Fungal Meningitis Still a Threat?

photo by zeathiel

photo by zeathiel

While authorities continue to investigate the recent outbreak of fungal meningitis, which may possibly be the result of contaminated steroid injections, the number of infections has grown to over 360 cases and covers 23 states in the U.S. This type of injection is usually given to those who suffer from severe and chronic pain. Some doctors use nerve block injections to try to diagnose what’s causing the back pain.

It appears all infected patients received spinal injections of a steroid solution that was prepared by New England Compounding Center, in Framingham, Mass. The pharmacy has voluntarily ceased operations and recalled the steroid, which health officials suspect was contaminated with one or more fungi. Reports say that 17,700 vials had been shipped to approximately 75 facilities and reached over 23 states.

As an additional precaution, the pharmacy has implemented another safety precaution and recalled nearly a dozen other medications it produced that have not been linked to the outbreak.

In addition to the meningitis scare, the Centers For Disease Control (CDC) has received other reports of infections related to these types of injections. The CDC states, “CDC continues to receive reports of patients presenting with paraspinal/spinal infections (e.g., epidural abscess, phlegmon, discitis, vertebral osteomyelitis, or arachnoiditis at or near the site of injection). These syndromes have occurred in patients with and without evidence of fungal meningitis.” (Source CDC).

Regardless of the contaminated vials produced by the Massachusetts based compounding pharmacy, this leads us to question the safety of these types of “pain relieving” therapies.

Terry Lewis, who was quoted in an article by USA Today, said, “I hate that this happened, but it was inevitable. This procedure is not safe.” Lewis said her 29-year-old son was injured by epidural steroid shots unrelated to the meningitis outbreak. She claims the shots caused him to develop arachnoiditis, an incurable condition in which scar tissue slowly builds in the spinal column, compressing nerves that lead to debilitating pain and, ultimately, death. She said more people like her son are being hurt as the number of injections grows. (Source USA Today).

In this same article, it stated that an estimated 8.9 million shots are delivered annually and have grown in use by more than 150% since 2010, according to a recent study by Dr. Laxmaiah Manchikanti, chairman of the American Society of Interventional Pain Physicians.

Some industry officials believe that such a large number of injections with relatively few reported cases of adverse side effects, along with the fact that Medicare, Medicaid and other major insurers cover these injections, can be interpreted as evidence of the safety of such a procedure. However, in a 2010 audit by the U.S. Department of Health and Human Services, the inspector general found that one third of the 433 injections from 2007 it studied didn’t meet Medicare requirements. They were either not medically necessary or had insufficient documentation about the need for the shot, the audit said.

With all the infections and complications surrounding these steroidal shots brought to light after the recent outbreak of fungal meningitis from contaminated vials, maybe we should all reconsider the safety of such procedures, regardless of its effectiveness against pain. In fact, it sounds to me like another case where we may want to ask the question, “Just because we can, does it always mean we should?”

Roy Shaw

Roy is the lead trainer and co-founder of ProTrainings. He is also an EMT paramedic whose opinions about rescue come from many years of experience on the ambulance. In his spare time, Roy is also the host of a video podcast called Roy on Rescue, a show where Roy lets his “Training Mask” slip a little and reveals some of the more personal things about himself and his business and training career.

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