Doctors in Central Florida are on alert and looking for fungal meningitis after two residents contracted the infection.
At most, thousands of people could be at risk as part of a nationwide outbreak that's left five people dead and sickened dozens of others. There are now 47 cases in six states in addition to Florida: Tennessee, Virginia, Maryland, North Carolina and Michigan.
According to the Florida Health Department, officials believe fungal meningitis, which is not transmitted from person to person, was contracted from a contaminated product shipped to facilities.
Officials said 8 facilities in Florida have been identified to have received the shipments from one or more of the CDC-identified contaminated lot numbers.
The facilities include:
- Florida Pain Clinic, Ocala, Fla.
- International Rehab Center, Pensacola, Fla.
- Marion Pain Management Center, Ocala, Fla.
- North County Surgicenter, Palm Beach, Fla.
- Orlando Center for Outpatient Surgery, Orlando, Fla.
- Pain Consultants of West Florida, Pensacola, Fla.
- Surgery Center of Ocala, Ocala, Fla.
- Surgical Park Center, Miami
Health officials are working with the facilities to determine if there are additional cases of the meningitis and have quarantined the medication, according to a release.
“Our department has asked the facilities to contact all patients who may have been treated with the implicated product to identify patients with neurological illness in need of testing and treatment,” said State Surgeon General and Secretary of Health Dr. John Armstrong. “Rest assured that this outbreak is not contagious and we will continue our work with all stakeholders to ensure that Florida’s residents and visitors are safe.”
Dr. Hendrix of Centra Care, an urgent care center in Sanford, said fungal meningitis is extremely deadly and hard to treat. There are only a few anti-fungal medications on the market.
"Usually, you don't see this type of overwhelming threat to health," said Dr. Hendrix.
Meningitis causes an infection to the membrane around the spinal cord and brain.
"Basically, that infection overwhelms the person," said Dr. Hendrix.
So far, there have been 35 cases in six states, including two cases in Marion County. There, a 65-year-old woman and an 87-year-old man were expected to recover.
Unlike viral and bacterial meningitis, fungal meningitis is not contagious.
Scientists with the Centers for Disease Control blame the outbreak on the New England Compounding Center in Framingham, Mass. The pharmacy apparently produced fungus-contaminated steroids, specifically Methylprednisolone Acetate, or prednisone.
"We use it. I probably give several injections a day in urgent care," said Hendrix.
But unlike at Centra Care, where people get prednisone shots for asthma or allergies into their muscles, people diagnosed with meningitis had a shot straight into their spine for back pain.
The pharmacy in question shipped some 17,000 doses across 23 states, including Florida, starting in July. None of the contaminated medicine was sent to Centra Care, but urgent care doctors are now trying to identify meningitis symptoms that can take up to four weeks to develop in patients.
"When somebody walks into an urgent care center and they say they got a headache and their neck hurts and they're throwing up, that's an immediate transfer to the hospital for a workup for meningitis," said Dr. Hendrix.
The medication linked to the outbreak was recalled last week, but the CDC has asked health care providers to stop using all drugs from the New England Compounding Center and to contact any patient who received the contaminated medication.
Several companies manufacture Methylprednisolone Acetate, so patients who are unsure whether they received the contaminated doses are urged to call their health care provider.
The lots of medication that were used on infected patients are:
- Methylprednisolone Acetate (PF) 80 mg/ml Injection, Lot #05212012@68, BUD 11/17/2012
- Methylprednisolone Acetate (PF) 80 mg/ml Injection, Lot #06292012@26, BUD 12/26/2012
- Methylprednisolone Acetate (PF) 80 mg/ml Injection, Lot #08102012@51, BUD 2/6/2013
Infected patients have shown symptoms approximately one to four weeks following their injection. The symptoms include fever, new or worsening headache, nausea, and/or new symptoms consistent with a stroke. Some of the patients’ symptoms were very mild.