MercoPress. South Atlantic News Agency

Steroid injection spreading rare form of fungal meningitis infection in the US

Extent of outbreak is unclear as possibly thousands of patients 23 in US states could have received a tainted injection.

The United States Center for Disease Control and Prevention and the Food and Drug Administration are quickly moving to determine the source of the fungal infection causing a rare form of meningitis that has killed seven people in nine states in the last few weeks, as the producer of the steroid injection apparently carrying the infection recalled all of its products.

According to the CDC, states possibly affected by the outbreak include: 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; Virginia; Texas; and West Virginia.

The extent of the outbreak is unclear, as possibly thousands of patients in those states could have received a tainted injection. Federal health officials have said that 17.676 single-dose vials of the steroid were sent to 75 clinics and other facilities in 23 states between July and September. So far according to CDC until Monday 105 cases have been reported.

The FDA said on Oct. 6 that the producer of the epidural steroid injection used for back pain has expanded an earlier voluntarily recall of the drug to include all of the other products made at its Framingham, MA facility.

New England Compounding Center (NECC) recalled its preservative-free methylprednisolone acetate (80mg/ml) and of all products currently in circulation that were compounded at and distributed from the facility, said an FDA and NECC joint statement on Oct. 6. The agency and NECC said the recall was “being taken out of an abundance of caution due to the potential risk of contamination, and in cooperation with an investigation being conducted by the FDA, the CDC and the Massachusetts Board of Registration in Pharmacy.”

FDA investigators said on Oct. 5, they had observed fungal contamination by direct microscopic examination of foreign matter taken from a sealed vial of methylprednisolone acetate collected from NECC. The agency said it is in the process of conducting additional microbial testing to confirm the exact species of the fungus.

According to the CDC in an Oct. 7 update on its Web page, several patients who received the injections have had strokes related to meningitis. In several patients, the meningitis was found to be caused by a fungus that is common in the environment but rarely causes meningitis, it said, noting the particular form of the infection is not contagious. “The source of the fungus has not yet been identified, and the cause of infections in the other patients is still being assessed,” it said.