The Indiana State Health Department reports that three Hoosiers have tested positive for fungal meningitis after receiving a recalled back pain medication linked to a deadly nationwide outbreak, which has killed four and sickened nearly 50 people across the country.
Six Indiana health facilities in Elkhart, Evansville, Fort Wayne, South Bend, Terre Haute and Columbus have received batches of the medication that was recently recalled by New England Compounding Center, a specialty pharmacy in Massachusetts, which sent out more than 17,000 doses of the recalled steroid shot for back pain to facilities in 23 states.
“There are some people who do specialized compounding, but I don’t know that they do anything on this scale,” said Lawrence Sage, executive vice president of the Indiana Pharmacists Alliance.
According to the International Academy of Compounding Pharmacists, less than half of the compounding community pharmacies in the country provide sterile compounding. In Indiana, about 500 facilities have permits to do sterile compounding, but not all of them with permits do so.
In the meantime, the Centers for Disease Control and Prevention (CDC) and the Food and Drug Administration are coordinating a multi-state investigation of meningitis among patients who had received epidural steroid injection. Many of these patients have also had strokes that are believed to have resulted from their infection.
The CDC reports that 47 people in seven states, including Indiana, Tennessee, Michigan, Virginia, Maryland, Florida and North Carolina have contracted the hard-to-treat fungal meningitis, and five of them have died. All had received steroid shots for back pain, a highly common treatment.
The Indiana State Department of Health has instructed physicians and other healthcare providers to call patients who have had any injection (e.g., spinal, joint) containing preservative-free methylprednisolone acetate prepared by New England Compounding Center.
“Our phone has been ringing off the hook. Patients are calling. Of course they’re concerned,” said Paulette Fry, practice manager at Wellspring Pain Solutions in Columbus, about 40 miles south of Indianapolis. She said the clinic was sending a letter to about 300 patients who received spinal injections with the drug between July 1 and September 28.
Dr. John Bolinger, chief medical officer at Union Hospital in Terre Haute, said 90 patients had been treated with the drug. All but five had been contacted by Friday afternoon, and the hospital was following up with letters. He said the injections were administered at the Wabash Valley Surgery Center between July 15 and September 26.
Bolinger said the hospital is “trying to lessen the panic as much as we can” by telling people the illness is not contagious, and that only the 90 patients who received the injection are at risk.
Meningitis is an inflammation of the lining of the brain and spinal cord. Symptoms include severe headache, nausea, dizziness and fever. Young children, the elderly, pregnant women, and those with compromised immune systems are particularly at risk, and death can occur. Otherwise healthy individuals can also contract the infection, but symptoms are usually less severe.