It starts with a headache, nothing major. Then the neck stiffness sets in, the high fever. That's all the warning you have before fungal meningitis inflames your brain and takes your life. And it's happening, all of a sudden, to unprecedented numbers of people all across America.
Fungal meningitis is a devastating illness, but also historically an incredibly rare one. Which is why the 64 recent cases—spread over seven states—that have plagued the US in a very short time is so troubling. Five have died, thousands more are at risk. Even worse? It can all be traced back to a single, preventable source.
Methylprednisolone acetate is an injected steroid, commonly used to treat the pain and swelling associated with arthritis but also deployed against blood disorders, severe allergies, even some cancers. Between the months of July and September, 52,848 vials of the stuff were shipped from New England Compounding Center Inc, in Framingham, MA, to treatment centers throughout the country.
In all, Reuters reports, 76 facilities in 23 states received shipments from NECC's warehouse. The steroid has a shelf life of 180 days, which means that thousands of patients could have been injected in that time, and thousands more could be still.
Why does all of this matter? Because every single case of fungal meningitis that has been reported in the last several weeks can be traced back to a dose of methylprednisolone acetate, provided by the New England Compounding Center.
Twenty-three states. 76 facilities. 52,858 vials. And most of them still unaccounted for.
There's good news, yet; fungal meningitis—unlike its viral and bacterial brethren—is not contagious. This may count as an outbreak, but it won't reach full-fledged epidemic. It helps, too, that the offending batches of steroid have been recalled, and that NECC has suspended operations until it can figure out exactly what went wrong. But we're far from out of the woods, according to the Center for Disease Control's Benjamin Park:
Unfortunately, despite the current recall, we expect to see additional cases as this investigation unfolds. However, it is possible if patients are identified soon and started on appropriate antifungal therapy some of the unfortunate consequences may be averted.
It takes up to a month for symptoms to present themselves, which means that we'll be seeing the fallout throughout October, and maybe beyond.
Meanwhile, the best thing you can do to protect yourself is to pass on the steroid treatments until it's absolutely certain that every one of those 52,858 tainted vials is accounted for. That, and hope the CDC and drug manufacturers can figure out how to make sure this never happens again. [CDC, Reuters]
Image credit: CDC