Fungal Meningitis Outbreak: A Sobering Tragedy

By: Mahdieh Danesh Yazdi, Associate Student Editor

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For the past few weeks, we have heard about the terrible breakout of fungal meningitis from contaminated methylprednisolone acetate vials manufactured by the New England Compounding Center (NECC).  Approximately 14,000 patients received medication from the contaminated lots.  So far, over 400 cases have been reported and over 40 people have tragically lost their lives.  Most cases were caused by the fungus Exserohilum rostarum, but there has also been one confirmed case of infection due to Aspergillus fumigatus.

Since the outbreak, the FDA has visited the compounding site, and Congress has begun to hold hearings on the case.  The CDC, state and local health officials, and the Massachusetts Board of Pharmacy are also tracking the case, in order to try to identify potentially infected patients and limit the damage caused by the outbreak.

There were serious problems with proper sterilization at the NECC site.  The company voluntarily recalled all of its products on October 6.  Ameridose, a company closely connected with the NECC, also voluntarily withdrew its products on October 31.  The FDA has encouraged health care professionals who administered any product produced by the NECC after May 21, 2012 to reach their patients and follow up with them to rule out any infection.

The drug shortage office of the FDA announced that it did not anticipate any drug shortages to result from the shutdown of the NECC and Ameridose.  However, the ramifications could be felt across the nation.  Pharmacies have had to scramble to find replacements for the missing NECC and Ameridose products.  From gathering information to finding alternate sources of drugs to trying to track down patients who have been potentially infected, this outbreak has had a tremendous impact on day-to-day pharmacy operations.

However, no impact is more profound than that of the lesson it teaches us.  Many of us take our compounding classes and the details of aseptic techniques for granted.  We do not fully realize how something as simple as hand washing could literally mean life or death for a patient.  Please remember this the next time you are in the lab and are compounding a preparation:  someday this will go into a patient’s body.  That patient could be your parent, brother, sister, spouse; someone you care for.  Treat your patients as if they were members of your family.  My father once spent a night at the hospital where I currently work.  Each time that I fill a patient’s medications, I cannot help but ask myself, “would I have wanted my father to receive this medication?”  I assure you, it is the most sobering thought a person could have.

Our hearts go out to those affected by this outbreak.  For more information regarding the outbreak, please visit the CDC and FDA websites at http://www.cdc.gov/HAI/outbreaks/currentsituation/ & http://www.fda.gov/Drugs/DrugSafety/FungalMeningitis/default.htm