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Of the 89 residents of Cameron and Hidalgo counties at high risk of having fungal meningitis, only nine have been admitted to the hospital to be tested for the potentially deadly disease.
Sixty-nine residents of Cameron County and 20 residents of Hidalgo County are on the high-risk list after having received cosmetic surgery procedures involving the use of contaminated epidural anesthesia at either of two Matamoros clinics, Clinica K-3 or River Side Surgical Center, between Jan. 1 and May 13. Both clinics were closed on May 13.
In all, approximately 215 U.S. residents, including about 170 Texas residents, were determined by the Centers for Disease Control and Prevention to have potential exposure after undergoing procedures at one of the clinics. Two people have died so far as a result. Fungal meningitis is not contagious and cannot be spread person to person.
CDC is urging anyone who underwent procedures at either of the clinics during the relevant time period to go to the nearest health center, emergency room or urgent care center for lumbar-puncture (spinal tap) and MRI testing, and treatment if necessary.
A person can be infected with fungal meningitis and feel no symptoms, which when present include fever, headache, stiff neck, nausea, vomiting, sensitivity to light, and confusion or altered state of mind, according to CDC. It can take weeks for symptoms to develop and they may be very mild at first, though once symptoms begin they can “quickly become severe and life-threatening,” the CDC said, adding that “early testing and treatment can save lives.”
Cameron County Public Health Administrator Esmeralda Guajardo said the county is “ground zero” for the outbreak due to the high number of residents on the high-risk list.
“Luckily we’re getting on top of it,” she said.
With contact information provided by CDC and public health officials in Mexico, the public health departments in Cameron and Hidalgo counties have been attempting to contact every affected individual, Guajardo said.
“We’ve reached out to the majority of them, but we still have a few that we’re still trying to get a hold of,” she said. “They’re wrong numbers or they’re not calling us back. … Unfortunately these symptoms are so common that a lot of people might attribute it to something else. That’s a big concern for us.”
Dr. Ivan Melendez, health authority and chief physician for the Hidalgo County Health and Human Services Department, said 19 of the 20 people affected in that county have been contacted. Of the 19, just two have been admitted for testing. One was showing symptoms and the other was not, he said.
“Even if you do not have any symptoms we strongly urge you to go to your doctor or to the ER and get a lumbar puncture and an MRI or a CT scan of the head,” Melendez said.
If anyone is hesitating to come forward for testing because of embarrassment over having cosmetic surgery, they need to leave those thoughts behind now, he said.
“My advice would be to throw all that nonsense out the window,” Melendez said. “We’re still in the window where we can get ahead of this if we start treatment early enough.”
One complicating factor is that some high-risk individuals who have gone to an emergency room seeking testing have been turned by doctors who decide it’s not necessary, Melendez said.
“Imagine how that person feels when they’re turned away,” he said. “So then I get the phone call, and I have to admit the patient, because I work at all the hospitals. Even the medical community in my opinion does not perceive the potential danger of this disease.”
Dr. James Castillo, health authority for Cameron County Public Health, said many health care providers may not think to diagnose fungal meningitis because it’s so rare. The last U.S. outbreak was in 2012 in Michigan, involving contaminated steroid injections. More than 750 people became sick and 64 died during the outbreak.
Last November in Durango, Mexico, 80 clinic patients were infected with fungal meningitis through contaminated epidural anesthesia and 39 of them died — almost a 50 percent mortality rate. Castillo noted that the United States has treatment tools unavailable in Mexico, such as neuro-interventional treatment technology available through Valley Baptist Medical Center’s stroke program, which he said may be helpful in fungal meningitis cases.
Still, his message to individuals with potential exposure and health care professionals alike: Don’t assume it’s “just a headache.”
“The symptoms can creep up on you,” Castillo said. “It can be really minor, something like a headache that just won’t go away. And then it just gets worse and worse and worse. These patients are taking two to three weeks of symptoms before they even show up at the hospital, and that’s a problem.”
Guajardo asked that anyone who knows someone who underwent surgery at either of the Matamoros clinics between Jan. 1 and May 13 tell that person to get to a doctor or call the county health department right away, adding that the cause of the contamination has not yet been determined.
Cameron County Public Health can be reached at (956) 247-3650.
Hidalgo County HHS Department can be reached at (956) 383-6221.
“We have calls more than once a week with officials at the federal level and state level and with Mexico,” she said. “We’re still working together in trying to get to the bottom of this.”
Even though only two clinics have been identified as the source of the outbreak, Guajardo advised caution in dealing with surgery clinics in Matamoros in general — at least for the time being.
“Until we’re able to determine that there’s no longer a risk from infection at these clinics, we highly recommend that they cancel those procedures that involve any epidural injection in Matamoros at this point,” Guajardo said.