Fungal Meningitis Outbreak In Mexico Kills 2 After Cosmetic Surgeries. Here’s What We Know—And Symptoms And Treatment.

Topline

A probable outbreak of fungal meningitis—an infection that causes inflammation near the brain and spinal cord—in Mexican medical clinics has left two Americans dead and over 200 infected, causing the U.S. and Mexico to ask the World Health Organization to issue a public health emergency declaration.

Photomicrograph of mild meningitis along with hemorrhage, and the presence of Bacillus anthracis.

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Key Facts

The Centers for Disease Control and Prevention announced two Americans have died from suspected cases of fungal meningitis and at least 220 others have been infected following an outbreak of the infection among patients who had surgery in Matamoros, Mexico.

According to the CDC, the outbreak was spread via epidural anesthesia (a procedure used to numb parts of the body by injecting anesthetic into a space next to the spinal cord) given to patients before surgery, and was associated with two clinics in the border city of Matamoros—River Side Surgical Center and Clinica K-3—that shut down on May 13.

Dallas Smith, a CDC epidemiologist, said in a webinar Friday that out of 10 possible cases, 100% of the patients received liposuction under epidural, 40% received breast augmentation and 30% got Brazilian butt lifts.

Smith also mentioned in the webinar that 205 of those exposed were women and 16 were men. The average age of the patients was 32, and 178 were from Texas.

The agency urges anyone who was administered epidural anesthesia at either of these clinics between January 1 and May 13 to seek immediate medical treatment—according to Mexico’s Ministry of Health, around 547 people have surgery at the two clinics over that period.

The CDC has since placed Matamoros, Mexico on a level two travel advisory, cautioning Americans to practice enhanced precautions, like canceling any medical procedures that involve an epidural injection until there’s no longer a risk.

U.S. and Mexican authorities have asked the World Health Organization to declare a public health emergency in response to the outbreak, which is meant to accelerate funding, treatment and international collaboration.

Key Background

Meningitis is the inflammation of the protective membranes covering the brain and spinal cord and can be caused by fungi, bacteria, viruses, amebas or parasites. There are six types of meningitis with varying levels of severity, and according to WHO, bacterial meningitis is the greatest concern. One in six people who get bacterial meningitis die, and one in five have severe complications.

Types Of Meningitis

Fungal meningitis develops after a fungal infection is spread to the brain or spinal cord from elsewhere in the body. It’s usually treated with antifungal medicine, and those with weakened immune systems are more at risk. The CDC recommends risk-prone people to avoid areas and activities with lots of dust or wear N95 masks, use air filtration indoors and clean skin injuries thoroughly.
Bacterial meningitis is a severe condition, which can cause death in as little as a few hours. However, with proper care, most people recover—sometimes facing permanent disabilities, like brain damage, hearing loss and learning disabilities. Infants, people with certain medical conditions like those with HIV or those without a spleen and travelers to sub-Saharan Africa and Mecca are most at risk.
Viral meningitis is the most popular form, caused by several different viruses.Most people recover on their own, though anyone with symptoms should see a doctor to rule out another form of meningitis, and there’s typically not a specific treatment because most people with mild cases recover in seven to 10 days.
Parasitic meningitis is caused by parasitic infection and is much less common than viral and bacterial meningitis. Infection is typically caused by consumption of an infected animal—human to human spread is rare. Some parasites can cause a rare form of parasitic meningitis called eosinophilic meningitis (EM). There isn’t specific treatment for EM, but pain medication may be given to reduce symptoms.
Amebic meningitis is a rare, fatal brain infection caused by Naegleria fowleri, which is found in water sources like tap water, soil, poorly managed pools and water heaters. There’ve only been 154 reported cases of this infection in the U.S. between 1962 and 2021—only four people have survived. Non-infectious meningitis is caused by medical conditions or situations and not from person to person. Causes include cancers, lupus, certain medicines, head injury and brain surgery.

Meningitis Symptoms

According to the Mayo Clinic, it can take weeks for symptoms to appear. Early meningitis symptoms for people two years and older resemble flu-like symptoms and include fever, nausea or vomiting, severe headaches, stiff neck, trouble sleeping, loss of appetite or thirst, seizures, trouble walking, confusion or trouble concentrating and rashes. Symptoms present slightly differently in infants and include fever, constant crying, irritability or trouble sleeping, vomiting, poor feeding, stiffness in the neck or body, not waking to eat and a bulge in the soft spot on top of the head. Medical attention is recommended if a patient develops a fever, stiff neck, confusion, vomiting or a severe headache that doesn’t go away.

Tangent

Matamoros is a popular medical tourist destination, especially for U.S. patients. A study published in Infection Control & Hospital Epidemiology found Mexico was the most common destination of choice for Americans seeking medical tourism, accounting for 41% of all visits. The study also reports dental work accounts for 55% of all treatment, though cosmetic surgeries, cancer care, fertility treatments and organ transplants are all popular among Americans seeking treatment abroad. Cost is typically the main reason for medical tourism—a 2020 study found 92% participants cited low cost in Mexico as a driving factor. However, the State Department recommends against traveling to the border state of Tamaulipas—home to Matamoros—due to rampant violence: In March, four Americans who traveled there for surgery were kidnapped by a suspected Mexican cartel, two of whom died.