Estimated deaths and illnesses averted during fungal meningitis outbreak associated with contaminated steroid injections, United States, 2012-2013

Emerg Infect Dis. 2015 Jun;21(6):933-40. doi: 10.3201/eid2106.141558.

Abstract

During 2012-2013, the US Centers for Disease Control and Prevention and partners responded to a multistate outbreak of fungal infections linked to methylprednisolone acetate (MPA) injections produced by a compounding pharmacy. We evaluated the effects of public health actions on the scope of this outbreak. A comparison of 60-day case-fatality rates and clinical characteristics of patients given a diagnosis on or before October 4, the date the outbreak was widely publicized, with those of patients given a diagnosis after October 4 showed that an estimated 3,150 MPA injections, 153 cases of meningitis or stroke, and 124 deaths were averted. Compared with diagnosis after October 4, diagnosis on or before October 4 was significantly associated with a higher 60-day case-fatality rate (28% vs. 5%; p<0.0001). Aggressive public health action resulted in a substantially reduced estimated number of persons affected by this outbreak and improved survival of affected patients.

Keywords: Meningitis; United States; contaminated steroid injections; deaths; disease modeling; disease outbreaks; fungal; fungi; illness; public health response.

Publication types

  • Historical Article
  • Research Support, U.S. Gov't, Non-P.H.S.

MeSH terms

  • Disease Outbreaks*
  • Drug Contamination*
  • Female
  • History, 21st Century
  • Humans
  • Kaplan-Meier Estimate
  • Male
  • Meningitis, Fungal / epidemiology*
  • Meningitis, Fungal / history
  • Meningitis, Fungal / mortality
  • Meningitis, Fungal / transmission*
  • Mortality
  • Public Health
  • Public Health Surveillance
  • Steroids / administration & dosage*
  • United States / epidemiology

Substances

  • Steroids