I had an epidural steroid injection on Tuesday and now one facility in my city — Durham — is on the CDC radar.
UPDATE (7:08 PM ET): It looks like my facility isn’t on the affected list.
I lucked out. The facility where I had the ESI is not one that used the tainted vials of methylprednisolone acetate from New England Compounding Center in Framingham, MA, but today’s news of the outbreak is disturbing. (NBC17):
The Wilson Surgical Center and the North Carolina Orthopaedic Clinic in Durham were the two sites announced Friday. A site in High Point had previously been announced.
…Duke Medicine said it had evaluted its supply chain to see if any places had used the medication, and found just one site, the Orthopaedic Clinic, that had.
Dr. Laura Gerald, the State Health Director, said no infections have been noted yet from injections at the Durham clinic.
U.S. Food and Drug Administration and U.S. Centers for Disease Control and Prevention have been notifying states; Here’s the N.C. Board of Pharmacy’s order to health care providers. Here is the CDC advisory. More fun info from ABC:
Meningitis affects the membranous lining of the brain and spinal cord. Early symptoms of fungal meningitis, such as headache, fever, dizziness, nausea and slurred speech, are subtler than those of bacterial meningitis and can take nearly a month to appear. Left untreated, the inflammatory disease can cause permanent neurological damage and death.
“Fungal meningitis in general is rare. But aspergillus meningitis — the kind we’re talking about here — is super rare and very serious,” said Dr. William Schaffner, president of the National Foundation for Infectious Diseases and chairman of preventive medicine at Vanderbilt University Medical Center in Nashville, Tenn. “There’s no such thing as mild aspergillus meningitis.”
The disease is diagnosed with a lumbar puncture, which draws cerebrospinal fluid from the spine that can be inspected for signs of the disease. Once detected, it can be treated with high doses of intravenous antifungal medications.
“Treatment could be prolonged, possibly on the order of months,” said Park, adding that the IV treatment would require a hospital stay.
Honestly, if the unit wasn’t cleared, it’s not like much I could do about this other than contact tthem and find out if they used the tainted stuff or mixed their own. For most patients this is pretty much watch and wait. The real scandal is the oversight that allowed a place like New England Compounding Center to ship out this hot mess. The NYT:
The current outbreak is not the first time a steroid made by this type of pharmacy has caused fungal meningitis in people receiving spinal steroid injections. There were five similar cases, including a death, in 2002, all traced to one pharmacy in South Carolina that had been shipping its product to five states. Inspectors found contaminated vials and a complete lack of quality controls or sterility testing at the pharmacy.
In 2011, nine patients at an Alabama hospital died after receiving a feeding solution contaminated with bacteria, which had been prepared by a compounding pharmacy in Birmingham.
But special care is needed in making drugs to be injected into the spine because of the seriousness of infections there, said Charles Leiter, the president of Leiter’s Compounding Pharmacy in San Jose, Calif.
“I try and stay away from drugs for the spinal column because if you make a mistake, they are dead,” Mr. Leiter said.