KNOXVILLE (WATE/AP) - The number of people dead from the fungal meningitis outbreak in Tennessee is on the rise.
The outbreak involves 10 states, but so far Tennessee has reported the greatest number of cases.
The Department of Health announced Tuesday that six people have now died in the state, with 39 patients infected. The Centers for Disease Control and Prevention said Tuesday that there have been 119 infections and 11 deaths across the nation.
In addition to the new cases, the Tennessee Department of Health has expanded the incubation period to 42 days from the time of injection.
On average, most people have begun seeing symptoms 16 days after receiving the steroid injections, however health officials said it could take well over a month for symptoms to show.
"It's very important for these patients and their families to remain vigilant. Fungal meningitis can be very difficult to detect early in some patients," said Tennessee Health Commissioner Dr. John Dreyzehner.
Health officials now believe the dominant fungus in this outbreak, stemming from what they believe to be contaminated steroid drugs from the New England Compounding Center, is a rare pathogen called Exserohilum.
"It's a fungus so rare that most physicians will never see it in a lifetime," said Dr. Dreyzehner.
The health department said most people exposed will not be infected. As of Oct. 9, about 5% of people in Tennessee who received the possibly-contaminated injections have developed the fungal infection.
Officials are urging people to be extremely aware of possible symptoms.
"The period of risk is ongoing, but the period of exposure is over," Dr. Dreyzehner explained.
In Tennessee, officials believe approximately 1,000 people have received these contaminated injections. They said it's possible the batches could have varying degrees of toxicity and anyone who received them could be at risk.
"There's not a way to exclude anyone from the risk pool based on age, illness or demographic at this point," he said.
Health officials said the anti-fungal treatment given to those who have developed the injection is working. But again, they warn that anyone with new or worsening symptoms should seek attention.
Spinal taps or lumbar punctures conducted early after the initial injections may not have indicated an infection, but people can develop the infection more than a month after the initial injection.
Symptoms include headaches, fever and a stiff neck. Experts said anyone who has received a steroid injection in the spine since July should check with their doctor to see if it's from the tainted source.
The Tennessee Department of Health has activated six regional health operations centers as a part of the investigation: Upper Cumberland, Mid-Cumberland, South Central, East, Southeast and Nashville/Davidson County.
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