More on that later. There are some serious issues at stake here, the first being why common, can become lethal.
Let’s talk hypothetical basics:
“Okay everyone. Line up. I want to swab your skin, and your throats. … Great…. Off you go now, and I’ll come back later with the results.”
Guess what.
Those throat swabs
would show a RAFT of bacteria, normally thought of as big killers. Things
like Staph Aureus,
or the dreaded MRSA.
Pneumococcus, neisseriae
– both of which can cause invasive disease. You might even find clostridium
of many types in the throat, since it’s known that quite a high percentage
of people carry it in their guts normally. There might also be fungi, and a
raft of rhinoviruses, adenoviruses, whooping cough bacteria and… goodness
knows what else… as well. Normal people probably inhale millions of
Aspergillus and Exserohilum spores into their lungs, and often introduce
these fungi into their broken skin. It’s called, “life”!
Those skin swabs
usually show diphtheroids, streptococcus types, and staphylococcus, all of
which can cause problems particularly necrotising
fasciitis which is on the rise in New Zealand. It’s
notable to me that necrotising fasciitis is far more common amongst people
prescribed “pain medication” or “non-steroidal anti-inflammatories” (same
difference). Why might that be? Because pain medication markedly slows down
the part of the immune system which deals with bacteria in the system, and
gives the bacteria a survival advantage.
We are literally riddled with all sorts of things which just because you
can’t see them, you assume they aren’t there. As
one
website puts it:
“Our skin is home to about a
trillion microscopic organisms like bacteria and fungi. Together, these
creatures and their genetic material—their genomes—make up the microbiome of
human skin.”
Your tummy button alone, is a veritable mine of more than 1,400 different
species.
To get a good handle on what they are starting to find on, and in your
body, read
this
If some of these bacteria somehow get into your system, and if your immune
system, for whatever reason, can’t cope – you can be in serious trouble. Why
and how, might that happen?
Part of the answer to that problem is the WAY the medical profession treats
both infection AND pain.
Far too often, if a doctor sees a pain problem, their “go-to” method of
stopping the person feeling the pain is to drug it. In my opinion, that’s
something that has to stop. This
article stated that millions of steroid joint injections are given yearly
for pain, because it’s “bread and butter” orthopaedics.
If the problem is seen to be bacterial, viral or fungi, the system
recommends the napalm it, nuke it,
poison it, or kill it approach. This systemic napalm
approach, especially for non-life threatening events, is a practice that
needs to be rethought.
But back to the Meningitis outbreak
In May this year, the FDA notified the
public that they were investigating an outbreak of
meningitis amongst people who received spinal injections of a steroid called
methylprednisolone acetate produced and distributed by New England
Compounding Center (NECC) in Framingham, Massachusetts.
As of Tuesday, the
toll from the fungal meningitis outbreak stood at 15 dead and 231 people
infected, some of whom have had strokes as a result. The fungi involved are
very common - "ubiquitous" is the word used to describe it. The one causing
the most infections, is called Exserohilum
rostratum
which is a common mold that grows on my lawn, in my garden
soil and on my plants. The other is Aspergillus, which loves to contaminate
starchy foods like bread and potatoes, but also happily grows in or on
plants and trees. Both fungus species are in most people’s houses and they
don’t know it; we eat it, and it could come up as a finding on skin swabs,
or throat swabs.
BUT under normal circumstance, these two fungus species ONLY cause
infections in immunosuppressed people, people who are on cancer treatments,
whose body flora has been utterly trashed by the treatment….or …. like
clostridicum difficile, in people napalm-bombed with antibiotics
indiscriminately.
When a dose of steroids is injected, it’s designed to suppress
inflammation. If you inject a sterile steroid dose into the spinal lesion,
and introduce some fungal spores into the skin abrasion, that’s still not a
big deal, no serious consequences. But when they are injected together, then
a culture media for the fungi to grow unchecked is created at the site of
injection, and then the fungus literally explodes into the body from there,
so this contamination in a STEROID, because of what a steroid does, is a big
deal.
Most of the infections from the spinally injected steroids have so far been
Exserohilum rostratum, causing meningitis, strokes and other conditions.
One medical website describes some
Exserohilum presentations as mycotic
keratitis, an inflammation of the cornea, the transparent membrane that
covers the colored part of the eye (iris) and pupil of the eye, subcutaneous
phaeohyphomycosis (usually under the skin cysts or abscesses, but can be
elsewhere) , endocarditis (inflammation of the inside chambers of the heart
and the valves), osteomyelitis (bone infection) and sinusitis in both normal
and immunosuppressed patients, but they are USUALLY only in immunosuppressed
patients.
Icky pictures can be seen here
Why don’t normal people get these fungal infections?
Because there are a raft of things we eat, funguses, listeria etc, which any
normal immune system just flicks off, deals with, and passes by. A normal
immune system works. A steroid suppressed immune system doesn’t work the
same.
However, the problems aren’t just limited to spinal injections. Steroid
injections into joints are also causing problems. Again,
the steroid is suppressing the immune system at the site of the injection –
after all, that’s what the steroid is designed to do. Shut up the immune
system therefore, stop the pain.
"Fungal infections in a joint can be extremely difficult to
treat and can be quite devastating," said Dr. Sanjeev Suratwala, a spinal
reconstructive surgeon at Glen Cove Hospital in Glen Cove, N.Y. "Typically,
these patients need several months of antibiotics and are prone to relapses,
and may even require surgical treatment."…
Suratwala said that while the waiting period for meningitis in the spine or
brain has been about one to four weeks, joint infections can take longer to
appear. "Fungal infections can be masked, so it may take a longer time to
present itself," he said.
Damage control experts have said that…
“The outbreak has led to calls for
tighter regulation of the loosely controlled pharmaceutical compounding
industry. Critics said drug manufacturers have found a way to sidestep
costly and strict oversight by classifying themselves as pharmacies, which
are given freer rein to mix drug compounds for patients.”
There is a hitch here though. Compounding pharmacists normally make drugs
that the big companies won't. This problem however,
isn’t unique
.“Just last year, there were at
least three apparently similar incidents: At least 33 patients suffered
fungal eye infections traced to products made by a compounding pharmacy in
Ocala, Fla.; at least a dozen Florida patients were blinded or damaged in an
outbreak linked to a compounder in Hollywood, Fla.; and the deaths of nine
Alabama patients were attributed to tainted intravenous nutritional
supplement provided by a compounder in Birmingham.
"These events have been happening once or twice a year for the last 15
years," Kastango said. "We wouldn't tolerate this if a plane crashed once or
twice a year. But in health care, we've grown desensitized to these kinds of
problems."
.........That’s not the only thing the medical system has become
desensitized to.
General information
Q6. What led FDA to take this action?
http://www.fda.gov/Drugs/DrugSafety/ucm322735.htm
A6: As a result of FDA, CDC, and state health departments’ ongoing
investigation of contamination at the New England Compounding Center’s (NECC)
Framingham, Massachusetts facility, we have learned that two patients may
have infections associated with other possibly contaminated NECC products.
While the investigation of these patients is ongoing, and there may be other
explanations for their infections, out of an abundance of caution, we are
issuing new guidance for providers to contact their patients for whom they
administered an injectable product, including an ophthalmic drug that is
injectable or used in conjunction with eye surgery, or a cardioplegic
solution purchased from or produced by NECC after May 21, 2012.
With regard to the two patients who are being evaluated, we can provide the
following information. One patient, identified through active surveillance,
is under investigation for possible meningitis potentially associated with
epidural injection of an additional NECC product, triamcinolone acetonide.
Triamcinolone acetonide is a type of steroid injectable product made by NECC.
FDA-approved triamcinolone acetonide is approved for intra-articular (within
a joint) or soft tissue injection. The cases of meningitis identified to
date have all been associated with methylprednisolone acetate, another
similar steroid injectable product.
In addition, one heart transplant patient with Aspergillus fumigatus
infection who was administered NECC cardioplegic solution during surgery
hase been reported. Investigation of these patients is ongoing, and, there
may be other explanations for their Aspergillus infection. Cardioplegic
solution is used to induce cardiac muscle paralysis during open heart
surgery to prevent injury to the heart.
At this time, no patients are under investigation in connection with any
NECC-produced ophthalmic drug that is injectable or used in conjunction with
eye surgery, but FDA believes this class of products could present
potentially similar risks of infection because of concerns about sterility.
Pdf of 1,200 potentially contaminated products =
http://www.fda.gov/downloads/Safety/Recalls/UCM322970.pdf
URL
http://edition.cnn.com/2012/10/15/health/meningitis-outbreak-duplicate-2/index.html?hpt=hp_t3
Part 2
