TWO AMERICANS have died from suspected fungal infections in their brains and spinal cords after traveling to Mexico for cheap cosmetic surgeries.
A further 18 people in the US are suspected to have contracted the infection – called fungal meningitis – after having surgical procedures, including liposuction, under epidural anesthesia in Matamoros, Tamaulipas, Mexico.
And the Centers for Disease Control and Prevention (CDC) is monitoring another 206 who have potentially been exposed, the agency said in an update issued on May 24.
Epidurals are often used in labor and delivery and other surgeries and involve injecting anesthetic directly into the spine – specifically into a space around spinal nerves called the epidural space.
At least two specific clinics have been linked to the fungal meningitis outbreak: River Side Surgical Center and Clinica K-3 are situated just across the border from Brownsville, Texas.
The Mexican Ministry of Health shuttered both on May 13 and the CDC a list of 221 US patients who might be at risk for meningitis based on records of procedures at these clinics between January 1 and May 13, the US agency said.
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Three more patients not included on the list were identified by the CDC, bringing the total of Americans known to have been exposed to 224 – the agency is working with health departments across different states to contact them.
It urged anyone who had epidural anesthesia at either of those clinics during that time period to go to a health center, urgent care or emergency room as soon as possible to be tested for meningitis, even if they don’t have symptoms.
People who test positive for infection will be given antifungal medicines; those who test negative will be asked to watch for symptoms and possibly to return after two weeks for further testing.
The CDC noted that fungal meningitis infections are not contagious and are not transmitted person to person
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But it urged anyone who had booked a procedure involving an epidural injection of an anesthetic in Matamoros, Mexico, to cancel it "until there is evidence that there is no longer a risk for infection at these clinics".
The CDC first received word of the outbreak on May 8 after Texas state officials were notified of two female patients hospitalized in Texas with symptoms consistent with meningitis – headache, fever, photophobia, stiff neck – that began approximately two to four weeks after receiving cosmetic procedures at the River Side Surgical Center.
Two more Texan women hospitalised with similar symptoms after getting surgery at Clinica K-3.
Medical tourism to Mexico, has become more common as people seek lower-cost procedures and shorter waits for care, particularly for dental care, surgery, cosmetic surgery, fertility treatments and other procedures, according to CNN Health.
The recent outbreak of fungal meningitis echoes an outbreak that began a year ago in Durango, a Mexican state directly west of Tamaulipas.
In that outbreak, epidural anesthesia was linked to at least 80 cases of fungal meningitis, 39 of which were fatal.
Nearly all of the cases were in women undergoing gynecological and obstetric procedures.
Laboratory testing linked the meningitis cases to a specific fungal pathogen: Fusarium solani, but health officials have not yet linked a specipic pathogen to this newest outbreak in Matamoros.
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Fusarium fungi are naturally found in the environment (organic matter, soil, and water) and have been known to contaminate pharmaceutical products made improperly, Ars Technica reported.
A rare bacterial infection linked to contaminated eye drops has also claimed the lives of four Americans this year.
Symptoms of fungal mengitis
It can take weeks for symptoms of fungal meningitis to develop, and they may be very mild or absent at first.
- Stiff neck
- Nausea and vomiting
- Eyes being more sensitive to light (photophobia)
- Altered mental status, confusion
Fungal meningitis can develop after a fungal infection is accidently introduced during a medical or surgical procedure or spreads from somewhere else in the body to the brain or spinal cord, according to the CDC.
Although anyone can get fungal meningitis, people with weakened immune systems are at increased risk. Certain health conditions, medications, and surgical procedures may weaken the immune system.
Fungal meningitis is treated oral medications and drugs injected through the vein. Treatment length can vary depending on the type of fungus.
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