Community Health Issues

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Local Community Health Care Issues

Local Community Health Care Issues
The Centers for Disease Control and Prevention (CDC) has been working with state and public health departments on a multistate investigation concerning fungal meningitis and other infections among patients who received methylprednisolone acetate (MPA) injection, prepared by the New England Compound Center (NECC). As of November 19, 2012 a total of 490 cases, including 34 deaths have been reported in 19 states. The predominant fungus identified in patients and confirmed by the CDC laboratory is called Exserohilum rostratum. More than seven weeks after the recall of three lots of the steroid, CDC and FDA have confirmed the presence of a fungus known as Exserohilum rostratum [JPG - 183 KB] in unopened medication vials of preservative-free MPA from two of the three implicated lots (Lot #06292012@26, BUD12/26/2012 and Lot #08102012@51, BUD 2/6/2013). The laboratory confirmation further links steroid injections from these lots from NECC to the outbreak. Testing on the third implicated lot continues. The CDC continues to receive reports of the fungal infection in exposed patients. CDC and state health departments estimate that approximately 14,000 patients may have received injections with medication from the three implicated lots of methylprednisolone, and nearly 97% have now been contacted for further follow-up. Previously, the majority of new cases were patients with fungal meningitis following injection. The CDC has observed an increase in patients with symptoms of epidural abscess, phlegmon, discitis, vertebral osteomyelitis, or arachnoiditis near the site. These symptoms have been found in those with or without fungal meningitis. Of the 91 cases reported since November 4, 2012, a total of 26 were classified as meningitis, 61 has spinal or paraspinal epidural abscess, 2 had peripheral joint infection, and 2 had more than one condition. The CDC has recommended the following protocol:

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