The outbreak has caused five deaths and dozens of illnesses in at least seven other states. Investigators have focused on a steroid medication made by a specialty pharmacy in Massachusetts. All the outbreak patients had gotten shots of the steroid for back pain.
In New Jersey, patients were given the epidural steroid injection at six facilities: Central Jersey Orthopedics Specialists in South Plainfield; Edison Surgical Center in Edison; IF Pain Associates/Isaiah Florence in Teaneck; Premier Orthopedics Surgical Associates in Vineland; South Jersey Healthcare in Elmer and Vineland, and Comprehensive Pain Management of Sparta.
Dr. Richard Siegfried, who runs Comprehensive Pain Management, estimated Friday that he had been using New England Compounding Center in Framingham, Mass., the source of the steroid medication, for about six months.
He said the current outbreak was particularly troubling because it involves an unusual form of meningitis that is affecting people with healthy immune systems. Meningitis more commonly is associated with people with compromised immune systems, such as AIDS sufferers or cancer patients.
Siegfried said he and other doctors he spoke to were "shocked" by the outbreak. He said he has been in touch with the five patients who were given the injection at his office and none has reported symptoms.
"We're dealing with an animal that we're really not familiar with," he said. "Right now I've got things on hold. I'm not sure what direction to go in right now. I'm hoping for guidance from the CDC in regard to that. This has basically affected pain management nationwide, if not worldwide."
Siegfried said he and other doctors use the products from compounding pharmacies even though they usually are more expensive because they are preservative-free.
"So believe it or not, it's for patients' safety because there's no truly preservative-free alternative available commercially," he said.Meningitis symptoms include fever, headache, nausea and new neurological deficit consistent with deep brain stroke.
According to the CDC, the form of fungal meningitis that has been identified is not contagious-meaning it is not spread from person to person.
The source of the fungus has not yet been identified, and the cause of infections in the other patients is still being assessed. Additional information about the outbreak is available on the CDC's website at http://www.cdc.gov/HAI/outbreaks/meningitis.html