75 clinics in 23 states in USA are monitoring their patients who received a spinal steroid injection for pain. They may be infected with a rare meningitis caused by a fungus. The name of the steroid is methylprednisolone acetate. The Calgary Herald’s Malcolm Ritter discusses the fact that there were (on October 8, 2012), at least two fungi linked to this unusual meningitis outbreak and they are Aspergillus and Exserohilum. Therapy is limited by the fact that very few anti-fungals penetrate the blood-brain barrier and researchers are working on more effective antifungals (see scientists below).
The causal fungi were contaminating the vials of the steroid produced and packed only by the New England Compounding Center in Massachussetts. Dr.John Jernigan, an epideomologist at the CDC, is leading the charge against these fungi. He has been quoted by various news sources stressing the fact that unlike bacterial meningitis, this is a very rare type of meningitis with little clinical research (PBS – a video recording, NY Times, Wall Street Journal). According to Huffington Post’s Amanda Chen, patients in Tennessee, Indiana, Florida, North Carolina, Maryland and Virginia have developed Meningitis. Dr. William Schaffner, President of the National Foundation of Infectious Disease said that the causal fungus is commonly found all around us, normally does not make people sick, but does cause an illness in some immunocompromised people like those with AIDS, and is not contagious.
Meningitis may be caused by fungi, bacteria or virus. To get this disease from a tainted vial is highly unusual. Needless to say, this steroid has been recalled immediately. By October 7, 2012 there were 18 confirmed deaths from fungal meningitis linked to tainted steroid back pain spinal injections says the local Detroit CBS news. Only those patients who sought relief for back pain with a steroid spinal injection July to September 2012 should be concerned. Senator Richard Blumenthal has called for extending the FDA’s monitoring authority, if necessary (Wall Street Journal)
The Centers For Disease Control and Prevention (CDC) USA, assures that fungal meningitis is not contagious. You may click here to reach the CDC site to learn about typical Fungal Meningitis. It talks about:
RISK FACTORS –
SIGNS AND SYMPTOMS
TREATMENT – usually IV medication and usually patients are immunocompromised already.
WHAT IS MENINGITIS?
The Tennessean has done such a wonderful job explaining this disease that you should probably click here to learn more about their explanations on:
What is meningitis and how many types are there?
What is Aspergillus Meningitis?
How is it diagnosed?
Should I go to the doctor for Aspergillus Meningitis?
Should I pursue other pain management options until this has been cleared?
THE DEDICATED SCIENTISTS WHO RESEARCH FUNGI THAT CAUSE MENINGITIS
Do email these scientists and encourage them to continue their research. Send them dolloar bills if you must, but mostly tell them you appreciate their contribution.
ASPERGILLUS FUMIGATUS – involved in the tainted steroid outbreak
CRYPTOCOCCUS NEOFORMANS – not involved in this 2012 outbreak
The Duke University’s mycology group studies several fungi that cause diseases of humans including Aspergillus. One of their researchers in the Division of Pediatric Infectious Diseases is Associate Professor William Steinbach. He is interested specifically in Aspergillus fumigatus because it is the leading killer of immunocompromised patients with cancer or following transplantation. You may write to him at: 427 Jones Bldg
Research Drive, Durham, N.C. 27710 or email him at firstname.lastname@example.org.
Texas A&M University has biologists who have recently discovered that ZOLOFT, a medication already FDA approved for and most commonly prescribed for depression, and can cross the blood-brain barrier, can pack quite the punch against Cryptococcus neoformans, a fungus that may cause meningitis. The two chief scientists who are working to discover anti-fungals against C. neoformans are Professor Mathew Sachs and Assistant Professor Xiaorong Lin and published in the July 2012 issue of the Journal of Antimicrobial agents and Chemotherapy, where they discuss how there are a limited number of anti-fungals today. Also, the fact that antifungals available today do not penetrate the blood-brain barrier thus complicating anti-fungal therapy. Their research so far is only in the lab but is promising. Sertraline or ZOLOFT acs by not allowing the fungi to synthesize proteins for their own use, thus destroying them. Address correspondence to Xiaorong Lin, email@example.com, or Matthew S. Sachs, firstname.lastname@example.org or you may write at Department of Biology, Texas A&M University, College Station, Texas, USA.