Thousands may be at risk in expanding meningitis outbreak officials

At least 5 people have already been killed in the epidemic, stemming from tainted steroid back injections given in 23 states. So far, 35 people have contracted fungal meningitis, according to the CDC.

Dr. Robert Latham, chief of medicine at Saint Thomas Hospital in Nashville, Tenn., said a fifth person has died in a growing outbreak of a rare form of meningitis that has sickened more than two dozen people in five U.S. states.

NEW YORK — The potential scope of the meningitis outbreak that has killed at least five people widened dramatically Thursday as health officials warned that hundreds, perhaps thousands, of patients who got steroid back injections in 23 states could be at risk.

Clinics and medical centers rushed to contact patients who may have received the apparently fungus-contaminated shots. And the Food and Drug Administration urged doctors not to use any products at all from the Massachusetts pharmacy that supplied the suspect steroid solution.

It is not clear how many patients received tainted injections, or even whether everyone who got one will get sick.

So far, 35 people in six states — Tennessee, Virginia, Maryland, Florida, North Carolina and Indiana — have contracted fungal meningitis, and five of them have died, according to the Centers for Disease Control and Prevention. All had received steroid shots for back pain, a highly common treatment.

In an alarming indication the outbreak could get a lot bigger, Massachusetts health officials said 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.

An unknown number of those vials reached 75 clinics and other facilities in 23 states between July and September, federal health officials said. Several hundred of the vials, maybe more, have been returned unused, one Massachusetts official said

An outbreak of a rare and deadly form of fungal meningitis that has killed 4 people and sickened another 26 in five states is believed to have been traced back to a steroid manufactured by the New England Compounding Center.

But many other vials were used. At one clinic in Evansville, Ind., more than 500 patients got shots from the suspect lots, officials said. At two clinics in Tennessee, more than 900 patients — perhaps many more — did.

The investigation began about two weeks ago after a case was diagnosed in Tennessee. 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.

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

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