October 24, 2012
Families across the state are understandably worried due to recent headlines about a nationwide outbreak of the fungal disease meningitis. The outbreak has been especially concerning due to the fact that its source has been traced to right here in Massachusetts. However, it is not time to panic, but rather time to educate yourself about the disease. While it is smart to remain vigilant, the Department of Public Health has informed me that the risk of infection remains low, and there are precautions we all can take.
First, it's important to note that the outbreak's source in Massachusetts is not some wandering rabid cow or a town that has been infected and whose residents are spreading the disease contagiously. It was a drug shipping center that appears to have sold a certain injectable steroid, methylprednisolone, contaminated with the disease, meaning that the disease did not actually start infecting people until the drugs were sent out to their destinations across the country. Therefore, there is no greater risk of infection in Massachusetts than anywhere else in the US. In fact, there have been no reported cases in Massachusetts so far; in bordering states, New Hampshire has reported eight cases and New York one (no deaths).
According to the government, 97% of potentially exposed patients have been contacted, so if you are at immediate risk, you almost certainly know about it already. There is no direct cause for concern for people who do not use injectable steroids, and even if you do, only steroids made by the New England Compounding Center are possibly infected. Again, if your steroids come from there, your pharmacy or the government will have contacted you. And, of course, the NECC has ceased operations, so you can no longer just go out and unknowingly buy one of their contaminated drugs.
Unfortunately, using an infected drug is not the only way to get meningitis; infected people can transmit the disease as well, although this is preventable through common sense. Meningitis is not transmitted through the air, but rather by coming into contact with "infected secretions" from someone who is sick with it—in other words, saliva and nose mucus. Out of an abundance of caution, do not share eating utensils or food with a potentially infected person, and do not be around them when they are coughing or sneezing. However, if you are just walking around in public, you have no need to fear contracting the disease.
Symptoms of meningitis include fever and chills, nausea and vomiting, severe headache, and most famously, a stiff neck. People with compromised immune systems, such as people with transplants, are particularly at risk.
The good news—and there is plenty—is that meningitis is treatable. Voriconazole, a powerful anti-fungal drug, has proven effective in holding back the infection. The earlier the disease is diagnosed, the better, of course, so if you are among the at-risk population and experience the symptoms, get checked out and get the medication sooner rather than later. Luckily, doctors have so far been able to identify this strain of meningitis relatively easily, resulting in a low infection rate (2% of exposed people) and a low mortality rate (8% of those infected) so far for this specific outbreak.
If you know you have received a potentially contaminated shot but are not experiencing symptoms, authorities actually recommend against taking anti-fungal medications. The side effects are not worth the possible—and, indeed, still theoretical—benefits. However, people in this situation should obviously keep a very close eye on their health and may even choose to get tested for meningitis or the presence of a fungus before symptoms appear. After the fungus that causes meningitis is introduced, it can take between two and 28 days for it to incubate and for symptoms to manifest themselves.
If you have any questions or concerns, the Massachusetts Department of Public Health is here to help. Call them at (617) 983-6800 or toll-free at (888) 658-2850.