Dear SIDP Members:
Below please find updated information from the CDC regarding the Fungal Meningitis Outbreak, including a new telephone consultation network and unusual complications associated with the outbreak.
We are writing to request your organization’s assistance in sharing the following information about the ongoing multistate outbreak of fungal meningitis and other infections:
- the availability of a new telephone-based Clinicians Consultation Network service to assist clinicians treating patients who received injections with the contaminated steroid medication; and
- recent indications of two unusual clinical complications – epidural abscess and arachnoiditis – among a portion of patients undergoing treatment for meningitis associated with injections of a contaminated steroid medication, preservative-free methylprednisolone acetate.
Clinicians Consultation Network
Beginning on November 6, CDC is establishing a volunteer Clinicians Consultation Network of experts in fungal disease treatment and management to assist physicians who are directly involved in the treatment of patients associated with the current outbreak of fungal meningitis and other infections. Through this service, doctors who are treating patients will be able to consult by telephone or email with one of a group of participating infectious disease medical experts. To access the service, physicians should call 1-800-CDC-INFO (1-800-232-4636) and then select the appropriate prompts (e.g., “1” for English, “1” for Clinician). A CDC-INFO call agent will verify each physician’s role in direct patient management. After this verification, the calling physician will be referred to the Clinicians Consultation Network. The Network consultants have entered into volunteer agreements with CDC to provide this consultation service to treating physicians. There is no charge for the consultation. The consultants will report their findings to CDC, which may provide valuable information for the response to the outbreak. Operating hours for the service are the same as those for CDC-INFO: 8:00 am to 8:00 pm Monday through Friday (Eastern Time), except federal holidays.
If you have questions about the Clinicians Consultation Network, please contact CDC-INFO (1-800-232-4636).
New Information on Clinical Course
During the course of this investigation, CDC has worked closely with a group of fungal infectious disease experts who provided their individual input to help CDC develop interim guidance and other information about clinical aspects of the outbreak, including patient management and treatment. The guidance documents have been updated regularly as CDC and its partners have learned more about the outbreak; the latest versions are available on CDC’s outbreak-related Clinician Guidance webpage at http://www.cdc.gov/hai/outbreaks/clinicians/index.html. CDC has also advised that healthcare providers involved in the treatment of these patients consult with an infectious disease medical specialist because of the diagnostic and clinical challenges presented by these fungal infections.
CDC has recently become aware of reports of epidural abscess and arachnoiditis among a number of patients undergoing treatment for fungal meningitis associated with injections of contaminated steroid. Spinal epidural abscesses are characterized by inflammation and a collection of pus around the spine, sometimes resulting in swelling of the infected areas (though several recently reported patients with this condition had no detectable swelling). Arachnoiditis is caused by inflammation of the arachnoid, one of the membranes that surround and protect the nerves of the spinal cord. Both conditions are normally rare but serious disorders that require prompt medical attention. Most of these early reports have been for patients in Michigan and Tennessee, but other states have reported patients with these conditions as well. CDC is working with clinicians and public health officials to obtain more information and refine its clinical guidance as needed.
For additional information about the outbreak of fungal meningitis and other infections, see CDC’s website at http://wwwdev.cdc.gov/hai/outbreaks/meningitis.html.