WebMD Medical News
Daniel J. DeNoon
Louise Chang, MD
Oct. 9, 2012 – About 13,000 people in 23 states got the fungus-contaminated steroid pain shots in the ongoing outbreak of fungal meningitis.
So far, 119 people who got the shots have come down with fungal infections of the fluid surrounding their spinal cords and brains.
Eleven of those people have died. The case count rises daily, as symptoms of fungal infection can take up to a month to appear, and there's often a delay in case reporting.
Most of the 13,000 who got the tainted shots will not get the infection, suggests John Jernigan, MD, director of the CDC's office of health care infection prevention, research, and evaluation.
"The attack rate is still to be determined, but so far it appears that the vast majority of patients who received the injection have not developed evidence of meningitis," Jernigan says in an email. "But the investigation is ongoing, and exposed patients and their physicians should be vigilant for signs of illness."
All of the fungal infections to date have been in patients who received spinal injections. Some of the patients who received the contaminated steroids got shots in painful joints such as the knee or elbow. To date, none of these patients has reported a fungal infection.
The source of the outbreak is a compounding pharmacy called New England Compounding Center (NECC). The company makes more than 2,400 different medicines sold throughout the U.S. All have been recalled.
All cases so far have been in patients who received one of 17,676 single-shot vials of a steroid, methylprednisolone, since May 21, 2012. An FDA investigation of the NECC facility, including studies of whether other medications might be contaminated, is ongoing.
There haven't yet been any reports of fungal infection in patients who got joint injections of the NECC steroids. Even so, the CDC is warning such patients to be on the lookout for symptoms of fungal infection:
Patients who have such symptoms should see a doctor for further tests. Doctors likely will collect joint fluid to test it for fungal infection.
If you suspect you may have received a dose of contaminated medicine, contact the health provider who gave it to you. Ask if the medication came from NECC. All NECC products carry the NECC logo.
Clinics that gave the suspect shots are contacting all patients to warn them to look out for symptoms. Symptoms may appear one to four weeks after getting a pain injection.
For patients who got spinal injections, early symptoms may be very mild. At first, most patients only feel a little worse than usual. For example, patients with back pain may feel slightly worse pain, or slightly more weakness.
The CDC warns patients who have had a spinal steroid shot since May 21, 2012, to call a doctor immediately if they have any of these symptoms:
Treatment of fungal meningitis is complicated. Antifungal drugs must be given intravenously, every day. At least at first, patients should be treated in a hospital.
Treatment often lasts for several months, and can have serious side effects.
As of Oct. 9, the CDC reports deaths and cases in these states:
SOURCES:Curtis Allen, public information officer, CDC, email interview.CDC web site.FDA web site.David Kibbe, public information officer, Massachusetts Department of Health.