An outbreak of meningitis has been reported among patients who received injection of preservative-free methylprednisone acetate, a steroid medication which is administered by injection into the spinal cavity. As of today, 47 cases of meningitis and 5 deaths as a result of the distribution of contaminated compounds have been reported. 
The New England Compounding Center in Framingham, Massachusetts, a compounding pharmacy responsible for mixing ingredients to make medications, has been identified as the most likely source of the contaminated vials. Twenty three states received shipments of the product, although it is not clear how many of the vials are contaminated. Seven states have already reported finding cases of meningitis linked to the steroid injection. The NECC subsequently issued a recall on several lots of the medication, followed by a complete halt of all production and recall of all products which are injected into the spinal cavity. 

 The first case of meningitis was reported by the Tenessee Department of Health on September 21st. The patient had received the injection 19 days prior to the onset of symptoms. On September 28th, another case outside of Tenessee was reported, indicating that the outbreak was more widespread than previously believed.

 The extent of the outbreak is not yet clear, as the symptoms of meningitis can take up to a month to appear. Meningitis loosely refers to inflammation of the meninges, which are the membranes surrounding the brain and spinal cord. Other symptoms include headache, nausea, fever, neck stiffness, stroke, and other neurological symptoms. The causes of meningitis range from bacterial, viral, or fungal infection. In this particular instance, the vials appear to be contaminated with a fungus which has infected the meninges in affected individuals. 

 Although the fungus has not been identified as the official cause, evidence of fungal infection has been identified in at least five infected individuals. In the interim, doctors are being advised to cover all possible causes of meningitis in their treatment, but have been encouraged to include antifungal therapy in their treatment of potentially infected individuals. The contaminating fungus is often found in the environment but typically does not cause meningitis. Fortunately, the fungus is not contagious and so only individuals who have received the steroid injection are at risk. 

 The outbreak has provided fodder for critics of compound pharmacies, which are currently regulated by state pharmacy boards. It has been argued that state agencies are ill equipped to monitor the distributing pharmacies, and that they should fall under the jurisdiction of the FDA. In light of recent events the call for increased regulation has been vehemently renewed. 

 The outbreak is currently being investigated by the CDC, but doctors and patients who have received the injections are being advised to take every necessary precaution, as any intervention could potentially be life-saving.