Study: Aftermath of contaminated steroid injections lingers

UC Davis study finds lingering effects of meningitis outbreak.

UC Davis study finds lingering effects of meningitis outbreak.

September 2012 marked the beginning of a widespread meningitis outbreak that resulted from a contaminated batch of steroid injections. The first case was reported in Tennessee, according to the U.S. Centers for Disease Control and Prevention, but soon the rest of the country would experience hundreds of reports of meningitis infections, all linked to steroids derived from the New England Compounding Center. 

In total, 722 cases were documented and 50 individuals succumbed to their infections, making this outbreak the largest case of healthcare-acquired infection to date in the U.S., the CDC reported. 

While the incident is no longer the daily subject of headlines in major newspapers, the effects linger on. The CDC estimated that more than 13,500 patients were exposed to the tainted steroids, and a new study from researchers at the University of California, Davis indicates that even if patients who received the injections never experienced worsening symptoms, they still may be at risk of long-term effects

"Exposed patients may have paraspinal or spinal infections even though they do not notice any increase in pain or neuropathic symptoms. Magnetic resonance imaging at the injection site is recommended to screen for infection in high-risk patients, but it should not be widely adopted, particularly for patients who received injections in peripheral joints, which the study associated with a much lower attack rate," said George R. Thompson, researcher and UC Davis assistant professor of medical microbiology and immunology, in a release. 

Thompson added that awareness of this issue and collaboration between healthcare professionals is integral to stemming further complications. Chiropractors, family physicians and radiologists should be well-versed in identifying signs of lingering infection, and also know what symptoms to look for in an MRI. Long-term effects of fungal meningitis include cognitive problems, loss of balance or coordination, deafness, weakness or paralysis, loss of vision, seizures and difficulties speaking. 

How web based medical software can help
On a small scale, practitioners can use their chiropractic EHR to identify patients who may have been exposed to contaminated steroids, as the technology makes patients' treatment history easy to access. Using this data, chiropractors can be proactive in screening for ongoing infection in steroid injection patients, potentially helping to curb serious problems – a boon to both overall patient care and lowering healthcare costs. 

On a larger scale, EHRs can help identify future outbreaks that could pose serious threats to public health. According to a 2012 report by the New York Times, web based medical software can allow healthcare professionals to swiftly pick up on the epidemiology of contagious disease, as well as illnesses that may stem from contaminated water, food or drugs. 

"By combing through the data now received almost continuously from hospitals and other medical facilities, some health departments are spotting and combating outbreaks with unprecedented speed," according to the news source. 

The Times cited one instance in Michigan, where officials noticed an increased number of E. coli infections across several counties. It took less than one week for them to conclude that the bacteria was stemming from sprouts used by a popular sandwich chain, allowing them to issue a public notice and recall the vegetables, and potentially preventing infection in many more people. 

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