As the case count continued to rise in a multistate outbreak of meningitis linked to a tainted drug, federal health officials emphasized on Friday that it was absolutely essential to find everyone who may have been exposed to the drug, which was used in spinal injections for back pain.
"All patients who may have received these medications need to be tracked down immediately," Dr. Benjamin Park, a medical officer at the Centers for Disease Control and Prevention, said in a statement. "It is possible that if patients with infection are identified soon and put on appropriate antifungal therapy, lives may be saved."
Health officials said they were concerned that some patients who initially had mild symptoms did not realize they needed medical attention. But this type of meningitis, caused by a fungus, can become very severe, so there is an urgent need for early treatment.
Doctors urged anyone who had a spinal injection for pain in the last few months to contact a doctor if they became ill, particularly with symptoms that include a new or worsening headache, fever, stiff neck, sensitivity to light, nausea, slurred speech or loss of balance. The medical name for the injections is a lumbar epidural steroid injection.
Fungal meningitis does not spread from person to person.
By Friday, there were 47 cases in seven states, including five deaths — an increase of 12 cases since Thursday. Health officials say they expect more cases to occur because the illness has an incubation period that can be a month or possibly longer. The contaminated medicine, a steroid called methylprednisolone acetate, was still being used in the third week of September, so there may be people who are infected but have not yet fallen ill.
Doctors want to treat sick people as soon as possible, but they say it is not appropriate to give antifungal drugs as preventive medicine to people who have been exposed but are not ill because the side effects of the drugs, which may include kidney problems, are too harsh.
Hundreds and possibly thousands of people have been exposed to the fungus-laden drug. The pharmacy that made it, the New England Compounding Center in Framingham, Mass., shipped 17,676 vials of the potentially contaminated product to 75 pain clinics in 23 states. The disease centers posted on its Web site a list of all the clinics that received the drugs.
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