The Centers for Disease Control and Prevention (CDC) is issuing this Health Alert Network (HAN) Health Update to supplement the CDC HAN Health Advisory issued on May 17, 2023. This Health Update provides updates on the status of the ongoing fungal meningitis outbreak and highlights interim recommendations for diagnosis and treatment.

As of June 1, 2023, a multistate outbreak of fungal meningitis is ongoing among patients who underwent procedures under epidural anesthesia in the city of Matamoros, Tamaulipas, Mexico, at two clinics: River Side Surgical Center and Clinica K-3. Three U.S. laboratories (CDC Mycotic Diseases Branch’s Laboratory, UCSF Clinical Microbiology Laboratory, and UW Medicine Molecular Microbiology laboratory) and the Mexican national laboratory (InDRE) have detected fungal signals consistent with the Fusarium solani species complex from the cerebrospinal fluid (CSF) of patients receiving follow-up care in Mexico or the United States. In addition, elevated levels of beta-D-glucan, a biomarker of fungal infection, have been detected in the CSF of at least six patients. A total of 212 residents in 25 U.S. states and jurisdictions have been identified who might be at risk of fungal meningitis because they received epidural anesthesia at the clinics of interest in 2023. Among these patients, 14 suspected, 11 probable, and two confirmed U.S cases have been diagnosed (see case definitions below); three patients (two probable cases and one confirmed case) have died. Efforts by public health officials are ongoing to find and notify additional patients who might be at risk.

Healthcare providers, public health officials, and the public should be aware that all patients, including those without symptoms, who underwent medical or surgical procedures under epidural anesthesia at River Side Surgical Center or Clinica K-3 in Matamoros, Mexico, since January 1, 2023, should be evaluated for fungal meningitis as soon as possible. Evaluation for fungal meningitis includes a lumbar puncture (LP, also known as spinal tap) and magnetic resonance imaging (MRI) of the brain.

California healthcare providers should immediately report suspected fungal meningitis cases, including those possibly related to this outbreak, to their local health department and the CDPH Healthcare-Associated Infections (HAI) Program at HAIProgram@cdph.ca.gov.

Please see the full CDC Health Advisory at the following link: https://emergency.cdc.gov/han/2023/han00492.asp