Some of the tainted medicine linked to 35 cases of meningitis nationwide was injected into patients at one Tarrant County clinic, state health officials said Friday.
On Thursday, health providers learned that steroid shots given to patients for back pain might have been contaminated with a fungus that causes a rare form of meningitis. Five people have died as a result.
No illnesses have been reported in Tarrant County and all who were given the shot have been notified, according to the Texas Department of State Health Services. One Dallas County clinic also received a shipment but did not inject any patients.
The Associated Press reported 75 clinics in 23 states received the tainted steroids, which originated from a specialty pharmacy in Massachusetts. On Friday, the Food and Drug Administration issued a list of 30 medications produced by the company and urged clinics not to issue them to any patients.
The AP says the Framingham, Mass.-based New England Compounding Center recalled 17,675 single-dose vials of the steroids. So far, 35 people in Tennessee, Virginia, Maryland, Florida, North Carolina and Indiana have become infected with meningitis. Twenty-five of those cases are in Tennessee, the first of which was diagnosed two weeks ago.
It’s not clear how many patients in Tarrant County were injected with the steroid or which clinic it was.
Meningitis isn’t contagious but can be fatal, health experts say.
Nationwide, the number of sickened will rise, said Dr. Benjamin Park with the U.S. Centers for Disease Control and Prevention.
“However, it is possible that if patients are identified soon and started on appropriate antifungal therapy, some of the unfortunate consequences may be avoided,” Park said.
One antifungal is voriconazole, but it has severe toxic side effects that can damage the kidney and liver. And officials with the CDC continue testing to determine the exact contaminants, which can make a difference in what medicine is prescribed.
All those sickened received epidural steroid injections, a treatment for pain. In Tennessee, three sites — Saint Thomas in Nashville, the Specialty Surgery Center in Crossville and PCA Pain Care Center of Oak Ridge — had vials of the recalled medicine.
Dr. Marion Kainer, director of health-care-associated infections for the state Department of Health, said all the patients treated at those three clinics during the “window of concern” from July 1 to Sept. 28 are believed to have received injections from medicines with recalled lot numbers.
Fungal meningitis is not contagious. Its symptoms include headaches, fever, numbness, stiff neck, slurring of speech and confusion. Unlike bacterial meningitis, the symptoms manifest themselves slowly.
Investigators began inspections Monday at the New England Compounding Center in Massachusetts, which was the source of the recalled medicine, and observed “foreign particulate matter” in an unopened vial, said Mutahar Shamsi, the New England district director for the U.S. Food and Drug Administration.
The material was identified as a fungal contaminant, said Ilisa Bernstein, director of the office of compliance for the FDA.
“For the sake of time, because everything is unraveling and unfolding very quickly, we have not been able to do further microbial testing of additional vials,” Bernstein said.
More tests are under way to identify the specific type of fungus.
At a news conference in Boston, Dr. Madeleine Biondolillo, director of the Bureau of Healthcare Safety for the Massachusetts Health Department, said that 17,676 single-dose vials were included in the three recalled lots. They were distributed by the company between July and late September.
“Hundreds have been returned,” she said, adding that she did not have an exact number.
She said that as a precautionary measure and to be “abundantly cautious,” the company was recalling all similar drugs it had issued. The FDA advised health facilities across the nation to discard all products from the Massachusetts compounding pharmacy.
The probable first victim of the fungal meningitis outbreak in Tennessee was Kentucky Circuit Court Judge Eddie C. Lovelace, who died at Vanderbilt University Medical Center on Sept. 17.
The Associated Press contributed to this report which was found on wfaa.com channel 8 news in Dallas Texas.