The Georgia Department of Public Health, the CDC and the FDA are working together to investigate an outbreak of fungal (Aspergillus) meningitis among patients who received an epidural steroid injection. 

“Georgia has been notified that affected medication was delivered to the Forsyth Street Ambulatory Surgery Center in the Macon area,” said J. Patrick O’Neal, M.D., director, Division of Health Protection. “We’re asking clinicians in that area to be extra vigilant.”   As of today, CDC has identified a total of 43 cases nationwide and five deaths.

“To date, DPH is aware of no other affected shipments arriving in Georgia,” said Cherie Drenzek, D.V.M., M.S., state epidemiologist.

The U.S. Food and Drug Administration found contamination this week in a sealed vial of the steroid at the company. Tests are under way to determine if it is the same fungus blamed in the outbreak.   Dr. J. Patrick O'Neal, director of Georgia's division of health protection, said 160 of the 189 patients who received the drug in Macon, GA have been contacted.

O’Neal told Channel 2’s Diana Davis his team was working to contact the remaining patients.  None have tested positive for meningitis, though O'Neal said it can take an extended time for the disease to manifest itself.

Six Georgia patients had reported mild symptoms like headaches, but all six had the symptoms before the injection, O’Neal said.

Officials said they remain very optimistic because no one else in Georgia received the injection, but they will continue to monitor the situation.

As of Oct. 4, 2012, five deaths have been reported nationawide.  None, however, occurred in Georgia and no infections have been found in Georgia to date.

Because the greatest risk for patients infected with fungal meningitis is delayed diagnosis, DPH is working to inform the state’s physicians and physician assistants.

In an alert sent to approximately 32,000 physicians and physician assistants in Georgia, DPH Commissioner Brenda Fitzgerald, M.D., noted the difficulty in diagnosing fungal meningitis is its subtlety.

“It is a slow and undulating illness that may take one to four weeks following an injection to lead to a variety of symptoms, including fever, new or worsening headache, nausea, and new neurological deficit consistent with deep brain stroke,” Fitzgerald wrote.

DPH is working with the middle Georgia facility to contact patients who have had an injection. CDC and FDA recommend healthcare professionals cease use of any product produced by the New England Compounding Center until further information is available.

Additional information can be found at: http://www.cdc.gov/hai/outbreaks/meningitis.html.