On September 14, Tonya Snyder made an unexpected but crucial discovery, while tucked away inside a lab inside Vanderbilt University Medical Center.
Snyder found a type of fungus, which is a mold, somewhere it didn't belong.
“Finding this in the central nervous system, in the cerebral spinal fluid, is what made this so significant,” said Dr. Carol Rauch, a clinical pathologist and clinical microbiologist with VUMC.
At the time, a doctor at Vanderbilt was treating someone researchers are now calling “the index patient” and no one could figure out what was wrong.
“It seemed like the usual suspects that could account for those symptoms of meningitis were not being found,” explained Dr. Rauch.
On a hunch, the doctor ordered a test for fungal meningitis, and Snyder identified the sample taken was as a match for aspergillus fumigatus.
Dr. Rauch told Nashville's News 2, “It's common in the environment; it's common for everyone to be exposed to it.”
It's something we breathe every day, but typically doesn't affect us and is not supposed to be in cerebral spinal fluid.
Once the discovery was made, Dr. Rauch said they notified public health officials and the race to identify everyone else involved began all over the country.
“More things are unraveling, they are unraveling every day, even on our index patient,” said Dr. Rauch.
Researchers at VUMC are testing samples of cerebral spinal fluid from potential patients every single day.
So far, the index patient from VUMC is the only person infected by the aspergillus fumigatus form of the meningitis in Tennessee.
According to the Tennessee Department of Health, the rest of the cases identified up until this point are people sickened by a type of fungus called exserohilum that is linked to the meningitis outbreak.
A refrigerator in the lab currently holds about 80 vials, which are being tested for many things other than just the aspergillus and exserohilum fungi.
Dr. Rauch told Nashville's News 2 the samples are being kept for a longer period of time, as a precaution since things continue to change with the outbreak on a daily basis.
“This is still early in the investigation and although we know a lot now, there's so much more that we need to know,” said Dr. Rauch, “We are continuing to keep our eyes open and share that information as quickly as we can.”
Dr. Rauch added, “We still don't know about a variety of things and if we suspect an environmental contamination, the environmental source is likely to have many organisms in it. So we are paying attention to see ultimately, how many things are in there.”
Also, Dr. Rauch told Nashville's News 2, “After the investigation, which also involves the FDA and other authorities, we're hopeful that some response will occur to address the underlying concern of quality control and regulation.”
Dr. Rauch anticipated the number of samples they get from around the state only to increase as more and more information is discovered about the outbreak.
“This will be at least many months,” she said, “This has been occupying a lot of time and energy for a number of us.”
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- Oct. 11, 2012: Attorneys expect number of lawsuits in meningitis outbreak
- Oct. 11, 2012: Meningitis outbreak toll: 170 cases, 14 deaths
- Oct. 10, 2012: Meningitis cases in Tennessee increase to 44
- Oct. 9, 2012: What does life look like for fungal meningitis survivors?
- Oct. 9, 2012: Meningitis outbreak deaths rise to 6 in Tenn.
- Oct. 8, 2012: 4 Tenn. deaths linked to meningitis, 8 nationwide
- Oct. 7, 2012: CDC: More than 90 people ill with meningitis
- Oct. 6, 2012: CDC: Meningitis outbreak death toll rises to 7
- Oct. 5, 2012: 29 Sickened from fungal meningitis in Tennessee
- Oct. 4, 2012: Meningitis outbreak claims 3rd victim in Tennessee
- Oct. 3, 2012: Massachusetts firm tied to outbreak suspends operations
- Oct. 3, 2012: Rare meningitis cases up to 26 in 5 states, 4 die
- Oct. 2, 2012: Epidural patients worry about meningitis
- Oct. 2, 2012: 2 additional cases identified in meningitis 'outbreak'
- Oct. 1, 2012: Meningitis vaccinations offer best protection against infection
- Oct. 1, 2012: Nashville outpatient facility closed after 2 meningitis deaths