Meningitis outbreak: Cases rise in Md., Va.

RICHMOND, Va. (AP) - Virginia has 24 cases of suspected meningitis among hundreds of patients who received steroid shots that may have been contaminated with a potentially deadly fungus, public health officials said Tuesday.

The number is likely to rise, they said, as they began a new effort this week to ensure that every patient who received the steroid shots at two Virginia clinics is notified.

They could not say with certainty whether all 689 who received the shots had been contacted, despite outreach efforts.

The Virginia Department of Health sent out a new round of notices statewide to more than 150,000 doctors and other health professionals this week.

"Our concern really at this point is to make sure that the individual patients who received one of these products know of their exposure and have the most up-to-date information we can provide them," said Dr. David Trump, the state epidemiologist.

Virginia has previously reported one death linked to the outbreak. Of the 24 suspected cases, up from a handful reported late last week, three are from West Virginia residents who received back pain treatment with the possibility tainted steroid at either New River Valley Surgical Center in Christiansburg or Insight Imaging in Roanoke, which accounted for all but 28 of the 689 patients.

The number of people sickened by the deadly meningitis outbreak reached 119 cases, including 11 deaths, the Centers for Disease Control and Prevention reported Tuesday.

Officials have tied the outbreak of the rare fungal meningitis to steroid shots for back pain. The steroid was made by a specialty pharmacy in suburban Boston.

The company recalled the steroid that was sent to clinics in 23 states, and later recalled everything it makes.

Trump and Virginia health commissioner Dr. Karen Remley said the public health drama is likely to drag on for weeks or more because of the rare nature of fungal meningitis and the many unknowns - who is more susceptible, how long does it take for illness to occur in the infected?

"What we don't know of those 689 people how many, if exposed, will get sick," Remley said. "There may be some people who were exposed to the contaminated produced but will not get sick."

One medical facility in the Roanoke area had reported 31 suspected cases, but Trump and Remley said the state would need to collect additional data before adding them to totals for Virginia.

Nationwide, as many as 13,000 people received the steroid shots suspected in the outbreak, but officials don't know who many shots may have been contaminated with the meningitis-causing fungus.