By LISA M. HOFFMANN
NIAGARA, Wis. - The Centers for Disease Control and Prevention (CDC) has reported there were 119 cases of fungal meningitis (Aspergillus meningitis), including 11 deaths.
Twenty-five of those cases, including three deaths, were reported in Lower Michigan.
Dr. Vijay Singh of Pain Diagnostics in Niagara, Wis. said as most people are aware, fungal meningitis in connection with three lots of contaminated steroids (methylprednisolone acetate) are used in epidural steroid injections, a procedure used to relieve back pain.
Spine Pain Diagnostics Associates wants to assure its patients that they are safe from harm from this outbreak.
The steroid was made by a specialty pharmacy in Massachusetts. At least one contaminated vial was found at the company.
Officials said no health care facility in Upper Michigan or in Wisconsin received the contaminated medication.
Dr. Terry Frankovich of the Dickinson-Iron District Health Department said there are a few very important things for people in our area to know.
"Fortunately, with computerized systems, it is very easy to track medication from factory to medical facilities and then to patients. Although this is a commonly used medication, it is produced by more than one company and only three lots of the medication from one particular company are implicated," she said. "None of these doses were distributed in the Upper Peninsula."
Medicines arrive at compounding centers directly from the manufacturers, and are then mixed, or compounded, by pharmacists into the specialized medications that patients need to get well.
Compounding medication is a common and safe practice, and used in nearly every area of medicine, Dr. Singh said.
Though this outbreak is the result of contaminated medication used in epidural injection procedures, it is not a result of the procedure itself. Epidural injections are safe procedures, with a very low rate of complication.
Dr. Singh said fungal meningitis is extremely rare in any situation, including after epidural injections.
"It occurs when the protective membranes that cover the brain and spinal cord are infected with a fungus. According to the CDC, symptoms are similar to other forms of meningitis, but they often appear more gradually and can be very mild at first," Dr. Singh said. "In addition to typical meningitis symptoms of headache, fever, nausea, and stiffness of the neck, people with fungal meningitis may also experience confusion, dizziness and discomfort from bright lights."
Dr. Singh added it is also important to note that the type of epidural medication given to patients affected by this outbreak is not the same type of medication that is given to women during childbirth.
Four Michigan facilities that received shipments of these recalled lots are working with MDCH to notify patients who may have received this product between May and October and may be at risk for developing illness.
The facilities are: Michigan Neurosurgical Institutes in Grand Blanc, Michigan Pain Specialists in Brighton, Neuromuscular and Rehabilitation in Traverse City, and Southeast Michigan Surgical Hospital in Warren.
As this is a developing investigation, the number of cases is expected to increase. The age range of current identified cases is 46 to 89 years old. Of the three deaths in Michigan, all were females ages 56, 67 and 78.
The Massachusetts company recalled the steroid that was sent to clinics in 23 states, and later recalled everything it makes.
New Jersey is the 10th state to report at least one illness. Other states involved in the outbreak are Tennessee, Michigan, Virginia, Indiana, Florida, Maryland, Minnesota, North Carolina and Ohio.
Spine Pain Diagnostics Associates extends its sincere condolences to the victims and families of this outbreak.
"Our thoughts and prayers are with all affected by this tragedy. We are committed to providing our patients with the highest quality, safest treatments available," Dr. Singh said. "Patient safety and well-being is our highest priority, and we will continue to monitor this developing situation and keep our patients informed of any pertinent updates."
If anyone has questions or concerns regarding meningitis, they are asked to contact Pain Diagnostics at (888) 724-6377 or visit paindiagnostics.net.
Lisa M. Hoffmann's e-mail address is firstname.lastname@example.org.