
Meningitis outbreak death toll rises to 7
October 6, 2012

ATLANTA Health officials say the death toll in a rare fungal meningitis outbreak across several states has risen to seven.

In updated figures posted to its website Saturday, the Centers for Disease Control and Prevention says the outbreak has spread to more than 60 people across nine states. The latest cases have been confirmed in Minnesota and Ohio.

 ::snipping2::
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« Reply #11 on: October 07, 2012, 06:51:06 PM »

http://www.boston.com/metrodesk/2012/10/07/framingham-pharmacy-recalls-all-its-products-meningitis-cases-double/ZO4bSyK6pTsUwpBfxgbrRP/story.html
Framingham pharmacy recalls all its products as meningitis cases nearly double
October 7, 2012

The number of meningitis cases linked to a Framingham pharmacy has nearly doubled as of the latest count today, and the company has issued a voluntary nationwide recall of all of its products,

The Centers for Disease Control and Prevention reported on its websitetoday that the nationwide outbreak of a rare form of fungal meningitis linked to the steroid produced by the New England Compounding Center has grown to 91 cases, including seven deaths.

The pharmacy issued a statement about the recall yesterday, saying “this action is being taken out of an abundance of caution due to the potential risk of contamination, and in cooperation with an investigation,” by federal and state health agencies.

“While there is no indication at this time of any contamination in other NECC products, this recall is being taken as a precautionary measure.”

The company has posted a 71-page list of the products being recalled.

Products from can be identified by markings that indicate New England Compounding Center by name, its acronym NECC or the company’s logo.

The company’s statement said customers are being notified of the recall by fax.
 ::snipping2::
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« Reply #12 on: October 08, 2012, 06:34:50 PM »

http://www.reuters.com/article/2012/10/08/us-usa-health-meningitis-idUSBRE8970TQ20121008
Meningitis-linked steroid may have affected 13,000 people in U.S.: CDC
October 8, 2012

(Reuters) - Some 13,000 people in 23 U.S. states may have received steroid injections linked to a rare fungal meningitis outbreak that has killed eight people, but far fewer are likely to contract the disease, the Centers for Disease Control said on Monday.

The CDC for the first time estimated the number of patients potentially affected, after previously saying only that it could be in the thousands.

So far, 105 cases of the rare form of meningitis have been confirmed in nine states. In hardest hit Tennessee another person has died, bringing the national death toll to eight, the CDC and Tennessee state authorities said on Monday.
 ::snipping2::
Fungal meningitis is not contagious, the CDC said. Symptoms include fever, headache, nausea and neurological problems that would be consistent with deep brain stroke.

The steroid was sent to California, Connecticut, Florida, Georgia, Idaho, Illinois, Indiana, Maryland, Michigan, Minnesota, North Carolina, New Hampshire, New Jersey, Nevada, New York, Ohio, Pennsylvania, Rhode Island, South Carolina, Tennessee, Texas, Virginia and West Virginia, the CDC said.

A list of facilities that received vials from the infected lots can be found via the website www.cdc.gov .
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« Reply #13 on: October 09, 2012, 04:48:20 PM »

http://www.guardian.co.uk/world/2012/oct/09/meningitis-death-toll-reaches-11
Meningitis death toll reaches 11 as disease claims three more lives
New Jersey becomes 10th US state to report at least one case of meningitis, health officials say, with 119 people now infected

October 11, 2012

The death toll from a fatal outbreak of meningitis has reached 11, with 119 now sick with the illness, according to health officials.

An update from the Centers for Disease Control and Prevention, issued on Tuesday afternoon, has now included New Jersey to the list of states in which at least one person has contracted meningitis. Some of the patients have had strokes but health agencies have provided no details of the conditions of any patients.
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« Reply #14 on: October 09, 2012, 08:48:14 PM »

http://www.cnn.com/2012/10/09/health/meningitis-exposure/index.html
Deaths rise to 12, with nearly 120 sickened in rare meningitis outbreak
October 9, 2012

(CNN) -- Florida recorded its first death connected to the outbreak of a rare, noncontagious form of meningitis, raising the toll Tuesday to a total of 12 fatalities nationwide.

Earlier in the day, federal authorities reported 11 deaths and 119 persons becoming ill in the outbreak, the Centers for Disease Control and Prevention announced Tuesday. Those figures were an increase from Monday's count of eight deaths and 105 illnesses.
Florida health officials also reported a total of six cases connected to the outbreak -- all in Marion County.
That figure -- one more than federal officials have so far counted in Florida -- means that a total of 120 persons nationwide have become ill, according to state officials.
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« Reply #15 on: October 10, 2012, 04:11:47 PM »

http://vitals.nbcnews.com/_news/2012/10/10/14346842-12-deaths-now-linked-to-fungal-meningitis-137-cases?lite
12 deaths now linked to fungal meningitis; 137 cases
October 10, 2012


An outbreak of fungal meningitis linked to steroid shots for back pain has now killed 12 people, with 137 confirmed cases, according to the latest numbers from the Centers for Disease Control and Prevention.
Cases have been identified in 10 states: Florida, Indiana, Maryland, Michigan, Minnesota, New Jersey, North Carolina, Ohio, Tennessee and Virginia. Ten of the people infected have been infected with a black mold called Exserohilum rostratum, CDC officials told doctors in a conference call on Wednesday. While at first the outbreak was linked to another mold called Aspergillus, just one of 11 patients whose tests have come back so far has been infected with that particular fungus.

Exserophilum has never been known to cause meningitis before, Dr. Tom Chiller of the CDC's Division of Foodborne, Waterborne and Environmental Diseases said. This makes it tricky to treat. So the CDC is recommending a strong intravenous cocktail of two antifungal drugs called voriconazole and lipsomal amphotericin B for as long as patients can tolerate it. "We realize these are two antifungal medicines that are toxic," Chiller said. He said CDC is still trying to figure out the best dose and the best length of time to treat patients.
Because the drugs can damage the kidneys and have other toxic side-effects, the CDC doesn't recommend treating anyone who isn't showing symptoms. Most of the patients who have tested positive for signs of fungal meningitis have a headache, neck pain or nausea, Chiller said. A few patients also have reported dizziness or sensitivity to light. Most of the patients who have died had strokes, Chiller said.
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« Reply #16 on: October 10, 2012, 10:25:03 PM »

http://online.wsj.com/article/SB10000872396390444657804578048873547928866.html?mod=googlenews_wsj
Doctors Are Off Balance as Patients Show Atypical Meningitis Reactions
October 10, 2012

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« Reply #17 on: October 11, 2012, 02:54:52 PM »

http://www.washingtonpost.com/national/health-science/cdc-cases-of-a-rare-fungal-meningitis-rise-to-170-2-more-death-makes-14/2012/10/11/14bed1a0-13cd-11e2-9a39-1f5a7f6fe945_story.html
CDC: Cases of a rare fungal meningitis rise to 170; 2 more death makes 14
October 11, 2012

An outbreak of fungal meningitis has been linked to steroid shots for back pain. The medication, made by a specialty pharmacy in Massachusetts, has been recalled.

Latest numbers from the Centers for Disease Control and Prevention:
Illnesses: 170

Deaths: 14
 ::snipping2::
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« Reply #18 on: October 12, 2012, 06:10:37 PM »

http://www.medpagetoday.com/Neurology/GeneralNeurology/35293
Meningitis Cases Still Rising, First Patient Goes Home
October 12, 2012

The number of cases in the outbreak of fungal meningitis continues to rise -- reaching 185, up 15 from Thursday -- but there have been no new fatalities, the CDC said on Friday, and the first patients affected by the nationwide outbreak have begun to go home.

The first patient released – of 33 treated at Nashville's St. Thomas Hospital – is "on intravenous medication and doing very well" at home, according to Robert Latham, MD, the hospital's chief of medicine.

A second patient is ready to go home, he said, but her release has been delayed because of difficulties organizing home care for her IV medication, Latham told reporters in a conference call organized by the Tennessee department of health.

Both patients, he said, were treated early in the course of infection with intravenous antifungal agents "and they responded very quickly." He added the symptoms have almost completely resolved.

On the other hand, Latham said, the hospital has seen two of the six deaths reported in the state and has two patients that are still critically ill. The remaining 28, he added, are making progress in fighting off the infection at different rates.
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« Reply #19 on: October 13, 2012, 09:16:59 AM »

http://www.miamiherald.com/2012/10/12/3047255/coral-reef-senior-high-student.html

Posted on Friday, 10.12.12

Coral Reef Senior High student dies of meningitis

Health officials and school district administrators are urging Coral Reef parents and students to watch for symptoms. The student’s death is not related to the national outbreak of fungal meningitis.
By Laura Isensee
lisensee@MiamiHerald.com

A senior at Coral Reef Senior High School died Friday at a local hospital of bacterial meningitis.

The sudden death shocked the school community — a mega magnet program with 3,200 students from all over Miami-Dade - and put parents and students on alert for the symptoms of the disease.

The case is not related to the national fungal meningitis outbreak that has killed 14, including two in Florida, according to the Miami-Dade County Health Department.


 ::snipping2::
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