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Doc: 'Never seen' meningitis outbreak like this

Associated Press Television—October 4, 2012

A rare meningitis outbreak has infected 35 people in six states, health officials warn. All received steroid injections, a fairly typical treatment. One New York anesthesiologist, Dr. Daniel Richman, of Hospital for Special Surgery, says "It's the first time I've ever seen anything like this."

As you can see the drugs are injected either here or sometimes in cervical epidural space into the spinal canal called neuraxial injection--injecting into the neuraxis.

If you have something as contagious as fungus aspergillus that was injected that can get into the spinal canal and into the meninges which is the covering of the spinal cord and around the spinal fluid and develop meningitis, which is a severe infection.

It's the first time I have ever seen anything like this. I have been safely giving epidural steroid injections for 22 years and have never seen this or heard of anything like this.

Overall, this is one of the safest procedures that one can have for back pain or sciatica. We perform these injections frequently and it's very common and can help manage pain in a big way for patients who don’t wish to have surgery or aren’t candidates for surgery.

The fear that has been generated is that there is no way of knowing or protecting against this because the anesthesiologist who is doing the injection, the nurse who is preparing the materials for the injection, would have no idea that this is a contaminated lot.

Many patients come for an epidural steroid injection. I think the patient should ask what is the name of the steroid they are getting. Is it a single dose vial? There are all sorts of things we can do to prevent against infections, what I call iatrogenic infections that can be caused by the person doing the procedure. That is the best that we can do, to do it under meticulous sterile technique from the storage of the drug to the point were it is provided to the patient.

This video originally appeared at video.ap.org.


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