NASHVILLE, Tenn. (AP) — A Nashville hospital announced the death of another patient from fungal meningitis late Monday.
The patient died at Saint Thomas Hospital over the weekend, hospital spokeswoman Rebecca Climer said. A second meningitis patient died last week at the hospital.
The death would bring the state’s toll to five, and the nationwide toll to nine, although neither state nor federal officials have yet included it in their counts.
Health Department spokesman Woody McMillin said he could not confirm the death, and that anyone who died in the past day or two would not be included in the state’s count.
Earlier Monday, state officials raised Tennessee’s death toll to four based on new information about a person who died early in the outbreak on Sept. 26. Based on that information, the Centers for Disease Control raised the number of people killed nationwide to eight.
The Sept. 26 death was not reported to the state until this past weekend, Tennessee Commissioner of Health Dr. John Dreyzehner explained Monday.
As the number of cases increases, Tennessee health officials announced Monday that they would review recent deaths not previously linked to the outbreak to see if some may have been related. Officials did not release details on what sort of deaths they would review.
CDC officials say fungal meningitis broke out among patients who received steroid shots for back pain. The tainted steroid suspected in the outbreak is believed to have come from the New England Compounding Center, a specialty pharmacy in Massachusetts. The steroid has sickened 105 people in Tennessee, Michigan, Virginia, Indiana, Florida, Maryland, Minnesota, North Carolina and Ohio.
Unlike bacterial meningitis, fungal meningitis is not contagious, so doctors were not required to report cases to the state, Dreyzehner said.
Clinics are now alerting state officials when patients turn up with symptoms of the disease and are informing them of patients who they think in retrospect may have had it.
Dr. Marion Kainer, director of health care-associated infections and antimicrobial resistance program for the state, said following the outbreak, Tennessee is now requiring providers to report cases of fungal meningitis to the state.
Meningitis is caused by the inflammation of protective membranes covering the brain and spinal cord. Symptoms include a splitting headache, fever, stiff neck, difficulty walking or worsening back pain.
Some patients affected by this outbreak have had deep brain strokes and the early cases that were not recognized also had the strokes, Kainer said.
‘‘We hope and pray as we are recognizing these cases earlier and treating them earlier that we can avoid those complications,’’ Kainer said.
The state also said the CDC has also identified a second pathogen, called exserohilum, responsible for the infection. The other pathogen that was found in the first patient that died in Tennessee was identified as Aspergillus, a type of fungus.
The pharmacy that distributed the steroid issued a voluntary recall of all of its products Saturday, calling the move a precautionary measure. Tennessee health officials had already directed clinics and hospitals not to use any products provided by the New England Compounding Center and further urged any consumers to avoid any medications from the pharmacy.
In Tennessee, officials believe about 1,000 people could have received the contaminated medication and thus could be at risk, Dreyzehner said. Although the CDC has said the potentially contaminated injections were given starting on May 21, Dreyzehner said the earliest date that people could have received the injection in Tennessee was June 27.
Over the weekend, local health officials contacted about 66 people who were among those at risk after receiving injections and in some cases, knocked on doors in an effort to reach people.