Outbreak of Fungal Meningitis and Other Infections

Virginia Department of Health is working with the Centers for Disease Control (CDC) and Prevention and other states on a multi-state investigation of meningitis and strokes in patients who received spinal injections. Virginia cases counts are updated weekly and information on national cases can be viewed by visiting the CDC, http://www.cdc.gov/HAI/outbreaks/meningitis.html.

Case Counts Last Updated May 13, 2013

All infected patients received preservative-free methylprednisolone acetate among three lots which have been voluntarily recalled by the New England Compounding Center, in Framingham, Massachusetts. VDH is working closely with Insight Imaging in Roanoke and New River Valley Surgery Center in Christiansburg to assist the 680 patients who received this medication via injection between June 28, 2012 and September 26, 2012. The manufacturer has recalled the implicated lots of the medication and the product is no longer being used.

Patients who had spinal injection procedures at these two facilities are being asked if they developed any new symptoms since their spinal injection. If they develop any new or worsening symptoms, patients should seek immediate evaluation and let a physician know about this investigation and the concern for possible infection. Symptoms of concern are new or worsening headache, fever, localized weakness, falls, difficulty walking, slurred speech or other symptoms that may suggest a stroke. Other symptoms may also include redness, heat, pain or discharge at the site of injection, pain or numbness in one or both legs, or changes in urination or bowel function.

If you have questions or concerns that you may be experiencing illness after receiving a spinal injection, please contact your health care provider.

For more information, contact your local health department or 211.

Updated Guidance and Best Practices
Investigation of Meningitis and Stroke after Spinal Injections, 2012

• Virginia Clinicians' Letter: Meningitis and Stroke Associated with Contaminated Product (March 22, 2013)
• Virginia Clinicians' Letter: Meningitis and Stroke Associated with Contaminated Product (March 7, 2013)
• Virginia Clinicians' Letter: Meningitis and Stroke Associated with Potentially Contaminated Product (Oct 1, 2012)
• Update: Fungal Infections Associated with Contaminated Product and CDC Recommendations Regarding Magnetic Resonance Imaging (Dec 21, 2012)
• Virginia Clinicians' Letter: Meningitis Investigation Update (Dec 19, 2012)
• Virginia Clinicians' Letter: Update on Fungal Meningitis Associated with Contaminated Product (Nov 28, 2012)
• Epidemiology Update: Fungal Infections Associated with Contaminated Product
• Clinician Guidance from the CDC (last updated Nov 21, 2012)
• FDA Statement on Fungal Meningitis Outbreak: Additional Patient Notification Advised (last updated Nov 1, 2012)
• Virginia Clinicians' Letter: FDA MedWatch Update (Oct 17, 2012)
• Virginia Clinicians' Letter: Update on Fungal Meningitis Associated with Contaminated Product (Oct 25, 2012)
• Epidemiology Update: Fungal Meningitis (Oct 25, 2012)
• Virginia Clinicians' Letter: Meningitis and Stroke Associated with Potentially Contaminated Product (Oct 12, 2012)
• Virginia Clinicians' Letter: Update on Fungal Meningitis Associated with Potentially Contaminated Product (Oct 7, 2012)
• Virginia Clinicians' Letter: Meningitis and Stroke Associated with Potentially Contaminated Product (Oct 5, 2012)

Additional Information:

• CDC Multistate Meningitis Outbreak
• FDA Statement on Fungal Meningitis Outbreak
• VDH – Frequently Asked Questions About Meningitis Associated with Epidural Spinal Updated: Oct 10, 2012