Fungal Meningitis Risk Period Over But Threat Remains

Good Morning America
Fungal Meningitis Risk Period Over But Threat Remains

View photo

Fungal Meningitis Risk Period Over But Threat Remains (ABC News)

The 42-day risk period for contracting fungal meningitis from tainted steroid injections ended on Wednesday, since the drugs were recalled on Sept. 26, but new case reports will probably continue to trickle into the Centers for Disease Control and Prevention for at least a few months, said Dr. Tom Chiller, a fungal disease expert at the CDC

With 18 new cases reported last Friday, and abscesses causing even fungal meningitis survivors to go back to the hospital with new symptoms, sighs of relief could be premature.

"Forty-two days is not a magic number by any sense of the word," said Chiller, who is the deputy chief of the CDC's Mycotic Diseases Branch. "This is a moving target. The outbreak is evolving."

The CDC publicized the 42-day period as a way for individual physicians to determine whether putting all at-risk patients on anti-fungal medications was a good idea, Chiller said. Since anti-fungal medicine can cause liver and kidney damage, there was a risk it could do more harm than good. The long risk period would mean a long anti-fungal regimen.

A CDC analysis revealed that while preemptive anti-fungal prescriptions reduced patients' risk of death or stroke from meningitis by .1 percent, they increased the risk of other adverse health problems by up to 14 percent, Chiller said.

Chiller said this kind of fungus, exserohilum rostratum, can have a very long incubation period. Although the median incubation period so far has been 20 days, the longest incubation period went beyond 100 days, he said.

"One of the important things to add is that we do feel pretty confident that the further out you are from injection, the lower the risk," Chiller said. "When that risk becomes zero, we don't know."

So far, 409 fungal meningitis cases, including 30 deaths, have been reported to the CDC this fall. In addition, 10 people who received the shots to other parts of their bodies came down with fungal joint infections. Fungal meningitis, a deadly disease that causes inflammation of the membrane surrounding the brain and spinal column, is not spread from person to person.

Up to 14,000 people received the tainted injections produced at New England Compounding Center in Framingham, Mass, which recalled all products and shut down on Oct. 6. It is now being investigated by the Food and Drug Administration, even though its oversight usually falls under its state's pharmacy board's jurisdiction.

It's not clear how the fungus got in the steroid vials, but an FDA investigation revealed that a quarter of the steroid vials in an NECC bin contained "greenish black foreign matter," according to an FDA form released Oct. 26. The form went on to identify several clean rooms -- where sterile products are produced -- that had either mold or bacterial overgrowths.

Signs that the CDC believes new cases will taper off include the CDC's new, more relaxed online case reporting schedule. Instead of updating case counts by state every day at 2 p.m., as it had for the last month, the CDC will update Monday, Wednesday and Friday only. This Monday's steep new case count of 15 was actually only five new cases per day.

However, 18 new cases were reported between Thursday and Friday of last week, according to CDC reports. Case counts only reached 18 or higher on four days of the whole outbreak.

"All of us have our fingers crossed, and everyone acknowledges that with every day that passes, the risk diminishes," said Dr. William Schaffner, chair of preventive medicine at Vanderbilt University in Tennessee. "Although at 42 days, I'm sure people are taking a deep breath, but the reality is that they're not completely out of the woods yet."

Going forward, the CDC is encouraging people who have received the tainted shots to be vigilant about keeping track of their symptoms, and to seek medical help if necessary, Chiller said.

But even the people who got meningitis and were treated are not in the clear. The CDC has now learned that those patients are coming back with abscesses filled with fungus and pus located near the injection site.

"The new finding is that patients during treatment or reaching the end of their treatment may actually relapse and come back with new symptoms," said Schaffner, who used to be president of the National Foundation for Infectious Diseases.

Schaffner said that the abscesses, which are located just outside the spinal casing, or dura, can grow and make their way into the dura, causing a meningitis relapse.

In some patients, the abscesses are present when they receive their first meningitis diagnosis, Chiller said. In others, the abscesses form several weeks later. These pockets of infection are often treated with oral antifungal medications or surgically drained, he said.

"This has been an unprecedented event," Chiller said. "It's a new entity to us, and we're trying to engage experts in the fungal and clinical word."

View Comments (2)

Recommended for You

  • Countdown to New Hampshire With 5 Things to Watch in Tuesday's Primary

    Tuesday will be a critical moment on the road to the White House as residents of the Granite State cast their votes in the first-in-the-nation primary. With independents making up more than 40 percent of the electorate, the New Hampshire primary can often surprise, and that may be the case…

    Good Morning America
  • 'Girls' Star Lena Dunham Taking Time Off for 'Chronic' Illness

    The acclaimed HBO show "Girls" is back for a new season this month, but its biggest star will not being making press appearances due to a "chronic condition."Lena Dunham took to Instagram today to write, "I just wanted to let you know that, while I am so excited for Girls to return on Feb 21, I…

    Good Morning America
  • Royal Caribbean Cruise Ship Rocked by Hurricane-Force Winds Heads Back to New Jersey

    A Royal Caribbean cruise ship that was rocked by hurricane-force winds overnight is sailing back to port in Bayonne, New Jersey. The ship left from Cape Liberty, New Jersey, on Saturday for a seven-night cruise to the Bahamas. The company posted a message on Twitter saying that all guests are…

    Good Morning America
  • US Veteran Says He is 'ISIS Soldier,' Calls Bin Laden 'Beautiful Man,' Officials Say

    The FBI has arrested a former member of the Army on weapons charges after he allegedly expressed sympathy for ISIS, called Osama bin Laden "a beautiful man" and said the murder of government agents was "a hundred percent obligation," according to court documents filed in a Washington state federal…

    Good Morning America
  • Giant Rabbit From Scotland Looking for a Home

    The Scottish SPCA center in Glasgow has a 7-month-old continental giant rabbit up for adoption. The rabbit, Atlas, is already about the size of a Westie dog and is still expected to grow, according to a Feb. 8 press release from the Scottish SPCA. Atlas is not only the same size as a dog, but…

    Good Morning America
  • Dad Tells Other Fathers, 'Respect the Mother of Your Child' in Viral Facebook Post

    A U.K. dad’s advice to fellow dads “respect the mother of your child” has gone viral after being posted in a Facebook tribute to the mother of his 9-month-old son.Tony Emms, of Cresswell Northumberland, in the U.K., posted on Facebook last month a photo of his fiancé, Charlotte Sperry, sleeping…

    Good Morning America
  • Duchess Kate Champions Mental Health in New PSA

    Duchess Kate is on a mission. The Duchess of Cambridge, 34, is speaking out in a new public service announcement (PSA) to raise awareness for Children’s Mental Health week for her mental health charity, Place2Be. The Duchess recorded a special video message to coincide with Children’s Mental…

    Good Morning America
  • 'Kung Fu Panda 3' Stays on Top at the Box Office

    "Kung Fu Panda 3" scored another box office win during Super Bowl weekend.The animated sequel earned an estimated $21 million in its second weekend of release.'Kung Fu Panda 3' Tops the Box Office'The Revenant' Tops Weekend Box OfficeThe Coen brothers' "Hail, Caesar!" opened in second place,…

    Good Morning America
  • Peyton Manning Knows What He's Doing After Super Bowl Win

    Peyton Manning kept with tradition when it came to his Super Bowl celebration plans. The Denver Broncos won the Super Bowl against the Carolina Panthers, 24-10. During a press conference after Sunday night's game, Manning said that he was "taking his kids to Disneyland" before he and his family…

    Good Morning America
  • White House Asks Congress for $1.8 Billion to Fight Zika Virus

    The Obama administration is requesting $1.8 billion in emergency funding from Congress to fight the Zika virus in the United States and abroad, the White House announced today. The request comes after lawmakers on Capitol Hill urged the White House to address the spread of the virus, which is…

    Good Morning America
  • Dad's Piano-Playing Lullaby Soothes Baby Boy to Sleep in Seconds

    Take a look at little Samuel who couldn’t fall asleep because he had an ear infection. The moment his crafty dad starts playing his own version of the classic “Brahms’ Lullaby” however, the soothing sounds work like magic, putting the tiny tot to sleep within seconds.

    Good Morning America
  • Super Bowl 50: Beyonce Takes Fans Behind the Scenes of Her Performance

    Although Coldplay headlined the Super Bowl 50 halftime performance, all eyes were on Beyonce, who shared the stage with the British band along with pop star Bruno Mars.The singer, who announced her Formation World Tour right after the big game ended, is letting fans in on how her performance came…

    Good Morning America
  • Super Bowl 50: Peyton Manning 'Very Much at Peace'

    Peyton Manning says he’s “very much at peace” as he contemplates retirement from the NFL just hours after winning his second Super Bowl title. Manning, 39, finished 13 for 23 for 141 yards in the Broncos’ 24-10 win over the Carolina Panthers in Sunday’s Super Bowl game at California’s Levi’s…

    Good Morning America
  • Panda Cub Bei Bei Climbs a Tree With the Help of His Mom

    Bei Bei is moving up in the world.The Smithsonian National Zoo’s baby panda experienced the outdoors for the first time last week and now the nearly six-month-old cub is scaling trees—-with the help of his mom Mei Xiang, of course. The Washington DC based Zoo posted a video of the feat online this…

    Good Morning America
  • 4 Ways to Increase Your Chances of Scoring Beyonce Tour Tickets

    Minutes after Beyonce announced her 2016 Formation World Tour during Super Bowl 50, fans flooded to her website looking for more information about the tour, and temporarily crashed the site. Fans have also been tweeting in anticipation and excitement for the ticket sales to go live. Securing…

    Good Morning America
  • Paris Jackson Reveals Struggle With Alcoholism, Pressures of Fame

    Paris Jackson, the only daughter of music legend Michael Jackson, is apparently struggling with alcoholism.In a now-deleted, profanity-laced rant on Instagram, the 17-year-old told her followers that she was being attacked online."I am expected to literally sit … all day replying to comments people…

    Good Morning America
  • Russians Arrest 7 in Alleged ISIS-Related Terror Plot

    Russian security services have arrested seven people accused of plotting terror attacks on behalf of the Islamic State in major Russian cities, the country’s FSB intelligence agency said today. The arrests were made in the city of Ekaterinburg, located in the Urals region on the edge of Siberia,…

    Good Morning America