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CDC Responds to Multistate Meningitis Outbreak

On Behalf of | Nov 7, 2012 | Fungal Meningitis

The Centers for Disease Control and Prevention (CDC) and the  Food and Drug Administration (FDA) are currently coordinating a multistate  investigation of fungal infection among patients who received a steroid  injection with a potentially contaminated product either into the spinal area or  in a joint space, such as a knee, shoulder or ankle.

CDC and  FDA have confirmed the presence of a fungus known as Exserohilum rostratum in unopened medication vials of  preservative-free methylprednisolone acetate (80mg/ml) from one of the three  implicated lots from NECC (Lot #[email protected], BUD 2/6/2013).  The laboratory confirmation further links  steroid injections from these lots from NECC to the multistate outbreak of  fungal meningitis and joint infections.   Testing on the other two implicated lots of methylprednisolone acetate  and other NECC injectable medications continues. Of the 47  patients with laboratory confirmed fungal meningitis as of October 17, 2012, Exserohilum  rostratum has been found in clinical specimens for all but two  patients.  Of the other two patients, one  has been found to be infected with Aspergillus fumigatus and one with Cladosporium.

Clinicians  should continue to contact patients who have received medicines associated with the following three lots of  preservative-free methylprednisolone acetate (80mg/ml) from the New England  Compounding Center (NECC) that were recalled on September 26, 2012.

  • Methylprednisolone  Acetate (PF) 80 mg/ml Injection, Lot #[email protected], BUD 11/17/2012
  • Methylprednisolone Acetate (PF) 80 mg/ml  Injection, Lot #[email protected], BUD 12/26/2012
  • Methylprednisolone Acetate (PF) 80 mg/ml  Injection, Lot #[email protected], BUD 2/6/2013

The potentially contaminated injections were given starting  May 21, 2012. See updated Clinician  Guidance webpage for more information.

CDC’s  guidance to patients has not changed as a result of the expanded voluntary  recall of all NECC products, announced on October 6, 2012.

Patients  who believe they might have received a potentially contaminated medication should contact the  physician who performed their procedure to find out if their medication was  from one of the three lots.

Patients  who received a  potentially contaminated medication should seek medical attention if they have  any symptoms.

Patients need to remain vigilant for onset of symptoms because fungal infections can be slow to develop. Typically in this outbreak,  symptoms have appeared 1 to 4 weeks following injection, but it’s important to  know that longer and shorter periods of time between injection and onset of symptoms have been reported. Therefore, patients and physicians need to closely watch  for symptoms for at least several months following the injection. For more  information, see updated Patient  Guidance.


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