Md. braces for more cases in meningitis outbreak - DC News FOX 5 DC WTTG

Md. braces for more cases in meningitis outbreak

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More illnesses are expected in Maryland as hundreds of people are believed to have received a steroid medication linked to an outbreak of meningitis that has left at least five dead nationwide, a health department official said Thursday.

State health officials have so far linked only two Maryland meningitis cases to the outbreak, but many more people who have received a possibly tainted steroid injection for back pain may experience symptoms -- including fever or headache -- in the coming days and weeks.

"We believe that there are probably hundreds of patients who may have received an injection, and those cases are currently under investigation," Lucy Wilson, chief of the state's Center for Surveillance, Infection Prevention and Outbreak Response, said at a Thursday afternoon news conference.

Nationwide, 35 people in six states have been sickened from the steroid, which was distributed to 23 states. One person has died in Maryland and another is ill; officials have not identified either individual or revealed how they contracted the illness.

The seven Maryland clinics that received the steroid from a specialty pharmacy in Massachusetts called patients to alert them to the problem. The pharmacy issued a recall last week and has shut down operations.

"We have a lot of patients that are calling in that are concerned," said Kim Merrill, the nurse administrator at the Harford County Ambulatory Surgery Center, one of the clinics that received the drug. She, like officials at several other clinics interviewed by The Associated Press, said she had no reports that anyone had become ill.

Some patients weren't waiting to hear from the clinics.

Robert Cherry, 71, a patient who received a steroid shot about a month ago, visited the Berlin Interventional Pain Management clinic Thursday morning after hearing it had received some of the tainted medicine. Cherry said he received the shot there on Aug. 28.

"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 steroid medication was distributed by the New England Compounding Center, a specialty pharmacy based in Framingham, Mass. Investigators said they are still trying to confirm the source of the infection.

LaVerne Naesea, executive director of the Maryland pharmacy board, declined Thursday to say whether Maryland pharmacy regulators were probing the pharmacy's operations. She said the company has had a permit to do business in Maryland since 2003 and that there's no record of it having been publicly disciplined.

A new regulation enacted earlier this fall empowers Maryland to investigate out-of-state pharmacies that do business in the state, regardless of any investigations taken by the state where the pharmacy is located, Naesea said. She said the law change was inspired by a concern that the state pharmacy board was unable to investigate, and sometimes kept in the dark, when out-of-state pharmacies licensed in Maryland were disciplined by their home states for violations that affected Maryland patients.

"Our new law says that the Board of Pharmacy can conduct its own investigation, that the Board of Pharmacy can make its own conclusions, that it can draw information from the other states that may or may not be involved," she said.

In addition to the Harford County Ambulatory Surgery Center and Berlin Interventional Pain Management, state officials say the drug was distributed to Box Hill Surgery Center, Abingdon; Greenspring Surgery Center, Baltimore; Maryland Pain Specialists, Towson; SurgCenter of Bel Air, and Zion Ambulatory Center, Baltimore.

An administrator at the SurgCenter of Bel Air said they had contacted six patients and none reported problems. An administrator at the Greenspring Surgery Center said they had about 300 people to contact and expected to finish those calls Thursday. Diana Beach, practice administrator at Maryland Pain Specialists of Towson, said Thursday no patients received spinal injections of the identified steroid from New England Compounding Center. Dr. Christopher Galuardi, who runs the Berlin clinic, said there were no reports that any of his patients had become ill, and a doctor at Box Hill said she was unaware of any new cases of illness.



Chase reported from Berlin, Md. Jessica Gresko, Karen Mahabir and Eric Tucker and Jessica Gresko in Washington and Alex Dominguez in Towson, Md., contributed to this report.

Federal and state health officials are investigating an outbreak of a rare and deadly form of meningitis. Some details:

Q: How big is the outbreak?

A: At least 35 people have contracted fungal meningitis and five of them have died. All received steroid injections, a common treatment for back pain, in the past few months. Most of the cases are in Tennessee, the rest in Florida, Indiana, Maryland, North Carolina and Virginia.

Q: How were people infected?

A: The prime suspect is the steroid shots. Federal officials said that a fungus was found inside one sealed vial of the steroid and other vials also appeared to be contaminated.

Q: Where did the steroid come from?

A: A specialty pharmacy, New England Compounding Center in Framingham, Mass., custom-made the steroid. The company has recalled nearly 17,700 vials. Shipments went to 75 clinics and other facilities in 23 states, but it isn't known how many vials may have been used. U.S. health officials urged doctors not to use any products from the company, which has shut down production.

Q: What is meningitis?

A: Meningitis is an inflammation of the lining of the brain and spinal cord. Symptoms include a severe headache, nausea, dizziness and fever. Fungal meningitis is not contagious like the more common forms, bacterial and viral meningitis. It is caused by a fungus often found in leaf mold.



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