UPDATE: Denton Woman 1st North Carolina Bad Drug Meningitis Death

North Carolina health officials say a Davidson County resident has died from complications of fungal meningitis she likely contracted from a tainted steroid injection in her back.

State Health Director Laura Gerald said Friday's death was the first in North Carolina from the outbreak that began when a Massachusetts compounding pharmacy shipped contaminated medication in August.

Gerald says one other meningitis case has been found in the state, and that person is recovering out of the hospital. Twenty-three people have died and nearly 300 have been sickened across the nation.

Gerald wouldn't identify the North Carolina case, but her family identified her as 77-year-old Elwina Shaw of Denton. They told reporters she was sick with debilitating headaches for more than a month before health officials realized what was wrong.

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Health officials say one of two North Carolina victims of the fungal meningitis outbreak has died, raising the nationwide death toll to 23.

Centers for Disease Control and Prevention spokesman Curtis Allen confirmed the death Saturday. Allen couldn't identify the victim, or where the death occurred, He referred additional questions to state health officials, who weren't available for comment Saturday night.

Fungal meningitis -- which is not contagious -- is a tenacious disease that can be treated only with powerful drugs. Those who survive the illness will continue antifungal drugs for weeks or months.

Across the nation, 284 people are victims of an outbreak that began when a Massachusetts compounding pharmacy shipped contaminated medication.

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An outbreak of fungal meningitis has been linked to steroid shots for back pain. The medication, made by a specialty pharmacy in Massachusetts, has been recalled.

Latest numbers from the Centers for Disease Control and Prevention:

Illnesses: 284, including three joint infections.

Deaths: 23

States: 16; Florida, Idaho, Illinois, Indiana, Maryland, Michigan, Minnesota, New Hampshire, New Jersey, New York, North Carolina, Ohio, Pennsylvania, Tennessee, Texas and Virginia.

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Tennessee's chief medical officer says the rate of new infections from a deadly fungal meningitis outbreak appears to be declining in the state where it was first discovered.

Dr. David Reagan said in an interview Thursday that not everyone who received the contaminated medicine that caused the infections will get sick.

He said the most important factor determining who does get sick is how much fungus was contaminating the vial of medication they received, not their age or even how healthy they were. Tennessee's meningitis patients range in age from 23 to 91.

Tennessee has 66 of the 271 patients sickened with meningitis or joint infections. Eight of the 21 who have died were in Tennessee.

(Copyright 2012 by The Associated Press. All Rights Reserved.)


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Federal health officials are reporting the death toll from an outbreak of fungal meningitis has risen to 15.

The Centers for Disease Control and Prevention says the outbreak has now sickened 205 people in 13 states.

The latest state reporting cases is Illinois.

The outbreak has been linked to steroid shots used for back pain made by a specialty pharmacy in Massachusetts. The medication has been recalled.

Copyright 2012 by The Associated Press. All Rights Reserved.
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WASHINGTON (AP) -- Federal health officials have tracked down 12,000 of the roughly 14,000 people who may have received contaminated steroid shots in the nation's growing meningitis outbreak, warning Thursday that patients will need to keep watch for symptoms of the deadly infection for months.

"We know that we are not out of the woods yet," Dr. J. Todd Weber of the Centers for Disease Control and Prevention said as the death toll reached 14.

Of the 170 people sickened in the outbreak, all but one have a rare fungal form of meningitis after receiving suspect steroid shots for back pain, the CDC said. The other case is an ankle infection discovered in Michigan; steroid shots also can be given to treat aching knees, shoulders or other joints.

Fungus has been found in at least 50 vials of an injectable steroid medication made at a specialty compounding pharmacy in Massachusetts, investigators said. Health authorities haven't yet said how they think the medication was contaminated, but they have ruled out other suspects - other products used in administering the shots - and the focus continues to be on that pharmacy, the New England Compounding Center.

Compounding pharmacies traditionally supply products that aren't commercially available, unlike the steroid at issue in the outbreak. And Dr. Madeleine Biondolillo of the Massachusetts Department of Public Health said it appears the company violated state law governing those pharmacies, which aren't supposed to do large-scale production like a drug manufacturer. Instead, they're supposed to produce medication for patient-specific prescriptions, she said.

Company officials weren't immediately available to comment Thursday but earlier this week declined comment except to say they were cooperating with the investigation.

Idaho becomes the 11th state to report at least one illness. The others are Florida, Indiana, Maryland, Michigan, Minnesota, New Jersey, North Carolina, Ohio, Tennessee and Virginia.

Last month, after illnesses began coming to light, the company recalled three lots of the steroid medicine - known as preservative-free methylprednisolone acetate- that were made in May, June and August. The recall involved about 17,700 single-dose vials of the steroid sent to clinics in 23 states.

It's not known if all or just some of the vials were contaminated, or how many doses were administered for back pain or for other reasons. Those given joint injections are not believed to be at risk for fungal meningitis, which is an inflammation of the lining of the brain and spinal cord. A back injection would put any contaminant in more direct contact with that lining.

Symptoms of meningitis include severe headache, nausea, dizziness and fever. The CDC said many of the cases have been mild, and some people had strokes. Symptoms have been appearing between one and four weeks after patients got the shots, but CDC officials on Thursday warned at least one illness occurred 42 days after a shot.

The fungus behind the outbreaks was initially identified as Aspergillus, but as more testing of patients has been completed, it's become clear that another fungus - a kind of black mold called Exserohilum - is the primary cause. As of Wednesday, CDC's fungal disease laboratory confirmed Exserohilum in 10 people with meningitis and Aspergillus in just one.

Fungal meningitis is not contagious like the more common forms.

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The government says 170 people now have been sickened in the meningitis outbreak linked to tainted steroid shots, and 14 of them have died.

Idaho becomes the 11th state to report at least one illness. The others are Florida, Indiana, Maryland, Michigan, Minnesota, New Jersey, North Carolina, Ohio, Tennessee and Virginia.

The Centers for Disease Control and Prevention updated the count Thursday, showing 33 more cases and two additional deaths reported to the agency in the past day. The outbreak of rare fungal meningitis has been linked to steroid shots for back pain. A specialty pharmacy in Massachusetts has recalled the steroid that was sent to clinics in 23 states, as well as everything else it makes.


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The number of people sickened by a deadly meningitis outbreak has now reached 119 cases, including 11 deaths.

The Centers for Disease Control and Prevention updated the count on Tuesday.

New Jersey is the 10th state to report at least one illness. The other states involved in the outbreak are Tennessee, Michigan, Virginia, Indiana, Florida, Maryland, Minnesota, North Carolina and Ohio.

Officials have tied the outbreak of rare fungal meningitis to steroid shots for back pain. The steroid was made by a specialty pharmacy in Massachusetts. At least one contaminated vial was found at the company.

The company recalled the steroid that was sent to clinics in 23 states, and later recalled everything it makes.

(Copyright 2012 by The Associated Press. All Rights Reserved.)


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Health officials say the number of people sickened by a deadly meningitis outbreak has now reached 105 cases.

The number of deaths rose by one to eight, with another fatality in Tennessee.

The Centers for Disease Control and Prevention updated the count on Monday. The list of nine states with reported cases stayed the same. Tennessee, Michigan, Virginia, Indiana, Florida, Maryland, Minnesota, North Carolina and Ohio previously reported cases.

Officials have tied the fungal meningitis outbreak to steroid shots for back pain. The steroid was made by a specialty pharmacy in Massachusetts.

The company has recalled the steroid which was sent to clinics in 23 states. The government last week urged doctors not to use any of the company's products.


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Health officials say they have now confirmed more than 90 cases of a rare fungal meningitis that has been linked to a steroid commonly used to ease back pain.

The Centers for Disease Control and Prevention posted updated figures to its website Sunday. The death toll stood at 7, the same number as a day earlier. The outbreak is spread across nine states, the same states reported Saturday: Florida, Indiana, Maryland, Michigan, Minnesota, North Carolina, Ohio, Tennessee and Virginia.

The CDC figures show there are 91 cases in the U.S. altogether.

The steroid linked to the outbreak has been recalled, and health officials have been scrambling to notify anyone who may have received an injection of it. The Massachusetts pharmacy that made it has said it is cooperating with investigators.

Copyright 2012 by The Associated Press. All Rights Reserved.



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Health officials say the death toll in a rare fungal meningitis outbreak across several states has risen to seven.

In updated figures posted to its website Saturday, the Centers for Disease Control and Prevention says the outbreak has spread to more than 60 people across nine states. The latest cases have been confirmed in Minnesota and Ohio.

The outbreak has been linked a steroid produced by a specialty pharmacy in Massachusetts. The steroid has been recalled, and health officials have been scrambling to notify anyone who may have been injected with it.

The New England Compounding Center has said it is cooperating with health investigators to determine the source of the infections.

Copyright 2012 by The Associated Press. All Rights Reserved.

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North Carolina health officials now say three clinics, including one here in Eastern Carolina, received steroid shots that may be tied to the deadly meningitis outbreak.

Health providers are scrambling to notify patients in nearly two dozen states.

In North Carolina, Wilson Surgical Center, High Point Surgery Center and North Carolina Orthopaedic Clinic in Durham received shipments.

High Point Regional Health System spokeswoman Tracie Blackmon says its High Point Surgery Center subsidiary has notified about 70 patients. A medical epidemiologist with the state health agency says about 30 patients of the Wilson clinic have been identified.

The state now says a second patient has been diagnosed with meningitis after getting a spinal injection with the recalled steroids.

The clinic in Durham used the steroids for joint injections. Health officials say so far no one has been infected from those type of shots.

It became apparent Thursday that hundreds, and perhaps thousands, of people who got the shots between July and September could be at risk. Officials disclosed that a steroid suspected in the fungal meningitis outbreak in the South had made its way to 75 clinics in 23 states.

The Food and Drug Administration urged physicians not to use any products at all from the Massachusetts specialty pharmacy that supplied the steroid.

On Friday, the FDA released a list of about 30 medications distributed by the company, including other steroids, anesthetics and blood pressure medicine.

So far, 47 people in seven states — Tennessee, Virginia, Maryland, Florida, North Carolina, Michigan and Indiana — have contracted fungal meningitis, and five of them have died, according to the Centers for Disease Control and Prevention. All received steroid shots for back pain, a highly common treatment.

It is not clear how many patients received tainted injections, or even whether everyone who got one will get sick. The time from infection to onset of symptoms is anywhere from a few days to a month, so the number of people stricken could rise.

The pharmacy involved, the New England Compounding Center of Framingham, Mass., has recalled three lots consisting of a total of 17,676 single-dose vials of the steroid, preservative-free methylprednisolone acetate, Massachusetts health officials said.

Investigators this week found contamination in a sealed vial of the steroid at the company, FDA officials said. Tests are under way to determine if it is the same fungus blamed in the outbreak.

Several hundred of the vials, maybe more, have been returned unused, but many others were used. At one clinic in Evansville, Ind., more than 500 patients received shots from the suspect lots, officials said. At two clinics in Tennessee, more than 900 patients — perhaps many more — did.

The company has shut down operations and said it is working with regulators to identify the source of the infection.

"Out of an abundance of caution, we advise all health care practitioners not to use any product" from the company, said Ilisa Bernstein, director of compliance for the FDA's Center for Drug Evaluation and Research.

Massachusetts health officials said the company has a pending complaint against it from this year, related to the potency of a medication used in eye surgery. It appears unrelated to the current outbreak, said Dr. Madeleine Biondolillo, director of the state's Bureau of Healthcare Safety.

Biondolillo said two prior complaints, including one for sterile compounding procedures, were both resolved in 2006. The pharmacy was inspected and cleared by the state Department of Public Health last year after relocating its operations on the same site, she said.

The first known case in the meningitis outbreak was diagnosed about two weeks ago in Tennessee, which still has by far the most cases with 25, including three deaths. Deaths have also been reported in Virginia and Maryland.

Meningitis is an inflammation of the lining of the brain and spinal cord. Symptoms include severe headache, nausea, dizziness and fever.

The type of fungal meningitis involved is not contagious like the more common forms. It is caused by a fungus that's widespread but very rarely causes illness. It is treated with high-dose antifungal medications, usually given intravenously in a hospital.

Robert Cherry, 71, a patient who received a steroid shot at a clinic in Berlin, Md., about a month ago, went back Thursday morning after hearing it had received some of the tainted medicine.

"So far, I haven't had any symptoms ... but I just wanted to double check with them," Cherry said. "They told me to check my temperature and if I have any symptoms, I should report straight to the emergency room, and that's what I'll do."

The company that supplied the steroid is what is known as a compounding pharmacy. These pharmacies custom-mix solutions, creams and other medications in doses or in forms that generally aren't commercially available.

Other compounding pharmacies have been blamed in recent years for serious and sometimes deadly outbreaks caused by contaminated medicines.

Two people were blinded in Washington, D.C., in 2005. Three died in Virginia in 2006 and three more in Oregon the following year. Twenty-one polo horses died in Florida in 2009. Earlier this year, 33 people in seven states developed fungal eye infections.

Compounding pharmacies are not regulated as closely as drug manufacturers, and their products are not subject to FDA approval. A national shortage of many drugs has forced doctors to seek custom-made alternatives from compounding pharmacies.

New England Compounding Center said in a statement Thursday that despite the FDA warning, "there is no indication of any potential issues with other products." It called the deaths and illnesses tragic and added: "The thoughts and prayers of everyone employed by NECC are with those who have been affected."


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The government is warning doctors and hospitals not to use any product from the Massachusetts specialty pharmacy that made the steroid suspected in a deadly meningitis outbreak. The steroid was sent to 75 facilities in 23 states including North Carolina. The CDC has not named the facilities, but says those states are 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.

U.S. health officials say a very rare form of fungal meningitis killed five people and sickened 30 in six states, and more illness was expected.

In addition to the 25 cases so far in Tennessee, one has been reported in North Carolina, two in Florida, four in Virginia, two in Maryland and one in Indiana, according to CDC's Park.

The CDC says the outbreak of aspergillus meningitis was linked to steroid injections methylprednisolone acetate into the spine to treat back pain. The FDA said a sealed vial of methylprednisolone acetate was found to have a fungal contaminate. The steroid came from the New England Compounding Center in Framingham, Mass., a specialty pharmacy that recalled three lots of the drug and shut down operations according to reports. The FDA has advised healthcare providers to stop using any product made by the New England Compounding Center for now.

Fungal meningitis is rare and life-threatening, but is not contagious from person to person. Meningitis can be passed to humans from steroid medications that weaken the immune system. Symptoms include a sudden onset of fever, headache, stiff neck, nausea, and vomiting, according to the CDC web site.

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The government is warning doctors and hospitals not to use any product from the specialty pharmacy that made the steroid suspected in a meningitis outbreak.

An official with the Food and Drug Administration said tests found contamination in a sealed vial of the steroid at the New England Compounding Center in Massachusetts. Tests are under way to determine if it is the same fungus blamed in the outbreak.

Federal officials on Thursday also updated the number of cases in the outbreak. Five people have died and 30 people in six states are ill. All received steroid shots for back pain.

The pharmacy issued a recall last week and has shut down operations. The steroid was sent to 75 facilities in 23 states.

(Copyright 2012 by The Associated Press. All Rights Reserved.)


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