Grady, Denise. "Tracing Crucial Components
of Meningitis Outbreak." The New York Times. The New York
Times, 16 Oct. 2012. Web. 18 Oct. 2012. <http://www.nytimes.com/2012/10/16/health/tracing-crucial-components-of-meningitis-outbreak.html?ref=science>.
This article describes the
meningitis outbreak across the country caused by contaminated treatments for
spine and neck problems. The fungus causes a severe form of meningitis that can
cause strokes and has resulted in now 19 deaths (the article, written two days
ago, says 14), and 205 severe cases. It is estimated that 14,000 people have
come in contact with the fungus. The fungus is called Exserohilum, one so rare
that most doctors have never heard of it. The treatment that is contaminated is
called methylprednisolone, and a total of 17,676 vials of it are involved
in the outbreak. Though several patients have experienced symptoms, there are
several more who have not gotten sick (some doctors estimate that the
proportion may be as low as 5 percent). Doctors are now trying to find out why some
people have been killed while others have gone symptom-free.
Figuring out why some people are
contaminated could have several positive implications on the science of
administering drugs to the spine. There are a number of possible explanations
for why some people get sick, relating to variations in the extent of
contamination, the patients’ underlying health, and the procedure itself. As
most of the patients had strong immune systems, doctors are led to believe that
it is due to bad procedures on behalf of the doctors. The injection used to
administer the drug should not pierce the Dura, one of the membranes that cover
the spinal cord and brain. As most doctors do not use fluoroscopy to help
them guide the needle, the contamination may be due to nicks in the Dura. This
would allow the fungus to enter into the spinal fluids, and consequently, the
brain. More research by specialists could help determine what physicians could
improve when administering drugs, and could lead to better safety procedures in
the field.
I believe that the author could have
done a better job organizing the article and explaining the effects of the
fungus. She often went back to previous arguments, and sometimes her
progression of ideas was confusing. She also didn’t explain how the fungus
killed patients; she only explained what it was. She did do a good job
explaining what could have caused the fungus to enter the spinal fluids and the
controversy surrounding safety regulations in administering these drugs.
Ap Bio Andrew Jones
ReplyDeleteComment 10/18/12
Malika does a phenomenal job breaking down the article, “Steroid Shot Near Spine Gives Illness an Opening.” Malika provides context on the specifics of a fungus, called Exserohilum, which has made contact with an estimated 14,000 people. She did a great job integrating other research into her review of the article as well. For example, the article recorded a total of fourteen deaths as of October 16th, however, new information Malika found states that the death total has climbed to 19. Malika lastly examines the possible reasons for the spread of such a disease and digs deep into the procedures, which may have resulted in the initial spread of the fungus, Exserohilum.
A suggestion I have for this article review is that Malika include, where, in the world, this disease has broken out. Even if it is a worldwide issue, I think it is worth noting somewhere in the review. A second recommendation I have for Malika is that she expand on her ideas regarding the potential research that specialists may do to improve pharmaceutical and any other applicable drugs. This could be very interesting.
I am very impressed by Malika’s ability in identifying the problem in her given article, meanwhile, voicing her own opinion on the issue and even as to how the author could have done a better job writing her piece. I was completely unfamiliar with this disease before reading this article review and now I feel well informed and educated on the topic.
Maddy Foley
ReplyDeleteAP Biology Comment
10.18.12
I read the review of the article “Tracing Crucial Components of Meningitis Outbreak.” The reviewer, Malika, had some very good elements to her critique. Firstly I think the reviewer did a good job at explaining the cause of the meningitis. Malika notes that the outbreak is resulting from a contamination in a treatment called methylprednisolone, a drug administered for spine and neck problems. The reviewer clearly describes that the unfortunate contamination is attributed to doctors who are piercing the Dura during administration, a membrane that covers the spinal chord and brain. This allows fungus to enter into the spinal fluids and then brain. Secondly, the reviewer provided depth into the results of this contamination. The fungus is causing severe strokes and as killed an estimated 19 people. These statistics help to display the severity of the meningitis. Lastly, I thought Malika did a good job at critiquing the writing of the article. I also agreed that the article flip-flopped between arguments, but Malika helped to provide a clear, condensed form of the most important points.
I think the reviewer could have included some more information about the particular fungus Exserohilum and how it comes from the misuse of the methylprednisolone. The fungus can grow on this drug when vials have sat on a shelf for a long time. By introducing the fungus to the body along with a steroid immune response can be stifled allowing fungus to attack patients. This would have provided a clearer explanation for the reasons of this disease and it’s impact. I think, secondly, the reviewer could have included the importance that 14,000 people may have been exposed to this disease. While the drug has been recalled, many patients could still fall ill within the next weeks or months. Some patients even received a series of three shots of the tainted drug a few weeks apart, only increasing the spreading.
One thing I was interested to learn was that there are still flaws in the medicinal practice and the administration of drugs. With the advancement of medicine as well as the advancement of diseases it is more crucial then ever to perfect methods of treatment.
Malika’s review of the New York Times article "Tracing Crucial Components of Meningitis Outbreak" was very interesting. Malika not only did a good job presenting the facts of the article, but also did extra work after it was published, to inform the reader of the current data on the subject. Her extra work made her review more powerful, since it reminded the reader that this is an issue currently effecting people’s lives. Malika also did a great job explaining how the meningitis outbreak occurred. As Malika had said the author, “often went back to previous arguments, and sometimes her progression of ideas was confusing.” Malika, however, in her review, explained how the outbreak started in a much clearer way. Like Malika, I was also left wondering how the fungus actually killed people. They explained that the drug, when it had broken through the dura, traveled up the spinal cord to the brain. I am curious, as was Mailka, to therefore know what kind of symptoms the fungus caused.
ReplyDeleteAt the end of Malika’s review, the topic of how the safety regulations of administrating the drugs really should have been expressed. It would have been interesting had Malika added along with this fact that many people, such as nurse anesthetists, physician assistants, and radiation technologists, were administering the drug. This seems very important, since, were one of these people giving the drug, a mistake, such as breaking the dura could have been more likely. However, as the article says, “Even if the needle did not penetrate the dura, the fungus itself might have done the job.” Another fact that could have been addressed was that steroids suppress the immune system. As a result, the contaminated steroid, not only brought in a dangerous fungus, but also weakened the body’s ability to fight off the fungus.
The piece of information that I found most interesting was that some of the fungus was visible to the naked eye. This is concerning, for some patients could have been injected with these vial’s substances, and yet the contamination was quite visible. In other vials, however, the “foreign matter” was less or not visible, so it was more understandable for a doctor to have continued with the epidural.
Malika did an amazing job reviewing the article “Steroid Shot Near Spine Gives Illness an Opening”. One thing I think Malika did well was putting in the most important facts and statistics. She really put in the most important facts so you knew how many people could be affected and how many people are affected now. Another aspect of Malika’s review that I liked was her incorporation outside information. When she posted her review the article had already been published for two days. So she found out the most up to date statistics and found out the death toll for the day she posted her review. I found this very helpful because you could see how this is going to affect people for a long time. A third aspect of Malika’s review that I think she did well was explaining how doctors think the fungus affected people. She explained it very well, so even someone who does not know anything about this disease could understand it.
ReplyDeleteWhile Malika did a great job on her review there are a few areas where she could have improved it. I think Malika should have included in her review that the longer the vials were sitting on the shelf the more dangerous they could become. This is because the fungus has time to grow, and in some cases the fungus grew so big that it could be seen by the naked eye. I think this was an important piece of information that Malika left out of her review. Another fact Malika could have included in her review was the states and areas of the country that were affected by the fungus.
One thing I was shocked to learn from the article was that some of these patients could have been infected because of an error by the doctors. For example, if the doctors punctured the dura, a membrane that covers the spinal cord and brain, the fungus could have easily reached the brain. I also found it troubling that some doctors didn’t even use fluoroscopy to try to prevent this from occurring.
Nastaran Soroori-Motlagh
ReplyDeleteOctober 21, 2012
AP Biology
“Tracing Crucial Components of Meningitis Outbreak” by Denise Grady explains the Meningitis outbreak that recently occurred in the United States. The fungus causes a severe form of meningitis that can cause strokes and result in death. Until now, 19 people have dies and currently there is 205 severe cases. It has been estimated that about 14,000 people have come in contact with the fungus. The fungus is called Exserohilum, one that is so rare that most physicians do not know what it is. A total of 17,676 vials are involved in this outbreak and the treatment was contaminated is called methylprednisolone. There are many patients who have experienced symptoms, although some who have not. The issue now is that some people were killed by this fungus while other are not showing any symptoms. Some patients did not become ill because they had a stronger immune system. Another factor was the method the physicians used to inject the viral into the spinal cord. If the drug was administered and punctured the Dura, one of the membranes that cover the spinal cord and the brain, then the patient was most infected.
The review could have been improved if the author explained how the fungus was killing patients. By not just explaining how the patients were being infected by it. Also, the review could have been better if it explained why some doctors were using a different approach than others. Why is it that some doctors did not choose to use fluoroscopy to help them guide the needle? Lastly, did this cause many problems for the physicians who used a different approach and potentially killed some patients?
I though the article was very well written. It provided a good understanding of a current issue that is occurring in the United States today. I was interested to know more about the issue when I heard it on the news and this review provided that. I was impressed by how well the article was written. It gave a full understanding of the outbreak. I was glad to read that specialists are helping physicians to better understand what they did wrong so in the future these outbreaks do not occur.
Marika Chrisanthopoulos
ReplyDeleteAP Biology Commentary
October 21, 2012
Comment on Malika Lawrence’s Review; “Tracing Crucial Components of Meningitis Outbreak” The New York Times by Denise Grady
While reading Malika’s review on this surprising news story, I remembered hearing someone talk about this event that has become a major problem for people who have undergone this procedure. This article talks about the major meningitis outbreak that was caused by a procedure for spine and neck problems that included contaminated treatments. Apparently, the treatment had a fungus that causes a severe form of meningitis that can result in strokes, and has now caused 19 deaths across the country, as well as 205 severe cases. One thing that Malika did well was that she described the fungus and the cause of the meningitis along with the procedure very well, including questioning why only some people got sick and some did not. Another thing she also dos well is that she provides some of her own explanations for why some people may have gotten sick while others did not, including the patient’s underlying health, the extent of contamination, and the procedure itself. Another thing that Malika does well is that she pointed out some of the major flaws of the article itself, including that the author’s “progression of ideas was confusing.”
There were some aspects of the review that could have been better, even though it was extremely well written. Maika could have included some outside research on the actual symptoms of the severe cases of meningitis, since many people do not know what the actual conditions are. She also could have included where this was actually happening, and some statistics about the people who were experiencing this disease and the strokes involved. It would have been nice to hear more about the fungus, even though it is extremely rare, as Malika states in her review. One thing that I learned from the article and the review is how sensitive the body can be to contaminated tools and procedures that aren’t performed exactly the way they should be; the specificity of doctors and surgeons while they are doing their work is very important and must be taken seriously. I also learned more about the actual disease meningitis, and how specific procedures can be altered and changed to cause life-threatening diseases.
The review of steroid shot near spine gives illness an opening was very well explained. One thing that was well presented was how the review started off explaining that there was an outbreak in meningitis caused by a fungus called Exserohilum, which is very rare and quite unknown to most doctors. The article also went into specifics in how many deaths have occurred so far (19) and how many severe cases were recorded (205). The review also made a good point in explaining that even though there were many recorded illnesses, some people have gone symptom free. Another really well presented point in the article was a way to possibly avoid infecting people with the fungus, as the needle injected in the Dura should never be punctured. If it happens to be nicked by the needle, the fungus could easily travel to the spinal chord and brain. Avoiding this occurrence would be using a fluoroscopy to help guide the needle and not to damage the Dura.
ReplyDeleteOne thing that could have been better presented was just how dangerous the fungus Exserohilum is. Leaving the vials on the shelf, gives time for the fungus to grow and by using a needle full of the fungus filled steroid, the body’s immune system is slowed down and the fungus is able to attack more easily. Another thing that could have been better presented is why some doctors choose to do a fluoroscopy to help guide the needle into the body, while others don’t? Is it the expense, or that it is more time consuming or difficult? If by performing a fluoroscopy would help avoid nicking the Dura, and therefore not allowing the fungus to enter the spinal chord and brain, why wouldn’t all doctors choose to use it as a regular procedure when giving needles to areas like the spine.
One thing that really interested me was how easily a fungus could enter the body and cause meningitis and how a fungus could be thriving in a vial used in spinal procedures. It shocked me how easily that can occur and how the fungus was undetected in the vial until it caused an outbreak of meningitis.
Malika did an excellent job presenting the article, “Steroid Shot Near Spine Gives Illness and Opening.” In her review, Malika displayed a vast knowledge of a wide variety of data in the article, which I thought was very good because it allows the reader to understand the recent devastation that this discovery has had. I also admired how Malika did a little extra research, which shows the reader that she really cares about the topic discussed. Finally, I thought that she did a great job of how this disease manifests itself into our bodies in the second paragraph. After reading this I definitely have a greater understanding of the topic of Meningitis, and the many subcategories of this, which are rare diseases that have recently surfaced.
ReplyDeleteWhile Malika did a great job with her review, there were a few aspects that I would have changed. Firstly, I would have liked it if she described the diseases in a little more detail. I would have liked this because I think that it is probably the most complex part of this discussion, which if the reader doesn’t know, they surely will not fully understand the disease itself. Also, I think that she should have included a little detail on how this disease actually kills people.
One interesting thing that I learned from this article is that there is a very controversial reasoning behind the outbreak of the disease. She describes how the general reason for people to get this disease is that when doctors are injected patients in the spine with steroids, they are accidentally piercing the membrane that surrounds the spinal cord. I thought this was very interesting because it provides doctors with a very easy way to prevent this disease, which is to take better care with patients and be very cautious and careful when dealing with something as fragile as the spinal cord.
Samantha Past
ReplyDeleteAP Biology Commentary
October 22, 2012
The review of the article headlined, “Steroid Shot Near Spine Gives Illness an Opening” by Denise Grady, reviewed by Malika includes information pertaining to the recent meningitis outbreak in the United States. In Malika’s review she did a good job of providing specific numbers/ statistics to represent the impact the outbreak. For example, Malika includes the information regarding the 19 deaths that have resulted already, as well as the estimated 14,000 people that have come in contact with the fungus. Likewise, Malika simplified the article significantly in her summary, which allows the reader to gain a basic understanding of what is going on regarding the outbreak. Another aspect of the review that was well presented, was a sort of solution Malika included in her review. Within the review she describes how more research could help determine what physicians could improve on when administering drugs, and also she describes how more research could lead to better safety procedures.
Although this review includes a basic description, or a significantly simplified summary of the article, perhaps if the reviewer included more detail from the article it would help readers better understand the article in its entirety (included facts, and multiple opinions within the article; not just the basic understanding). For example, Malika briefly describes the possible explanations for why some people get sick, as she talks a little about the extent of contamination, the patient’s underlying health, and the procedure. However, within the article there was a lot of information regarding possible explanations for why some people got sick, that if Malika had included would have enhanced understanding of the article, and the meningitis outbreak. For example, Malika could have discussed in her review Dr. William Schaffner’s, an infectious disease expert at Vanderbilt University, reference regarding how the more people are exposed to the germ, the more likely they are to get sick. Likewise Malika could have explained, how the article discusses that not all of the vials were equally contaminated, as Dr. Marion Kainer, chief of Tennessee’s health- care associated infections and antimicrobial resistance program, further discovered. Another suggestion on how the review could have been made even better, is if Malika discussed/ stated where exactly the outbreak began/ where the vials containing the fungus were departed from. (The drug was made by a pharmacy known as the New England Compounding Center, in Framingham Mass.) (The particular lot many scientists believe the vials containing the contaminated fungi were shipped to one clinic in Nashville, the St. Thomas Outpatient Neurosurgery Center, where many of the state’s meningitis patients were infected.
One aspect of this article that really stood out to me, was the open ended resolution at the end of the article regarding the outbreak, and the reason for the cause in illness. The article itself, contains various information including reasons why many people got sick, where the outbreak started/ came from etc. but at the very end, the article closes with an open ended resolution, as there are still so many possibilities for what could have happened. Therefore I found this to be a little disconcerning, because as the article says, “And there is always a still more awful possibility,” meaning we may never know the true reason for why/ how such a big outbreak, that has killed many people, and may continue to infect more, came about/ spread.
Declan
ReplyDeleteAP Bio- Current Event Comment
I thought that Malika wrote a very strong summary of her article.
She formed a very fluid review, explaining the major points of the article in a way that made sense. I liked that she included updated information, by adding that after the article was published, the death toll had climbed to 19. Malika made a good point in that the author did not go into much depth in describing how the actual infection spreads and can actually kill. The way she transitioned into possible positive implications of this tragedy in this field was excellent as well. She pointed out how doctors are trying to figure out exactly how to defeat this outbreak, which is opening up new information to doctors.
I believe that Malika could have checked some minor grammatical errors. First, the word “dura,” referring to the covering over the spinal cord, should not be capitalized. Also, the use of word “proportion,” doesn’t quite make sense as it used in context. Also, Malika could have been more detailed in certain places. She could have more elaborately described how injection procedures take place, and where the infection is coming from.
I found this article to be interesting ad very alarming. Obviously, tainted drugs are huge threat to our health if they can so easily be missed by federal regulations. The fact that some samples were so overgrown with fungus that the fungus could be seen with the naked eye is astounding. It seems that some medical professionals need to take better care and pay more attention during such procedures and administrations of drugs.
I thought that Malika did avery good job with reviewing the article "Tracing Crucial Components of Meningitis Outbreak." In her review should listed several good facts that connected to the article, and helped to support her summary. She gave specific examples of the outbreak, what causes it, and how many cases there have been. Another good thing that Malika did was how she did some outside research on the number of cases there have been, since the article was not exactly up to date. In doing this, she found that there have been five more deaths, since the article was written, which is an important piece of information for this topic. Finally, I thought that Malika did a very good job with underlining the important issues that this may cause for the world and people today. In this section, she talked about what doctors are doing wrong, and its negative impacts, which was very important.
ReplyDeleteAlthough Malika's article review was very good, there are a few places that she could have improved. In her summary, I think that Malika could have gone into some more detail about the article, and explained it a little bit better. Even though summaries are concise, it was a little too concise, and at times I found it somewhat difficult to understand. Malika could have also proof read her review a little bit better, since there were some minor errors, and it became a little bit hard to read at times.
Overall, Malika's article review was very good. I found it amazing that a treatment that is meant to cure certain problems is causing the outbreak of a serious disease, like meningitis because of the small mistakes of a few doctors. This could have serious effects on people and the world.