January 10, 2013

VU’s Pettit named ‘Tennessean of the Year’

Vanderbilt’s April Pettit, M.D., MPH, instructor in Medicine, is being recognized as the “Tennessean of the Year” by the readers and editorial board of The Tennessean.

Vanderbilt’s April Pettit, M.D., MPH, instructor in Medicine, is being recognized as the “Tennessean of the Year” by the readers and editorial board of The Tennessean.

April Pettit, M.D.

Pettit, who is a co-recipient of the annual honor along with Marion Kainer, M.B., B.S., MPH, from the Tennessee Department of Health, won the award for her role in the discovery of the national meningitis outbreak and lifesaving actions that followed.

In early September 2012, Pettit treated a man in his 50s who presented at Vanderbilt University Hospital with classic symptoms of meningitis: headache and neck pain, along with nausea, malaise, fatigue, chills and decreased appetite. He improved briefly with medication but died on day 22 of his hospitalization.

The infectious disease team was seeking to find out how a seemingly healthy man could have such a raging meningitis infection with no known cause. The lab was ordered to retest his spinal fluid for unusual microbes. Pettit, an infectious diseases specialist, was surprised at what showed up on the laboratory plate — Aspergillus fumigatus, a fungus common in the environment but unheard of in a person’s spinal fluid.

“It’s rare in anyone, even in people who have immune system problems,” she said. “I’ve never seen it in someone who has a normal immune system.”

Pettit began to connect the dots on what would be a nationwide outbreak of fungal meningitis. She went back to the patient’s chart and interviewed his family to determine the cause, learning that the patient had received a spinal steroid injection at a local outpatient neurosurgery center. She felt that something wasn’t right and notified the Tennessee Department of Health.

“I thought this was one patient and in no way was thinking I’d found an outbreak. I just thought the only possible way that the fungus could have gotten there is through this injection and it called for investigation,” she said.

The Centers for Disease Control and Prevention (CDC) and Food and Drug Administration took the information and identified three contaminated lots of the drug methylprednisolone acetate that were implicated in the meningitis cases, all produced by the Massachusetts-based New England Compounding Center. An estimated 14,000 patients received an injection of these drug lots.

The number of patients and deaths continues to grow, with 656 cases of fungal meningitis, including 39 deaths, in 19 states. Tennessee was one of the hardest hit, with 139 cases and 14 deaths.

Pettit is one in a small group of physicians with connections to Vanderbilt to receive the award from The Tennessean.

In 2009, the award was given to a team of Meharry Medical College researchers for their groundbreaking work on AIDS, women’s health issues and other medical concerns.

In 1995, The Tennessean of the Year was Henry Foster, M.D., who didn’t win the nomination to become U.S. Surgeon General but did create awareness about teen pregnancies after his nomination turned to a politicized debate on the hot-button issue of abortion. Foster has fought for quality health care for disadvantaged populations throughout his career in medicine.

Last year’s winners were Amy Grant and Vince Gill and the 2010 recipient was Mayor Karl Dean. Al Gore (2007) and Dolly Parton (2006) have also received the honor.