ELKHART — An outbreak of fungal meningitis that has spread to 17 states has hit home for doctors and nurses at Elkhart General Hospital who have been working tirelessly to treat patients with the potentially deadly infection.
Medical staff at the hospital have been caring for patients around the clock since the beginning of October after they were exposed to a tainted batch of steroids used to relieve back pain at OSMC Outpatient Surgery Center in Elkhart. As of Tuesday, there were 10 people recovering from fungal meningitis at EGH, and about 17 other patients have been discharged.
The past three weeks have been an unusual experience, according to Elkhart County health officer Dr. Dan Nafziger.
“I think of when I was in medical school, the first cases of HIV and AIDS were described, and Lyme disease was a relatively newly discovered problem, but it’s not everyday that a new disorder comes along, and so I think that’s the most remarkable thing,” Nafziger said. “It’s really a different problem than what we’ve seen, even though we see fungal infections and we’ve seen meningitis. Both of those problems are relatively uncommon, and to see this particular kind of fungal meningitis is extraordinary.”
The U.S. Centers for Disease Control and Prevention, or CDC, has confirmed 40 cases of fungal meningitis in Indiana, including 27 in Elkhart County. More than 300 people across the country have been infected.
Since news of the outbreak surfaced, medical staff at EGH have been meeting three times a week to discuss patient needs. The hospital’s medical experts have been working side by side with the CDC, the Indiana State Board of Health and the Elkhart County Health Department to care for patients.
“We’re really blessed here at Elkhart General because we have a great medical staff,” said Karra Heggen, vice president of nursing at EGH. “We have lots of different specialties. We have nurses in all different specialities ready to take care. Since we work in the health care industry, we’re ready for these incidents as they arise.”
The fungal meningitis patients at EGH are being treated in a single unit, Heggen said.
“That way, the physicians, the pharmacists, nurses, case managers, everyone, since it was a new diagnosis, we could treat it more effectively and without variation, and that’s worked out well also for families,” Heggen explained. “They also have more of a support if there was more than one patient there.”
Physicians at EGH are administering doses of an antifungal drug to fight off the meningitis infections. EGH pharmacy director Susan Hawes said the hospital’s case managers are working closely with patients’ insurance companies. Medicaid covers the antifungal drugs, and Medicare copayments are slightly different, she said. The hospital is also providing medications to patients who can’t afford them through a special needs program, Hawes added.
There have been two deaths attributed to fungal meningitis in Indiana. Both people received injections at OSMC. There have been 23 deaths reported across the country, according to the CDC.
OSMC staff contacted close to 400 patients following the outbreak, instructing them to watch for fungal meningitis symptoms including headache, fever, nausea, neck stiffness and sensitivity to light. The patients received injections from June 28 until the drug was recalled on Sept. 26.
Nafziger noted that fungal meningitis is not a concern for the general public. The infection cannot be spread from person to person.
Six health care facilities in Indiana received batches of the contaminated medications manufactured by the New England Compounding Center in Framingham, Mass. An Elkhart man, who was infected with fungal meningitis, filed a lawsuit Oct. 15 against the pharmaceutical company and two of its affiliates. Nathan Owen Tacy is seeking unspecified damages for the companies’ apparent negligence, allowing tainted medications to slip through to about 75 clinics in 23 states.
Nafziger said he is “reasonably optimistic at this point that the worst of the epidemic is over” but expects a few more cases to trickle in.
In the meantime, Heggen said EGH is prepared with protocols in place in case more fungal meningitis cases are identified.
“We’re ready for whatever comes in our door,” she said.