Injection Site Infections Join Meningitis, Joint Infections from Tainted Drugs

Public Health Officials Issue an Advisory

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As if the more than 14,000 people who were potentially exposed to tainted injectable drugs through back or joint injections don't have enough on their plate, public health officials announced Nov. 20 that they are seeing an increase in serious injection site infections. These injection site infections have been reported both in individuals who have fungal meningitis or peripheral joint infections and in individuals who had neither of the illnesses.

CDC Issues Public Health Advisory

The U.S. Centers for Disease Control and Prevention, working closely with state public health officials whose residents may have been exposed to the tainted drugs produced and distributed by the New England Compounding Center, NECC, issued a health alert on Tuesday. In addition to updated information about the fungal meningitis outbreak of 2012, the alert also explains that since Nov. 4, 61 people have been reported to have spinal or paraspinal epidural abscesses or osteomyelitis, two people had injection site infections in joints other than the spine, and an additional two individuals had these infections along with meningitis.

Those Who Received Potentially Contaminated Injections Receive New Information reported that Dr. Marion Kainer , director of health care-related infections with the Tennessee Health Department and one of two doctors credited with solving the initial mystery cause of the fungal meningitis outbreak, is cautioning people who've received the potentially contaminated injections between May 10 and Sept. 26 not to rush to hospital emergency rooms. While it's important such people be aware of the symptoms of injection site infections, the infections themselves develop more slowly than meningitis and are not cause for panic.

Symptoms of Injection Site Infections

One of the difficulties in recognizing the symptoms of injection site infections to the spinal area in the affected individuals is the fact that back pain is one of the principal symptoms. The people who received the outpatient injections were doing so due to chronic back pain. A change in the intensity of the pain may be difficult for the individual to notice, or even for the health care provider to discern.

Other symptoms to be alert for include changes in bowel or bladder habits; if these are noted, your health care provider should be immediately notified.

There may be no outward visible signs of the injection site infections, but a feeling of swelling under the skin or increased warmth or redness of the injection site should also be reported.

CDC Advises Health Care Providers to Order MRIs

The CDC advised health care providers to order magnetic resonance imaging, MRI, with contrast on anyone potentially exposed to the tainted injectable drugs if that person experiences any new or worsening symptoms of pain or discomfort to the back.

If injection site infection is diagnosed, health care providers are encouraged to consult early with a neurosurgeon to develop an appropriate treatment plan.

Most Recent Updates on Meningitis Outbreak Statistics

The good news is that the rate at which new cases of meningitis are being reported has been decreasing. The current case count is 490 with 34 deaths having occurred, according to the CDC . Michigan, with 164 cases reported, and Tennessee, with 82 cases reported, have the highest case counts of the 19 states involved in the fungal meningitis outbreak.

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