The Centers for Disease Control and Prevention, in collaboration with the U.S. Food and Drug Administration, and state and local health departments, said how long fungus can take to incubate can vary, and in this outbreak it has been about one to four weeks.
The CDC and FDA confirmed Thursday the fungus Exserohilum rostratum was detected in unopened vials of a preservative-free steroid -- methylprednisolone acetate -- linked to the meningitis outbreak that has sickened 285 people and killed 23 in 16 states.
About 17,000 doses of the steroid were shipped from the New England Compounding Center in Framingham, Mass., and an estimated 14,000 were used in treatment to ease back and joint pain.
Because the fungus can be slow to develop, federal health officials have asked patients treated with the steroid and their physicians to remain vigilant for symptoms that suggest possible fungal infection, including:
-- New or worsening headache.
-- Sensitivity to light.
-- Stiff neck.
-- New weakness or numbness in any part of the body.
-- Slurred speech.
-- Increased pain, redness or swelling at the injection site.
The CDC said Tennessee was the first state to identify the fungal meningitis and had the most cases at 69 and nine deaths, followed by: 53 cases in Michigan and five deaths; 41 cases and two deaths in Virginia; 38 cases in Indiana and two deaths; 16 cases and one death in Maryland; 17 cases and three deaths in Florida; seven cases in Minnesota; 10 cases in New Hampshire; 11 cases in Ohio; two cases in North Carolina and one death; 16 cases in New Jersey, one case in New York; one case in Idaho, one case in Illinois, one case in Texas and one case in Pennsylvania.