U.S. meningitis cases mount from thousands of patients at risk

By Tim Ghianni

NASHVILLE, Tenn., Oct 9 (Reuters) - More cases of fungalmeningitis tied to contaminated steroid shots are expected to beconfirmed on Tuesday, U.S. health officials said, and somepatients who received the injections may have to wait weeks toknow if they are infected.

Since the Sept. 25 recall of three lots of a steroidproduced by a Massachusetts company, the outbreak has spread tonine states and 105 patients, with eight people killed, theCenters for Disease Control said.

As many as 13,000 people received the injections and are atrisk of infection, the CDC said, although the number ultimatelystricken is likely to be far fewer.

The outbreak has alarmed health officials and highlighted agap in regulation of so-called pharmacy compounders, which arefacilities that take drug ingredients and package them intomedications and dosages for specific clients.

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

Some of the thousands of people exposed may have to waitanxiously for weeks because the incubation period of the diseaseis up to a month, health experts said.

"Infected patients have (come forward) approximately one tofour weeks following their injection with a variety of symptomsincluding fever, new or worsening headache, nausea and other newsymptoms consistent with a stroke," the CDC's Dr Benjamin Parkhas said.

The number of cases rapidly increased as healthpractitioners at 76 facilities in 23 states notified those whoreceived the shots and patients were examined.

Tennessee is the hardest hit state with 35 cases confirmedso far, and one hospital, Saint Thomas in Nashville, receivedabout 2,000 vials from the steroid supplies recalled by thecompany.

"The response from Saint Thomas Hospital has been dramatic,"said Dr Robert Latham, the hospital's chief of medicine. "We'veseen upwards of 40 to 50 patients a day since last Mondaythrough the emergency room that have had to be extensivelyevaluated."

The nine states with cases are Tennessee, Indiana, Ohio,Minnesota, Michigan, North Carolina, Virginia, Maryland andFlorida.

Four people have died in Tennessee, two in Michigan and oneeach in Maryland and Virginia.

Meningitis is an infection of the membranes covering thebrain and spinal cord. It is not contagious.

(Reporting By Greg McCune; Editing by David Brunnstrom)