Vilinda York lies in her Florida hospital bed, facing a dry-erase board
that lists in green marker her name, her four doctors and a smiley face.
Also on the board is this: "Anticipated date of discharge: NOT YET
DETERMINED." The 64-year-old contracted fungal meningitis after receiving
three tainted steroid shots in her back. She's one of 284 people nationwide who
are victims of an outbreak that began when a Massachusetts compounding pharmacy
shipped contaminated medication. Twenty-three people have died.
Like many trying to recover, York, who has been hospitalized since Sept.
27, faces a long and uncertain road. Many people have died days or even weeks
after being hospitalized. Fungal meningitis — which is not contagious — is a
tenacious disease that can be treated only with powerful drugs. "I'm
determined I'm going to fight this thing," she said. "The devil is
not going to win."
Dr. William Schaffner, an infectious disease specialist who chairs
Vanderbilt University's Department of Preventive Medicine, said the treatment
includes intravenous anti-fungal medicines that are tricky to use. "These
are powerful drugs. They're toxic," he said. "You're walking a
tightrope because you want to get enough into a patient to have the therapeutic
effect while at the same time you're trying not to affect, or to minimize the
effect on the liver and kidneys."
Even after leaving the hospital, patients will continue antifungal drugs
for weeks or months, he said. The infectious disease doctor handling York's
case did not immediately respond to a phone message. When York talks about the
last six weeks, tears run down her cheeks. She knows the disease is deadly. And
if she needed a reminder, it's right there in the headline from a local
newspaper on her hospital bed: "Third death reported in Marion County from
fungal meningitis."
For York, 2012 started well. The retired clothing shop clerk and widow
from Illinois was doing water aerobics three times a week, tending to her
flower garden and spending time with church friends. They'd get together at
Olive Garden and Red Lobster restaurants a couple of times a week and go to
church every Sunday. On Jan. 21, she was on her way to a wedding when she got
into a car crash. It wasn't enough to put her in the hospital, but she did
suffer back problems. The pain was strong enough for her to visit a doctor at
Marion Pain Clinic, where she received two steroid shots on Aug. 16. A week
later, the pain was still there and she began feeling headachy, nauseous and
dizzy. She chalked it up to her back and got a third shot Aug. 28.
In the weeks that followed, her health deteriorated. She couldn't lie
down without extreme back pain. A friend gave her a recliner to sleep in. The
headaches grew severe, sharp pains shooting from all directions into her skull.
"I couldn't walk well, I couldn't see good and I could wipe the sweat off
my arms," she said. On Sept. 27, her legs and arms grew numb. The numbness
flowed upwards to her waist. That's when she called the emergency dispatcher. "I
didn't know whether I was getting ready for a stroke," she said. When she
arrived at the hospital, doctors took a spinal tap and discovered she had
meningitis.
Health officials have noticed that the sickest patients with meningitis
are those who either did not catch the symptoms early or who didn't receive
appropriate treatment early because doctors didn't know what they were dealing
with. The fungi become harder to kill once they have established themselves in
a person's body.
"If treatment is given early, it is very effective," said Dr.
David Reagan, medical officer for Tennessee, where the outbreak was first
detected. "If it is given late, it is not very effective." Most of
the positively identified cases are caused by Exserohilum rostratum
(ex-sir-oh-HY-lum ross-TRAH-tum). The fungus is commonly found in the
environment, but it has never before been observed as a cause of meningitis. Because
of that, Reagan said, officials have been unable to firmly establish the
incubation period and give those who received the tainted injections a date for
when they will no longer need to worry about developing meningitis. "We're
saying at least six weeks, or 42 days, but we probably will extend that,"
he said. "This is new territory. There's no literature to tell us how
long."
In York's case, doctors initially thought she had bacterial meningitis,
but when she told them about the steroid shots, doctors began to assemble a
theory. On Sept. 25, the New England Compounding Center had voluntarily
recalled three lots of the steroid methylprednisolone acetate. York's three
shots were that steroid — and the Marion Pain Clinic had gotten some of the
tainted medicine, health officials said. York said a doctor from Marion Pain
Clinic visited her in the hospital and told her about the contaminated shots.
The doctor was crying as she spoke, York added.
York passes her days by talking on the phone to two children and three
grandchildren who live out of state, receiving visitors from her church and
reading the Bible. She's lost more than 10 pounds (4.5 kilograms) in the past
month. She realizes she's not the woman she once was; now she's pale and weak
whereas before, she liked to put on a little makeup, fix up her short brown
hair and go for a walk. The only time she has walked since Sept. 27 was to
shuffle to the shower on Oct. 17. "I got to shampoo my hair and the whole
nine yards," she smiled. "I enjoyed it tremendously." York is
worried about whether the meningitis will have lasting effects on her body, and
she's concerned about the powerful anti-fungal medication she's taking. Doctors
have had to pause the treatment because they were concerned about her liver and
kidney.
York has filed a lawsuit against NECC claiming negligence, and her
lawyer is getting calls from others who were sickened. She says she's
"blessed, not lucky," to be alive at this point. "I want to get
out of here," she said. "I want to go home, I want to live a normal
life again. God still has a plan for me, and I'm looking forward to it."
ABC News
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