UPDATE 2-CDC says 14,000 people at meningitis risk amid call for criminal probe


* Death toll rises to 14; total sickened jumps to 170

* U.S. senator calls for federal probe

(Adds details, background, previous NASHVILLE)

By David Morgan

WASHINGTON, Oct 11 (Reuters) - U.S. health authorities saidon Thursday that more people than previously thought receivedpossibly tainted steroid injections and that some 14,000patients could be at risk of contracting meningitis in anunprecedented outbreak of the disease.

The U.S. Centers for Disease Control and Prevention said thenumber of people at risk, which is 1,000 higher than earlierestimated, was revised after consulting with health authorities.

Fourteen patients have died from meningitis and 170 peoplehave been infected, the CDC said in its latest update onThursday. The number of infections rose by 33 since Wednesday,the CDC said.

Florida reported a second death from meningitis and Indianareported its first death from the outbreak. Meningitis caseshave been confirmed in 11 states.

The health scare prompted U.S. Senator Richard Blumenthal,who sits on the Senate's health oversight committee, to askfederal authorities to probe whether a Massachusetts specialtypharmacy that produced the steroid misled regulators about itsoperations.

The outbreak has developed into a major health scandal, withauthorities scrambling to determine how vials of a steroid usedmainly to treat back pain were contaminated, track down thoseaffected and treat them. It has also raised questions about howthe pharmaceuticals industry operates and is regulated.

Blumenthal, a former Connecticut state attorney general andfederal prosecutor, said he had reached no conclusions but thatan investigation was warranted.

"The company, its officers, employees and maybe others mayhave violated state and federal criminal laws in their potentialmisrepresentations to government agencies regarding theirproducts," Blumenthal told Reuters in a telephone interview.

Blumenthal said he submitted his request for a federalcriminal probe in a letter to U.S. Attorney General Eric Holder.

"The fact that death and serious injuries resulted from thepotential violations of law certainly is relevant, and themisstatements or fraud could constitute a violation of federalmail and wire fraud prohibitions," Blumenthal said.

Lawmakers have come under pressure to close what critics seeas a loophole in oversight that left the New England CompoundingCompany, or NECC, the Massachusetts pharmacy linked to thetainted steroids, largely exempt from federal regulation.


The U.S. Food and Drug Administration regulates only theingredients and their suppliers, not the little-known corner ofthe drug world known as "compounding," which is subject to apatchwork of state oversight.

State and federal officials are now investigating NECC,which distributed thousands of vials of a contaminated steroidmade at a shabby brick complex next to a waste and recyclingoperation in a western suburb of Boston. The company hassuspended operations and recalled all of its products.

The pharmacies are owned by Gregory Conigliaro, an engineer,and his brother-in-law Barry Cadden, a pharmacist who was incharge of pharmacy operations at NECC. The waste and recyclingfacility is another of Conigliaro's business interests.

Compounding pharmacies such as NECC are permitted to makemedications based on specific prescriptions for individualpatients.

State and federal regulators are investigating why NECCshipped thousands of vials of preservative-freemethylprednisolone acetate steroid to healthcare facilities inmultiple states.

"It does seem like the agencies, both at the state and thefederal level, may have been misled by some of the informationwe were given," Massachusetts Governor Deval Patrick toldreporters on Wednesday.

The number of cases has grown rapidly as healthpractitioners contacted about 13,000 people who receivedinjections from a potentially tainted supply of steroidmedication shipped to 23 states.

In six states - Tennessee, Michigan, Maryland, Virginia,Florida and now Indiana - the outbreak has claimed lives.

Five new cases were reported in Tennessee, which remainedthe hardest-hit state with 49 cases, the CDC said. Michiganadded 11 cases and was at 39 on Thursday, with Virginia addingthree to reach 30 and Indiana six to reach 21, the CDC said.

The other states reporting cases are Maryland (13), Florida(7), Ohio (3), Minnesota (3), New Jersey (2), North Carolina (2)and Idaho (1), the CDC said.

Thousands of people received the injections to relieve backpain and other complaints and are at risk of infection.

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.

(Additional reporting by Tim Ghianni in Nashville; Writing byJames B. Kelleher and David Bailey; Editing By Greg McCune andPeter Cooney)