A daily chronicle of ongoing events pertaining to infectious diseases
Friday, October 5, 2012
Multistate Meningitis Outbreak Investigation
October 5, 2012
CDC is coordinating a multistate investigation of meningitis
among patients who received epidural steroid injections (medication
injected into the spine). Several of these patients have had strokes
related to the meningitis. In several patients, the meningitis was
found to be caused by a fungus that is common in the environment but
rarely causes meningitis. This form of meningitis is not contagious.
The source of the fungus has not yet been identified, and the cause of
infections in the other patients is still being assessed.
Patient 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.