CDC Issues a Level 2 Travel Notice Regarding Fungal Meningitis

May 22, 2023 - After investigations of fungal meningitis revealed a link between the condition and traveled to Mexico, the CDC issued a level 2 travel notice, urging United States residents to practice enhanced precaution while traveling.  

Although those who contracted fungal meningitis likely got it from a medical or surgical procedure performed in Matamoros, Mexico, the public health organization still instructs US residents to be vigilant. According to the travel notice, the medical procedures, including liposuction, each required an epidural. The CDC has traced the infection to multiple clinics in Matamoros, namely, the River Side Surgical Center and Clinica K-3.  

Fungal meningitis is caused by an infection from one of the following fungi that spread to the brain or spinal cord: Cryptococcus, Histoplasma, Coccidioides, and Candida. Most of these fungi are picked up through the environment.  

Many patients may be able to fight off a fungal infection before it develops into meningitis; however, patients with compromised immune systems may be at higher risk. High-risk patient populations include those taking steroids, antirejection drugs, or anti-TNF medications. Additionally, certain health conditions, such as HIV or cancer, may push patients into the high-risk category. 

While the condition is not contagious and cannot be transmitted between humans, it can be fatal if contracted. Common symptoms of fungal meningitis may include fever, headache, stiff neck, nausea, vomiting, sensitivity to light, and confusion.  

Patients who contract fungal meningitis may be treated with high-dose intravenous antifungal medications followed by oral antifungals. The treatment length is dependent on the severity of the condition. According to an article in Disaster Medicine and Public Health Preparedness, 100% of cases are fatal without treatment. However, less than 10% of cases are fatal with appropriate and timely treatment.  

Despite a readily available treatment option, rising rates of antimicrobial resistance and recent evidence suggesting the presence of antifungal-resistant fungi worry public health professionals.  

The CDC acknowledges that many US residents may turn to other countries for medical care to save money, have a provider with a shared culture, or get a procedure unavailable in the US. While those reasons may be enticing, the organization does warn about the dangers of traveling for medical care, including infectious disease and antibiotic resistance.  

The CDC recommends consulting a medical professional to minimize infection rates and keep US residents safe before seeking international care. Additionally, arranging follow-up care, adequately researching the facility, and maintaining a copy of health records may help minimize patient risk.  

In the meantime, providers who see a patient that has gotten a medical procedure in Matamoros are urged to evaluate them for meningitis and report any cases to the CDC.