Michigan woman identified as first Indiana fungal meningitis death

INDIANAPOLIS (WISH/AP) - Health officials now confirm a Michigan woman is believed to have died after receiving a tainted steroid injection from an Indiana clinic.

The family of Pauline Burema, 89, of Cassopolis, Michigan says it believes she died of fungal meningitis after receiving two injections of a tainted back pain medication at a northern Indiana clinic.
 
Lisa Ann Durbin says her grandmother died Wednesday at a daughter's home in Bristol, Indiana in Elkhart County.
 
 Durbin says the family is still awaiting autopsy results to confirm the cause of death. However, doctors told the family they believe Burema had contracted meningitis from shots she received Aug. 22 and Sept. 8 at OSMC Outpatient Surgery Center in Elkhart. She says Burema was found unconscious in her home Oct. 3.
 
The CDC confirmed an Indiana fungal meningitis death Thursday, and a Michigan Community Health Department spokeswoman says it was a Cass County resident.

The Indiana State Department of Health was not confirming the identity of the patient late Thursday.

At least 21 people have now contracted meningitis in Indiana after receiving a dose of a steroid containing fungal meningitis from a lab in Massachusetts. Despite that rising number, the department lowered the number of total patients it believes were exposed to the shot, from 1,577 to 1,568. All of the patients believed to have received the injection have been contacted, ISDH State Epidemiologist Pam Pantones told 24-Hour News 8.

Five of the six locations where the shots were given in Indiana are near state borders, including South Bend, Elkhart, Evansville, Fort Wayne and Terre Haute. Injections manufactured at the New England Compounding Center (NECC) were also administered in Columbus.

“CDC from the beginning of this outbreak investigation has determined that states should count cases according to where the injection was received. This is because people may cross state lines to seek health care, and they want to make sure this is tracked very appropriately, without duplicate cases being counted among states,” said Pantones.

The State Health Department is redoubling its efforts to see if other patients may have traveled to Indiana from out of state for the injection as well.

“That happens across many different states, where folks may live in one state but seek health care over the border in a neighboring state. So, we work very closely with our border states about residents we might see from those other states, where they potentially sought health care. if we know of an out of state resident, then we notify that other state,” Pantones said.

State health officials are confident no additional Indiana clinics are involved, and all doses of the tainted drug that were delivered to Indiana have been quarantined for further investigation, Pantones said.

Federal health officials said they've tracked down more than 90 percent of the roughly 14,000 people who may have received contaminated steroid shots, urging anyone with early symptoms of potentially deadly meningitis to seek help fast. Of the 170 people sickened in the outbreak, all but one have a rare fungal meningitis, and 14 have died, the Centers for Disease Control and Prevention said Thursday. View the map from the CDC here .

While the biggest concern is for people given the shots for back pain, the CDC said people who received the injections in joints should also be alert to signs of localized infection, including redness, pain, swelling and fever.

More than 50 vials of the steroid produced by the NECC have been found contaminated with some sort of fungus, said Deborah Autor of the Food and Drug Administration. The investigation is continuing into how the contamination could have occurred.

An investigation is also underway through the Indiana Board of Pharmacy, though its director Gregory Pachmayr told 24-Hour News 8 Thursday that no formal complaint or petition for suspension has been filed against the lab in Indiana. While the NECC has voluntarily recalled its medications and temporarily shut down operations, its non-resident license to distribute medicine in Indiana remains valid.