• Gays in LA area warned after meningitis kills 33-year-old man

    By Melissa Pamer, NBCLosAngeles.com

    Officials in West Hollywood, Calif., are warning members of the public to protect themselves against meningococcal infection, an illness caused by a bacteria or virus that can be fatal.

    City Councilman John Duran held a news conference Friday afternoon alongside Chris Brown, director of health and mental health for the LA Gay and Lesbian Center, to sound an alarm.

    See original report at NBCLosAngeles.com

    Duran told NBC4 one of his long-time supporters -- a 33-year-old gay man -- had been diagnosed with meningitis two days ago, was hospitalized and fell into a coma. The man died Friday afternoon, Duran said.

    The man had attended an annual Palm Springs event known as the White Party, which took place over Easter weekend and draws thousands of gay men from across the country to the desert city, Duran said.

    "If this resident was in fact in attendance at the White Party, it raises the issue, so we want to get the word out to any gay men that were at the White Party, that if they have any of these symptoms, go see their physician immediately," Duran said at the news conference.

    Duran said he didn't want to be alarmist, but wanted gay men and others to be on alert for signs of the disease, which can initially resemble the flu.

    Dr. Maxine Liggins, area medical director for the Los Angeles County Department of Public Health, said people who think they may have been exposed should watch for a stiff neck, fever, headache, sometimes a rash, and generally not feeling well.

    Duran suggested the West Hollywood case may be from a similar bacterial meningitis strain that circulated among gay men in New York City -- an outbreak that infected 22 people and has killed seven people since 2010.

    Los Angeles County Department of Public Health officials said they have not confirmed a direct connection between the Los Angeles-area case and the New York City strain.

    Officials don't want to cause panic, Duran said, but are taking an active stance to avoid the delays in response to AIDS 30 years ago.

    On Friday, the Equinox fitness club on Sunset Boulevard in West Hollywood sent a notice to members that a person who used the facility April 6 had been diagnosed with bacterial meningitis. Officials at the press conference confirmed the individual was the same man being treated at Cedars Sinai.

    "The Los Angeles County Department of Public Health has assured us that there is virtually no risk of exposure in a health club setting," the email stated. "We are notifying you to let you know that Equinox members and staff are safe, we have taken all necessary safety precautions and we will continue to do everything we can to guarantee our members have the best fitness experience possible."

    The email included a link to a letter sent by the Department of Public Health to the club.

    Meningococcal disease can have severe health impacts and can progress quickly from flu-like symptoms, rashes and a stiff neck, so health officials say early diagnosis and treatment are crucial. If treated quickly, the disease can often be cured with antibiotics.

    Last month, Orange County health officials warned public schools about an outbreak of meningococcal infections in Tijuana that began in January.

    A teen was being treated at UC Irvine Medical Center for meningocococcemia and had had all of her limbs amputed, prompting her parents to advocate for awareness about a vaccine that protects against the disease.

    The bacteria -- Neisseria meningitidis -- that causes the bloodstream infection afflicting 18-year-old Kaitlyn Dobrow also causes meningococcal meningitis, an inflammation of tissue around the brain and spinal cord, according to the federal Centers for Disease Control and Prevention.

    Infections from the bacteria can be spread from person to person through respiratory and throat secretions and are common in close quarters -- such as military barracks and college dormitories -- according to the CDC website. Person-to-person contact must be close – such as kissing, sex or sharing food – for the bacteria to spread.

    Those who have been in close contact with a patient with meningococcal disease should be treated with antibiotics to prevent the illness from progressing, according to the CDC.

    The Associated Press contributed to this story.

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  • VA at fault for death of lab worker, OSHA says

    By Associated Press staff

    Federal officials on Wednesday blamed unsafe working conditions and poor training for the death of a young Veterans Affairs medical center researcher in San Francisco who died after handling bacteria that cause meningitis. 

    The federal Occupational Safety and Health Administration found three serious violations at the lab that exposed Richard Din, 25, to the bacteria and led to his death on the way to the hospital on April 28.

    In particular, OSHA chided the lab for allowing Din to work with the bacteria in the open rather than in a so-called biosafety cabinet, which isolates germs behind a protective screen and provides ventilation.

    “Richard Din died because the VA failed to supervise and protect these workers adequately,” said Ken Atha, OSHA’s regional administrator in San Francisco. “Research hospitals and medical centers have the responsibility as employers to protect workers from exposure to recognized on-the-job hazards such as this.”

    OSHA also said that lab workers, including Din, should have received meningitis vaccines and training on recognizing symptoms of the disease. Din wasn’t vaccinated and complained of headache, fever and chills after he left work on a Friday but did not seek medical help until his condition worsened the next day.

    VA officials didn’t immediately return phone and email messages.

    At the time of Din’s death, Dr. Harry Lampiris said a vaccine may not have saved Din because he was working with a strain of the disease resistant to vaccines. Lampiris didn’t return a phone call or email query.

    OSHA spokeswoman Deanne Amaden said “the serious violation is because the VA did not provide vaccines to workers for other strains where there are vaccines available — based on the work they were doing.”

    OSHA’s notice of violations requires the VA to vaccinate its lab workers against any dangerous germs they are working with, provide better training to recognize symptoms of illness, and mandate that work with disease be conducted in safety cabinets.

    Meanwhile, a vaccine for the meningitis strain that killed Din may soon be available in the United States. Novartis AG won approval to sell its vaccine in Europe this year while it’s negotiating with U.S. regulators to do the same here. Other companies are also developing vaccines.

    OSHA can’t fine other federal agencies as it can private companies.

    A 2005 paper published in the Journal of Clinical Microbiology — the most recent study of its kind — said 16 cases of probable laboratory-acquired meningitis occurred worldwide between 1985 and 2001, and eight were fatal.

    Bacterial meningitis causes an estimated 170,000 deaths worldwide each year, according to the World Health Organization.

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  • Some infections thwart treatment in fungal meningitis outbreak

    By JoNel Aleccia, Senior Writer, NBC News

    As the death toll and the case counts continued to climb Monday in an outbreak of fungal meningitis tied to tainted pain shots, health officials admit they’ve been stymied in their best efforts to treat patients.

    “I don’t think we have a very good handle on exactly what is happening or how this is playing out,” said Dr. Tom Chiller, deputy chief of the mycotic diseases branch at the Centers for Disease Control and Prevention.

    Thirty people have died and 419 have developed fungal meningitis or joint infections in 19 states after receiving injections of contaminated steroid drugs earlier this year, the CDC reported Monday.

    Those numbers include dozens of patients who have developed abscesses at the infection site or another condition called arachnoiditis, an inflammation of the delicate membranes that surround and protect the nerves of the spinal cord.

    In Michigan, for instance, which has logged the most cases -- 119, plus seven deaths -- 61 patients have developed fungal meningitis; 51 who developed epidural abscesses, six joint infections and one stroke.

    “In some cases, those abscesses have developed into meningitis,” said Angela Minicuci, a spokeswoman for the Michigan Department of Community Health.

    What’s particularly alarming is that some patients have become sicker even though they’ve been taking powerful antifungal drugs aimed at wiping out the black mold Exserohilium, which has been responsible for most of the illnesses.

    “What we do know from hearing from a few centers is that around a third of patients with meningitis are having some sort of disease progression,” Chiller said.

    It’s not clear why some patients aren’t responding to the therapy. The fungi are difficult to treat, Chiller said, but tests showed that  the organisms should have been killed by the drugs. Doctors don’t know whether the problem is the natural progression of the disease itself, or perhaps the body’s immune system kicking into action, Chiller said.

    “Are we actually killing the fungi and this is a reaction?” he asked. “It’s not responding to therapy that well, or it’s responding very slowly.”

    For patients who already have been affected, that means they can expect a protracted recovery from the fungal infections. “It will be a long-term therapeutic management issue,” Chiller said.

    About 17,000 vials of contaminated steroids were sent out by the New England Compounding Center, the Framingham, Mass., pharmacy at the center of the outbreak. That company has lost its license. A sister firm, Ameridose LLC, is also being investigated for problems with sterility. Both companies have recalled all their products.

    For the 14,000 patients who received the shots, the greatest risk of developing infections is in the first 42 days -- six weeks -- after the injections, CDC has said. Unfortunately, Chiller said, some risk of serious illness does remain.

    “By 42 days, your risk is really, really low,” he said. “But that doesn’t mean that anyone with a symptom, a sign, shouldn’t express that to their physician. Any pain that’s not getting better, that’s getting worse, they should report that.”

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  • Bacteria, more fungi found in drugs from firm tied to meningitis outbreak

    Handout / Reuters

    The fungus Exserohilum has caused most of the infections tied to a deadly outbreak of fungal meningitis.

    By JoNel Aleccia, Senior Writer, NBC News

    Contamination has been found in two additional drugs made by the pharmacy tied to a deadly outbreak of fungal meningitis, federal health officials said Thursday.

    Ten different kinds of bacteria were detected in the drugs, including eight in separate lots of betamethasone, a steroid injection used to relieve severe itching, and two more types of bacteria found in a batch of cardioplegia solution used to stop the heart during surgery, the Food and Drug Administration reported.

    That’s in addition to five kinds of fungi that now have been detected in people or products linked to the New England Compounding Center, the Framingham, Mass., firm at the center of the outbreak.

    As of Thursday, the outbreak has caused 377 cases of fungal meningitis, stroke caused by fungal meningitis or other central nervous system infections, plus nine joint infections, for a total of 386 cases in 19 states, according to the Centers for Disease Control and Prevention. At least 28 people have died. 

    FDA officials also said they're testing the two additional drugs from NECC for fungal contamination and expect those results soon. 

    "The presence of additional microbial organisms and/or fungus in these products cannot be ruled out at this time," FDA officials said in a statement. 

    One lot of preservative-free betamethasone was contaminated with paenibacillus pabuli/amolyticus, Bacillus idriensis, Bacillus flexus, Bacillus simplex and Lysinibacillus sp. Another lot was tainted with Bacillus niabensis and Bacillus circulans, while a third lot held Bacillus lentus and Bacillus circulans. Lab tests found Bacillus halmapalus and Brevibacillus choshinens in the cardioplegia solution.

    No infections tied to the bacterial contamination of the betamethasone or the cardioplegia solution have been detected, officials said. 

    The FDA released the results of new laboratory tests the day after the CDC released lab results that found two new types of fungi in the contaminated injection steroids linked to infections in the ongoing outbreak. 

    CDC found that the same fungus that caused most of the meningitis and joint infections in outbreak was also found in unopened vials of the drug, methylprednisolone. 

    All but two of 54 infections confirmed by CDC labs as of Oct. 22 were caused by Exserohilum rostrum, a fungus typically found in the environment. That same fungus was found in two lots of unopened vials of methylprednisolone acetate recalled by the now-shuttered New England Compounding Center on Sept. 26.

    The remaining two CDC lab-confirmed infections were caused by the fungi Aspergillus and Cladosproium, CDC has previously reported.

    In addition, CDC says it has detected two more fungi, Rhodotorula larynges and Rhizopus stolonifer, in unopened vials of the drugs. Those fungi are not known to cause human infections because they can’t grow at body temperature, the agency said.

    The CDC lab tests don’t reflect the total case count because laboratory methods used to detect fungal meningitis are not highly sensitive, the agency said. Many patients with fungal infections can actually have negative laboratory results.

    State and federal inspections have revealed significant problems with sterility at NECC’s site. The company itself documented mold and bacteria throughout its clean rooms dating from January through September, an FDA inspection report showed.

    All products from NECC have been recalled and the company’s pharmacy license has been permanently revoked. In addition, unexpired drugs produced by a sister company, Ameridose LLC, were recalled this week after FDA inspectors raised questions about problems with sterility.

    Nearly 14,000 people in 23 states may have received injections of the tainted drugs. The greatest risk of stroke, death or other problems is in the first six weeks after the injections, the CDC has said. For most patients who got the shots, that means that the danger will be largely over by next week, health officials have said.

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  • 'Black mold' meningitis is uncharted medical territory

    By Lauran Neergaard, AP
    WASHINGTON - The black mold creeping into the spines of hundreds of people who got tainted shots for back pain marks uncharted medical territory.
    Never before has this particular fungus been found to cause meningitis. It's incredibly hard to diagnose, and to kill — requiring at least three months of a treatment that can cause hallucinations. There's no good way to predict survival, or when it's safe to stop treating, or exactly how to monitor those who fear the fungus may be festering silently in their bodies. 

    "I don't think there is a precedent for this kind of thing," said Dr. Arjun Srinivasan of the Centers for Disease Control and Prevention. Health officials and doctors have tracked down most of the 14,000 people potentially at risk for fungal meningitis, blamed for the deaths of 24 people and sickening more than 300.

    "This is definitely new territory for us," he said.

    The fungus' brown-black color signals an armor that — along with being injected near the spine —helped this mold sneak past the immune defenses of otherwise healthy people, said Dr. Arturo Casadevall, a fungal disease specialist at New York's Albert Einstein College of Medicine.

    "What we're dealing with here is fundamentally different" from a typical fungal infection, he said. "This is a bug that most of us don't know much about."

    But they're learning fast, piecing together clues that promise some hope.

    Doctors are beginning to detail in medical journals the first deaths in this outbreak, and the grim autopsy findings make clear that treating early is crucial, before the fungus becomes entrenched. In one case, a woman died in Maryland after the fungus pierced blood vessels in her brain, leading to severe damage.

    People getting treated earlier "seem to be doing OK," with fewer of the strokes that characterized the outbreak's beginning, said Dr. Carol Kauffman of the University of Michigan. She has advised the CDC and co-authored advice in the New England Journal of Medicine on how to handle the complex medication used in treatment.

    People who got contaminated steroid shots made by a Massachusetts pharmacy have been told to be on guard for months for meningitis symptoms. But the CDC said Wednesday that the biggest risk for getting sick seems to be within 42 days of receiving one of the implicated back injections.

    With the tainted shots recalled in late September, that means the period of greatest risk is nearing an end. And it should help doctors bombarded with calls from the worried determine who most needs a spinal tap to look for the very earliest signs of infection.

    "We know the farther out you are from receiving an injection, the lower your risk becomes for developing meningitis or other infections. We want to emphasize that," CDC's Dr. Tom Chiller told a conference call for physicians on Thursday.

    Still, public health officials recall a 2002 meningitis cluster linked to steroid injections contaminated with a different fungus; one of those victims got sick 152 days after the shot.

    Fungal infections don't get a lot of attention, but they afflict millions around the world, said David Perlin of the University of Medicine and Dentistry of New Jersey, who is studying better ways to diagnose them. Most are skin infections like athlete's foot, but fungi also can cause pneumonia, sinusitis and other problems.

    Serious infections tend to strike people with immune systems weakened because of cancer, AIDS or other problems. Fungus-caused meningitis in particular is extremely rare— especially in otherwise healthy people like in this outbreak — and it's "very bad news," said Michigan's Kauffman.

    While the more common bacterial and viral forms of meningitis tend to strike quickly with obvious symptoms, fungal meningitis grows very slowly and is hard to diagnose. Few antifungal drugs are absorbed into the central nervous system, limiting treatment options. Plus, human cells and fungal cells have a lot of similarities, making it hard to attack the fungus without side effects, Kauffman explained.

    The main culprit in this outbreak is a black mold called Exserohilum rostratum, common in dirt and grasses. Only 33 human infections previously had been reported, mostly eye or skin infections in people with weak immune systems, Casadevall said.

    Here's how scientists think it's sneaking into the well-guarded spinal cord and brain of a healthy person:

    • The steroid injected near the spine reduces inflammation, one of the immune system's defenses against contamination. 
    • The mold grows quietly until enough accumulates for it to burrow a tiny hole, or abscess, into the lining of the spinal canal, said Dr. William Schaffner of Vanderbilt University. Reaching the spinal fluid inside offers a direct pathway to the brain. 
    • The fungus' color signals how intractable it is. Brown-black molds produce melanin, the same chemical that helps human skin tan. It guards against the sun's mold-killing ultraviolet rays — and inside people, it fends off both antifungal drugs and other immune-system attacks, Casadevall said. 

    The good news: Black mold is treatable with a drug named voriconazole, with far fewer side effects than the older treatment initially recommended when the outbreak began.

    Still, Kauffman cautioned doctors to carefully monitor patients because differences in metabolism can make levels surge in the bloodstream, causing hallucinations, confusion, nausea and occasionally liver damage. On the flip side, their bodies may process the drug too quickly to battle the fungus. Plus, voriconazole can interact badly with a list of other common medications.

    "It's not clear" how long to treat but at least three months is advised, Kauffman said. It begins with intravenous infusions that are hard to administer outside of a hospital. Then once the patient is stable enough, pills can be used.

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    After wife dies of meningitis, husband hospitalized for same

  • After wife dies of meningitis, husband is hospitalized for same

    By Ryan Felton, Reuters

     

    DETROIT - A Michigan man whose wife died of meningitis after receiving injections of potentially tainted steroids is now in a hospital being treated for meningitis, his daughter said on Wednesday.

    Lilian Cary, 67, who died September 30, is one of two dozen people who have died in an outbreak of fungal meningitis linked to the tainted injections.

    Now her widower, George Cary, 65, is among more than 300 people who have been stricken with meningitis after receiving the injections.

    "We just can't believe this is happening again, but at least we know what it is this time," said his daughter Jill Bloser, 43, of Mount Pleasant, South Carolina. She is Lilian Cary's stepdaughter.

    The number of cases in the outbreak has continued to mount despite a recall of the product by the New England Compounding Center.

    "This company needs to be held accountable," Bloser said.

    George Cary was preparing to return home from an out-of-state business trip this past week when he fell ill, Bloser said. He went to a hospital, then flew home on Tuesday and was admitted to a Michigan hospital later that day.

    Bloser said she spoke to him on Wednesday evening and that he was in good spirits. "He's getting the treatment he needs," she said.

    In September, he was treated for back pain with the suspect medication.

    His wife received the medication in early August as part of a regular treatment for chronic back problems. She started suffering weakness, fever, chills and sleepiness in the third week of August, George Cary has said.

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    Cases tied to fungal meningitis rise to 328

  • Cases tied to fungal meningitis rise to 328; no new deaths

    By JoNel Aleccia, Senior Writer, NBC News

    Infections tied to the outbreak of fungal meningitis from contaminated steroid injections continued to climb Thursday, with 328 cases in 18 states. The death toll still stands at 24. 

    So far, 323 cases of fungal meningitis, stroke or other infections related to the central nervous system have been reported. In addition, five infections have been detected in patients who got shots in joints such as the knee, hip, shoulder or elbow. All of the deaths have been associated with the fungal meningitis cases, according the Centers for Disease Control and Prevention. 

    The new tally included two cases reported in Indiana, seven in Michigan and one in Minnesota. South Carolina reported its first case.

    About 14,000 people may have received injections of tainted steroids produced by the New England Compounding Center of Framingham, Mass. The firm has been shut down, its products recalled and it license permanently revoked. 

    On Wednesday, the CDC reported that the most serious infections and illnesses, including stroke and death, appear to occur within the first 42 days -- six weeks -- after receiving the injections. The agency said that the risk of developing serious complications is much lower after that. 

    Because the NECC drugs were recalled on Sept. 26, the CDC estimates that the highest risk of infections will end on about Nov. 6. 

    Patients who received the injections should be monitored for fever, dizziness, sensitivity to light and other signs of meningitis. They should be in close contact with their doctors if they have any signs of illness. 

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  • CDC panel OKs Glaxo meningitis vaccine for infants at risk

    By Julie Steenhuysen, Reuters

    CHICAGO - Advisers to the U.S. Centers for Disease Control and Prevention voted on Wednesday to recommend the use of GlaxoSmithKline's newly approved vaccine for bacterial meningitis in babies at increased risk of the infection.

    The vote is not related to the ongoing outbreak of fungal meningitis that has been linked to tainted steroid injections and has so far killed 24 people.

    Children at increased risk include those with sickle cell disease and an immune system disorder known as complement component deficiency.

    The CDC panel said the vaccine could also be used in babies 2 months through 18 months who live in communities battling an outbreak of meningococcal disease caused by serogroup C and Y.

    The vaccine, known as MenHibrix, targets two common causes of bacterial meningitis, a serious infection of the thin lining surrounding the brain and spinal cord. It can cause severe brain damage, and it is fatal in 50 percent of cases if untreated.

    The Advisory Committee for Immunization Practices, which advises the CDC, voted 13 to 1, with 1 abstention, to recommend the vaccine for use in infants at greater risk for meningococcal disease, with 4 doses starting at 2, 4, 6 months and 12 through 15 months.

    The U.S. Food and Drug Administration approved the vaccine in June.

    The vaccine is intended to prevent disease caused by the bacteria Neisseria meningitidis serogroups C and Y, two of the three most common causes of meningococcal disease in the United States.

    It also protects against Haemophilus influenzae type b or Hib bacteria. Hib was the most common cause of bacterial meningitis in children under the age of 5 before vaccines for the strain became common.

    About 4,100 cases of bacterial meningitis occurred in the United States each year from 2003 to 2007, the most recent data available, and 500 people died from the disease, according to the CDC. Infants are at highest risk.

  • Fungal meningitis toll tops 300; still 23 dead

    By JoNel Aleccia, Senior Writer, NBC News

    Infections related to an ongoing outbreak of fungal meningitis reached 308 on Tuesday, with 23 deaths.

    That includes 304 cases of meningitis, stroke or other nervous system problems tied to epidural injections of contaminated steroids, plus four infections in patients who received pain shots in joints such as the hip, knee shoulder or elbow. 

    The death toll has held steady for a few days, but officials with the Centers for Disease Control and Prevention said that doesn't necessarily mean that the outbreak is waning. 

    "Too early to say," said Curtis Allen, a CDC spokesman, in an email to NBC News. 

    The outbreak has now affected patients in 17 states. Nearly 14,000 patients may have received contaminated steroid injections since May 21 produced by the New England Compounding Center of Framingham, Mass. The potentially tainted drugs were sent to pain clinics and health care facilities in 23 states. 

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  • Two more deaths tied to fungal meningitis

    By Ian Simpson, Reuters

    The death toll from fungal meningitis linked to potentially contaminated steroid injections has risen by two to 23, with North Carolina reporting its first death, health officials said on Saturday.

    Tennessee's death total in the outbreak rose to eight, the highest state total, the Centers for Disease Control and Prevention said on its website.

    States reported 14 new cases of fungal meningitis, raising the total to 282 as of Sunday. There are also three peripheral infections caused by injections into joints.

    The outbreak stems from medications shipped by the New England Compounding Center in Massachusetts. The company faces federal and state investigations and lawsuits over the tainted medications.

    Indiana and New Hampshire reported two new cases apiece. Virginia, Tennessee and New Jersey each had three new cases, the CDC said.

    Related: Long, uncertain recovery for victims

    Health regulators confirmed on Thursday the presence of the deadly Exserohilum fungus in vials of the NECC steroid used for pain injections. They estimate that as many as 14,000 people may have been exposed to the contaminated medication.

    NECC and its executives face a civil suit in Massachusetts that seeks to freeze the officers' personal assets. Florida, which has had three deaths and 17 cases, has barred NECC from doing business in the state. 

    Copyright 2013 Thomson Reuters. Click for restrictions.

  • Fungal meningitis deaths climb to 21; 271 infections

    CDC

    Health officials have found the black mold Exserohilium in unopened vials of injection drugs made by a Massachusetts pharmacy and implicated in an outbreak of fungal meningitis that has killed more than 20 people.

    By JoNel Aleccia, Senior Writer, NBC News

    The toll of a growing outbreak of fungal meningitis continued to rise Friday, with 21 deaths and 271 confirmed infections in 16 states linked to contaminated steroid shots from a Massachusetts pharmacy.

    There have been 268 cases of fungal meningitis, stroke believed to be caused by fungal meningitis or central nervous system infections tied to the tainted drugs. Three other patients who received shots in their joints, such as hips, knees, shoulders or elbows, have developed infections as well, according to latest figures from the Centers for Disease Control and Prevention.

    Nearly 14,000 patients may have received the fungus-contaminated shots distributed by the New England Compounding Pharmacy in Framingham, Mass., since May. All products from the pharmacy have been recalled. 

    On Thursday, federal health officials confirmed that they found the fungus Exserohilum rostratum in unopened medication vials of one of three lots of methylprednisolone, a steroid, implicated in the infections and deaths. That discovery confirmed the link between the type of fungus in the drugs and that found in most of the patients who became sick after the shots.

    Officials have also confirmed the mold Aspergillus in one infected patient. Another was found to be infected with the fungus Cladosporium. All of the fungi are present in the environment, but rarely cause meningitis.

    A second pharmacy connected to the NECC is also being investigated. Ameridose LLC said on Friday that it has agreed to extend a temporary shutdown while state and federal regulators continue an investigation into the company. Ameridose, based in Westborough, Mass., shares some common ownership with NECC. Investigators launched an investigation on Oct. 10.

    Most patients got the shots to help relieve back pain. The time it takes for an infection to show up in people who got the tainted shots may be up to four weeks, officials said. 

    Patients should be watching for symptoms including fever, headache, stiff neck, nausea and vomiting, sensitivity to light and altered mental status, the Food and Drug Administration said. Symptoms for other infections might include fever, swelling at the injection site, increasing pain, redness, visual changes, discharge from the eye, chest pain or drainage from a surgical site. Anyone who develops these symptoms should seek medical attention. 

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  • Meningitis outbreak deaths rise to 20, CDC says

    By David Bailey, Reuters

    The number of deaths from fungal meningitis linked to potentially contaminated steroid injections has risen to 20 and the outbreak has reached a 16th state, New York, the Centers for Disease Control and Prevention said on Thursday. 

    The deadly outbreak of the rare disease showed no signs of abating, as nine new cases of meningitis were reported, bringing the national total to 254, plus three peripheral infections in joints.

    Michigan reported its fourth death from meningitis. New cases also were reported in Indiana, New Hampshire, New Jersey, Ohio and Tennessee.

    The outbreak stems from medications shipped by the New England Compounding Center in Massachusetts. The company faces multiple federal and state investigations and lawsuits over the tainted medications.

    Also on Thursday, the Food and Drug Administration said it has confirmed the presence of Exserohilum fungus in one of three lots of steroids used for pain injections from the pharmacy at the center of the widespread meningitis outbreak. That confirms the link between the contaminated drugs and the infections found in most of the afflicted patients. 

    Testing on the other two implicated lots of the steroid methylprednisolone acetate and other injectable drugs from the New England Compounding Center continues, the agency said. 

    The U.S. Centers for Disease Control and Prevention said there was no firm evidence of infection in any patients beyond those exposed to the contaminated lots. However, FDA officials warned doctors earlier this week to reach out to patients who received any drugs from NECC to check their health status because the agency could not assure that any of the products were sterile.

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