Related: Fungal meningitis patient's sickness started with a
cure
The discovery of new cases in the fungal meningitis outbreak has slowed in
Virginia, prompting state health officials to change the way they monitor those
at risk for becoming ill.
This week, health officials will begin to reign in surveillance efforts aimed
at identifying new cases in the outbreak, which was tied to tainted steroid
injections and has killed 36 and sickened hundreds in 19 states. The change
comes as data collected by the Virginia Department of Health show a 20-day
average incubation period from when a person received the steroid injection and
first developed symptoms of the fungal infection.
"We do expect that there may be additional cases, but in much smaller numbers
and with a decreasing frequency," said Dr. David Trump, state epidemiologist for
the health department. "Hopefully, everyone who was exposed knows what to look
for and won't hesitate to seek medical attention."
In Virginia, only about 13 percent of people who received one of the recalled
shots blamed in the outbreak developed a fungal infection.
But early in the outbreak, before officials knew the likelihood of developing
an infection after receiving one of the shots, the state decided to take the
rare — and time-intensive — step of calling anyone at risk of becoming ill.
Since October, health department nurses have made weekly calls to everyone
who received one of the shots but had not yet had a lumbar puncture to test for
meningitis.
In the Roanoke and Alleghany health districts, the process involved assigning
about 25 employees to call about 260 people, said Dr. Stephanie Harper, director
of the two districts.
"We directed a lot of resources to getting it done," she said. "It's manpower
intensive."
The department also made home visits and sent certified letters to ensure
that no person was missed, she said.
Many of those on the original list ended up being referred to the emergency
rooms at Carilion Roanoke Memorial Hospital and LewisGale Medical Center for
lumbar punctures, Harper said.
This week will mark the last time Harper's nurses make the weekly calls, she
said. After that, her staff will be available to answer questions, but they will
not actively check in with people, she said.
The decision follows the recommendation from Trump that the surveillance is
no longer necessary, although he has left the ultimate decision up to the
various health district directors in Southwest Virginia who have been
coordinating the efforts.
So, for instance, the outreach will continue until Dec. 23 to the 94 affected
people living in the New River Valley Health District, said Dr. Molly O'Dell,
director of that district.
"We're considering going to once a month for three months after that," she
said. "But we haven't decided."
Virginia identified 680 people who received a contaminated injection made by
New England Compounding Center at one of two outpatient clinics in Southwest
Virginia. In Virginia, most people received the shot at Insight Imaging in
Roanoke, but 27 were exposed after getting an injection at New River Valley
Surgery Center in Montgomery County.
O'Dell said none of the 51 cases identified in Virginia so far have involved
patients who got the shot at the New River center.
The vast majority of people who developed meningitis began to have symptoms
between the end of September and the middle of October, Trump said.
Source found
here
Basic
Veterinary Compounding Course Outline.pdf