Meningitis outbreak is linked to steroid

When Steve Hlusak's wife spent a week in the hospital for pneumonia and kidney and bladder infections last month, doctors gave her antibiotics to fight the bacteria they considered at fault.

But with news this week that a tainted steroid might be to blame for a nationwide outbreak of meningitis and other illnesses, the Brooklyn Park couple are no longer sure the doctors had the right culprit.

Katherine Hlusak, 72, was among hundreds of patients who received steroid injections for pain relief at one of two Twin Cities clinics that purchased the drug from a Massachusetts firm now under scrutiny.

"She was receiving those shots for her back," Steve Hlusak said, "We're kind of wondering if all those infections might have come from the steroid shots."

The Hlusaks' story reflects the unease that many Minnesotans felt late this week upon learning of the disease outbreak and its link to fairly common injections of methylprednisolone acetate, a steroid given for chronic pain.

Early Friday, Minnesota Advanced Pain Specialists (MAPS), one of two local clinic groups to use the steroid, reported four patients with symptoms that suggested a possible infection. By late afternoon, Dr. Ruth Lynfield, state epidemiologist, said that number was at 25.

No actual meningitis cases were confirmed in Minnesota as of late Friday.

Cases in seven states

The U.S. Centers for Disease Control and Prevention said late Friday that it had confirmed 47 patients in seven states with fungal infections linked to the steroid. Five have died.

Investigators said Thursday they found fungus in at least one sealed vial of the steroid at the company's facility and were conducting tests to identify it. The company has recalled the product, and on Friday, federal authorities identified 75 clinics nationwide that had received it.

"All patients who may have received these medications need to be tracked down immediately," said the CDC's Dr. Benjamin Park. "It is possible that if patients with infection are identified soon and put on appropriate antifungal therapy lives may be saved."

The Minnesota Department of Health said the pool of people at risk in this state is confined to several hundred patients who received the steroid injections epidurally (in the spine) or in other parts of the body at the MAPS clinics or the Minnesota Surgery Center locations in Edina and Maple Grove.

The growing number of Minnesota patients reporting symptoms may reflect the "low threshold" the state is using to consider people at risk and to recommend that they seek medical evaluations, Lynfield said. The fact that all of these patients suffered chronic pain — and already suffered from a variety of symptoms — makes it difficult to sort out by phone those who were already sick from those who might have suffered infections from the steroids.

"It's going to be very challenging to sort things out," Lynfield said.

Fever, dizziness

Possible symptoms include headaches, fevers, light sensitivity, neck stiffness, and pain at the injection site. In severe cases, patients suffered stroke-like symptoms that included weakness, difficulty with speech and vision changes.

Katherine Hlusak received a steroid injection for back pain in mid-August, and weeks later suffered a variety of symptoms including severe nausea, dizziness and slurred speech. After a week in the hospital and two weeks in nursing care, she returned home Oct. 2.

Now she's eager to learn if the injection was the cause.

"If that's the case," she said, "and this is what I had, I'm mighty mad. Mighty mad."

Jeremy Olson • 612-673-7744