UPDATE 3-U.S. meningitis deaths rise, prompting call for tighter drug rules

* Widening outbreak brings death toll to 12

* Lawmakers seek tighter regulation of compounding companies

* Some 13,000 people may have been exposed throughinjections

(Adds death in Florida, brings nationwide toll to 12)

By Tim Ghianni

NASHVILLE, Tenn., Oct 9 (Reuters) - A rare U.S. outbreak offungal meningitis linked to steroid injections has claimed fourmore lives with Florida the latest state to report at least onedeath linked to the illness in a widening health scare,authorities said on Tuesday.

The Centers for Disease Control and Prevention confirmedthat two more people had died from meningitis in Tennessee, andone more in Michigan after receiving steroid injections.

Officials in Florida meanwhile said late Tuesday that a70-year-old man died in July as a result of the same outbreak,the first in that state, bringing the number of deathsnationwide to 12.

The widening outbreak has alarmed U.S. health officials andfocused attention on regulation of pharmaceutical compoundingcompanies such as the one that produced the drugs, the NewEngland Compounding Center Inc in Framingham, Massachusetts.

Some leading Democratic members of Congress proposed tighterregulation on compounding companies on Tuesday.

In Michigan and Tennessee, the two states hit hardest by theoutbreak, family and friends mourned the loss of victims.

George Cary attended a memorial on Tuesday for hisBritish-born wife of 35 years, Lilian, who died of meningitis onSept. 30 several weeks after receiving an injection for backpain. Standing with his two daughters at their house in Howell,Michigan, Cary said that he now would await the results of atest for meningitis after he also received an injection.

"I'm fine right now. I'm waiting to see if anythingdevelops," Cary said.

Meningitis is an infection of the membranes covering thebrain and spinal cord. Symptoms include headache, fever andnausea. Fungal meningitis, unlike viral and bacterialmeningitis, is not contagious.

One of the dead in Tennessee, 80-year-old Reba Temple, was aformer health director for rural Hickman County.

"She was a wonderful, wonderful lady," said County TrusteeCheryl Chessor, who attended the same church as Temple,Centerville Church of Christ.


The number of people sickened nationwide reached 121 onTuesday, an increase of 16 cases from Monday.

The potentially tainted steroid vials, which have beenrecalled, were shipped to 76 facilities in 23 states and some13,000 people may have received injections from the medications,the CDC has said.

Tennessee Health Commissioner Dr. John Dreyzehner said itcould be early November before all the patients stricken withmeningitis are identified.

This is because the incubation period may be longer than theone month health experts first thought. Of the patients whocontracted meningitis in Tennessee, the latest case was reported42 days after the injection, he said on Tuesday.

In Tennessee, Saint Thomas Outpatient Neurosurgery Center inNashville received 2,000 vials of recalled steroid, the most ofany facility in the nation.

The New Jersey Department of Health said a 70-year-oldCumberland County man was hospitalized with apparent fungalmeningitis, the first case in that state.

"He developed headaches and went to the emergency room withfever and continued headaches," the New Jersey agency said,adding that he was receiving anti-fungal medication at SouthJersey Healthcare Regional Medical Center in Vineland.

The Florida Department of Health said six cases of thedisease had been reported so far in the state, all in MarionCounty, with one death.


The federal Food and Drug Administration regulates only theingredients and not the compounders, which are subject to apatchwork of state oversight.

Three Democratic members of the U.S. House ofRepresentatives called on Tuesday for a congressional probe ofthe meningitis outbreak.

A fourth Democrat, Representative Edward Markey, whoseMassachusetts district includes Framingham, said separately thathe would introduce legislation to strengthen FDA's regulatoryauthority.

But the office of the Republican chairman of the committeethat would consider Markey's proposal, Fred Upton, did notrespond to requests seeking comment.

"This incident raises serious concerns about the scope ofthe practice of pharmacy compounding in the United States andthe current patchwork of federal and state laws," the DemocratsHenry Waxman, Frank Pallone and Diana DeGette said in a letter.

Tennessee has reported six deaths and 39 cases ofmeningitis, followed by Michigan with three deaths and 25 cases,Virginia with one death and 24 cases and Maryland with one deathand eight cases.

The other states with cases are Indiana (12), Florida (6),Minnesota (3), North Carolina (2), Ohio (1) and New Jersey (1).

(Additional reporting by David Bailey, Meghana Keshavan andDavid Morgan; Writing by Greg McCune; Editing by ClaudiaParsons, Lisa Shumaker and James B. Kelleher)