By SYDNEY LUPKIN
Nov. 7, 2012
The 42-day risk period for contracting fungal meningitis from tainted steroid injections ended on Wednesday, since the drugs were recalled on Sept. 26, but new case reports will probably continue to trickle into the Centers for Disease Control and Prevention for at least a few months, said Dr. Tom Chiller, a fungal disease expert at the CDC
With 18 new cases reported last Friday, and abscesses causing even fungal meningitis survivors to go back to the hospital with new symptoms, sighs of relief could be premature.
“Forty-two days is not a magic number by any sense of the word,” said Chiller, who is the deputy chief of the CDC’s Mycotic Diseases Branch. “This is a moving target. The outbreak is evolving.”
The CDC publicized the 42-day period as a way for individual physicians to determine whether putting all at-risk patients on anti-fungal medications was a good idea, Chiller said. Since anti-fungal medicine can cause liver and kidney damage, there was a risk it could do more harm than good. The long risk period would mean a long anti-fungal regimen.
A CDC analysis revealed that while preemptive anti-fungal prescriptions reduced patients’ risk of death or stroke from meningitis by .1 percent, they increased the risk of other adverse health problems by up to 14 percent, Chiller said.
Chiller said this kind of fungus, exserohilum rostratum, can have a very long incubation period. Although the median incubation period so far has been 20 days, the longest incubation period went beyond 100 days, he said.
“One of the important things to add is that we do feel pretty confident that the further out you are from injection, the lower the risk,” Chiller said. “When that risk becomes zero, we don’t know.”
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