Meningitis outbreak claims 3rd victim in Tennessee

Meningitis outbreak claims 3rd victim in Tennessee (Image 1)

Tennessee has recorded its third death likely caused by a rare and deadly form of meningitis that has sickened at least 35 people in six states.

Dr. Robert Latham, chief of medicine at Saint Thomas Hospital in Nashville, said Thursday a patient died there Wednesday afternoon.

The woman, 56-year-old Diana Reed, was a member of the Otter Creek Church of Christ in Brentwood and the wife of Wayne Reed, namesake of The Wayne Reed Christian Childcare Center on Lindsley Avenue.  Church officials declined to provide any additional information.

Reed’s death brings the number of deaths in Tennessee linked to the meningitis outbreak to three.  Two other deaths were reported in Virginia and in Maryland.

According to The Tennessean, the first death in Tennessee occurred on September 17 when a 78-year-old man died at Vanderbilt University Medical Center.

Less than two weeks later, 55-year-old Thomas Warren Rybinski, of Smyrna, died at Vanderbilt.

Rybinski worked at General Motors for more than 35 years, according to his obituary. His brother in Michigan, Bob Rybinski, told The Tennessean his death was too fresh to talk about when reached by phone Thursday evening.  He is survived by his wife, Colette, a daughter and two sons.

Vanderbilt spokeswoman Melissa Stamm confirmed with the paper that Rybinski died of aspergillus meningitis on September 29. Aspergillus is a mold commonly found in the environment.

All victims received steroid injections, mostly for back pain, a fairly typical treatment.

The type of meningitis involved is not contagious and is caused by a fungus often found in leaf mold.  Health officials suspect that may have been in the steroid and more cases are almost certain to appear in the coming days.

The drug linked to the outbreak was made by the New England Compounding Center.

The government on Thursday issued a warning to doctors and hospitals across the country to not use any product from the Massachusetts specialty pharmacy.

A Food and Drug Administration official said tests found contamination in a sealed vial of the steroid at the pharmacy.  Tests are underway to determine if it is the same fungus blamed in the outbreak.

The pharmacy issued a recall last week and has shut down operations.  The steroid was sent to 75 facilities in 23 states.

Saint Thomas Outpatient Neurosurgery Center in Nashville received the largest shipment.

While TriStar Health did not have any of the medicine from the batch in question, the medical group that includes Skyline, Summit, Horizon, Stonecrest, Southern Hills, Hendersonville and Bowling Green’s Greenview hospitals pulled all NECC products as a precaution.

Neither Baptist Hospital nor Vanderbilt University Medical Center had NECC products on site.

Pharmacists: Compounding important part of protecting public health

Compounding is when a pharmacist makes a tailored medication for a specific patient based on a doctor’s instructions.

“Pharmacists are educated and for centuries have been in the practice of bringing together ingredients to make a product to help individuals get better and improve the quality of life,” Dr. Roger Davis, Dean of Lipscomb University’s College of Pharmacy, said.

Dr. Davis said compounding was the standard form of producing prescriptions up until the 1940s and 1950s when prescription manufacturing began to increase.

Compounding began to make a comeback after a shortage of commercially produced drugs combined with a shortage in specialty prescription drugs in the 1990s.

“Compounding has to be differentiated from manufacturing,” Dr. Davis said. “Manufacturing is something that’s done and regulated by the Food and Drug Administration on a national basis and the product is manufactured under good manufacturing principles.”

Even though the New England Compounding Center has compounding in its name, it appears to be more of a manufacturing operation.

According to the FDA, the company produced thousands of vials of the epidural steroid now linked to the fungal meningitis outbreak. The vials were distributed to at least five states in mass quantities.

There are two types of compounding pharmacies. One is a sterile compounding pharmacy which compounds medications that are injected, like the epidural steroid, IV solutions and eye drops.

Non-sterile compounding pharmacies can make creams, lotions and capsules.

Compounding pharmacies are regulated by state boards.  In Tennessee, the Board of Pharmacy within the Tennessee Department of Health monitors compounding pharmacies.

Tennessee Poison Center inundated with calls

As expected, the Tennessee Poison Center hotline is experiencing an exceptionally high call volume due to the meningitis outbreak.

The agency partnered with the Tennessee Department of Health to try to address the citizens’ concerns.

This week calls coming in to the hotline have increased by 30%.

“It has been really challenging but the staff has really stepped up.  Everyone has been working extra shifts and coming in off vacation and things like that,” said Dr. Donna Seger, Medical Director of the Tennessee Poison Center.

A staff of doctors, nurses and pharmacists who take the calls have been able to calm the nerves of many concerned residents.

Dr. Seger says most of them want to know more about the different types of meningitis and what the symptoms are, but some are asking questions the center simply can’t answer.

“I think it’s very important for the public to realize we do not have information that has not been released to the media by the department of health.  We have the same information as everybody does,” Dr. Seger told Nashville’s News 2.

Anyone with concerns should call the state hotline at 1-800-222-1222.

Fungal meningitis unrelated to other meningitis cases

The most recent meningitis deaths are unrelated to two deaths linked to meningitis last month in Tennessee.

On September 10, 18-year-old Jacob Nunley, a freshman at Middle Tennessee State University in Murfreesboro, died of bacterial meningitis.  Eighteen days later, on September 28, nine-year-old Sam McLeod, a student at West Elementary School in Mt. Juliet, died from a non-contagious form of the illness.

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