ELKHART — The two Indiana fatalities linked to a multistate fungal meningitis outbreak received injections of the tainted medicine in Elkhart County, according to a local health official.
Dr. Dan Nafziger, head of the Elkhart County Health Department, said there are 18 identified cases of fungal meningitis related to contaminated medications in Elkhart County, all administered at OSMC Outpatient Surgery Center in Elkhart.
“That’s actually a fairly substantial number,” Nafziger said.
There have been 28 confirmed fungal meningitis cases in all reported in Indiana, out of 205 nationwide. The batches of contaminated medication, manufactured by the New England Compounding Center in Framingham, Mass., were distributed to about 75 clinics in 23 states. The drugs were recalled Sept. 26.
Nafziger noted that just because the two fatal victims linked to Indiana received treatment in Elkhart County does not mean that they live in the county or died here. One of the two suspected victims, Pauline Burema, was from Cass County, Mich., but received treatment at OSMC, according to family members who are awaiting autopsy results confirming her cause of death. There have been 15 deaths nationwide.
According to the most recent figures from the Indiana State Department of Health, 1,568 people were exposed to the contaminated medications through epidural or joint injections at six clinics across the state, including OSMC. Of the total, around 400 received treatment at OSMC, and OSMC Marketing Director Jaime Wrigley said the clinic plans to keep in close contact with them.
Clinic staff made initial contacts with the patients soon after news of the outbreak emerged on Oct. 4, warning them to keep alert for symptoms related to fungal meningitis — headache, fever, nausea and neck stiffness. Because the onset of symptoms can be delayed, staff members will continue making periodic calls to the patients.
“It’s definitely something we want to stay ahead of,” Wrigley said.
According to the U.S. Centers for Disease Control and Prevention, or CDC, symptoms in the outbreak have typically appeared one to four weeks after injections of the medicine, a steroid used to help control back pain. The OSMC patients received injections from the suspected medicine between June 28 and Sept. 26, when a recall was ordered on the drug.
OSMC officials have instructed their steroid patients who experience the meningitis symptoms to go to a hospital emergency room.
The Elkhart County Health Department is working with local clinicians caring for the infected patients as well as the Indiana State Department of Health and CDC. Nafziger said fungal meningitis is a relatively new type of infection.
“Obviously, there has been meningitis in the past, and there have been infections with this particular rare kind of fungus, but we haven’t seen the two of them together, so essentially this is a new problem,” Nafziger said. “Public health is trying to gather information so that clinicians have the best information available in terms of how to diagnose, treat and manage these patients.”
This has created several challenges, Nafziger said. Doctors are pooling their knowledge of other types of fungal infections and the antibiotics that treat them to develop treatment recommendations for patients, he said. Nafziger also noted that fungal meningitis is not contagious, meaning it cannot be spread from person to person.