This photo provided Oct. 9, 2012, by the Minnesota Department of Health shows shows vials of the injectable steroid product made by New England Compounding Center implicated in a fungal meningitis outbreak that were being shipped to the CDC from Minneapolis. (AP Photo/Minnesota Department of Health)
NASHVILLE, Tenn. (AP) - Another person has died in Tennessee from a fungal meningitis outbreak caused by contaminated steroid injections for back pain.
On Friday, the State Department of Health said a total of 74 people who received the injections in Tennessee have been sickened and 10 of them have died.
State health officials said earlier this week that the great majority of risk for stroke or death associated with the outbreak is gone by 42 days after the injection. By Nov. 8, all 1,009 people in Tennessee who got the contaminated steroids will have passed the 42-day mark.
However, that does not mean people have no risk of developing meningitis after Nov. 8. Health officials warned those who received the injections to remain vigilant for symptoms.
Fungal meningitis is not contagious.
On Friday, federal health inspectors announced they found bacteria and mold growing in rooms that were supposed to be kept sterile at the pharmacy linked to a deadly outbreak of meningitis.
The Food and Drug Administration has released its initial report after investigating the New England Compounding Center in Framingham, Massachusetts, earlier this month.
Inspectors said they found green, yellow and red growths, water droplets and other potential contaminants in a room used to mix and seal specially formulated medicines.
Steroid injections made by the New England Compounding Center have been tied to an outbreak of fungal meningitis that has sickened 338 people across the U.S., causing 25 deaths. Last week FDA officials confirmed the black fungus found in company vials is the same as that which has sickened patients.
With the tainted shots recalled in late September, that means the period of greatest risk is nearing an end. And it should help doctors bombarded with calls from the worried determine who most needs a spinal tap to look for the very earliest signs of infection.
The CDC said doctors have two valid options: To watch patients closely for symptoms or to consider a just-in-case spinal tap, possibly repeated weekly, for at-risk people still inside that 42-day window. However, CDC officials note that spinal taps come with their own risks.
The main culprit in this outbreak is a black mold called Exserohilum rostratum, common in dirt and grasses. Only 33 human infections previously had been reported, mostly eye or skin infections in people with weak immune systems, Casadevall said.
The good news: Black mold is treatable with a drug named voriconazole, with far fewer side effects than the older treatment initially recommended when the outbreak began.
Still, Kauffman cautioned doctors to carefully monitor patients because differences in metabolism can make levels surge in the bloodstream, causing hallucinations, confusion, nausea and occasionally liver damage. On the flip side, their bodies may process the drug too quickly to battle the fungus. Plus, voriconazole can interact badly with a list of other common medications.
"It's not clear" how long to treat but at least three months is advised, Kauffman said. It begins with intravenous infusions that are hard to administer outside of a hospital. Then once the patient is stable enough, pills can be used.
(Copyright 2012 by The Associated Press. All Rights Reserved.)