2 Are Dead in Suspected Meningitis Outbreak Linked to Surgeries in Mexico

Two people in the United States have died with probable cases of fungal meningitis and more than 200 others are at risk after an outbreak of the infection among patients who had surgery in Matamoros, Mexico, the Centers for Disease Control and Prevention said on Friday.

At least 220 people in the United States who were treated at two clinics in Matamoros this year could be at risk after having epidural anesthesia, which is injected near the spinal column, the C.D.C. said. The people at risk traveled from the United States to the Mexican clinics for surgical procedures that included liposuction, Brazilian butt lifts and breast augmentation.

The C.D.C. said that as of Friday two people had died who had been classified as having probable cases of fungal meningitis. There were 11 more probable cases of the infection, based on spinal tap results, and 14 suspected cases, based on symptoms consistent with meningitis, the C.D.C. said.

Health authorities in the United States and Mexico have asked the World Health Organization to issue an emergency declaration in response to the outbreak.

The two clinics linked to the infections are River Side Surgical Center and Clinica K-3 in Matamoros, and both closed on May 13, the C.D.C. said.

People who had epidural anesthesia at these clinics should go to their nearest health center, urgent care facility or emergency room as soon as possible to be tested for meningitis, even if they do not have symptoms, health officials said.

It can take weeks for meningitis symptoms to appear, and once they do, they can quickly become severe and life-threatening, the C.D.C. said. Symptoms may include sensitivity to light, a stiff neck, fever, vomiting and confusion. Fungal meningitis infections are not contagious or transmitted person to person.

The C.D.C. said that anyone who has planned an elective procedure involving an epidural injection of an anesthetic in Matamoros should cancel the surgery and related travel “until there is evidence that there is no longer a risk of infection at these clinics.”

According to the C.D.C., millions of people in the United States travel to another country for medical care each year, a practice known as medical tourism. The most common procedures people seek on those trips include dental care, surgery, cosmetic surgery, fertility treatments, organ and tissue transplantation, and cancer treatment.

The C.D.C. said Mexico’s Ministry of Health provided it with a list of 221 U.S. residents who might be at risk for meningitis because they were listed as having had a surgical procedure at one of the two clinics this year.

Dallas Smith, a C.D.C. epidemiologist, said in a webinar for scientists and medical providers on Friday that 205 of those exposed were women and 16 were men. The median age of the patients was 32, and 178 of them were from Texas.

Dr. Smith said the outbreak was similar to a fungal meningitis outbreak that started in November 2022 in Durango, Mexico, where more than 1,400 patients were possibly exposed through contaminated epidural anesthesia. In that outbreak, 80 people were found to have meningitis and 39 of them died, he said.

“The outbreak that we’re experiencing now is pretty similar, and it has the capacity to have this high mortality rate and just devastate families and communities,” Dr. Smith said.

He said that Mexican and United States authorities had submitted a request for a public health emergency of international concern to the W.H.O. because the outbreak had exposed people in Mexico, the United States, Canada and Colombia.

This declaration is meant to accelerate international collaboration, funding and treatment development in response to a disease. The W.H.O. declared Covid-19 an emergency in January 2020 and lifted the designation this month.

The C.D.C. said it was working with Mexico’s Ministry of Health and local health departments in 24 U.S. states and the District of Columbia to respond to the outbreak and to contact people who officials know had surgery at the clinics.

C.D.C. officials found that six of the 221 people potentially exposed to the infection did not have epidural anesthesia and are not considered at risk. The agency also found five other people who were not in the initial group of 221, meaning at least 220 people in the United States were potentially exposed.

Health officials are trying to determine which organism or organisms caused the outbreak and whether any other clinics were involved.

Mexico’s Ministry of Health said on Thursday that an estimated 547 people had surgery at the two clinics between Jan. 1 and May 13.