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Published Date: 2012-10-10 14:16:01
Subject: PRO/EDR> Aspergillus meningitis - USA (07)
Archive Number: 20121010.1333926

ASPERGILLUS MENINGITIS - USA (07)
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Date: Tue 9 Oct 2012
Source: CDC [edited]
http://www.cdc.gov/HAI/outbreaks/meningitis.html

Current situation
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The Centers for Disease Control and Prevention (CDC) is aware that New England Compounding Center (NECC) has voluntarily expanded its recall to include all products currently in circulation that were compounded at and distributed from its facility in Framingham, Massachusetts.

CDC's guidance to patients has not changed as a result of this voluntary recall. Patients who feel ill and are concerned about whether they received a medication from NECC at one of the affected facilities should contact their physicians.

Clinicians should actively contact patients who have received medicines associated with 3 lots of preservative-free methylprednisolone acetate (80mg/ml) recalled on 26 Sep 2012. The potentially contaminated injections were given starting 21 May 2012.

Patients have had symptoms generally starting from 1 to 4 weeks after their injection. Not all patients who received the medicine will become sick. Symptoms that should prompt patients to seek medical care include: fever, new or worsening headache, neck stiffness, sensitivity to light, new weakness or numbness, increasing pain, redness or swelling of the injection site.

At-a-glance
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Status: ongoing investigation
Infection: fungal meningitis
Facility type: outpatient setting
Case count: 119
States: 10
Deaths: 11

A map of the outbreak by state can be found at http://www.cdc.gov/hai/outbreaks/meningitis-map.html:
State / Case count / Deaths
Florida / 4 / 0
Indiana / 12 / 0
Maryland / 8 / 1
Michigan / 25 / 3
Minnesota / 3 / 0
New Jersey / 1 / 0
North Carolina / 2 / 0
Ohio / 1 / 0
Tennessee / 39 / 6
Virginia / 24 /1
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TOTALS: 119 cases with 11 deaths. Case fatality rate: 9.2 per cent

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[It would be useful to know the date of administration of the contaminated corticosteroid and the date of initial onset of symptoms as well as the cell count, chemistries and time to positive culture in documented cases. As well, the species of _Aspergillus_ mold and the number of cases with _Exserohilum_ species has not been reported.

Related to the date of reporting (not date of onset), the number of cases, number of states involved and deaths is:

Date of report / Cases / States / Deaths
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2 Oct 2012 / 12 / 2 / 2
4 Oct 2012 / 26 / 5 / 4
5 Oct 2012 / 35 / 5 / 5
6 Oct 2012 / 64 / 9 / 7
7 Oct 2012 / 91 / 9 / 7
8 Oct 2012 / 101 / 9 / 8
9 Oct 2012 / 119 / 10 / 11

The scope of this outbreak is yet to be determined. - Mod.LL

A HealthMap/ProMED-mail map can be accessed at: http://healthmap.org/r/1hiS.]

See Also