Monday, September 22, 2014

Deaths, Infections Increase in 2012 Meningitis Outbreak

By Walter F. Roche Jr.

There have been yet more deaths and illnesses from a 2012 fungal meningitis outbreak but just who those victims are and where they were stricken remains a mystery amidst an ongoing federal criminal investigation.
The increased toll was disclosed in a footnote to an affidavit filed in federal court on Sept. 4. The affidavit was filed to back a move by federal prosecutors to arrest Glenn A. Chin, 46, a former employee of the now defunct Massachusetts drug compounding firm blamed for the outbreak.
The last official count from the U.S. Centers for Disease Control and Prevention showed 751 patients across the country were stricken with infections in the outbreak. Sixty-four patients died.
A CDC official, in response to an inquiry, stated that the agency stopped collecting data from state health departments in October of 2013. After that individual state health departments were left with the responsibility to report any additional cases.
A survey of some 20 state health agencies where cases had been previously reported turned up only a single additional victim. That patient in the state of Virginia boosted the total number of victims in that state to 55. Deaths in that state from the outbreak remained at five.
Calls to other state health agencies including the hardest hit, like Michigan and Tennessee, turned up no additional cases
An FDA spokesman declined to state how many additional cases have been uncovered because the investigation is still ongoing.
The five-page affidavit filed by FDA Special Agent Benedict Celso in Chin's case states, "the total of patients (sickened) has continued to rise as have the total number of patients who died."
Recently filed documents in a massive civil suit stemming from the outbreak give further evidence of a possible undercount.
According to a report prepared by attorneys for victims of the outbreak, four cases have been filed in behalf of four patients who contend they became infected after being treated at three different California health facilities.
Nonetheless the official CDC case report includes no cases from California.
Lynn Janssen, an official of the California Department of Public Health, said her agency was not aware of any illnesses  or deaths in California patients who received injections from medications  distributed by the Massachusetts compounding firm.
Suits have been filed in other states, such as Alabama and Nevada, where no cases have been reported by the CDC.
Another unanswered question is the number of patients who have suffered relapses of fungal meningitis or other infections caused by the fungus tainted methylprednisolone acetate.
According to CDC spokewoman Christine Pearson, five relapse cases have been confirmed. A sixth case, she said, has not been confirmed and is still under investigation.
One person to suffer a relapse was Joan Peay of Nashville, Tenn., who underwent nearly two months of hospital treatment followed by two weeks of rehabilitation for a relapse just over a year ago. The other relapse victims have not been publicly identified.

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