Meningitis research & treatment updates

waltky · Nov 16, 2012

Meningitis vaccine need no longer be kept in cold-storage...

Cold-Storage Requirement Dropped for Life-Saving Meningitis Vaccine
November 15, 2012 : New research has shown that a vaccine against bacterial meningitis, which previously required cold storage to transport across Africa, can be shipped and administered safely for up to four days without refrigeration. Public health experts are calling this a potentially game-changing development for immunization efforts in resource-poor tropical countries.

The fact that the meningitis A vaccine can be removed from the so-called "cold chain" and transported throughout Africa at essentially room temperature means children and young adults who have not been receiving the potentially life-saving vaccine can now get it. The breakthrough was announced by international public health officials at the American Society of Tropical Medicine and Hygiene meeting in Atlanta, Georgia. Godwin Enwere heads the Meningitis Vaccine Project, a joint collaboration between the World Health Organization and the Program for Appropriate Technology in Health, or PATH. Enwere said the discovery that the vaccine could be in transit for up to four days without refrigeration or even coldpacks came after an extensive re-evaluation of stability data by drug regulators in India and Canada.

Prior to the finding, the drug agencies recommended that the meningitis vaccine be transported at temperatures between two and eight degrees centigrade. The ability to transport it safely at ambient temperatures of up to 40 degrees will allow it to reach tens of thousands of children who need it. Enwere recalls that during a meningitis outbreak in Chad last year, there wasnt enough of the drug to go around, and public health officials were only able to immunize youngsters in three districts. That left tens of thousands of children in the rest of the country unprotected. So, this clearly demonstrates not only the effect of the vaccine; that if a system is developed whereby this vaccine can be carried and administered at ambient temperature, then it will increase the coverage," said Enwere. "If we had had this information as of last year, Chad would have introduced this vaccine to a larger population and then perhaps they would not have had this outbreak.

Meningitis A is a serious, potentially fatal bacterial infection common in resource-poor counties. It causes inflammation of the protective linings of the brain and spinal cord, sometimes causing the brain to swell, producing severe fever, headache and confusion. The vaccine is known as MenAfriVac. It originally was created to meet the needs of Africas so-called meningitis belt, which the WHO estimates includes 400 million people who live across a swath of 21 countries that runs from Senegal to Ethiopia.

While the vaccine costs less than 50 cents per dose and is very effective, the biggest obstacle has been keeping it cool enough in the "cold chain" so it doesnt spoil during the final kilometers to its intended destination. Researchers are now investigating whether other cold-chain vaccines can be shipped at room temperature. In particular, they are studying a vaccine against bacterial pneumonia, a disease that kills an estimated half a million children each year.

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Richard Powell · Nov 19, 2012

This seems to be a good news for the people who are taking Meningitis medicines for long. with the advancement in technology it is now possible to keep medicine in moderate temperature without cooling system. This will help those people who resides in tropical regions.

waltky · Mar 23, 2013

Scary...

Meningitis Spreading Via Anonymous Sex in NYC
Mar 22, 2013 > New York City health officials are urging some men to get vaccinated against meningitis amid an outbreak that has sickened 22 New Yorkers and killed seven.

The dangerous strain of bacterial meningitis appears to be spreading through sexual encounters between men who meet through websites or smartphone apps, or at bars or parties, according to the Citys health department. More than half of the infected men have had HIV, a virus that attacks the immune system making infections more likely and more severe. Vaccination is the best defense, City health commissioner Dr. Thomas Farley said in a statement. I urge all men who meet these criteria regardless of whether they identify as gay to get vaccinated now and protect themselves from this disease before it is too late.

Bacterial meningitis is an infection of the brains membranous lining, called the meninges. Early symptoms include fever, headache, vomiting, stiff neck and a rash within 10 days of the infection. If left untreated, the disease can cause severe brain damage and even death, according to the U.S. Centers for Disease Control and Prevention.

The disease is spread by prolonged close contact with nose or throat discharges from an infected person, the health department said in a September 2012 statement after the death of a patient. While vaccination can help prevent new infections, people that have been in prolonged close contact with infected people need to see their health-care provider immediately to receive preventive antibiotics, the department added.

Men from all five boroughs have been infected, health officials said, declining to comment on the kinds of websites or apps involved in the outbreak. I strongly recommend all men who have intimate contact with other men get vaccinated, Brooklyn Borough President Marty Markowitz said in a statement. This disease is both potentially fatal and extremely contagious, so increasing the publics awareness to this growing issue and encouraging vaccination are of the utmost importance. New Yorkers are advised to call 311 or search meningitis at nyc.gov for more vaccine information.

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waltky · Jun 7, 2013

MenAfriVac works!...

New Vaccine Drives Africa Meningitis Cases to Lowest in Decade
June 06, 2013 Case numbers in Africa's meningitis season this year were the lowest in 10 years thanks to a cheap new vaccine designed to treat a type of the disease common in the so-called meningitis belt, the World Health Organization said on Thursday.

The vaccine, called MenAfriVac, was developed with funding from the Bill & Melinda Gates Foundation specifically for use against meningitis A, a type which causes regular epidemics in Africa. Detailing data for Jan. 1 to May 12, the United Nations health agency said that just under 9,250 meningitis cases, including 857 deaths, were reported in 18 of the 19 African countries under enhanced surveillance for meningitis.

Women and children wait to participate in a vaccination campaign against meningitis at the community center in Al Neem camp for Internally Displaced People in El Daein, East Darfur, Sudan

Epidemics of meningitis A occur regularly in Africa's meningitis belt, a band of 26 countries stretching from Senegal to Ethiopia, and are particularly devastating to children and young adults. Bacterial meningitis, known as meningococcal meningitis, is a serious infection of the thin lining surrounding the brain and spinal cord. It can cause severe brain damage and is fatal in 50 percent of cases if untreated. According to the non-profit Meningitis Vaccine Project (MVP), which helped develop the MenAfriVac vaccine, the seasonal outbreak of meningitis across sub-Saharan Africa in 2009 infected at least 88,000 people and killed more than 5,000.

The WHO said the falling numbers this year were due to the introduction of the newly developed vaccine. MenAfriVac costs just 50 U.S. cents a dose and has been progressively introduced in Africa since 2010, starting in Burkina Faso, Mali and Niger. The introduction of this first meningococcal vaccine available for preventive purposes in Africa has enabled the immunization of over 100 million people from 10 countries in the meningitis belt in the past three years, the WHO said. The reduced case load and epidemic activity observed this year adds to the evidence on the impact...of this vaccine.

http://www.voanews.com/content/new-...ngitis-cases-to-lowest-in-decade/1676856.html
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waltky · Sep 18, 2013

New meningitis vaccine successful in Africa...

New Meningitis Vaccine a Success in Chad
September 16, 2013 A study published this month in the Lancet medical journal found a new meningitis vaccine being used in Chad reduced the incidence of the disease by 94 percent. According to the World Health Organization, meningitis affects nearly half a billion people living in sub-Saharan Africa each year and, even with proper treatment, is often deadly.

Researchers say the first meningitis vaccine developed specifically for Africa has dramatically reduced the number of cases of the disease in Chad, as well as prevented its spread. Dr. James Stuart, a professor at the London School of Hygiene and Tropical Medicine and a co-author of the study, said his team looked at the effects of what is known as MenAfriVac on 1.8 million people under the age of 29 across three regions in Chad during the 2012 meningitis epidemic. "What we found was that the number of cases dropped dramatically in the part of the country that was vaccinated and that the meningitis epidemic continued in the part of the country that had not been vaccinated," Stuart said. "So this, although it was not a trial, suggested that the vaccine had a very positive effect on protecting people against meningitis."

Stuart said MenAfriVac, which targets the type-A strain of the disease, completely prevented type A in all of the vaccinated regions. It also reduced the incidence of all types of meningitis. According to the World Health Organization, more than one million cases of meningitis, which is the inflammation of the protective tissue that covers the brain and spinal cord, have been reported in Africa since 1988. The highest incidence of the disease occurs in what is known as the meningitis belt of sub-Saharan Africa, a strip of 25 countries stretching from Senegal in the west to Ethiopia in the east. No other meningitis vaccines have proven to be as effective as MenAfriVac, Stuart said. "The new vaccine seems to stop people carrying the germ and it stops it therefore from being transmitted, whereas the old vaccine did not have an effect on carriage, so it did not stop the germ being transmitted between people," he said. "So this new vaccine therefore has a double effect. One is that it gives you a good individual protection against meningitis, and at the same time, it is actually stopping transmission, so it is actually preventing other people from getting meningitis as well."

A child receives a meningitis vaccination at the community center in El Daein, East Darfur, Sudan

Stuart said that such prevention is key when it comes to meningitis, as the disease can spread quickly, passing from person to person via bacteria that live in the throat. Outbreaks in sub-Saharan Africa are common and have killed as many as 25,000 people at a time. While this particular vaccine is not new, it was licensed in India in 2009 and introduced in Burkina Faso, Mali and Niger in December 2010, this was the first time researchers were able to test its effectiveness. The World Health Organization says antibiotics are available as treatment, but meningitis can lead to serious health problems once contracted, including seizures, deafness, paralysis and brain damage, and that it results in death in about 10 percent of reported cases. In Chad, the mortality rate has risen as high as 75 percent during outbreaks.

Stuart said that MenAfriVac will sell for less than 50 cents per dose in sub-Saharan Africa and can be included as part of routine preventative vaccinations for children. While its longterm effects are still being studied, Stuart said there have been no indications of negative side effects. Following its success in Chad, MenAfriVac has since been used to vaccinate an additional 100 million people against type A meningitis in sub-Saharan Africa. Stuart said plans are underway to roll out the vaccine in the rest of the meningitis belt countries.

http://www.voanews.com/content/new-meninngitis-vaccine-a-success-in-chad/1750542.html
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waltky · Jan 9, 2015

Africa to get Meningitis A Vaccine for Infants...

WHO OKs Use of Meningitis A Vaccine for Infants
January 08, 2015 ~ The World Health Organization has given the go-ahead for a meningitis A vaccine to be used in infants younger than a year old in Africa.

The vaccine, MenAfriVac, has been highly effective since its introduction four years ago in protecting children and adults ages 1 to 29. The inexpensive, safe vaccine has been administered to more than 215 million people in 15 countries in sub-Saharan Africa's so-called meningitis belt, where the disease occurs regularly in an area between Senegal in the west to Ethiopia in the east.

The countries include Benin, Burkina Faso, Cameroon, Chad, Cote d'Ivoire, Ethiopia, Ghana, Mali, Niger, Mauritania, Nigeria, Senegal, Sudan, Togo and Gambia. One of the most devastating outbreaks occurred in 1996-97, when an epidemic of meningitis A infected a quarter-million people and killed 25,000 in a few months.

The logo of the World Health Organization is seen at the WHO headquarters in Geneva, Switzerland.

But since the widespread use of MenAfriVac in 2010, there has been a dramatic decrease in the number of cases and it confers "community" immunity among unvaccinated groups. In 2012, there was a 90 percent drop in the incidence and transmission of meningitis A in Chad.

Meningitis A causes high fever and severe headache, along with vomiting and nausea, seizures, sleepiness and sensitivity to light. It is thought that giving the drug to infants as part of a routine vaccination schedule will further reduce the number of meningitis outbreaks. The low-cost MenAfriVac was developed by a partnership between the nonprofit Meningitis Vaccine Project and Serum Institute of India.

http://www.voanews.com/content/who-approves-menintitis-vaccine-infants/2591428.html
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waltky · Nov 11, 2015

Routine childhood immunisation rounds needed...

Huge gains on meningitis A in Africa could be under threat, warns WHO
Tuesday 10 November 2015 - Success of campaign that has almost rid 26 African countries of the disease could be at risk if vaccine not given routinely, says World Health Organisation

The dramatic gains made by a vaccination campaign that has almost rid 26 African countries of meningitis A could be undermined if the pioneering vaccine used is not included in routine childhood immunisation rounds, health experts have warned. The vaccine, MenAfriVac, was created to fight epidemics of the deadly disease, which used to kill or disable thousands of people each year across the meningitis belt that runs through a swath of sub-Saharan African countries, from Senegal to Ethiopia.

Because it is cheap costing less than $0.50 a dose and doesnt need to be stored in fridges or iceboxes, the vaccine has nearly eliminated the disease, which is a bacterial infection of the thin lining around the brain and spinal cord. MenAfriVac was developed by the World Health Organisation (WHO) and Path, a non-profit global health group, in response to the 1996 outbreak of meningitis A that killed 25,000 people and infected more than 250,00 over the course of a few months.

Five years after the vaccine was launched, 220 million people between the ages of one and 29 have been vaccinated in 16 of the 26 countries in the belt: Benin, Burkina Faso, Cameroon, Chad, Ivory Coast, Ethiopia, the Gambia, Ghana, Guinea, Mali, Mauritania, Niger, Nigeria, Senegal, Sudan and Togo. Meningitis A has disappeared wherever the vaccine has been used, and in 2013 just four laboratory-confirmed cases were reported across the belt. But despite the vaccines success, scientists say that the disease could easily recur within the next two decades if the vaccine is not rolled out more widely.

The other 10 countries in the belt Burundi, Central African Republic, the Democratic Republic of the Congo, Eritrea, Guinea Bissau, Kenya, Rwanda, South Sudan, Tanzania and Uganda still need to fully implement vaccination campaigns. We have nearly eliminated meningitis A epidemics from Africa, but the fact is the job is not yet done, said Dr Jean-Marie Okwo-Bele, director of immunisation, vaccines and biologicals at WHO. Our dramatic gains against meningitis A through mass vaccination campaigns will be jeopardised unless countries maintain a high level of protection by incorporating the meningitis A vaccine into their routine childhood immunisation schedules.

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waltky · Feb 18, 2016

Mum shares photo of dead girl's meningitis...

Thousands sign petition after mum shares image of girl's meningitis
Wed, 17 Feb 2016 - A mother shares an image of her two-year-old daughter before her death from meningitis to campaign for vaccines to be given to all children.

A mother has shared an image of her daughter before her death from meningitis to back a campaign for vaccines to be given to all children. Faye Burdett, aged two, from Maidstone, Kent died on Valentine's Day after fighting the infection for 11 days. Her family said they were enduring "a pain you cannot describe" after the toddler contracted meningitis B. Their photographs of Faye, including one of her in hospital, have been widely shared on social media.

Faye Burdett was taken to A&E with a rash on her forehead but died days later

'Massive operation'

The most widely shared image shows her covered in a rash from the infection lying in her hospital bed. More than 331,000 people have signed a petition calling for the NHS vaccination programme to be widened to all children. A vaccine to protect against meningitis B became available on the NHS for babies in September but parents who want to have older children vaccinated must pay privately. "We campaign for change in her memory," said Faye's mother, Jenny. "Faye was taken to A&E with a rash on her forehead. She was then transferred by South Thames Retrieval Service to Evelina Children's Hospital, where her heart stopped in the ambulance. "They revived her and spent hours working on stabilising her. "We were given a 1% survival chance but she proved them wrong and carried on fighting. "After a few days she seemed to have turned a corner, but the sepsis started to affect her more."

Faye's mother Jenny published this picture of her daughter to raise awareness

It was then that doctors presented the family with an option of amputation. "The extent of removal was massive, full leg amputation and one arm and plastic surgery," Jenny said. "We had to make the decision, a massive operation and she may die or we let her go peacefully on her own accord. "We decided the latter and then watched our little girl slip away." Charlene Reed, who set up a JustGiving page in memory of Faye, to raise money for the Evelina hospice, said Faye's mother shared the picture to raise awareness. "It's not nice, but it is reality. It's what this disease did to Faye which made her sadly lose her life on Sunday," she said.

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waltky · Jul 28, 2016

Bacterial meningitis outbreak in Niger...

Bacterial Meningitis Linked to Sand Storms in Sahel
July 27, 2016 - There’s new evidence linking hot desert sandstorms in Africa to bacterial meningitis in the Sahel, an area that stretches from Senegal in the west to Ethiopia in the east. Known as the “meningitis belt,” researchers have homed in on why the region has its name.

Sandstorms are a fact of life in West Africa's Sahel region. New research suggests that exposure to all that airborne dust, along with the already high temperatures contribute to the high number of bacterial meningitis cases each year.” Most people carry the bacteria that causes meningitis in their nasal passages, but British and Belgian researchers think that sand and other airborne debris people breathe in during a sandstorm carries the bacteria high into the respiratory tract where it is more likely to develop into the deadly infection.

Daniel Neill is a researcher at the University of Liverpool in the school’s Institute of Infection and Global Health. “In our noses, mouths and throats some of these bacteria live quite harmlessly, and that’s very common throughout the world ,” said Neill. "But what’s very rare is for these bacteria to move from these sites in the nose and mouth and throat to places like the brain, lungs or bloodstream where they cause severe disease. So what we were able to show was that the dust causes the likelihood of the bacteria moving from the mouth, nose or throat from these other sites where they cause severe infection.” Over the past ten years, there have been about one million cases of bacterial meningitis in the Sahel, resulting in some 100,000 deaths.

А boy is seen eating dry couscous in the village of Goudoude Diobe, in the Matam region of northeastern Senegal.

Streptococcus pneumoniae can cause often-lethal inflammation of the lining of the brain. Neill says it is treated aggressively with antibiotics, and effective meningitis vaccines have significantly reduced the incidence of the disease. For their study, published in the Journal of Allergy and Clinical Immunology, Neill and colleagues spent eight years studying dust storms in the Sahel – which encompasses 26 countries with a population of 300 million people. Their work focused on Niger. Investigators measured periods of visibility during the storms. They found that the lower the visibility - where people could see for no more than three meters - the more cases there were of meningitis. When combined with extremely hot temperatures, he suggests, the bacteria release toxins that make it hard for the immune system to fight off infection.

Neill says the number of meningitis cases might be reduced if people who must go outdoors during a sand storm cover their noses and mouths with scarves or gauze material. “And that’s something that we could test relatively simply in which we’d like to do in the future is just to see whether adopting simple measures like that can affect the incidences of meningitis in these parts of the world,” said Neill. Dust storms tend to occur during the Sahel’s dry season, the hottest part of the year. Neill says by monitoring climate conditions, it may be possible to forecast when the most dangerous storms are likely to occur.

http://www.voanews.com/content/bacterial-meningitis-linked-to-sand-in-sahel/3437305.html
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See also:

Scientists Find Potential New Antibiotic, Right Under Their Noses
July 27, 2016 — Scientists in Germany have discovered a bacteria hiding out in peoples' noses that produces an antibiotic compound that can kill several dangerous pathogens, including the superbug MRSA.

The early-stage finding, reported Wednesday in the journal Nature, could one day lead to a whole new class of antibiotic medicines being developed to fight drug-resistant bacterial infections, the researchers said. As well as being a focal point for many viral infections, the nasal cavity is also a rich ecosystem of 50 or so different species of bacteria, lead researcher Andreas Peschel of the University of Tuebingen told reporters in a telephone briefing. "[That's] the reason why we looked at this particular body site,” Peschel said. “[And] it led us to some very unexpected and exciting findings that may be very helpful in looking for new concepts for the development of antibiotics."

Most antibiotics discovered and developed until now have been isolated from soil-living or other environmental bacteria, but the researchers said this discovery highlights the value of the human microbiome as a potential new source. "The human body has a lot of different ecological niches," Peschel said. "Maybe this is just the right place to look for new human antibiotics. Lugdunin is an example that we've been able to characterize. We're sure there will be others to discover." Naming their new discovery lugdunin, the researchers said it was the first known example of a new class of peptide antibiotics.

Methicillin-resistant Staphylococcus aureus (MRSA) broths are shown in this file photo. Scientists have discovered a bacteria in people's noses that produces an antibiotic effective in treating a strain of the superbug MRSA.

Lugdunin is produced by the nostril-dwelling bacterium Staphylococcus lugdunensis (S. lugdunensis). In experiments with mice, Peschel's team showed it is able to effectively treat a skin infection caused by the bacteria Staphylococcus aureus (S. aureus), which can cause serious and superbug infections. They also found lugdunin was effective against a wide range of so-called Gram-positive bacteria, including strains of methicillin-resistant Staphylococcus aureus (MRSA).

The researchers then analyzed nasal swabs from 187 hospital patients and found that in those who had the S. lugdunensis bacteria in their noses, only 5.9 percent also harbored the potential infectious S. aureus bacteria. In those with no S. lugdunensis, however, 34.7 percent were found to have S. aureus in their noses. This suggests that in the human nose, S. lugdunensis helps to keep S. aureus at bay, the researchers said. Peschel stressed that the research is at a very early stage and the team would need many years of work, ideally with a pharmaceutical company, before a potential new antibiotic medicine could be developed and tested in clinical trials.

http://www.voanews.com/content/scientists-find-potential-new-antibiotic-noses/3438048.html
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waltky · Aug 25, 2016

New meningitis test hopes to contain outbreaks...

Scientists Hope New Test Could Help Contain Meningitis Outbreaks
August 24, 2016 A test has been developed that could help diagnose bacterial infections including meningitis in minutes, but it could take several years before a cheap testing device is available to developing countries, scientists said on Wednesday.

The new test could save lives, allow treatment of disease which is difficult to diagnose to start much sooner and reduce the risk of life-changing after effects, an international team of researchers led by Imperial College London said. "We would very much hope this could become something cheap enough to be applied even in resource poor regions," Imperial College Professor Michael Levin told the Thomson Reuters Foundation. Currently the only test available for meningitis, whose symptoms include a high fever, headaches and vomiting, is expensive and takes more than 48 hours, Levin said. A study led by the pediatrician shows that bacterial infections can be distinguished from other causes of fever.

Meningococcal meningitis survivor and vaccination advocate Leslie Meigs looks on as her brother Andrew (1, a college student in Texas, receives Bexsero(R), a meningococcal group B vaccine approved by the FDA for ages 10-25.

The research revealed that two genes in white blood cells become active only in case of bacterial infections, according to the study published in the JAMA medical journal. Researchers said a cheap pin-prick blood test able to accurately identify bacterial infections in less than one hour could be developed within five years. "If this works... [we] could have an accurate test in situations such as in sub-Saharan Africa where there are epidemics of meningitis and accurate testing using the current methodologies is really difficult," study co-author Dr Jethro Herberg said.

Meningitis is common across Africa's so-called "meningitis belt" from Senegal to Ethiopia. An outbreak of meningitis killed at least 90 people in Niger this year, according to medical charity Médecins Sans Frontières (MSF). A 2009 outbreak caused more than 80,000 cases, while some 20,000 people died in another epidemic, in 1996-1997. Meningitis, which is prevalent in children and elderly people, can be treated with antibiotics, but 10 percent to 15 percent of patients die and up to 19 percent of survivors have long-term disabilities, including brain damage and limb amputations.

http://www.voanews.com/a/scientists...elp-contain-meningitis-outbreaks/3479453.html
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waltky · Jun 27, 2017

NECC co-owner gets 9 years for meningitis outbreak...

Pharmacy boss blamed for meningitis outbreak gets 9 years
June 26, 2017 — The co-owner of a pharmacy deemed responsible for the deaths of 76 people in a national meningitis outbreak tearfully apologized to the victims on Monday and was sentenced to nine years in prison, far less than the victims had wanted.

"I'm sorry for your extraordinary losses," Barry Cadden said, wiping his eyes. A dozen victims who were sickened or lost loved ones asked the judge to give Cadden the harshest penalty allowed under the law for the deadly 2012 nationwide fungal meningitis outbreak, which sickened hundreds of people. Cadden was acquitted of second-degree murder charges under federal racketeering law but was convicted on conspiracy and fraud charges. He must report to prison by Aug. 7 but remains free on bond until then. The outbreak was traced to contaminated injections of medical steroids made by the New England Compounding Center in Framingham. Prosecutors say Cadden, 50, ran the center in a dangerous way by skirting industry regulations on sterility in an effort to push production and make more money. Assistant U.S. Attorney Amanda Strachan said the center was "a massive reckless and fraudulent organization."

At Cadden's sentencing Monday, victims told stories of shattered lives and unbearable loss caused by the tainted steroids made by Cadden's company. Penny Laperriere, whose husband died after receiving a contaminated steroid shot, said Cadden destroyed her family. "Who gave him the right to play God?" the Michigan woman said. She said her husband, Lyn, received the shot to try to get relief from his back pain. He died in 2012. Prosecutors asked the judge to sentence Cadden to 35 years in prison. Cadden's lawyer said he should get 2 1/2 to 3 years. The outbreak of fungal meningitis and other infections in 20 states was traced by the Centers for Disease Control and Prevention to contaminated injections of medical steroids, given mostly to people with back pain.

The CDC put the death toll at 64 as of October 2013. Federal prosecutors say 12 more people have died since then, raising the total to 76. More than 700 people were sickened. Indiana, Michigan and Tennessee were hit hardest. One of those who died was longtime Kentucky judge Eddie C. Lovelace, whose widow, Joyce Lovelace, told her story to Congress. The scandal prompted increased scrutiny on compounding pharmacies, which differ from ordinary drugstores in that they custom-mix medications and supply them directly to hospitals and doctors. In 2013, in reaction to the outbreak, Congress increased federal oversight of such pharmacies. Federal prosecutor Amanda Strachan told the jury during the two-month trial that the deaths and illnesses happened because Cadden "decided to put profits before patients."

NECC used expired ingredients and falsified logs to make it look as if the so-called clean rooms had been disinfected, prosecutors said. After the outbreak, regulators found multiple potential sources of contamination, including standing water and mold and bacteria in the air and on workers' gloved fingertips. Cadden's lawyer, Bruce Singal, told the jury Cadden was not responsible for the deaths and pointed the finger at Glenn Chin, a supervisory pharmacist who ran the clean rooms where drugs were made. Chin has pleaded not guilty and is scheduled to go on trial in September. NECC filed for bankruptcy after getting hit with hundreds of lawsuits. NECC and several related companies reached a $200 million settlement with victims and their families.

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