Saturday, October 06, 2012
Southwest Virginia hospitals screening for meningitis cases
Doctors have notified patients who received the tainted steroid.
Stephanie Klein-Davis | The Roanoke Times
Victor Giovanetti, CEO of LewisGale Regional Health System (from left); Dr. Stephanie Harper, director of the Alleghany Health District; Dr. Gary Winfield, chief medical officer for LewisGale Regional Health System; Dr. Thomas Kerkering, Carilion’s director for infection control; and Dr. Molly O’Dell, health director of the New River Valley Health District, address a news conference Friday concerning the recent fungal meningitis outbreak tied to tainted steroid injections.
A patient who died at LewisGale Medical Center in mid-September is the lone confirmed Virginia death in the meningitis outbreak that has sickened or killed people in seven states, Virginia Department of Health officials said Friday.
Meanwhile the number of people affected by the outbreak mounted, with 100 people evaluated at area hospitals for meningitis by late Friday afternoon.
State health officials said 661 patients of Insight Imaging in Roanoke and 28 patients of New River Valley Surgery Center in Montgomery County were among those who got a now-recalled steroid injection linked to the escalating U.S. outbreak.
Investigators have focused on a steroid that was custom-made by a specialty pharmacy, New England Compounding Center in Framingham, Mass. Health inspectors found fungus in at least one sealed vial of the steroid at the company's facility this week. The pharmacy recalled 17,676 single-dose vials of the steroid, methylprednisolone acetate. Shipments went to about 75 clinics in 23 states, including the two in Southwest Virginia. No other Virginia clinics received the contaminated medicine, officials said.
Health officials tried to warn the hundreds of patients who had received the shots to seek medical attention for even the mildest symptoms. But they also sought to calm a worried public by emphasizing that the rare form of fungal meningitis is not contagious.
Dr. Stephanie Harper, director of the Alleghany Health District, said hospitals and medical providers have expressed concerns that some patients may be reluctant to seek medical care for unrelated issues because of fear surrounding the outbreak.
"I just want to emphasize that this meningitis is not contagious, so it is not passed person to person," she said. "I just want to encourage our community residents to come and get care as is required."
Even as the number of people affected by the outbreak grew, the Virginia Department of Health confirmed just two more illnesses in the state, bringing the official number to six, including the one death. Nationally, the number of cases rose to 47 Friday. Five people have died.
Dr. David Trump, Virginia's state epidemiologist, said Friday that the single confirmed death was a patient admitted in mid-September with an "unexplained meningitis" infection that was under investigation by the medical examiner.
He said the death was linked to the outbreak through medical records that indicate the patient had the same infection seen in other patients, and said the patient received an injection from one of the contaminated lots.
Harper said that the death of a patient at LewisGale Medical Center is the same death being reported by the state. Salem is part of the Alleghany Health District.
Neither the health department nor LewisGale would provide additional information about the patient who died, citing privacy concerns.
But a Salem woman is convinced that the unnamed patient is her husband, and she said she is consulting a lawyer.
Douglas Wingate died Sept. 18 after being diagnosed with meningitis, Sharon Wingate said. He was 47.
He was admitted to LewisGale on Sept. 11 and was quickly diagnosed with meningitis. But he didn't respond to treatments and began to have seizures and strokes, his wife said.
After his death, officials began to suspect West Nile virus and ordered an autopsy, Wingate said.
She no longer thinks the cause was West Nile, but rather the outbreak that has killed at least five in the United States.
Fueling her suspicion is the fact that her husband had a steroid injection in his "neck area" at Insight just five days before he was diagnosed with meningitis. The injection was intended to relieve pain from a pinched nerve, she said.
A medical examiner office's administrator said Thursday that the cause and manner of Wingate's death are still pending, and that it will be at least Tuesday before any results are ready.
Sharon Wingate said she is frustrated that no state or hospital officials have called her or answered her questions when she has called.
"I'm going to meet with a lawyer," she said. "I'm hoping he can get me some definitive answers. I've got to have some closure. I can't do anything unless I have cause of death on the death certificate. I can't collect benefits. Right now I'm a single parent. I've got obligations that I have to meet."
As Wingate fights for information, health officials, with the help of the two outpatient centers, have focused on contacting all patients who received the tainted injections.
By now, every person affected has been contacted, Harper said. Insight and New River Surgery Center both called patients, and certified letters were sent Friday to patients who were not reached by phone, Harper said.
All affected patients were given a shot for back pain between July and September, health officials said.
Trump said the two clinics have been "extremely cooperative," with Insight setting up a call center to handle the high number of patients involved.
Some patients received multiple injections, Trump said, but Insight kept detailed records of which lot of the medication each received.
Additionally, the Virginia Department of Health has sent information about the outbreak to clinicians across the state, State Health Commissioner Karen Remley said.
There's no reason to be concerned about cases in other areas of the state, she said, but a person who lives in the Roanoke or New River valleys might become symptomatic while out of town, and the health department wants physicians across the state to be armed with the information that would allow them to recognize it.
In the weeks ahead, the health department will continue to track patients' experiences, Trump said.
The efforts to reach people have led to a flood of hospital visits.
As of Friday afternoon, 48 patients had been evaluated at Carilion Roanoke Memorial Hospital, with 11 admitted for care, spokesman Eric Earnhart said.
At least five patients were seen Friday at Carilion New River Valley Medical Center, he said.
At LewisGale Medical Center, which was the first hospital in the region to confirm a case, 41 patients have been evaluated and 10 have been admitted, according to a news release. LewisGale doctors also evaluated four patients and admitted one at its Alleghany hospital and evaluated one patient at LewisGale Hospital Montgomery.
Centra Lynchburg General Hospital is treating one meningitis patient, a spokeswoman said Friday.
The first known case in the outbreak was diagnosed about two weeks ago in Tennessee. Meningitis is an inflammation of the lining of the brain and spinal cord. Symptoms include severe headache, nausea, dizziness and fever.
"We expect the numbers to increase over the next several days to weeks," Trump said.
He said that while a quick examination of spinal fluid can give doctors a clue about infection, a lab confirmation can take weeks because a fungus is difficult to culture and is very slow-growing.
"We are very early in this investigation across the United States," he said. "We don't know how, in this setting, this infection is going to progress."
Staff writer Matt Chittum and The Associated Press contributed to this report.