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4 FL patients with fungal meningitis were treated at same clinic

All four Floridians who have so far contracted a rare fungal meningitis at the center of a national outbreak had been given injections at the Marion Pain Management Center in Ocala, the Florida Department of Health said Monday.

Five other clinics in the state have also given doses of the drugs to patients, but no cases linked to them have been reported yet, DOH press officer Ashley Carr said Monday.

The administrator of the Marion Pain Management Center, Lena Jedlicka, confirmed that it received 300 doses of the drug under suspicion, but she declined to say how many doses actually were given to patients.

DOH said the four clinic patients who were reported ill were three men, all in their 80s, and a 65-year-old woman. Their names were not released.

The Centers for Disease Control and Prevention (CDC) contacted the clinic on Oct. 2 with the unhappy news that it was one of the facilities that received a shipment of steroids suspected of contamination, Jedlicka said. CDC provided guidelines on what to do, and the five employees of the clinic have been contacting patients ever since, she said.

Dr. Mangala Shetty, who owns the practice, was not available to speak to Health News Florida the administrator said. Dr. Shetty is not making any public comment," Jedlicka said. "She's busy taking care of patients."

Seven other Florida clinics received shipments of the injectable drug from the New England Compounding Center (NECC), but two were removed from the at-risk list after assuring they had not used any of the doses, said DOH's Carr. They were identified as Interventional Rehab Center in Pensacola and North County Surgicenter in Palm Beach.

Aside from the Marion Pain Management Center, the clinics that gave doses of the suspect drug to patients, Carr said, are:

--Florida Pain Clinic, Ocala
--Orlando Center for Outpatient Surgery.
--Pain Consultants of West Florida.
--Surgery Center of Ocala.
--Surgical Park Center, Miami.

CDC and DOH updated other information on which patients may be at risk: Patients who received epidural steroid injections in their back or joint on or since May 21 at one of the clinics on the list.

The injectable fluids in question are methylprednisolone acetate, lot numbers 05212012@68, 06292012@26 and 08102012@51. However, NECC voluntarily recalled all products that it has distributed since January after health officials urged caution in their use.

The type of meningitis caused by the leaf-mold fungus is not contagious, health officials stressed. The four Floridians who contracted the illness are among 105 in nine states, CDC said Monday afternoon. Eight died, but none of them were in Florida.

Symptoms, which can develop weeks after the injections, include fever, headache, neck pain, nausea or stroke indicators including slurred speech and weakness on one side of the body.

Doctors and clinics that used NECC steroid injections from the contaminated lots are trying to contact all patients who received them and ask them to see their doctor or go to the hospital for a check.

At both the federal and state level, multiple agencies are involved in the outbreak investigation and recall efforts. CDC and DOH are in charge of information on patients and clinics, while the drug-compounding pharmacy and recall fall under the jurisdiction of the Food and Drug Administration and the Florida Department of Business and Professional Regulation.

Lena Jedlicka at the Marion Pain Management Center said the staff there has heard from all of them.

To see interviews with experts on this type of meningitis, see this article from HealthDay.

Also, theNew York Times reported this weekend that the NECC and other specialty pharmacies receive little regulatory oversight.

--Health News Florida, journalism for a healthy state, is part of WUSF Public Media. Question? Comment? Contact Carol Gentry, 813-974-8629 (desk) 727-410-3266 (cell) or by e-mail.

Carol Gentry, founder and special correspondent of Health News Florida, has four decades of experience covering health finance and policy, with an emphasis on consumer education and protection.