Oaklawn never used steroid product associated with fungal meningitis outbreak

Oaklawn Hospital patients are not at risk of contact with a potentially contaminated product associated with a recent outbreak of fungal meningitis.

Kellie DeLong, an Oaklawn pharmacist, confirmed that the hospital never has obtained the steroid injection product from the facility associated with the product being investigated in the wake of the recent outbreak.

The Michigan Department of Community Health (MDCH) has stated that the product was distributed to four facilities in Michigan, none of which is in Calhoun County.

The Centers for Disease Control and Prevention (CDC), in collaboration with state and local health departments and the Food and Drug Administration (FDA), is investigating a multistate fungal meningitis outbreak among patients who received contaminated steroid injections. 

Nationwide, several patients suffered strokes that are believed to have resulted from their infections. The investigation also includes fungal infections associated with injections in a peripheral joint, such as a knee, shoulder or ankle.

Because steroids are not used in obstetrical epidural procedures, steroids never have been used at Oaklawn for OB epidurals, nor are they used in epidurals for surgical procedures at Oaklawn.

This form of meningitis under investigation is not contagious. The outbreak's cause has been traced to a fungus known as Exserohilum rostratum in medication vials from the Framingham, Mass.-based New England Compounding Center (NECC).

According to the MDCH, interim data show infected patients received injections with preservative-free methylprednisolone acetate (80mg/ml) prepared by the NECC. On Sept. 26, the NECC recalled three lots of product associated with known cases of fungal meningitis:

- Methylprednisolone Acetate (PF) 80 mg/ml Injection, Lot #05212012@68, BUD 11/17/2012
- Methylprednisolone Acetate (PF) 80 mg/ml Injection, Lot #06292012@26, BUD 12/26/2012
- Methylprednisolone Acetate (PF) 80 mg/ml Injection, Lot #08102012@51, BUD 2/6/2013

Four Michigan facilities received shipments of these recalled lots and are working with the MDCH to identify and notify patients who may have received this product and be at risk for developing illness. The facilities are:

- Michigan Neurosurgical Institutes in Grand Blanc
- Michigan Pain Specialists in Brighton
- Neuromuscular and Rehabilitation in Traverse City
- Southeast Michigan Surgical Hospital in Warren

Oaklawn Hospital’s pharmacy does not stock any NECC products, and never has obtained the steroid injection product under investigation.

Any individual who received an epidural steroid injection or steroid injection into a joint at one of the four Michigan facilities and is experiencing symptoms consistent with fungal meningitis or a stroke should immediately contact their physician or seek medical attention.

The CDC continues to work with states to determine whether other fungal infections may have been caused by exposure to NECC products beyond the three lots recalled in September. The CDC said Tuesday that it does not have firm evidence that fungal infections have been caused by exposure to other NECC products.

CDC and public health officials are referring any patients who have symptoms that suggest possible meningitis or a possible peripheral joint infection to their physicians who can evaluate them further. Those patients injected in peripheral joints only are not believed to be at risk for fungal meningitis but could be at risk for joint infection.

Patients who feel ill and are concerned about whether they received a medication from one of the NECC products recalled in September should contact their physician. The potentially contaminated injections were given starting May 21, 2012.

On Oct. 3, the NECC ceased all production and initiated a recall of all methylprednisolone acetate and other drug products prepared for injection into the membrane surrounding the brain or spinal cord. Although all cases detected to date occurred after injections with products from these three lots, the CDC and FDA recommend that healthcare professionals cease use of any product produced by the NECC until further information is available.

Additional information about this investigation can be found under "Spotlight" on www.michigan.gov/emergingdiseases. Additional information is available at www.cdc.gov/hai/outbreaks/meningitis.html.

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