TheJournal.ie uses cookies. By continuing to browse this site you are agreeing to our use of cookies. Click here to find out more »
Dublin: 9 °C Sunday 19 May, 2013

Four die after rare meningitis outbreak in US

All cases involved patients who received steroid injections for back pain, health officials said today.

File photo
File photo
Image: David Jones/PA Archive/Press Association Images

AN OUTBREAK OF a rare and deadly form of meningitis has hospitalised 26 people and killed four people across five states  in America.

All the cases involved patients who received steroid injections.

Eighteen of the cases are in Tennessee where a Nashville clinic received the largest shipment of the steroid suspected in the outbreak. The drug was made by a specialty pharmacy in Massachusetts. It has since issued a recall.

Three cases have been reported in Virginia, two in Maryland, two in Florida and one in North Carolina. Two of the deaths were in Tennessee; Virginia and Maryland had one each, the Centres for Disease Control and Prevention said.

More new cases are almost certain to appear in the coming days, said Tennessee Department of Health Commissioner John Dreyzehner. Cases in that state began in July and five new cases were confirmed over the past 24 hours, he said Wednesday.

Investigators have been looking into at least three different products used for the back injections that could have been tainted by the fungus that appears to be behind the illnesses. None of the products have been ruled out. However, the primary suspicion is on steroid medication, which is commonly used for back pain.

The Food and Drug Administration identified the maker of the steroid as the New England Compounding Center, a specialty pharmacy in Framingham. Last week, the company issued a recall of three lots of the steroid. Company officials could not be immediately reached Wednesday afternoon by telephone; the company’s website was unavailable.

Read next:

Comments (16 Comments)

  • The article says it was a fungus. Obviously they suspect the steroid injections were contaminated with it.

    Reply
  • LAWLORD 03/10/12 #

    Any idea where in North Carolina one of the cases was?

    Reply
    • Michael

      You can only kill a virus with an anti viral and none of the items you mentioned have any anti viral properties.

      Reply
    • Michael 04/10/12 #

      Paddy, u cant really kill a virus, anti-virals don’t work like antibiotics, i think they prevent virus’s spreading rather than killing. Technically viruses aren’t alive (its just a shell with dna/rna)
      Plus how do we know it is a virus, bacterial meningitis is far more potent/life threatening than viral meningitis.

      Reply
    • Micheal 04/10/12 #

      This type would appear to be chemical – which is less common than bacterial or viral meningitis. As Michael said – you don’t kill a virus with antibiotics, you contain a virus with antiviral drugs. AVD’s don’t kill, the inhibit the ability of the virus to spread. Hence why we are all susceptible to flu in winter, or why you can’t currently effectively cure HIV.

      Reply
  • is norovirus not “winter vomiting bug”??

    Reply
  • Tommy C 03/10/12 #

    Did our norovirus in Beaumont make the news in the US?

    Reply
    • I don’t think norovirus is in quite the same league as a possible strain of man made meningitis. Read the article again, think you missed the point.

      Reply
    • Tommy C 03/10/12 #

      It depends on who has the virus, how their immune system is, what theyre in hospital with so id say theyre on a par.

      Reply
    • Micheal 03/10/12 #

      The article seems to imply that the meningitis was in some way related to a steroid, which is not usually the case. If that’s the case, (I don’t know, because the article isn’t very clear), then I’d say man made meningitis trumps what is essentially the flu. (Norovirus).

      Reply
    • Ah yes, that ‘flu’ has the potential to kill every immunosuppressed patient, elderly and neonate in every hospital in the country Michael. Do some research!

      Reply
    • Micheal 03/10/12 #

      No more than the influenza does each and every year. You should probably know that there are (at least) two outbreaks a year – both of influenza – one in northern hemisphere winter and one in Southern Hemisphere winter. Both outbreaks kill the very people you describe and have been doing so for centuries. Norovirus isn’t severe – yes it might claim a few sufferers, but by comparison to some infections, flus, etc, its practically a pussy cat. Norovirus is cured with fluids, paracetamol and decongestant. Not so much a cure with the meningitis.

      Reply
    • I’m with Tommy on this, if you’re an immunosuppressed patient then meningitis, the flu, norovirus or possibly even the common cold can kill you. Does it matter then? This article suggests that this particular outbreak of meningitis differs from the norm in that all those who got it also had recieved steroid injections, maybe they were contaminated, maybe this is something new, who knows. Daily doses of steroids of just 10mg are enough to reduce an immune system, I have had meningitis and norovirus and while I wouldn’t want either again it takes a lot more than “fluids, paracetamol and decongestant” to get rid of it in some patients. If I remember some elderly patients died of this around the time I had it.

      Reply
    • Micheal 04/10/12 #

      This outbreak does differ from the norm. Meningitis is normally always either viral or bacterial, and a lot less commonly, chemical. This outbreak – if it is related to the steroid taken – is chemical.
      To compare a condition that has a 40% mortality rate, and of the 60% survival rate, a further 40% of those are rendered physically and sometimes mentally incapacitated, with many survivors left with deafness, epilepsy and very often cognitive defects, well it’s childish.
      If you obtain Norovirus in Ireland, and are not a patient in a hospital setting, you have either gone to a hospital that has an outbreak, or been in contact with someone who has Norovirus, or you didn’t wash your hands after leaving the hospital. The standard treatment for Norovirus (standard – some (not many), do differ), is decongestant, paracetamol, pantoprazole (protein), flat 7up and cartoons. Rarely should the treatment include antibiotics, except for advanced cases. Recovery is usually about a week – often less, sometimes more. In immunosuppressed people, recovery does take longer, and may – rarely – result in death (again, usually untreated, advanced cases).
      Meningitis requires antibiotics, and some or all of the following: mechanical ventilation to aid with breathing and prevent respiratory arrest, IV fluids to lift BP, medication to prevent/reduce intracranial pressure, anticonvulsants to prevent seizures and a cerebral shunt (drainage) to prevent hydrocephalus (obstruction of Cerebrospinal Fluid – the fluid that surrounds the brain and spinal cord). That’s before you look at the side affects, or longer term affects.
      The reason meningitis was heard of here is because these cases are unusual, it may have implications for the steroid that was (or rather – wasn’t), mentioned, and may have implications for anyone here who may be on that steroid.
      Don’t compare meningitis to what is essentially a result of poor hygiene – meningitis, at the best of times, is a complex condition, resulting in most cases with death, or at least reduced ability. Norovirus is a slightly advanced version of the winter flu that results in most cases with a few days off work, rarely leading to anything more serious.
      Quit being so self centred and arrogant – you make the rest of us look like petulant, jealous children.

      Reply
    • Whooaa there, easy. We both agree that this meningitis outbreak differs from the norm, from what I’ve read elsewhere they believe it may be related to the steroid injections, possible contamination.
      I don’t want to argue with you, but I think the mortality rates you quoted for meningitis are quite high and while it is difficult to get a definitive figure, this one from a Wikipedia article seems to be about right;
      “Of newborns, 20–30% may die from an episode of bacterial meningitis. This risk is much lower in older children, whose mortality is about 2%, but rises again to about 19–37% in adults.”
      You went on to talk about Norovirus and believe it occurs mainly in a hospital setting as a result of poor hygiene. It occurs mainly, but not exclusively, in enclosed communites like hospitals where the patients are likely to already be immunosuppressed but it is transmitted by person to person, via contaminated water and food and by aerosol in the air. While washing hands is vital, alcohol gel is not effective and it takes strong bleach to kill this virus.
      I just checked with a relative who works in such a hospital setting about the treatment of these cases and as you said it differs, for healthy people who may get it they will basically suffer a bout of gastroenteritis and be fine in a few days, but for someone who may be immunosuppressed in a hospital setting it will be radically different.
      I’m told a decongestant would be pointless, oral medication would usually be rendered ineffictive in situations like this but if a patient needed it for a prior condition it may be given IV, as would any pain medication. She also said that flat 7UP should never be used with any norovirus or gastrointestinal problem as the sugars will make diarrhea worse and it contains none of the vital salts and minerals the body looses during bouts of vomiting and diarrea. Norovirus is a virus and no virus responds to antibiotics.
      I’m sorry if I offended you, it was never my intention.

      Reply

Add New Comment