Deadly meningitis outbreak spreads to eighth U.S. state

By Tim Ghianni

NASHVILLE, Tenn., Oct 6 (Reuters) - A widening outbreak of fungal meningitis has spread to Minnesota, which reported two cases to become the eighth U.S. state affected, officials said on Saturday.

The added cases bring to 52 the number of people who have fallen ill after receiving steroid injections linked to a pharmacy in Massachusetts. At least five people have died.

"Both women are in their 40s who showed possible symptoms of meningitis," including fever and headache, said Buddy Ferguson, spokesman for the Minnesota Department of Health.

Evidence of meningitis was found in their spinal fluid, he said. Meningitis is an infection of the membranes covering the brain and spinal cord.

Other states with reported cases of people who fell ill after receiving the injections - primarily for back pain - are Michigan, Tennessee, Virginia, Florida, Maryland, North Carolina and Indiana.

Vials of steroids linked to the outbreak were shipped to 76 facilities in 23 states and could have been used to inject thousands of patients, authorities have said.

Both women in Minnesota were hospitalized and being treated with antibiotics and anti-fungal drugs, officials said.

As in other states where the outbreak has been detected, Minnesota authorities are trying to find out who else may have been infected at six locations known to have used the implicated drugs, Ferguson said.

"We have identified a list of approximately 950 people who did receive injectable steroids from the implicated lots," he said, adding that authorities are in the process of contacting each patient.

The U.S. Centers for Disease Control and Prevention reported 47 cases of meningitis on Friday and has provided no update since then. However, along with the two fresh cases in Minnesota, Michigan has reported an additional two cases and North Carolina added one not included in the CDC count, bringing the national total to 52.

Tennessee, where the outbreak first was detected, accounts for most of the cases at 29, state officials said on Friday.

Three of the deaths have been in Tennessee, and one each in Virginia and Maryland.

In Tennessee, many patients remain hospitalized, some listed in critical condition.

The infected patients have shown a variety of symptoms from one to four weeks after their injections, including fever, a new or worsening headache, nausea and neurological problems that would be consistent with deep brain stroke, the CDC said.

All the cases have been traced to three lots of the steroid prepared at New England Compounding Center Inc in Framingham, Massachusetts. The company said it has suspended its operations while the investigation proceeds.

The Massachusetts Health Department said there were 17,676 vials of medication in each of three lots of methylprednisolone acetate sent out from July through September and have a shelf life of 180 days.

So far the tally of cases includes 29 in Tennessee, six in Michigan, six in Virginia, three in Indiana, two in North Carolina, two in Minnesota, two in Florida and two in Maryland.

The steroid was sent to California, Connecticut, Florida, Georgia, Idaho, Illinois, Indiana, Maryland, Michigan, Minnesota, North Carolina, New Hampshire, New Jersey, Nevada, New York, Ohio, Pennsylvania, Rhode Island, South Carolina, Tennessee, Virginia, Texas and West Virginia, the CDC said.

A list of facilities that used vials from the infected lots can be found online via the website

(Editing by Ellen Wulfhorst; Editing by Will Dunham)