Five more cases of meningitis found

Five more cases of meningitis found; outbreak linked to Oak Ridge, Crossville

PCA Pain Care Center in Oak Ridge was also linked to the outbreak. PCA Pain Care Center in Oak Ridge was also linked to the outbreak.

NASHVILLE (WATE/AP) - Five new cases of meningitis have been reported in Tennessee and the outbreak has been linked to Crossville and Oak Ridge.

The five cases were confirmed sometime between Tuesday and Wednesday. The new findings bring the total number of cases to 18 in Tennessee and 26 in the U.S.

Four people have died, two in Nashville.

According to the Centers for Disease Control and Prevention (CDC), the other cases are in Virginia, Maryland, Florida and North Carolina. Virginia and Maryland had one death each.

Tennessee Department of Health Commissioner Dr. John Dreyzehner made the announcement in a news conference Wednesday afternoon.

One of those new patients received a steroid injection at the Specialty Surgery Center in Crossville.

PCA Pain Care Center in Oak Ridge was also linked to the outbreak after officials determined the clinic received the same steroid injection medication that was linked to the Nashville cases.

A health official believe the steroid came from a specialty pharmacy in Massachusetts.

Dr. Donald Jones of PCA Pain Care Center issued a statement on Wednesday saying the group stopped all injections and threw out the medication as soon as they were contacted by health officials.

"We have identified all of our patients who may have been injected with steroid. Each potentially-affected patient has been contacted by phone and has been sent an explanatory letter," Dr. Jones said in the statement. "Those that have reported any symptoms of meningitis have been tested and do not have meningitis."

Dr. Jones said the business would not perform the injections until the CDC and state health department say it is safe to do so.

More new cases are almost certain to appear in the coming days and investigators have not ruled out contamination in other products.

Officials found fungi in the biopsies of two patients, supporting the belief that the outbreak is a fungal form of meningitis, caused by microbes in the Aspergillus genus, rather than a bacterial or viral form of the illness.

This type of meningitis is not contagious and cannot be spread from person to person.

The Tennessee Department of Health has issued a statewide alert notifying medical professionals that the prime suspect for the source of the outbreak is the steroid methylprednisolone acetate.

Dr. John Dreyzehner said the CDC and FDA are also looking into the outbreak.

Any patients who received a steroid injection between July 1 and Sept. 28 at one of the three clinics - PCA Pain Care Center in Oak Ridge, Specialty Surgery Center in Crossville or Saint Thomas Outpatient Neurosurgery Center in Nashville - should be on the lookout for possible symptoms.

Symptoms of fungal meningitis include: worsening to severe headache, nausea, dizziness and fevers. Other symptoms can include slurred speech, unsteady gait, urinary retention, weakness, sensory deficit. 

Officials broadened the window of time for possible infection to July 1, rather than July 30, as a precaution to identify other potential cases.

Of the initial 12 reported cases of meningitis, nine were women. The patients range in age from 49 to 89 years old. No information has been released on the new cases.

Dr. John Dreyzehner said the clinics in question are fully cooperating with the investigation and are working around the clock to help health officials.

Portions of this report Copyright 2012 The Associated Press. All rights reserved. This material may not be published, broadcast, rewritten or redistributed.

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