World Bulletin / News Desk
U.S. health officials on Sunday reported an additional 27 cases in a fungal meningitis outbreak linked to steroid injections that has killed seven people and now infected 91 in nine states.
The U.S. Centers for Disease Control and Prevention reported the new total of 91 cases in an update on its website, up from 64 on Saturday. Most of the new cases were reported in Michigan, where the total increased to 20 from eight. Virginia's total increased to 18 from 11.
The widening outbreak has alarmed U.S. health officials and focused attention on regulations of pharmaceutical compounding companies like the one that produced the drugs, the New England Compounding Center Inc in Framingham, Massachusetts.
The company shipped 17,676 vials of the steroid methylprednisolone acetate to 76 facilities in 23 states from July through September, the Massachusetts Health Department said.
The steroid is used as a painkiller, usually for the back, and could have been injected in thousands of patients, authorities have said.
Meningitis is an infection of the membranes covering the brain and spinal cord, and affected patients started showing a variety of symptoms from one to four weeks after their injections.
The company, which was previously the subject of complaints, has suspended its operations while an investigation proceeds and earlier recalled the three lots of the drug. It expanded its recall on Saturday to all products compounded and distributed at its Framingham facility.
According to an announcement on its website, the company issued the broader recall out of "an abundance of caution" because of the "potential risk of contamination."
A compounding pharmacy takes medications from pharmaceuticals manufacturers and makes them into specific dosages and strengths for use by doctors.
Complaints against the company in 2002 and 2003 about the processing of medication resulted in an agreement with government agencies in 2006 to correct deficiencies, the Massachusetts Health Department said.
LIMITED FDA AUTHORITY
In 2011, there was another inspection of the facility and no deficiencies were found. In March 2012, another complaint was made about the potency of a product used in eye surgery procedures. That investigation is continuing, the state health department said.
The U.S. Food and Drug administration has limited authority over the day-to-day operations of compounding pharmacies, which are regulated primarily by state boards that oversee the practices, licensing and certification of pharmacies and pharmacists.
Compounded products do not have to win FDA approval before they are sold, and the agency has no jurisdiction over how the products are manufactured or labeled for use. Instead, the FDA investigates cases of adulterated drugs in cooperation with state regulators.
The FDA has tried to exert greater authority over compounded drug products under a section of the Food, Drug and Cosmetic Act that covers new drugs. But those efforts led to federal court challenges that resulted in two separate and conflicting rulings at the appellate level.
The nine states where fungal meningitis cases have been reported are Florida, Indiana, Maryland, Michigan, Minnesota, North Carolina, Ohio, Tennessee and Virginia.
Tennessee, where the outbreak was first detected, accounted for most of the cases, with 32, including three deaths. Many patients there remain hospitalized, some in critical condition.
Michigan had 20 cases and two deaths. One person died in Maryland and another in Virginia, the CDC said.
Reuters had reported 65 cases on Saturday, including one additional case after the CDC published its total.
Fungal meningitis is not contagious, the CDC said. Symptoms include fever, headache, nausea and neurological problems that would be consistent with deep brain stroke.
The steroid was sent to California, Connecticut, Florida, Georgia, Idaho, Illinois, Indiana, Maryland, Michigan, Minnesota, North Carolina, New Hampshire, New Jersey, Nevada, New York, Ohio, Pennsylvania, Rhode Island, South Carolina, Tennessee, Texas, Virginia and West Virginia, the CDC said.
A list of facilities that received vials from the infected lots can be found via the website cdc.gov.
Security forces in Liberia were ordered to enforce the action plan, which includes placing all non-essential government workers on 30-day compulsory leave.
Scientists analysed blood samples from 1,241 malaria patients in 10 countries across Asia and Africa and found resistance to the world's most effective antimalarial drug.
The death of Sheik Umar Khan, who was credited with treating more than 100 patients, follows those of dozens of local health workers and the infection of two American medics in neighbouring Liberia
The hospital will be shut for a week and all staff monitored to ensure the virus has not spread
The new measures announced by the government came as Guinea, Liberia and Sierra Leone struggle to contain the worst outbreak yet of the virus.
Angry crowds gathered outside the country's main Ebola hospital in Kenema where dozens are receiving treatment for the virus, and threatened to burn it down and remove the patients.
Asia’s largest copper mine in the central Indian state of Madhya Pradesh is causing serious damage to the environment.
The victim has been identified as Patrick Sawyer, a 40-year-old Liberian who arrived in Lagos on Sunday.
An MSF report found that malaria cases in Bossangoa had more than tripled to 6,507 in May with almost two-thirds of those children under the age of five.
If confirmed, the case would be the first on record of one of the world's deadliest diseases in Nigeria, Africa's biggest economy and, with 170 million people, its most populous country.
Researchers said the findings challenge the universal endorsement of paracetamol as the first choice painkiller for lower back pain.
The 39-year-old Sheik Umar Khan, hailed as a "national hero" by the health ministry, was leading the fight to control an outbreak that has killed 206 people in the West African country
Shanghai food watchdog said it sealed more than 1,000 tonnes of suspected meat products from OSI in China, and a further 100 tonnes of products from a range of its customers.
Children in Syria are at greatest risk as routine immunisation has been disrupted and many health centres are severely damaged after more than three years of conflict
151 people who came into direct contact with the victim were also placed in quarantine.
Viruses that spread through air - such as flu viruses for example - are far more likely to spread swiftly and widely in human populations