UPDATED: Instructions for Clinicians Regarding Diagnostic Testing and Specimen Shipping for Central Nervous System and Parameningeal Infections

Updated case counts for October 14, 2012.

Updated case counts for October 13, 2012.

Added new Digital Press Kit to Multistate Meningitis Outbreak Investigation home page.

Updated case definition information.

Updated case counts for October 12, 2012.

Half of all lifetime cases of mental, emotional and behavioral disorders begin by age 14 and three-quarters by age 24 (Kessler, 2005; IOM, 2009). Intervening early at the individual, family and community level can delay or prevent the on-set of mental, emotional, and behavioral disorders (IOM 2009).

Instructions for Clinical Teams Regarding Diagnostic Testing and Specimen Submission to CDC - Outbreak Associated With Injection of Potentially Contaminated Steroid Products

Updated Current Situation bullets.

Updated case counts for October 11, 2012.

Updated Current Situation bullets.

Added image of Exserohilum rostratum.

Updated case counts for October 10, 2012.

Updated case definition information.

Updated with additional questions and answers.

Added a Spanish version of Frequently Asked Questions For Patients: Multistate Meningitis Outbreak Investigation.

COCA Email Updates: September 24 - October 8, 2012

At this time, CDC does not recommend initiation of antifungal prophylaxis in exposed patients who are asymptomatic. These patients should be closely monitored for development of symptoms, with a low threshold for performing lumbar puncture should the patient become symptomatic. In addition, CDC does not recommend empiric antifungal therapy for symptomatic patients who have normal cerebrospinal fluid laboratory examination. These patients should be closely monitored and re-evaluated should their symptoms. Should the patient have progression of symptoms, a lumbar puncture should be repeated immediately.

Related links for specific audiences were added to the Meningitis Outbreak Investigation home page.

The Centers for Disease Control and Prevention (CDC) and the Food and Drug Administration (FDA) continue to work closely with state public health departments on a multistate investigation of fungal meningitis among patients who received an epidural steroid injection. These cases are associated with a potentially contaminated steroid medication prepared by New England Compounding Center (NECC), located in Framingham, Mass. During this COCA Call, CDC subject matter experts will review current epidemiology of the outbreak, describe clinical presentation and features of fungal meningitis, and review CDC's recommended treatment guidance.