Fourteen months after the fungal meningitis outbreak was first recognized, it is finally grinding to a halt. Throughout the outbreak I have been providing intermittent analyses (see the bottom of this post for links), and I also tried my hand at science journalism by interviewing two professionals on the front lines of the outbreak. This will probably be my last update on the topic. As always, this blog is just a hobby, so enjoy these analyses at your own risk.
There are an astonishing 751 cases and 64 deaths across 20 states. Michigan (264 cases), Tennessee (153 cases), Indiana (94 cases) and Virginia (54) cases were the hardest hit.
One of the most striking features of the outbreak was how variable outcomes were from state to state. Attack rates ranged from just under 14% in Pennsylvania to 18% in North Carolina.
The case fatality risk ranged from 0% in multiple states to 28% in Florida. The case fatality risk is highly correlated with the proportion of cases diagnosed as meningitis (p < .01).
Some states experienced a lot of meningitis cases (Maryland with 96% of cases, Florida with 88% of cases) while others had little to no meningitis (West Virginia had 7 cases total, none were meningitis). Non-meningitis cases include spinal and paraspinal infections; peripheral joint infections; and stroke.
For the most part, the bulk of the outbreak was over by February 2013. Since then there have been a trickle of new cases.
After many, many months of hard work, I'm sure public health officials in affected areas are relieved that the end is in sight - not to mention the patients who received contaminated injections and have been waiting to see if they develop an infection.
Data for this analysis is available for download at Figshare (data is originally from the CDC website).
Previous posts on the outbreak:
Original analysis from January 14, 2013
Analysis from January 29, 2013
An interview with disease detectives battling the outbreak
"Send me your data - PDF is fine," said no one ever
The public health paradox ("When public health works, it's invisible")
Let's make data a civic right
Scholarly impact of open access journals
Six months later, disease detectives still battling fungal meningitis outbreak