Traverse City Record-Eagle

October 5, 2012

No meningitis symptoms from TC clinic


TRAVERSE CITY — State health officials report a steroid medication that is suspected of causing a meningitis outbreak in seven states was shipped to four facilities in Michigan, including one in Traverse City.

The U.S. Centers for Disease Control reported a rare form of fungal meningitis linked to a steroid injected into the spine resulted in five deaths and 47 illnesses, including six in Michigan. Several of the patients also had strokes related to the fungal infection. CDC officials believe the contaminant found in a sealed vial of the steroid to be leaf mold.

The Michigan Department of Community Health is working with the four clinics to reach out to patients "out of an abundance of caution," said spokeswoman Angela Minicuci.

Nationwide, hundreds, and perhaps thousands, of people who got the shots between July and September could be at risk, health officials said.

Meningitis refers to inflammation of the protective membranes covering the brain and spinal cord. The inflammation is usually caused by a viral or bacterial infection. Fungal meningitis is not spread by person-to-person contact, the agency said.

The Traverse City facility, Neuromuscular & Rehabilitation Associates of Northern Michigan, has eight practicing doctors with satellite offices in Cadillac, Charlevoix, and Gaylord. The clinic began contacting about 200 patients who had received injections on Thursday afternoon, said Dr. Stephen Andriese.

"We have since been notifying people who have received injections and what they should look for to be concerned about," Andriese said. "We have yet to have anybody describe the symptoms ... worsening headache, stiff neck, sensitivity to light, nausea and fever."

The steroid is a specialty compound that does not use a preservative linked in past studies to certain complications from epidural, or spinal, injections, Andriese said.

"It's potentially less risky because it is designed for the epidural space," Andriese said. "That's what so frustrating with this, you work so hard and expend so much energy about trying to help people and get them on the right track. Now you hear about how much harm has been done and it's frustrating and upsetting to go through."

The other Michigan facilities that received a shipment of the medication involved in the investigation are Michigan Neurosurgical Institute in Grand Blanc, Michigan Pain Specialists in Brighton, and Southeast Michigan Surgical Hospital in Warren.

The CDC reported it was notified of the first confirmed case in Tennessee on Sept. 21 and linked it to a drug created by the New England Compounding Center in Framingham, Mass. The specialty pharmacy recalled three lots consisting of a total of 17,676 single-dose vials of the steroid, preservative-free methylprednisolone acetate on Sept. 25, health officials said. The CDC reported the pharmacy recalled all other doses of the drug on Oct. 3 and has ceased production.

The company's website was shut down on Friday.

The Grand Traverse County Health Department urges anyone who has had a recent steroid injection who may have concerns to contact their doctor and describe any symptoms, said Wendy Trute, county health officer.

So far no cases have been reported in Grand Traverse County, Trute said, but the CDC expects the number of illnesses to grow over the weekend.

"It's not transmitted person-to-person, but the symptoms are a more gradual, slower onset," Trute said. "We want to identify cases as quickly as we can."

The ASSOCIATED PRESS contributed to this report.