* Vials of steroids linked to outbreak sent to 23 states
* Doctor urges that recipients be tracked down immediately
By Tim Ghianni
NASHVILLE, Tenn., Oct 5 (Reuters) – The number of people
stricken with a rare form of meningitis linked to steroid
injections rose to 49 in seven U.S. states, authorities said on
Friday, in a widening outbreak that has killed at least five
people.
Michigan said it had confirmed six cases of fungal
meningitis, the seventh state to report people falling ill after
receiving the injections, mainly for back pain.
Other states with cases are Tennessee, Virginia, Florida,
Maryland, North Carolina and Indiana.
The U.S. Centers for Disease Control reported 47 cases of
meningitis on Friday, while Michigan reported an additional two
cases not included in the CDC count. That brought the national
total to 49, compared with 35 on Thursday.
Tennessee accounts for most of those, and state officials
said on Friday the number there had risen to 29 cases, up four
from Thursday. While there were no more deaths reported on
Friday, Tennessee officials said on Thursday there were more
patients in critical condition in intensive care.
Three of the deaths so far have been in Tennessee, where the
outbreak began, and one each in Virginia and Maryland.
Vials of steroids linked to the outbreak were shipped to
about 75 facilities in 23 states and could have been used to
inject thousands of patients, authorities have said.
“All patients who may have received these medications need
to be tracked down immediately,” Dr. Benjamin Park, a medical
officer in the CDC Mycotic Diseases Branch, said on Friday in a
statement. “It is possible that if patients with infection are
identified soon and put on appropriate antifungal therapy, lives
may be saved.”
While fungal meningitis is rare and life-threatening, it is
not spread by person-to-person contact.
The infected patients have shown a variety of symptoms from
one to four weeks after their injections, including fever, a new
or worsening headache, nausea and neurological problems that
would be consistent with deep brain stroke, the CDC said.
All the cases have so far been traced to three lots of the
steroid prepared at New England Compounding Center Inc in
Framingham, Massachusetts. The company said it had suspended its
operations while the investigation proceeds.
RATE OF INFECTION NOT YET DETERMINED
The Massachusetts Health Department said there were 17,676
vials of medication in each of the three lots of
methylprednisolone acetate sent out July through September and
have a shelf life of 180 days.
Dr. Anders Cohen, chief of neurosurgery and spine surgery at
the Brooklyn Hospital Center in New York, said patients with
back pain should wait to have steroid injections until the CDC
confirms all the tainted lots are off the market.
“In the meantime, they can ask their physicians about other
alternatives such as oral pain medications,” Cohen said.
The CDC said it had not yet determined the rate of infection
among patients who received the potentially tainted steroid. The
rate of infection is important because it would help pinpoint
the scope of the potential outbreak.
In addition to Tennessee and Michigan, six cases have been
reported in Virginia, two in Florida, two in Maryland, one in
North Carolina and three in Indiana, the CDC said.
The steroid was sent to California, Connecticut, Florida,
Georgia, Idaho, Illinois, Indiana, Maryland, Michigan,
Minnesota, North Carolina, New Hampshire, New Jersey, Nevada,
New York, Ohio, Pennsylvania, Rhode Island, South Carolina,
Tennessee, Virginia, Texas and West Virginia, the CDC said.
Each state could have hundreds of patients or more who were
exposed through injections.
