Federal and state health officials are scrambling to contact patients who might be affected by the widening outbreak, which involves a medicine commonly used to treat lower back pain, methylprednisolone acetate. In Maryland and Virginia, more than 2,100 patients may have received contaminated injections, officials said.
A total of 105 cases of meningitis linked to the injections have been reported in 23 states, according to updated figures provided Monday by the federal Centers for Disease Control and Prevention. Those cases include 23 in Virginia and five in Maryland. One person has died in Virginia and another in Maryland.
Across the country, state and local health department officials have been trying to contact patients who may have been given the tainted injections, in some cases making home visits.
“They’re just trying to reach everyone, especially since the early symptoms might be considered just a plain old headache or flu,” said Beth Bickford, executive director of the Association of Ohio Health Commissioners. She said early treatment is key.
In Maryland, most of the estimated 1,500 patients who received injections of the implicated medicine at seven facilities have been contacted directly by phone, according to state epidemiologist David Blythe. In Virginia, about 630 patients received injections at two facilities in the Roanoke area and all have been contacted, according to state epidemiologist David Trump.
More than 17,000 vials of the injectable steroid were shipped from a compounding pharmacy, New England Compounding Center in Framingham, Mass., to 75 facilities over the summer. The injections were given from late May through late September.
Fungus in some of the vials appears to cause a rare brain infection that requires months of intravenous antibiotics to cure. Unlike other types of meningitis, symptoms might appear gradually, said CDC spokesman Curtis Allen. They include sensitivity to light, stiff neck, weakness or numbness and slurred speech.
The outbreak has focused attention on the regulation of pharmaceutical compounding companies. The Massachusetts company has voluntarily recalled all its products, suspended operations and said it is working with regulators to identify the source of the infection.
Massachusetts health officials, in a statement issued Monday, said that compounding pharmacies are only allowed to prepare and dispense medications for individual patients and that manufacturing products without prescriptions is a violation of a company’s license with the board of pharmacy.
Traditional compounding pharmacies typically custom-make medicines for individual patients. In the past two years, hospitals and other health-care providers have been relying increasingly on these pharmacies because of continuing drug shortages, particularly of generics, industry executives said.