Tainted pain relief injection results in fungal meningitis infections

Three dead in Michigan, 14 nationally

By: Chris Jackett | C&G Newspapers | Published October 17, 2012

LANSING — The Michigan Department of Community Health said 1,900 state residents have been given potentially tainted steroid injections, but the damage won’t be known until the end of the month.

Prepared by the New England Compounding Center in Framingham, Mass., the preservative-free methylprednisolone acetate was designed to relieve pain, but has instead resulted in 39 known infections and three deaths resulting from fungal meningitis, as of Oct. 11.

Meningitis is an inflammation of the protective membranes covering the brain and spinal cord. According to the Centers for Disease Control and Prevention, there had been 170 cases and 14 deaths between 11 states, as of Oct. 11.

“These injections were given to reduce pain,” said Angela Minicuci, MDCH public information officer. “It’s a very common procedure, it’s just that these three lots were potentially contaminated.”

Minicuci said the problem was first discovered in Tennessee at the end of September. On Sept. 25, the NECC recalled the three lots of methylprednisolone acetate and, on Oct. 3, the NECC ceased all production and initiated a recall of all methylprednisolone acetate and other drug products prepared for injection into the membrane surrounding the brain or spinal cord.

“They were able to trace out that 23 states, including Michigan, had received these lots,” Minicuci said. “We had these (injections) administered from the end of May to the beginning of October. There were about 1,900 individuals who received these injections in Michigan. All of the patients have been contacted and notified.”

The four Michigan facilities that were unknowingly injecting tainted product includes Southeast Michigan Surgical Hospital in Warren, Michigan Pain Specialists in Brighton, Michigan Neurosurgical Institutes in Grand Blanc and Neuromuscular and Rehabilitation Associates of Northern Michigan in Traverse City.

“Somewhere along the way, this got contaminated,” said Dr. Matthew Sims, director of Infectious Disease Research at Beaumont Hospital in Royal Oak. “Steroids decrease inflammation. There have been two cases in Michigan, I know, that were infections that were not meningitis. At this point, I’m not sure if there’s one or two fungi involved.”

The three Michigan deaths from fungal meningitis were a 56-year-old Genesee County woman, a 67-year-old Livingston County woman and a 78-year-old Washtenaw County woman.

Sims said no cases had been diagnosed at Beaumont as of Oct. 12, and that the Beaumont Centers for Pain Medicine purchases steroid medications directly from a pharmaceutical manufacturer.

“These sort of things do happen on occasion, but there are measures in place to keep them from happening,” Sims said. “It’s just tragic, of course, that this has happened. I’m glad the company is cooperating and everything that can be done is getting done.”

Minicuci said that, although 1,900 people received the injection, those feeling the effects may not exhibit symptoms until between one and four weeks after the injection, meaning those who received injections will not be in the clear until the end of October.

Those receiving the injection in a joint are not expected to be at risk. However, those receiving an epidural injection in the spinal membrane could experience symptoms, such as “fever, new or worsening headache, neck stiffness, sensitivity to light and/or a new neurological deficit, such as weakness or numbness consistent with deep brain stroke.”

“If they received the injection as a joint injection, they cannot get meningitis,” Minicuci said. “They can only get it if they received the injection as an epidural, which is an injection into the membrane on the spine. This is not a form of meningitis that’s transferable from human to human.”

Anyone experiencing symptoms is asked to contact their physician or seek medical attention.

For more information, visit www.michigan.gov/mdch, www.michigan.gov/emergingdiseases or www.cdc.gov/hai/outbreaks/meningitis. html.