3 contaminants linked to meningitis

U.S. health officials said there is growing evidence a brown-black mold is the predominant pathogen in the meningitis outbreak that killed 15 and sickened 233. Officials at the Centers for Disease Control and Prevention in Atlanta said Exserohilum rostratum -- a brown-black mold -- was the predominant pathogen, although Aspergillus species, a common fungus, was also detected in the outbreak. However, Cladosporium, a mold, was also detected in a patient, the CDC said. Expert opinion and published literature indicated voriconazole -- an antifungal medication that is generally used to treat serious, invasive fungal infections -- might be effective in treating infections due to brown-black molds as well as infections due to Aspergillus species, the CDC said. "This is interim guidance for treatment of adult patients with septic arthritis associated with intra-articular injections with potentially contaminated steroid products from the New England Compounding Center," the CDC said in a statement. "Interim guidance may change as new information becomes available." The New England Compounding Center in Framingham, Mass., shipped an estimated 17,000 doses of the injectable steroid methylprednisolone acetate used to treat back and joint pain to 23 states. Some 14,000 of the steroid doses are estimated to have been used. Some of those sickened by the tainted medication had strokes and some have been hospitalized and are seriously ill. Officials said treatment of those seriously ill could take three months. The CDC said Tennessee was the first state to identify the fungal meningitis and had the most cases at 59 and six deaths, followed by: 47 cases in Michigan and three deaths; 35 cases and one death in Virginia; 30 cases in Indiana and two deaths; 16 cases and one death in Maryland; 12 cases and two deaths in Florida; 10 cases in New Jersey; five cases in Minnesota; six cases in New Hampshire; seven cases in Ohio; two cases in North Carolina; one case in Idaho; one case in Illinois; one case in Texas and one case in Pennsylvania.