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CDC reports 185 cases of fungal meningitis in outbreak

CDC

CDC officials, including Dr. John Jernigan, center, discuss the ongoing outbreak of fungal meningitis in the U.S.

A few more people have been diagnosed with a rare form of fungal meningitis linked to contaminated back pain injections, federal health officials said Friday.

A case was reported in Texas, bringing the total number of patients diagnosed to 185, with 14 deaths, the Centers for Disease Control and Prevention reported. Overall, patients have been diagnosed in 12 states.

The CDC and the Food and Drug Administration are working to confirm the source of the contamination, which is traced to three lots of steroid injections made at a Framingham, Massachusetts pharmacy. All of the drugs made at the pharmacy, the New England Compounding Center, have been recalled.

The CDC suggests more cases will turn up. The two molds that have been found in patients grow slowly and can cause very subtle symptoms, at least at first.

“Patients need to remain vigilant for onset of symptoms because fungal infections can be slow to develop. Typically in this outbreak, symptoms have appeared 1 to 4 weeks following injection, but it’s important to know that longer and shorter periods of time between injection and onset of symptoms have been reported,” the CDC said in a statement on its website.

Many of the patients who have died suffered strokes, so doctors may have to go back and check records to see if patients who received the steroid injections died of strokes that may not have been linked to the treatment.

CDC

Two types of fungi have been detected in the ongoing outbreak of meningitis related to contaminated steroid injections. Exserohilum, left, and Aspergillus, right, have been detected in patients.

All of the patients who have been confirmed with the infection got injections in the neck or spine of a steroid called methylprednisolone. There is also one patient in Michigan with an infection in the ankle, and it's not clear yet if he has a fungal infection, the CDC says.

The meningitis cannot be passed to anyone else. Patients who are diagnosed must undergo weeks of infusion with two antifungal drugs.

NECC and a sister company, Ameridose, have closed for the time being.  Dr. Madeleine Biondolillo, director of the Massachusetts health department's Bureau of Health Care Safety and Quality, said NECC had broken the rules "This organization chose to apparently violate the licensing regulations under which they were allowed to operate," Biondolillo told reporters in a telephone briefing Thursday.

She and an FDA official said state and federal agencies needed more guidance on how to regulate such pharmacies, which have morphed from small operations licensed to mix drugs on a case-by-case basis to large scale manufacturers.

Reuters reported late on Friday that NECC had cut its work force by at least half, laying off 40 or so workers."The events of the past two weeks are a great tragedy, and the thoughts and prayers of all those connected to New England Compounding Center continue to be with the individuals and families affected," the company said in a statement. "As a result of these events, on Thursday and Friday of this week NECC informed employees of a workforce reduction at the company - a necessary step under the current circumstances."

 

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