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October 05. 2012 9:59PM

Meningitis threat scares NH patients

MERRIMACK — While a multistate investigation is under way to determine how many patients who received tainted epidural steroid injections have contracted fungal meningitis, New Hampshire clients who frequent a clinic where the recalled drug was distributed say the contamination is disturbing.

According to health officials, 186 New Hampshire patients received the medicine, which officials have determined could contain a fungus that triggers a rare form of meningitis. Although no one in the state has tested positive for meningitis from tainted injections, 50 people nationwide who received the injection have contracted the disease, and five have died — three in Tennessee and one each in Virginia and Maryland.

“The first thing I did was call them when I found out,” said Herb Jarvis of Salem, who visits PainCare LLC in Merrimack once a month for back, leg and arthritis pain relief. “It is scary. Meningitis can kill you.”

Jarvis, who received steroid injections when he started coming to the clinic in 2005, said he does not need the treatment any longer and did not receive a dose of the steroid medication that came from New England Compounding Pharmacy of Framingham, Mass.

Officials said that 17,676 single-dose vials of methylprednisolone acetate were manufactured at the Massachusetts site and distributed nationwide, including distribution to two PainCare LLC offices in New Hampshire — one in Merrimack and the other in Somersworth.

“I was assured that everyone who received the medication was called immediately. They seem to have it under control here,” Jarvis said Friday while leaving the Merrimack PainCare office. “It is a scary situation though.”

Dr. Jose Montero, New Hampshire's Public Health director, said the state is working closely with PainCare to contact the 186 patients who received the medication.

“We are not aware of any cases in New Hampshire related to this outbreak at this time. We are also conducting surveillance to identify people who might be affected by this situation,” Montero said in a statement. “We realize this is concerning as this can be an extremely serious and in some cases fatal illness.”

It is not clear how many of the 186 patients used the Merrimack PainCare center and how many received treatment at the Somersworth PainCare office.

The cause of the national outbreak of fungal meningitis is believed to be associated with the recalled medication, but it is still under investigation by the Centers for Disease Control and Prevention and the Federal Drug Administration, according to a release from the New Hampshire Department of Health and Human Services.

“I really can't believe this has happened here. It is very frightening,” said another patient while leaving PainCare in Merrimack. The woman, who declined to give her name, said she was unaware of the meningitis scare until she learned about it during her Friday morning appointment at the local office.

“I am lucky because I don't have spinal pain and I don't need that type of injection, but I am sure there are several people out there who are questioning their health status right now,” she said while leaving the office.

State health officials stressed that PainCare has sent all of the unused recalled product back to the manufacturer. PainCare began using the batch in August, and the last injection was sometime at the end of September, PainCare officials told the New Hampshire Union Leader this week.

The meningitis cases under investigation nationwide have no relation to the common forms of bacterial or viral meningitis, according to state health officials, explaining that fungal meningitis is not transmissible from person to person.

On Thursday, the CDC issued an official health advisory indicating that several patients who received the epidural steroid injection contracted fungal meningitis and suffered strokes as a result of their infection.

Infected patients who received an injection with preservative-free methylprednisolone acetate (80mg/ml) prepared by New England Compounding Center presented a variety of symptoms one to four weeks following their injection.

On Wednesday, the drug manufacturing center in Massachusetts ceased all production and initiated a recall of all methylprednisolone and other drug products prepared for intrathecal administration, according to the advisory.

“ … Out of an abundance of caution, CDC and FDA recommend that healthcare professionals cease use of any product produced by the New England Compounding Center until further information is available,” it states.

At the request of federal officials, NECC has voluntarily surrendered its licenses and halted production while the investigation is under way.

In addition to its Merrimack and Somersworth sites, PainCare also has offices in Franconia, Lebanon, Littleton, Concord, Newington, North Conway, Plymouth, Raymond, Wolfeboro and Woodsville. However, only the Merrimack and Somersworth locations distributed the suspect drug, according to state health officials.

khoughton@newstote.com


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