Fatal outbreak of meningitis in the United States

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Medicinal product contaminated with fungi Caused numerous meningitis?

In the United States, numerous patients have contracted meningitis, which was apparently caused by a drug contaminated with fungi. The responsible health authorities of the Center for Disease Control and Prevention (CDC) have already recorded seven deaths due to severe meningitis.

According to previous investigations, all affected patients had received an analgesic injection into the spinal canal before their illness. This so-called epidural injection of steroids is therefore considered the likely trigger of meningitis. Because meningitis was caused by a fungus in some patients, the authorities assume that the drug is contaminated. Fortunately, this fungus-related form of meningitis is not contagious. Nevertheless, the CDC experts fear a massive increase in diseases in the coming weeks. Some US physicians even assume more than 30,000 patients.

Injection of pain reliever triggers meningitis?
To date, 64 cases of meningitis from a total of nine states have been reported to the CDC. Seven patients died as a result of the illness. Given the fact that the suspected drugs were delivered to 23 states, the number of cases is expected to increase further, the U.S. health agency estimates. Although the numbers of US scientists on the news channel “CNN” may appear to be somewhat excessive with a possible 34,000 victims, they illustrate the extent to which the situation can take on. So far, "there is not yet enough evidence to determine the original source of the outbreak, but a link to injectable steroid medication is suspected," the CDC said. The drugs injected directly into the spinal canal are believed to come from a Massachusetts pharmaceutical company. The manufacturer recalled the medication and temporarily stopped producing it.

Meningitis due to fungal infection?
If bacteria, viruses or fungi get into the spinal canal, they can spread easily through the spinal fluid (cerebrospinal fluid) and cause inflammation of the protective skins in the brain and spinal cord (meninges). Injections into the spinal canal therefore always involve a certain risk. According to the CDC, meningitis is rarely caused by an infection with fungi, but this seems to be the case with the current wave of diseases. The so-called fungal meningitis, in which "the protective membranes that cover the brain and spinal cord are infected with a fungus", has already been detected in several affected people, the CDC experts report.

Possible signs of meningitis
Possible concerns about a general risk of infection due to epidural injections weakened the CDC by pointing out that these are "as a rule very safe procedures and complications rare". Also, the type of suspected epidural agent is not the same type of medication as some women are injected into the spinal canal during childbirth, the U.S. health agency said. The CDC experts describe headache, fever, neck stiffness, nausea and vomiting as typical symptoms of meningitis. "People with fungal meningitis also experience symptoms such as confusion, dizziness and discomfort when the lights are bright," according to the Centers for Disease Control and Prevention. All potentially affected patients are encouraged to report to a doctor urgently. (fp)

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Author and source information

Video: February 2019 ACIP Meeting - Meningococcal Vaccines


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