Atlanta, GA?(ENEWSPF)--October 9, 2012 10:45 AM EDT
At-A-Glance
Current Situation
- CDC is aware that New England Compounding Center (NECC) has voluntarily expanded its recall to include all products currently in circulation that were compounded at and distributed from its facility in Framingham, Massachusetts.
- CDC's guidance to patients has not changed as a result of this voluntary recall. Patients who feel ill and are concerned about whether they received a medication from NECC at one of the affected facilities should contact their physicians.
- Clinicians should actively contact patients who have received medicines associated with three lots of preservative-free methylprednisolone acetate (80mg/ml) recalled on September 26. The potentially contaminated injections were given starting May 21, 2012.
- Patients have had symptoms generally starting from 1 to 4 weeks after their injection. Not all patients who received the medicine will become sick. Symptoms that should prompt patients to seek medical care include: fever, new or worsening headache, neck stiffness, sensitivity to light, new weakness or numbness, increasing pain, redness or swelling of the injection site.
CDC Responds to Multistate Meningitis Outbreak:
The Centers for Disease Control and Prevention (CDC) and the Food and Drug Administration (FDA) are currently coordinating a multistate investigation of fungal meningitis among patients who received an epidural steroid injection with a potentially contaminated product. This form of meningitis is not contagious. Several of these patients also suffered strokes that are believed to have resulted from their infection.
General Information:
Is the source of the outbreak known?
CDC is investigating medications and products that are associated with this outbreak of meningitis. At this point, there is not enough evidence to determine the original source of the outbreak, however there is a link to an injectable steroid medication.? The lots of medication that were given to patients have been recalled by the manufacturer.
What are the states that received the implicated product?
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
What is meningitis?
Meningitis refers to inflammation of the protective membranes covering the brain and spinal cord known as the meninges. The inflammation is usually caused by an infection?frequently with a bacteria or virus, but meningitis can also be caused by less common pathogens such as fungi. The severity of illness and the treatment for meningitis differ depending on the cause. Thus, it is important to know the specific cause of meningitis.
What is fungal meningitis?
Fungal meningitis occurs when the protective membranes that cover the brain and spinal cord are infected with a fungus.? Fungal meningitis can develop after a fungus spreads through the bloodstream from somewhere else in the body, as a result of the fungus being introduced directly into the central nervous system, or by direct extension from an infected body site next to the central nervous system. ?
Is fungal meningitis common after epidural injections?
Epidural injections are generally very safe procedures, and complications are rare.? Fungal meningitis is an extremely rare cause of meningitis overall, including after epidural injections. The type of epidural medication given to patients affected by this outbreak is not the same type of medication as that given to women during childbirth.
What are the symptoms of fungal meningitis?
Symptoms of fungal meningitis are similar to symptoms of other forms of meningitis, however they often appear more gradually and can be very mild at first. ?In addition to typical meningitis symptoms, like headache, fever, nausea, and stiffness of the neck, people with fungal meningitis may also experience confusion, dizziness, and discomfort from bright lights. Patients might just have one or two of these symptoms.
Multi-State Meningitis Outbreak - Current Case Count
October 8, 2012 2:00 PM EDT
Persons with Meningitis Linked to Epidural Steroid Injections, by State
Persons by State with Meningitis Linked to Epidural Steroid Injections, as of October 8, 2012
| State | Case Count | Deaths |
|---|---|---|
| Florida (FL) | 4 | |
| Indiana (IN) | 11 | |
| Maryland (MD) | 5 | 1 |
| Michigan (MI) | 21 | 2 |
| Minnesota (MN) | 3 | |
| North Carolina (NC) | 2 | |
| Ohio (OH) | 1 | |
| Tennessee (TN) | 35 | 4 |
| Virginia (VA) | 23 | 1 |
| TOTALS | 105 | 8 |
Map of Healthcare Facilities which Received Three Lots* of Methylprednisolone Acetate (PF) Recalled from New England Compounding Center on September 26, 2012
October 8, 2012 5:45 PM EDT
*?Lot #05212012@68, BUD 11/17/2012; Lot #06292012@26, BUD 12/26/2012; Lot #08102012@51, BUD 2/6/2013
**?All vials of Methylprednisolone Acetate that were sent to Nevada were recalled prior to use.
List of Healthcare Facilities which Received Lots of Methylprednisolone Acetate (PF) Recalled from New England Compounding Center on September 26, 2012
| CYPRESS SURGERY CENTER DBA | 559 740 4094 | VISALIA | CA |
| ENCINO OUTPATIENT SURGICENTER | 818-986-1037 | ENCINO? | CA |
| UKIAH VALLEY MEDICAL CENTER | 707 463 7345 | UKIAH | CA |
| UNIVERSAL PAIN MANAGEMENAT | 661-267-6876 x166 | PALMDALE | CA |
| INTERVENTIONAL SPINE AND SPORTS MED | 203 598 7246 | MIDDLEBURY | CT |
| FLORIDA PAIN CLINIC | 352-237-5906 | OCALA | FL |
| INTERVENTIONAL REHAB CENTER | 850 484 8800 | PENSACOLA | FL |
| MARION PAIN MANAGEMENT CENTER | 352 622 1845 | OCALA | FL |
| NORTH COUNTY SURGICENTER | 561 626 6446 | PALM BEACH GARDENS | FL |
| ORLANDO CENTER FOR OUTPATIENT SURGERY | 407-426-8331 | ORLANDO | FL |
| PAIN CONSULTANTS OF WEST FLORIDA | 850 494 0000 | PENSACOLA | FL |
| SURGERY CENTER OF OCALA | 352-237-5906 | OCALA | FL |
| SURGICAL PARK CENTER | 305-271-9100 x226 | MIAMI | FL |
| FORSYTH STREET AMBULATORY SURG. CTR. | 478-749-1610 | MACON | GA |
| PAIN SPECIALISTS OF IDAHO | 208 522 7246 | IDAHO FALLS | ID |
| WALTER KNOX MEMORIAL HOSPITAL | 208-365-3561 x3342 | EMMETT | ID |
| APAC CENTERS FOR PAIN MANAGEMENT | 708-483-7007 | WESTCHESTER | IL |
| APAC CENTERS FOR PAIN MANAGEMENT- | 773-935-2760 | CHICAGO | IL |
| THOREK MEMORIAL HOSPITAL | 773 975-6734 | CHICAGO | IL |
| AMBULATORY CARE CENTER LLC | 812 475 1800 | EVANSVILLE | IN |
| FORT WAYNE PHYSICAL MEDICINE | 260-436-9337 | FORT WAYNE | IN |
| OSMC OUTPATIENT SURGERY CENTER | 574-266-4173 | ELKHART | IN |
| SOUTH BEND CLINIC | 574-237-9372 | SOUTH BEND | IN |
| UNION HOSPITAL-- | 812 238 4964 | TERRE HAUTE | IN |
| WELLSPRING | 812-376-0700 | COLUMBUS | IN |
| BALTIMORE PAIN MANAGEMENT | 410 682-5040 | BALTIMORE | MD |
| BERLIN INTERVENTIONAL PAIN MANAGEMENT | 410 641 3759 | BERLIN | MD |
| BOX HILL SURGERY CENTER | 410 877 8141 | ABINGDON | MD |
| GREENSPRING SURGERY CENTER | 410 653 0077 | BALTIMORE | MD |
| HARFORD COUNTY ASC, LLC | 410 538 7000 | EDGEWOOD | MD |
| PAIN MEDICINE SPECIALISTS | 410 825 6945 | TOWSON | MD |
| SURGCENTER OF BEL AIR | 410 638 5523 | BEL AIR | MD |
| MICHIGAN NEUROSURGICAL INST. | 810 606 7112 | GRAND BLANC | MI |
| MICHIGAN PAIN SPECIALISTS | 734 995 7246 | BRIGHTON | MI |
| NEUROMUSCULAR & REHABILITATION | 231 935 0860 | TRAVERSE CITY | MI |
| SOUTHEAST MICHIGAN SURGICAL HOSPITAL | 586-427-1000 | WARREN | MI |
| MAPS-EDINA MEDICAL PAIN CLINIC | 763 537 6000 | MINNEAPOLIS | MN |
| MAPS-MEDICAL ADVANCED PAIN | 763 537 6000 | FRIDLEY | MN |
| MEDICAL ADVANCED PAIN SPECIALISTS* | 763-537-6000 x238 | SHAKOPEE | MN |
| MEDICAL ADVANCED PAIN SPECIALISTS. | 763 537 6000 | MAPLE GROVE | MN |
| MINNESOTA SURGERY CENTER | 763-767-7139 | EDINA | MN |
| MINNESOTA SURGERY CENTER- | 763 537 6000 | MAPLE GROVE | MN |
| HIGH POINT SURGERY | 336 878 6048 | HIGH POINT | NC |
| NORTH CAROLINA ORTHOPAEDIC CLINIC | 919 403 5148 | DURHAM | NC |
| SURGERY CENTER OF WILSON | 252-237-5649 | WILSON | NC |
| DR. O'CONNELL'S PAIN CARE CTR | 603-335-5070 | MERRIMACK | NH |
| DR. O'CONNELL'S PAINCARE CENTERS, INC | 603 692 3166 | SOMERSWORTH | NH |
| CENTRAL JERSEY ORTHOPEDICS SPECIALISTS PC | 908 561 2122 | SOUTH PLAINFIELD | NJ |
| EDISON SURGICAL CENTER | 732 452 0123 | EDISON | NJ |
| IF PAIN ASSOCIATES / ISAIAH FLORENCE | 201 287 1100 | TEANECK | NJ |
| PREMIER ORTHOPEDICS SURG. ASSOC., LLC | 856 690 1750 | VINELAND | NJ |
| Comprehensive Pain Management | 973 796 5216 | SPARTA | NJ |
| SOUTH JERSEY HEALTH CARE | 856 363 1558 | ELMER | NJ |
| SOUTH JERSEY HEALTHCARE | 856-641-7557 | VINELAND | NJ |
| SAHARA SURGERY CENTER | 702-362-7874 | LAS VEGAS | NV |
| BUTANI, SUNIL H. PHYSICIAN PC | 516 747 5042 | MINEOLA | NY |
| OBOSA MEDICAL SERVICES | 914-530-2323 | MOUNT VERNON | NY |
| ROCHESTER BRAIN AND SPINE | 585 334 5560 | ROCHESTER | NY |
| BKC PAIN SPECIALISTS,LLC | 740-387-7246 | MARION | OH |
| CINCINNATI PAIN MANAGEMENT | 513 891 0022 | CINCINNATI | OH |
| MARION PAIN CLINIC | 740-375-0200 | MARION | OH |
| ORTHO-SPINE REHAB. CENTER, INC. | DUBLIN | OH | |
| ALLEGHENY PAIN MANAGEMENT | 814-940-2000 | ALTOONA | PA |
| SOUTH HILLS PAIN & REHAB ASSOC. | 412 469 7722 | JEFFERSON HILLS | PA |
| NEW ENGLAND ANESTHESIOLOGY (NEA) | 401-490-7530 | WARWICK | RI |
| OCEAN STATE PAIN MANAGEMENT | 401 766 7700 | WOONSOCKET | RI |
| OCEAN STATE PAIN MANAGEMENT- | 401 884 6070 | EAST GREENWICH | RI |
| INTERVENE MD | 843-216-4844 | MOUNT PLEASANT | SC |
| PCA PAIN CARE CENTER- | 865 835 5196 | OAK RIDGE | TN |
| SPECIALTY SURGERY CENTER | 931-484-2500 x125 | CROSSVILLE | TN |
| ST. THOMAS OUTPATIENT NEUROSURGIACL | 615 341 3433 | NASHVILLE | TN |
| DALLAS BACK PAIN MANAGEMENT | 214 445 5077 | DALLAS | TX |
| HARRIS METHODIST SOUTHLAKE CENTER | 817 748 8778 | SOUTHLAKE | TX |
| INSIGHT IMAGING-ROANOKE | 540 581 0882 | ROANOKE | VA |
| NEW RIVER VALLEY SURGERY CENTER | 540 639 5888 | CHRISTIANSBURG | VA |
| PARS INTERVENTIONAL PAIN | 304 865 7277 | PARKERSBURG | WV |
Source: cdc.gov
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