DETROIT -- William Wertz wonders whether the fungus will attack his body again — and what it would feel like to die.
"If I have fungal meningitis, how would my body shut down?" said the 68-year-old Howell man. "(Would I be) in a lot of pain, or would I go to sleep? Would I be like a dementia patient?
"They told me there's no guarantee that it's not going to be back."
Wertz is among the hundreds of patients devastated by a deadly national fungal meningitis outbreak that exploded last fall and was caused by steroid injections that came tainted with fungus from a Massachusetts pharmacy.
One year later, people are still suffering health problems linked to both the tainted shots and the powerful antifungal medicine they took to save their lives. Most are off the drugs, but some are back in the hospital.
Investigations and litigation connected to the outbreak are ongoing, as are efforts to strengthen regulation of the type of pharmacy responsible for the crisis. Health experts say more people could fall ill.
For patients, questions still linger: How did this happen? Why were some toxic shots injected after being recalled? Will I get sick again?
Fungus just the start
Michigan remains the hardest hit state in the outbreak, according to the most recent case counts from the Centers for Disease Control and Prevention. The shots sickened 264 people in the state. Nineteen have died, not including three Michigan residents whose deaths figure into Indiana's case count because that's where they got their shots.
Nationwide, there have been 750 illnesses reported and 64 deaths.
Wertz got meningitis and then an infection at the injection site from the shot he took to relieve thigh pain. He was hospitalized twice last fall at St. Joseph Mercy Ann Arbor. The hospital has treated 195 people sickened in the outbreak, more than any other facility in the country.
Today, about two-thirds of those patients are off antifungal drugs but still being monitored, said Dr. David Vandenberg, medical director of clinical outcomes management at the hospital. Another 25% with the most serious infections had yearlong treatment plans to begin with and are still on antifungal medicine.
About a dozen people have responded poorly to treatment or relapsed.
"None of us have ever seen a public health crisis that had this kind of a course, where it came on rapidly but sustained for this long," Vandenberg said. "I don't think we're in any position yet to say anybody whose been diagnosed and treated for this is in the clear."
The main fungus associated with the outbreak, Exserohilum rostratum, grows slowly and has caused diseases that are difficult to treat.
Donald Hixson, 68, of Pinckney was hospitalized for six days for meningitis and another time for 32 days because of an abscess at the injection site on his back. He had two surgeries. The antifungal medicine pumped through his IV caused kidney problems and strange hallucinations.
The retired toolmaker finally got off antifungal pills in June, but peculiar ailments remain — pimples on his face, hair that's fallen off his arms, armpits and legs, increased irritability and trouble with his balance. He also struggles with back pain and faces new physical limitations.
continue to read here