The CDC reported Tuesday that eleven deaths and 119 cases of fungal meningitis have now been identified as related to contaminated epidural steroid shots. The number is likely to rise, since approximately 13,000 patients in 75 clinics in 23 states are reported to have received injections with the contaminated steroid preparation to their joints and spine to treat pain and inflammation. Fortunately this type of meningitis is not contagious person to person like the common bacterial and viral types often seen in schools and colleges.
While the CDC says it cannot yet determine the original source of the outbreak, there is a link to an injectable steroid medication. Lots of medication given to patients have been recalled by the New England Compounding Pharmacy in Framingham, Massachusetts. A common fungus or mold called aspergillus fumigatus, the same blue-green or gray colored mold we sometimes see on decaying leaves or old bread or potatoes, was identified growing in several lots of the prepared vials of injectable steroids. As a result, patients receiving spinal injections are developing fungal meningitis. Symptoms may appear up to a 45 days or so after the injection. Not all of those who received the injections will become sick. The meningitis can be treated successfully with anti-fungal drugs.
The CDC and FDA were quick to identify the origin of the problem and at risk clinics, limiting the fear and panic and initiating proper treatment to those affected. The safety and standards of compounded drugs like these steroid injections is governed by each state board of pharmacy and not the federal government. Hopefully, the number of cases will level off and stop but an investigation into the inspection and safety standards of each state is needed to protect us all as patients from a healthcare system filled with risk.
Each year in the U.S. unintended errors and hospital infections kill and injure more people than the combined yearly fatalities and injuries of car accidents, plane crashes, and soldiers on the battlefield! Sadly this means that the U.S. healthcare system is a leading cause of death, right behind heart disease, cancers, and strokes.
Better safety standards and controls are desperately needed!
—Joseph Mosquera, M.D.