Column: Don't panic about Meningitis

With 15 people dead and more than 200 sickened after taking seemingly routine injections for back pain, it's no wonder that the headlines have people worried. About 14,000 additional patients in 14 states received similar injections, which contain potentially fungus-contaminated steroids.

Public health officials across the country are on alert. The Centers for Disease Control and Prevention in Atlanta is on the front lines, meeting daily to review new developments and working with the state and local health departments to track potential cases. Tennessee has been hardest hit with more than 50 cases and six deaths. Problems continue to occur because the fungus can live in your body for weeks before you get sick. The CDC has identified two rare pathogens, Aspergillus and Exserohilum, as the culprits. The very names sound forbidding.

If there ever was a time to be afraid, this sure sounds like it, but should we be? We fear the unknown, we fear being struck down with no warning by a tiny microbe. We have the feeling that it can attack anyone, even though it can't. Previous health scares from anthrax to West Nile virus to SARS and bird flu have created far more worry than actual risk.

'Over-personalized' risk

As we over-personalize the risk from what I call the "bug du jour," the resulting surge of stress hormones harms our health. A tiny almond-shaped organ in the brain known as the amygdala revs up our engines. Adrenaline, noradrenaline and cortisol are produced, which wear our bodies down over time.

The acute stress response, inherited from our ancestors, is supposed to protect us from imminent danger, not from an overhyped news story. But often, we're reacting to the headlines, not the news stories themselves. As with prior health scares, the fact that several states are involved and that people have died give the impression the disease is more widespread than it really is.

The cure to the meningitis scare is perspective, education and a plan to contain the problem. Information calms public fears.

People watching the frightening news about meningitis on TV need to understand that though it can take weeks to develop symptoms, they can not get sick unless they have received an injection of methylprednisolone (a steroid) or another medication (two heart patients have now gotten sick) that was compounded by the New England Compounding Center in Massachusetts. They need to know that the fungi causing meningitis are not contagious. You cannot get it by touching someone who has it or breathing the same air.

Even if you received one of the tainted vials, your chances of getting sick appear to be less than 2%, and the more time passes, the lower the risk.

That information is already out there in news stories, but many people don't read deeply, or they get spooked by daily updates of new infections. There is no easy way out. Even as public officials and the news media repeat crucial details, expanding coverage reinforces the very panic reporters are trying to assuage. Images and headlines can be more powerful than reasoned language.

Even as facts such as the reported symptoms of fever, headache, malaise, stiff neck, confusion, nausea and vomiting are being broadcast on every TV and radio station, listeners naturally react emotionally rather than after careful consideration. Many of my patients who have never had a back or neck shot for pain or inflammation are nevertheless worried that they will be next.

What's important

For those actually at risk, a call to your doctor or pharmacy asking whether your shot came from a tainted batch from the suspect pharmacy will give you what you need. If you are infected, early treatment with anti-fungal agents should cure you. As always, early diagnosis is especially important for the very young, the old and those with other chronic illnesses.

Some good still might come from this contagious case of public agita. For one thing, too many epidural steroid injections are given in the U.S. every year (estimated at 8.9 million), often for the wrong reasons. We need to think twice before we put a needle into our bodies.

Second, we need to shine a spotlight on the fact that not all the compounding pharmacies are doing their work safely. Though the Food and Drug Administration supervises the initial manufacturing process, such oversight is largely absent at the middleman level, allowing a fungus in the environment, such as Aspergillus and Exserohilum, to get in.

For another, we could address our prescription medication shortage -- with steroids on the short list. This problem leads to more compounding pharmacies and more corner-cutting practices.

While the solution is not to panic or over-personalize the risk, we should also not ignore what is happening. The FDA needs to step up its vigilance, even as we step down ours.

Marc Siegel is an associate professor of medicine and medical director of Doctor Radio at NYU Langone Medical Center. He also is a member of USA TODAY's Board of Contributors.

In addition to its own editorials, USA TODAY publishes diverse opinions from outside writers, including ourBoard of Contributors.