19 of 21 meningitis cases in state being treated at Ann Arbor hospitals
Editor's note: This article has been corrected to state the number of meningitis cases is 21 in Michigan. One joint infection has been linked to contaminated steroid shots.
Ann Arbor area hospitals are treating 19 of the 21 cases of fungal meningitis cases linked to contaminated steroid injections, health officials said Monday.
![Meningitis_Outbreak_AP.jpg](http://www.annarbor.com/assets_c/2012/10/Meningitis_Outbreak_AP-thumb-350x262-123878.jpg)
A vial of injectable steroids from the New England Compounding Center.
AP photo
Neither hospital received contaminated steroids that were shipped from the New England Compounding Center that is under investigation by the Centers for Disease Control and Prevention for the outbreak. However, four other Michigan facilities did - including Michigan Pain Specialists in Brighton.
Monday afternoon, Michigan health officials announced the number of fungal meningitis cases from contaminated steroid injections had risen to 21 from the 20 that had been reported over the weekend. Two of the 21 have died, including one person who died at the end of September at the University of Michigan Hospital.
An additional Michigan patient had a fungal infection in a joint from a contaminated steroid injection for pain, the Michigan Department of Community Health reported Monday.
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The state said the two who died were both women. One was 56 and the other was 67 years old.
People who have fallen ill from the contaminated steroid in Michigan cases range in age from 38 to 89 years old, the Michigan Department of Community Health said.
One of those patients is Lyn Laperriere, 61, of Milan. He’s been hospitalized at St. Joseph Mercy Ann Arbor for about 12 days, and it's uncertain when he'll be discharged.
Laperriere had received an injection for his back pain Sept. 6 from his doctor at Michigan Pain Specialists in Brighton.
Around Sept. 19 he began to feel off-balance and for the next week continually had headaches, said his wife, Penny Laperriere.
By Sept. 26 the symptoms were too severe to ignore - and Lyn Laperriere went to St. Joseph Mercy Ann Arbor in an ambulance.
At first, doctors thought he had bacterial meningitis and kept him quarantined, Penny Laperriere said.
Penny Laperriere said her husband has been receiving pain treatment at the Brighton facility for some time and has no complaints about the way he’s been treated.
All of the fungal meningitis cases that have been identified in Michigan are linked to the four facilities that received shipments of the contaminated steroid from the New England Compounding Center. They are:
- Michigan Pain Specialists in Brighton
- Michigan Neurosurgical Institute of Grand Blanc
- Neuromuscular & Rehabilitation in Traverse City
- Southeast Michigan Surgical Hospital in Warren
Michigan Pain Specialists also has a location at 135 South Prospect St. in Ypsilanti.
Across nine states, 105 cases of fungal meningitis and eight deaths have been reported as of Monday evening, according to the CDC.
The CDC has expanded the notification process beyond patients who received injections for back pain to patients who received injections in other sites, including joints.
Those that received contaminated steroid injections to their joints are at risk for a fungal infection.
Only patients who received epidural shots of the contaminated steroids are at risk for meningitis.
Fungal meningitis is rare and not contagious. It causes inflammation of the protective membranes around the brain and spinal cord.
Several patients with the type of fungal meningitis associated with the outbreak have had strokes induced by the illness, according to the CDC.
The New England Compounding Center has voluntarily recalled all of its products in circulation that were distributed from its Framingham, Mass. facility. The CDC believes potentially contaminated injections were given as early as May 21.
As of Monday, most of the patients that had received an epidural injection from the four Michigan facilities had been notified, state health officials said.
After the New England Compounding Center recalled the steroid linked to the meningitis outbreak Oct. 3, the CDC launched its investigation across the country.
Michigan officials confirmed the first six cases of fungal meningitis in the state Friday. That number increased to 20 cases by Sunday afternoon.
Amy Biolchini covers Washtenaw County, health and environmental issues for AnnArbor.com. Reach her at (734) 623-2552, amybiolchini@annarbor.com or on Twitter.
Comments
BhavanaJagat
Wed, Oct 10, 2012 : 4:54 a.m.
The use of Corticosteroids : There are specific indications and contraindications for using steroids and it is important to know if the standards of therapeutic care are being followed. Steroids are very powerful anti-inflammatory agents and people become susceptible to infections while receiving steroid therapy. Elderly people and others whose immune system is compromised would be at a higher risk. If over 13,000 patients have received these steroid injections, the investigation of this problem would naturally include the standards of this therapeutic practice. There is no escape. There is no getting away from this scrutiny. When people die, the concern is not about keeping medical information confidential. Public have to be informed as to how they can protect themselves while they seek drug therapy for their problems.
sHa
Wed, Oct 10, 2012 : noon
http://www.ddc-law.com/news_events/articlesofinterest/pdfs/Medical%20Records%20and%20HIPAA%20in%20Michigan%20.pdf
sHa
Wed, Oct 10, 2012 : 11:54 a.m.
@BhavanaJagat - You might want to become informed about the laws of Michigan: http://www.ddc-law.com/news_events/articlesofinterest/pdfs/Medical%20Records%20and%20HIPAA%20in%20Michigan%20.pdf
BhavanaJagat
Tue, Oct 9, 2012 : 6:18 p.m.
The problem now appears to be a little bigger than the earlier report. There are about 13, 000 victims who may have received this medication and several of them were treated for joint pain and not back pain. The patients with joint pain could be at a little less risk as compared to those who received treatment for the back pain( the medication is injected directly into the membranous sac around the spinal cord). The second victim of this meningitis outbreak had joint pain and the loss of life could be the result of a weak immune system response. Elderly patients and people with a weak immune system may have to carefully consider the option of this kind of treatment that involves the use of steroid injections. Hence, I would like to know the therapeutic regime that is being followed by these practitioners.
bugmenot
Wed, Oct 10, 2012 : 9:59 p.m.
I think what BhavanaJagat is trying to say is that there's a whole lot of people who got the shot as a joint injection (versus the spine) and some places do tend to "push" the steroid shot more than others. And they keep getting told that there's hardly any chance of having problems. But shooting a fungus into any part of the body has got to cause problems. Now at least we have this one case of a joint infection can validate that this is a possibility. I have been following this daily because I know someone who had the joint injection in her knee. She already has immune/inflammation problems and had been feeling much better (except for the knee injury) after starting an anti-inflammatory diet. But the last two weeks (_before_ this came into the news), she has been feeling worse. She's been put on steroids (which are not working) and was told it was most likely unrelated. Since this person is sort of "Patient 0" for the joint injection people, of course we're curious as to what is being done (and how the symptoms came on).
sHa
Tue, Oct 9, 2012 : 8:15 p.m.
I am having trouble understanding why you think you have a right to know any patient's medical history and/or treatment, other than your own. That is why it is standard practice for an "Authorization for Release of Medical Records" be signed by a patient before any of his/her medical records can be released to anyone other than the patient. In other words, it is none of your business as to what "therapeutic regime is being followed".
anti-thug
Tue, Oct 9, 2012 : 3:58 p.m.
We need to start questioning our Doctors more and asking for alternatives treatments. Big pharma are so powerful, there is so much money involved they think they can do whatever they want. The many doctors accepting bribes to pimp out your body to Big Pharma. Here more info. Only showing payments over $250 - http://projects.propublica.org/docdollars/search?utf8=%E2%9C%93&term=Ann+Arbor&state[id]=
fishermon
Tue, Oct 9, 2012 : 1:41 p.m.
I do not understand why the compounding of a an injectable drug is not under FDA regulation. All drugs manufactured by a pharmaceutical company are FDA regulated and must be prepared under the GMP ( Good Manufacturing Procedures). Perhaps this particular instance of contamination will cause Congress to put this obvious manufacturing ( the compounders sell this product to doctors to be used like any other injectable that is ordinarily under the FDA regulations) within the scope of all other regulated products. At the very least, such compounded products should have a separate GMP especially promulgated for the special circumstances surrounding their preparation. The ingredients of these injectibles have entered Interstate Commerce so there should be no legal difficulty in bringing them under the FDA umbrella.
A2comments
Tue, Oct 9, 2012 : 10:22 a.m.
Interesting how St. Joe's has rec'd nearly all of the patients. Always thought U of M was the predominant hospital.
sHa
Tue, Oct 9, 2012 : 12:52 p.m.
It might be because Michigan Pain Specialists in Brighton Michigan, one of the clinics who used the suspected injections, is affiliated with St. Joseph Mercy Hospital, not U of M Hospital.
actionjackson
Tue, Oct 9, 2012 : 3:15 a.m.
Too close to home for me. I dealt with Michigan Pain Specialist's in late Sept. for an epidural steroid injection. Hope Brighton doesn't share pharmaceutical's with Ypsilanti!
snapshot
Tue, Oct 9, 2012 : 1:42 a.m.
Sad. I feel for the victims and families. Our health care system is very fragile and relies greatly upon trust.