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Clinical Response, Outbreak Investigation, and Epidemiology of the Fungal Meningitis Epidemic in the United States: Systematic Review

Published online by Cambridge University Press:  18 December 2015

Kaja M. Abbas ,
Nargesalsadat Dorratoltaj ,
Margaret L. O’Dell ,
Paige Bordwine ,
Thomas M. Kerkering  and
Kerry J. Redican
Kaja M. Abbas*
Affiliation:
Department of Population Health Sciences, Virginia Tech, Blacksburg, Virginia
Nargesalsadat Dorratoltaj
Affiliation:
Department of Population Health Sciences, Virginia Tech, Blacksburg, Virginia
Margaret L. O’Dell
Affiliation:
New River Health District, Virginia Department of Health, Christiansburg, Virginia
Paige Bordwine
Affiliation:
New River Health District, Virginia Department of Health, Christiansburg, Virginia
Thomas M. Kerkering
Affiliation:
Division of Infectious Diseases, Virginia Tech Carilion School of Medicine, Roanoke, Virginia.
Kerry J. Redican
Affiliation:
Department of Population Health Sciences, Virginia Tech, Blacksburg, Virginia
*
Correspondence and reprint requests to Kaja M. Abbas, Department of Population Health Sciences, Virginia Tech, Blacksburg, VA 24061 (e-mail: kaja.abbas@vt.edu).
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Abstract

We conducted a systematic review of the 2012–2013 multistate fungal meningitis epidemic in the United States from the perspectives of clinical response, outbreak investigation, and epidemiology. Articles focused on clinical response, outbreak investigation, and epidemiology were included, whereas articles focused on compounding pharmacies, legislation and litigation, diagnostics, microbiology, and pathogenesis were excluded. We reviewed 19 articles by use of the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) framework. The source of the fungal meningitis outbreak was traced to the New England Compounding Center in Massachusetts, where injectable methylprednisolone acetate products were contaminated with the predominant pathogen, Exserohilum rostratum. As of October 23, 2013, the final case count stood at 751 patients and 64 deaths, and no additional cases are anticipated. The multisectoral public health response to the fungal meningitis epidemic from the hospitals, clinics, pharmacies, and the public health system at the local, state, and federal levels led to an efficient epidemiological investigation to trace the outbreak source and rapid implementation of multiple response plans. This systematic review reaffirms the effective execution of a multisectoral public health response and efficient delivery of the core functions of public health assessment, policy development, and service assurances to improve population health.(Disaster Med Public Health Preparedness. 2016;10:145–151)

Keywords

communicable diseasesdisease outbreaksepidemicsinfection controlpublic health practice
Type
Systematic Reviews
Information
Disaster Medicine and Public Health Preparedness , Volume 10 , Issue 1 , February 2016 , pp. 145 - 151
Copyright
Copyright © Society for Disaster Medicine and Public Health, Inc. 2015 

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