NH Confirms 2 More Cases of Fungal Meningitis

The  New Hampshire Department of Health and Human Services, Division of Public Health Services announced today that it has confirmed two additional cases related to the national outbreak of fungal meningitis associated medications produced by New England Compounding Center of Framingham, Mass. The first four confirmed cases in New Hampshire were announced over the weekend and the latest two bring the total number here to six. These two new patients are under care and are not hospitalized, according to the DHHS.

It was announced had used some of the tainted epidurals to treat patients. for people who received who received a different form of injection. New Hampshire's first four cases were found in three men and one woman, all between the ages of 40 an 60.

The medication initially believed to be linked to the illnesses here in New Hampshire and nationwide are three lots of methylprednisolone acetate used for injections for pain management. Monday, the Food and Drug Administration announced possible meningitis potentially associated with epidural injection of an additional NECC product, triamcinolone acetonide, has been identified. Triamcinolone acetonide is a type of steroid injectable product made by NECC. Also, one transplant patient with Aspergillus fumigatus infection who was administered NECC cardioplegic solution during surgery has been reported, according to the DHHS press release. Cardioplegic solution is used to induce cardiac muscle paralysis during open heart surgery to prevent injury to  the heart. The FDA is working with the Centers for Disease Control and Prevention and the states affected to get information out to clinicians and patients about these new developments.
 
To date, 15 states have reported 214 cases including 15 deaths.

NECC  has voluntarily recalled all products it produced since January 2012. but to hold onto them in the instance that they are need for sample. A complete list of over 1,200 drugs compounded by NECC is available for review, but at the current time, only three have been implicated as potentially causing infection.

“The  specifics  of  this  outbreak investigation are constantly changing,” said New  Hampshire’s Public Health Director Dr. José Montero. “As new information  becomes available, our team is working to adapt our strategies accordingly, all with the primary mission of reaching the affected patients as soon as  possible  and making sure they receive care. Our thoughts are with  these  patients and their families as they deal with this complex and upsetting situation.”

DPHS is working with Pain Care, LLC to ensure that all patients potentially exposed are notified. At last count that number was up to more than 740 patients.

Patients diagnosed with this infection as part of this outbreak are at risk for fungal meningitis, epidural abscess, stroke or joint symptoms associated with the injected medication. The investigation remains active and information on cases continues to be gathered to understand the extent of this outbreak.

There are many different types of meningitis, a general term for an infection or inflammatory process involving the lining of the brain and central nervous system.

The cases under investigation have no relation to the much more common forms of bacterial or viral meningitis. This particular form of meningitis cannot be passed from person to person, but can be very serious, even fatal. Symptoms to be aware of include: headache, fever, nausea, stiff neck and sensitivity to light and in this type of meningitis symptoms may be or have been mild in some cases.

The CDC is recommending that patients who feel ill with the above symptoms or have weakness or numbness in any part of the body or slurred speech after receiving this medication should contact their healthcare provider. Also patients who received injection of the medication to joints should report to their provider if they have local symptoms including increased pain, redness or warmth at the site of the injection.

For more information, visit the CDC website at www.cdc.gov/hai the DHHS
website at www.dhhs.nh.gov or call the DPHS Bureau of Infectious Disease
Control at 603-271-4496.