Tainted injections can trigger meningitis
Dozens of New Hampshire people suffering from spinal pain are being warned that medicine injected into their spine carries a fungus that could trigger a rare form of meningitis.
New Hampshire health officials said 168 patients, all of them likely patients of the Somersworth-based PainCare LLC, received the drug, a steroid designed to reduce back pain.
Nationwide, 35 people who received the injection have come down with meningitis, and five have died — three in Tennessee and one each in Virginia and Maryland.
“I'm flipping out right now,” said a woman shortly after receiving a telephone call from PainCare. She would not give her name, but her fiance, Michael Sasbon, blames the manufacturer of the medicine.
State health officials said the recalled medication — 17,676 single-dose vials of methylprednisolone acetate — came from New England Compounding Pharmacy of Framingham, Mass. In New Hampshire, the drug was distributed by PainCare at its locations in Somersworth and Merrimack.
The cases under investigation have no relation to the more common forms of bacterial or viral meningitis, according to health officials.
The outbreak is not transmissible from person to person, they say.
“We continue to monitor it; we will send messages to physicians across the state to make sure we don't have any other patients or symptoms missing,” said Dr. Jose Montero, New Hampshire's public health director.
Company's past issues
The manufacturer was directly regulated by Massachusetts public health officials who confirm that NECC has had issues in the past.
“In 2006, we entered into a consent decree in resolution of three open complaints, one relating to complaints over sterile compounding,” said Dr. Madeleine Biondolillo, director of the Massachusetts Bureau of Healthcare Safety. “In June 2006, NECC completed the terms of that consent.”
The company's plant and laboratories were again inspected in 2011, and no deficiencies were found, Biondolillo said. This year, a complaint about the potency of drugs used in eye surgery was initiated through the federal Food and Drug Administration.
At the request of federal officials, NECC has voluntarily surrendered its licenses and halted production while the investigation is under way.
PainCare first learned of problems with the medication Tuesday, said Dr. Michael O'Connell, owner and chief executive of the clinic. More information came out Wednesday, and on Thursday PainCare was contacting patients by telephone. None has mentioned any symptoms of meningitis, he said.
O'Connell said patients receiving the spinal injections suffer from severe pain, often caused by accidents.
“Life is a struggle for them, and now over 100 people are out there wondering if they have a very serious illness,” he said.
PainCare started using the tainted batch in August, and the last injection was sometime at the end of September, he said. PainCare has discontinued use of any medications from New England Compounding Pharmacy, he said.
O'Connell said patients are offered a spinal tap to determine if the fungus is in their spinal fluid, but the fungus can take weeks to develop through culture.
Officials can't answer questions such as whether the presence of fungus will guarantee meningitis, he said.
“We just don't know. There's so few cases where this has happened,” he said.
PainCare also has locations in Franconia, Lebanon, Littleton, Concord, Newington, North Conway, Plymouth, Raymond, Wolfeboro and Woodsville.
Dr. Benjamin Park, a medical officer with the federal Centers for Disease Control, said infected patients typicall present symptoms one to four weeks after treatment.
Symptoms include nausea, vomiting, sensitivity to light and altered mental state, and in some cases, confusion, hallucinations and personality changes.
Montero said fungal meningitis “is not common in people who are immune-competent.”
“People who don't have a disease that affects the immune system usually don't get it,” he said.
For more information visit the CDC website at www.cdc.gov or call the Bureau of Infectious Disease Control at 603-271-4496.
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