2 dead in suspected meningitis outbreak linked to surgery in Mexico

Two people in the United States have died with probable cases of fungal meningitis and more than 200 others are at risk following an outbreak of the infection in patients undergoing surgery in Matamoros, Mexico, the Centers for Disease Control and Prevention said Friday.

At least 220 people in the United States treated this year at two clinics in Matamoros could be at risk after epidural anesthesia, which is injected near the spine, the CDC said. Those at risk traveled from the United States to Mexican clinics for surgical procedures, including liposuction, Brazilian butt lifts and breast augmentation.

The CDC said as of Friday, two people classified as probable cases of fungal meningitis had died. There were 11 more likely cases of infection, based on epidural results, and 14 suspected cases, based on symptoms consistent with meningitis, said the CDC.

Health authorities in the United States and Mexico have asked the World Health Organization to issue an emergency declaration in response to the outbreak.

The two clinics linked to the infections are River Side Surgical Center and Clinica K-3 in Matamoros, and both closed May 13, the CDC said.

People who had had epidural anaesthesia these clinics should go to the nearest health center, emergency room or emergency room as soon as possible to get tested for meningitis, even if they have no symptoms, said health officials.

Symptoms of meningitis can take weeks to appear, and once they appear, they can quickly become serious and life-threatening, according to the CDC. Symptoms may include sensitivity to light, a stiff neck, fever, vomiting, and confusion. Fungal meningitis infections are not contagious or passed from person to person.

The CDC said anyone scheduled for an elective procedure involving an epidural injection of an anesthetic in Matamoros should cancel the surgery and associated travel “until there is evidence that there is no longer a risk of infection at these clinics.”

According to the CDC, millions of people in the United States travel to another country each year for medical care, a practice known as medical tourism. The most common procedures that people seek during those trips are dental care, surgery, cosmetic surgery, fertility treatments, organ and tissue transplantation, and cancer treatment.

The CDC said Mexico’s health ministry has provided it with a list of 221 U.S. residents who may be at risk for meningitis because they had surgery this year at one of its two clinics.

Dallas Smith, a CDC epidemiologist, said in a webinar for scientists and medical providers on Friday that 205 of those exposed were women and 16 were men. The median age of the patients was 32 and 178 of them were from Texas.

Dr. Smith said the outbreak was similar to an outbreak of fungal meningitis that began in November 2022 in Durango, Mexico, where more than 1,400 patients may have been exposed through contaminated epidural anesthesia. In that outbreak, 80 people were found to have meningitis and 39 of them died, he said.

“The outbreak we’re experiencing right now is quite similar, and it has the capacity to have this high mortality rate and just devastate families and communities,” said Dr. Smith.

He said Mexican and US authorities had submitted a request for a public health emergency of international concern to the WHO because the outbreak had exposed people in Mexico, the United States, Canada and Colombia.

This statement is intended to accelerate international collaboration, funding and treatment development in response to a disease. The WHO declared Covid-19 an emergency in January 2020 and lifted the designation this month.

The CDC said it was working with Mexico’s Department of Health and local health departments in 24 U.S. states and the District of Columbia to respond to the outbreak and to contact people whom officials know have had surgery at the clinics.

CDC officials found that six of the 221 people who may have been exposed to the infection were not on epidural anesthesia and are not considered at risk. The agency also found five other people who were not part of the original group of 221, meaning at least 220 people in the United States may have been exposed.

Health officials are trying to determine which organism or organisms caused the outbreak and whether other clinics were involved.

Mexico’s Ministry of Health said Thursday that between January 1 and May 13, an estimated 547 people were operated on in the two clinics.