This fall, a fungal meningitis outbreak of historic proportions is occurring locally and nationwide due to tainted methylprednisolone acetate, a common joint and epidural injection for pain purchased from the New England Compounding Center. The center shut down almost immediately as inspectors wrote about dirty floors and a leaky boiler. Floor mats near sterile drug-mixing areas were "visibly soiled with assorted debris," and a leak from a nearby boiler created an "environment susceptible to contaminant growth". Furthermore, according to Massachusetts law, compounding pharmacies must have a prescription for every patient for each dose they send out; otherwise it falls under manufacturing mandates. But documents recently released show multiple complaints against the pharmacy going back to 1999.
Two of these bulk loads were administered to 800 people in Maple Grove, Edina, Fridley, and Shakopee by the Medical Advanced Pain Specialists (MAPS), Minnesota Advanced Pain Center and the Minnesota Surgery Center, causing a major health concern for the area. Every one of these 800 patients were called and referred to diagnostics if they were symptomatic. Per the Center for Disease Control (CDC) website, 13 people contracted fungal meningitis in Minnesota with zero morbidity to date. Nationwide, the numbers continue to rise as the fungal meningitis outbreak has sickened more than 480 people and killed 33.
It gets worse- it has happened before. In 2002, at least seven people got sick and two died after being injected with the same methylprednisolone acetate infected with the same black fungus made in large quantities by a South Carolina pharmacy.
So what do we take away from this whole mess? And a mess it is, because of the incredible risk of such a devastating disease for so many people caused by a system we rely on for our most basic human need: healthcare. We can only hope that the CDC and the FDA mandate positive changes in the industry that will prevent recurrence (again).
But that is not a solution for us, the consumers of healthcare, when assessing the risks and benefits of treatment. So, in a new age of “consumer medicine”, it is up to each of us to be our first health champion. We must stay informed and seek guidance from those we trust- our acupuncturist, GP, or other caregiving expert.
In that vein, let me inform you in my next installment concerning steroid injections, their utility and their overuse. There are times when steroid injections are worth the inherent risks, specifically when more conservative measures have failed or the pain level is debilitating. That way, at least for this group, we will hopefully not be taking undue risk when seeking care.