December 31, 2012
Lilian Cary knew she wasn't feeling well, but what the late Howell resident didn't know — what no one knew — was that she would be among the first victims of a fungal meningitis outbreak whose impact will continue into the new year and beyond.
While remembered for her kindness and friendliness, the 67-year-old Cary's death Sept. 30 from fungal meningitis put a local focus on the national outbreak.
Livingston County remained at the forefront, even as the outbreak grew nationwide.
Meningitis is an inflammation of the membranes surrounding the brain and spinal cord.
By year's end, 13 Michigan residents had died, including four from Livingston County, and more than 200 others required medical treatment for meningitis or related symptoms.
Nationally, the outbreak claimed 39 lives, with at least 620 cases reported in 19 states from Florida to Idaho. Michigan, with at least 223 cases, was the state most heavily affected.
Many of those who fell ill had previously received steroid shots to relieve back pain at Michigan Pain Specialists, a Genoa Township-based medical facility. The steroid solutions, however, had been contaminated during mixing at the New England Compounding Center, a now-closed facility in Framingham, Mass.
Substances found in the contaminated steroid solutions were likened to black mold.
Due to the rising number of local cases, Saint Joseph Mercy Hospital in Washtenaw County gained emergency state permission to expand operating room capacity and add equipment to handle the outbreak.
The hospital system had earlier consolidated its meningitis treatment facilities at the Ypsilanti-area site, but officials admitted the outbreak was unlike any other.
"We don't have a lot to draw on — and by that, I mean the medical community at large," Dr. Lakshmi Halasyamani, Saint Joseph's chief medical officer, said in mid-October as the outbreak took hold.
The outbreak came in two waves. While the number of patients who developed meningitis began to taper off by late October, a second wave of patients developed epidural abscesses — painful infections near the injection site which themselves could have spread meningitis if left untreated.
Among Michigan residents, there were 64 cases of meningitis, including 38 with additional epidural abscesses; 142 reports of abscesses alone; 20 joint infections; and one meningitis-related stroke, in addition to the fatalities.
At the same time, Congress, began debating tougher restrictions on compounding facilities, like NECC, which produce large amounts of drugs for national distribution.
Compounding facilities, including neighborhood pharmacies, have generally been exempt from U.S. Food and Drug Administration regulation because their newly created compounds are made from already-approved drugs.
U.S. Rep. Mike Rogers, R-Brighton, was central to the initial congressional investigation as a member of the House Energy and Commerce Committee, which held a mid-November hearing on the outbreak.
At the same time, the Rogers' stepmother was being treated for a meningitis-related abscess at Saint Joseph Mercy Hospital.
Congressional hearings didn't forestall individuals from filing lawsuits against the compounding center.
In subsequent news, the compounding center linked to the outbreak filed for Chapter 11 bankruptcy protection, while its owners promised to create a fund to compensate victims.
It remains to be seen whether that action will forestall additional lawsuits, which could take years to resolve.
Families of those whose loved ones were still in treatment, or slowly recovering at home said they were worried the outbreak would soon fade from memory even as their struggles continued.
It also remains to be seen whether Congress will expand federal oversight into compounding pharmacies.
Contact Daily Press & Argus reporter Wayne Peal at 517-548-7081 or at wpeal@gannett.com.
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