Rare meningitis outbreak grows; 4 dead, more than 2 dozen sick

NASHVILLE -- An outbreak of a rare form of fungal meningitis is likely to grow after killing four people and sickening 26 in five U.S. states, health officials warned.

All had received steroid injections, mostly for back pain, a fairly typical treatment. The drug was made by a specialty pharmacy in Massachusetts that issued a recall last week and has shut down operations.

The type of meningitis involved is not contagious like the more common forms. This type is caused by a fungus often found in leaf mould and which health officials suspect may have been in the steroid.

Investigators, though, say they are still trying to confirm the source of the infection.

Federal health officials weren't clear about whether new infections were occurring. They were looking for -- and increasingly finding -- illnesses that occurred in the past two or three months.

Meningitis is an inflammation of the lining of the brain and spinal cord. Symptoms include severe and worsening headache, nausea, dizziness and fever. Some patients also experienced slurred speech, and difficulty walking and urinating, said health officials in Tennesse, which has seen most of the cases.

"Some are doing well and improving. Some are very ill -- very, very seriously ill and may die," Tennessee health official Dr. David Reagan said.

The incubation period is estimated at anywhere from two to 28 days, so some people may not have fallen ill yet, Tennessee health officials said. At three clinics in Tennessee, officials were contacting the more than 900 people who received the steroid in the past three months.

The Food and Drug Administration identified the maker of the steroid as New England Compounding Center. Last week, the company issued a recall of three lots of the steroid -- methylprednisolone acetate. In a statement, the company said it had voluntarily suspended operations and was working with regulators to identify the source of the infection.

Federal officials did not release condition reports or details on all the patients in the five states.