The number of people sickened by a deadly meningitis outbreak has now reached 354 cases across the U.S., and the death toll has risen to 26, according to the Centers for Disease Control.
Health officials said Tuesday the number of people affected in Tennessee now stands at 74, with 11 people who have died in the state.
A Nashville woman filed a multi-million dollar lawsuit against that compounding pharmacy, New England Compounding Clinic.
According to the complaint, Joan Peay said she got an injection at Saint Thomas Hospital in early September.
Weeks later she says she had a severe headache, sore neck and nausea.
She finally went to the hospital after seeing reports of meningitis on the news.
The suit accuses NECC of negligence and seeks a total of $5 million in damages.
Tennessee, Florida, Idaho, Illinois, Indiana, Maryland, Michigan, Minnesota, North Carolina, New Hampshire, New Jersey, New York, Ohio, Pennsylvania, South Carolina, Texas and Virginia all have reported cases.
Officials have tied the fungal meningitis outbreak to steroid shots for back pain. The steroid was made by a specialty pharmacy in Massachusetts called New England Compounding Clinic.
The company has recalled the steroid which was sent to clinics in 23 states. The government last week urged doctors not to use any of the company's products.
The Centers for Disease control has said that as many as 14,000 people received steroid injections from medication that came from the clinic.
The CDC said patients may have been infected starting as far back as May 21.
The Tennessee Department of Health said is expects new cases and patients to emerge through the beginning of November.
Most patients who receiving the tainted shots will not develop fungal meningitis, said state health officials. About 5 percent of the people who got the bad injections have later contracted meningitis.
"We expect that most people that were exposed to this will not develop the fungal infection," said Dr. David Reagan, with the Tennessee Department of Health.
The state has also pinpointed the predominant pathogen in the case a rare type of fungus called exserohilum. Most people can breathe the spores without consequence.
But somehow, spores wound up in otherwise-sterile steroid injections.
"What we don't know yet about this new exserohilum is how it will respond to the anti fungal drugs we have. This is not a fungus against which these drugs have been tested in the past," said Dr. William Schaffner, with Vanderbilt University Medical Center.
The CDC has pinpointed a cure, but the treatment can be very toxic on the system and could last months.
"The experience thus far has been that when people have been identified early, and they've begun to be treated earlier with these anti fungal medications, they've been doing much better," said Tennessee Commissioner of Health Dr. John Dreyzehner.
Cases as of Friday:
Tennessee: 74 cases, 11 deaths
Florida: 19 cases, 3 deaths
Idaho: 1 case
Illinois: 1 case
Indiana: 43 cases, 3 deaths
Maryland: 19 cases, 1 death
Michigan: 82 cases, 5 deaths
Minnesota: 9 cases
North Carolina: 2 cases, 1 death
New Hampshire: 11 cases
New York: 1 case
New Jersey: 13 cases
Ohio: 11 cases
Pennsylvania: 1 case
South Carolina: 1 case
Texas: 1 case
Virginia: 43 cases, 2 deaths
Should patients have been alerted sooner?
Tennessee Commissioner of Health Dr. John Dreyzehner addressed Monday why patients weren't told more as the outbreak first came to light.
"We wish we knew everything we now know now when we first notified the St. Thomas Neurosurgery Center that we were concerned on Sept. 20," he said.
State officials said they didn't know until the following week exactly what they were dealing with and that the prime suspect was a contaminated drug from the New England Compounding Center.
"Our goal is to continue to identify at-risk patients as soon as possible, knowing early recognition can benefit treatment results. Because of the aggressive follow-up of involved clinics and other efforts, patients are now being identified earlier in their illness, when treatment is expected to be more effective," said Dreyzehner.
It wasn't until the investigation pinned down the cause, state officials said, that they started giving patients more information.
"As this situation evolved, we've had additional scientific information upon which to base our messaging," Dreyzehner said.
Two experts in the field of medical ethics both said they think patients should have been told more about the potential risks they were facing.
Arthur Caplan, a bioethicist at New York University, said patients should have been made aware of the seriousness of the situation and the need for follow-up.
Keith Meador, the director of the Center for Biomedical Ethics at Vanderbilt University Medical Center, said patients should be made aware as soon as there is evidence of a definite risk.
A spokeswoman for St. Thomas, where many of the treatments were given said they didn't discuss the possibility of meningitis in the early calls to patients at the request of the state health department.
The health department said they wanted to avoid speculation before they knew what they had, and they didn't want to introduce paranoia and fear.
Copyright 2012 WSMV (Meredith Corporation), Associated Press. All rights reserved.
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