It became apparent Thursday that hundreds, and perhaps thousands, of people who got the shots between July and September could be at risk after officials revealed that a tainted steroid suspected to have caused a meningitis outbreak in the South had made its way to 75 clinics in 23 states.
The Food and Drug Administration urged physicians not to use any products at all from the Massachusetts pharmacy that supplied the preservative-free methylprednisolone acetate.
New Jersey Health Commissioner Mary O'Dowd says no cases have been uncovered in New Jersey. The outbreak has caused five deaths nationwide.
O'Dowd says the epidural steroid injections were administered at 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 Richard Siegfried of Sparta.
Those facilities are contacting patients who received the injections. O'Dowd says anyone who received an injection and hasn't been contacted should call the facility.
Meningitis symptoms include fever, worsening headache, nausea and new neurological deficit consistent with deep brain stroke.
So far, 47 people in seven states - Tennessee, Virginia, Maryland, Florida, North Carolina and Indiana - have contracted fungal meningitis, according to the Centers for Disease Control and Prevention. All had received steroid shots for back pain, a highly common treatment.
It is not clear how many patients received tainted injections, or even whether everyone who got one will get sick. The time from infection to onset of symptoms is anywhere from a few days to a month, so the number of people stricken could rise.
The pharmacy involved, the New England Compounding Center of Framingham, Mass., has recalled three lots consisting of a total of 17,676 single-dose vials of the steroid, preservative-free methylprednisolone acetate, Massachusetts health officials said.
Investigators this week found contamination in a sealed vial of the steroid at the company, FDA officials said. Tests are under way to determine if it is the same fungus blamed in the outbreak.
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LIST OF IMPACTED FACILITIES IN NEW JERSEY
Central Jersey Orthopedics Specialists, PC in South Plainfield
Edison Surgical Center, Edison
IF Pain Associates/Isaiah Florence, Teaneck
Premier Orthopedics Surgical Assoc, LLC, Vineland
Richard Siegfried, MD, Sparta
South Jersey Healthcare, Elmer and Vineland
Additional information about the outbreak is available on the CDC's website at http://www.cdc.gov/HAI/outbreaks/meningitis.html
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