In September 2012 the first case of fungal meningitis, linked to tainted steroid injections began appearing across the country, making this the largest outbreak of healthcare associated infections in the U.S. Thanks to fast actions by local, state, and federal public health agencies nearly 14,000 patients and their physicians were notified of the outbreak and given instructions on how to respond.
Exposure
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Patients at risk: 13,534
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89% of exposed patients received spinal injections. 12% of exposed patients received joint injections.
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99% of patients warned of the need to seek immediate care in less than one month.
[Graph depicting the number of meningitis cases compared with death rate from August 13, 2012 to November 19, 2012]
Despite the number of cases increasing, the death rate dramatically decreased thanks to swift public health action.
Epi Facts
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722 cases and 50 deaths as of March 11, 2013.
Labs
1,019 specimens processed by CDC and 182 specimens found positive for E. rostratum.
[Picture of a petry dish with fungus growing in it]
In 2 days CDC's fungal lab developed a new detection test to help diagnose possible cases in the outbreak. Many states have reduced their capacity for laboratory testing, relying on CDC instead.
Timeline
[Dates and events are listed in chronological order down a line in the center of the graphic]
May 21, 2012 First lot of contaminated steroid injections produced by NECC
[Picture of Tennessee]
September 18, 2012 First meningitis case reported to TN Dept. of Health
[Picture of a man with a thermometer in his mouth]
September 25, 2012 Seven more patients identified by TN Dept. of Health all were treated at the same ambulatory surgical center
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September 26, 2012 NECC voluntarily recalls three implicated lots of steroid injections
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September 27, 2012 NC Dept. of Health and Human Services informs CDC of a patient with similar symptoms to those in TN
[Picture of a sheet of paper with a list of names]
September 28, 2012 State and local health departments work with the clinical facilities that administered the medication to begin contacting exposed patients
[Picture of a medicine vial with fungus growing in it and a magnifying glass]
October 4, 2012 CDC activated its Emergency Operations Center. FDA confirms the presence of fungi in unopened vials of NECC steroid injections
[Picture of medicine vials of different shapes and colors]
October 6 2012 NECC expands its recall to include all products distributed from Framingham MA facility
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October 15, 2012 FDA releases an alert stating the sterility of any injectable drugs produced by NECC are of significant concern
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October 18, 2012 CDC announces that the environmental mold Exerohilum rostratum, has been recovered from unopened vials of steroid injections
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October 19, 2012 More than 99% of potentially exposed patients have been contacted by local, state, or CDC personnel informing them of their risk.
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