Six North Dakota pharmacies or clinics have received products from the New England Compounding Company, which has produced medications associated with a meningitis outbreak in the United States.
Kirby Kruger, director of the division of disease control for the North Dakota Department of Health, said the department has notified these facilities to inform them of new updated Food and Drug Administration recommendations.
Although all products from NECC have been recalled, not all of the NECC products sent to North Dakota facilities are subject to the new FDA guidance.
Facilities which received products from NECC are located in Fargo, Grand Forks and Williston.
Monday Kruger said it appears all of the NECC products that ended up in North Dakota were used â€śbefore the period of real concern. It appears there is nothing of real high risk.â€ť
Originally, only three lots of medications, none of which were shipped to North Dakota, were implicated in the outbreak. However, additional cases of meningitis reported in other states have indicated that other medications may also be causing meningitis.
Out of an abundance of caution, the North Dakota Department of Health is endorsing the Centers for Disease Control and Preventionâ€™s and FDAâ€™s recommendation that health-care providers notify any patients who may have received any injectable or ophthalmic medication from NECC produced or purchased on or after May 21, and advise them to seek health care if they develop symptoms suggestive of meningitis or symptoms suggesting they have an infection in a joint. No action is necessary for people who do not have symptoms.
Symptoms of meningitis include fever, headache, stiff neck, nausea and vomiting, sensitivity to light and altered mental status. Symptoms for fungal infections may include fever; swelling and increasing pain, redness, warmth at injection site; visual changes, pain, redness or discharge from the eye; chest pain; or drainage from the surgical site.
According to records received from CDC, the following North Dakota providers received NECC products:
Service Drug Pharmacy, Williston; Department of Veterans Affairs, Fargo; Hogue Vein Institute, Fargo; Altru FMC, Side A, Grand Forks; Lamb Plastic Surgery Center, Fargo and Northern Plains Surgery Center, Fargo.
Kruger said no cases of meningitis or joint infections have been reported in North Dakota to date. None of the products received in North Dakota have been implicated in any of the outbreak illnesses. In the United States, 233 cases in 15 states have been reported, including 15 deaths. Information from the CDC regarding the investigation and information about meningitis can be found at http://www.cdc.gov/HAI/outbreaks/meningitis.html.