NASHVILLE —
An outbreak of a rare form of meningitis is likely to grow after sickening 26 people in five states, including four who died, health officials warned.
All received steroid injections, mostly for back pain, a fairly typical treatment. The drug was made by a specialty pharmacy in Massachusetts that issued a recall last week and has shut down operations.
The type of meningitis involved is not contagious like the more common forms. This type is caused by a fungus often found in leaf mold and which health officials suspect may have been in the steroid.
Eighteen of the cases are in Tennessee, where a Nashville clinic received the largest shipment of the steroid.. Investigators, though, say they are still trying to confirm the source of the infection.
Three cases have been reported in Virginia, two in Maryland, two in Florida and one in North Carolina. Two of the deaths were in Tennessee, and Virginia and Maryland had one each, said officials at the Centers for Disease Control and Prevention.
More new cases are almost certain to appear in the coming days, said Tennessee Department of Health Commissioner John Dreyzehner. Five new cases were confirmed over the past 24 hours, he said Wednesday, calling the situation a “rapidly evolving outbreak.”
But federal health officials weren’t clear about whether new infections are occurring. They are looking for — and increasingly finding — illnesses that occurred in the past two or three months.
Meningitis is an inflammation of the lining of the brain and spinal cord. Symptoms include severe and worsening headache, nausea, dizziness and fever. Some of the patients also experienced slurred speech, and difficulty walking and urinating, Tennessee health officials said.
“Some are doing well and improving. Some are very ill — very, very seriously ill and may die,” Tennessee health official Dr. David Reagan said of the state’s patients.
The incubation period is estimated at anywhere from two to 28 days, so some people may not have fallen ill yet, Tennessee health officials said. At three clinics in Tennessee, officials are contacting the more than 900 people who received the steroid in the past three months.
Investigators also have been looking into the antiseptic and anesthetic used during the injections. Neither has been ruled out. However, the primary suspicion is on the steroid medication. Steroid shots are common for back pain, often given together with an anesthetic.
The Food and Drug Administration identified the maker of the steroid as New England Compounding Center, a specialty pharmacy in Framingham, Mass. Last week, the company issued a recall of three lots of the steroid — methylprednisolone acetate. In a statement, the company said it had voluntarily suspended operations and was working with regulators to identify the source of the infection.
Compounding pharmacies mix ingredients for customized medicines that generally aren’t commercially available. They are regulated by states.
The outbreak was discovered about two weeks ago when Vanderbilt University’s Dr. April Pettit was treating a patient who was not doing well for reasons doctors did not understand.
When the lab found the fungus in the patient’s spinal fluid, Pettit began asking questions and learned the patient recently had steroid injections in his spine, according to Dr. William Schaffner, who chairs Vanderbilt’s Department of Preventive Medicine.
“When it became clear that the infection-control practices at the clinic were up to par, the steroid medication became implicated,” Schaffner said.
Federal officials did not release condition reports or details on all the patients in the five states. Fungal meningitis is treated with high-dose antifungal medications, usually given intravenously in a hospital.
Seventeen of the Tennessee cases were treated at the Saint Thomas Outpatient Neurosurgery Center in Nashville. It had 2,000 vials of the suspect lots, the largest number. That clinic voluntarily closed last month to deal with the investigation.
Health
Related Photos
-
In this Tuesday, Oct. 2, 2012 photo, Dr. David Reagan, chief medical officer for the Tennessee Department of Health, right, and Dr. Marion Kayiner, also with the state health department tell local and national media about an outbreak of fungal meningitis infections that have already killed two and sickened 13 others in Nashville, Tenn. (AP Photo/The Tennessean, Shelley Mays) NO SALES
Discussion
Rare US meningitis outbreak grows; 4 dead, 22 sick
- Health
-
-
Her Doctor Dismissed the Lump in Her Breast
It was on the weekend of my 25th birthday that my boyfriend alerted me to a lump in my left breast. At first dismissive of his concern, I eventually promised to see my gynecologist. I was due for my annual exam anyway.
-
Tenn. hospital treats drug-dependent babies
He's less than two weeks old, but he shows the telltale signs of a baby agitated and in pain: an open sore on his chin where he's rubbed the skin raw, along with a scratch on his left check.
-
‘Fibro Fighter’ struggles with fatigue, debilitating pain
For some people life is a little more complicated than the normal rushing around with kids, doing errands, being on time for work and other everyday routines that consume most of our waking moments.
-
AP Exclusive: Calif. exchange granted secrecy
A California law that created an agency to oversee national health care reforms granted it broad authority to conceal spending on the contractors that will perform most of its functions, potentially shielding the public from seeing how hundreds of millions of dollars are spent.
-
Drugmakers, health groups bring poor girls vaccine
Two multinational drugmakers are teaming up with top global health groups to protect millions of girls in the world's poorest countries from deadly cervical cancer.
-
Study: Fish oil doesn’t help prevent heart attacks
Eating fish is good for your heart but taking fish oil capsules does not help people at high risk of heart problems who are already taking medicines to prevent them, a large study in Italy found.
-
Most and least-fit states in the U.S.
A new report released by the Centers for Disease Control highlights adult fitness levels based on participation in aerobic and muscle-building activities. Find out which states came in with the fittest and least-fit populations.
-
Bashful? Buy the little blue pill online
Men who are bashful about needing help in the bedroom no longer have to go to the drugstore to buy that little blue pill.
-
FDA wants cancer warnings on tanning beds
Indoor tanning beds would come with new warnings about the risk of cancer and be subject to more stringent federal oversight under a proposal unveiled Monday by the Food and Drug Administration.
-
The Lifefirst family
Young Vincent Karolewics dreamed of becoming a naval fighter pilot.
- More Health Headlines
-
Conn. Commuter Trains Collide; 60 Go to Hospital
Coffee Run Leads to Hatchet Hitchhiker Arrest
Fmr. IRS Head Insists No Politics in Targeting
CDC: Fecal Bacteria Common in Swimming Pools
$1 Million in Jewels Stolen at Cannes Film Fest
NM Mom Chases Down Child Abductor
Raw: Crash Sends Car Into Fla. Pool
Raw: Obama Sits Down With Elementary Kids
Raw: Bear Falls From Tampa Tree
Ousted IRS Chief: Errors Not Caused by Politics
Terror Suspect Due in Court in Idaho Friday
Raw: Driver Ejected From Truck, Over Bridge
Could Tobacco Be the Next Biofuel?
Wash. State Releases Draft Rules for Legal Pot
Dying Man's Blinks Lead to Murder Conviction
Officials: Texas Tornado Likely Had 200 Mph Wind
Brothers Arrested in NOLA Parade Shooting
Raw: School Bus Crash Injures Five Children
Quick Response Saved Baby on Phila. Train Tracks
One Million Evacuated As Cyclone Hits Bangladesh
