Meningitis Deaths Rise to 20 Nationwide

These cases were in 16 states of the 23 where the New England Compounding Center's preservative-free methylprednisolone acetate solution was distributed.

The newest CDC update, dated Oct. 18, says 20 people have died in the United States after contracting meningitis from the New England Compounding Center's preservative-free methylprednisolone acetate solution (MPA), and a total of 257 cases have been identified in 16 states.

The agency is regularly updating its online map that shows where these cases are located. Another map and table posted by the agency provide the names of health care facilities in these states that received vials of MPA from the NECC. 

The outbreak came to light Sept. 18 when a clinician reported a patient's culture-confirmed Aspergillus fumigatus meningitis diagnosed 46 days after epidural steroid injection at a Tennessee ambulatory surgical center. By Sept. 27, investigators had identified eight more patients in Tennessee and North Carolina. All nine patients had received epidural steroid injection with MPA produced by the center, which had been informed of the investigation Sept. 25 and recalled three lots of MPA the following day. It recalled all remaining products Oct. 6, according to an MMWR report.

"Some patients received multiple injections with the three lots of MPA, and some vials were unused. As of October 10, state and local health departments had identified almost 14,000 persons potentially exposed to medications from at least one of these lots. Active notification of exposed persons was initiated by state health departments and CDC on September 25," it stated. "As of October 10, state health departments had reported that approximately 90% of patients exposed to medication from one of the three lots of MPA recalled on September 26 had been contacted at least once, by telephone, voicemail, home visit, or registered mail."

The report said cases of this type, post-epidural injection meningitis caused by fungi, are extremely rare.

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