The Centers for Disease Control and Prevention (CDC) now say more people may have received a contaminated steroid injection than previously thought. Up to 14,000 patients may be at risk in this unprecedented outbreak of fungal meningitis, which could have an incubation time of up to three months.

The latest death toll as of Thursday, October 11, is 14 with 170 people infected, which represents 33 more cases since Wednesday, according to the CDC. Several of the patients have suffered strokes related to the meningitis outbreak after receiving a contaminated epidural steroid injection in the spine or neck for pain.

There has been a second death in Florida and a first death in Indiana. Eleven states have cases of meningitis linked to the contaminated steroid injection.

Searcy Denney is still hearing from people around the country who may have been exposed to injections prepared by the New England Compounding Center, a compounding pharmacy in Framingham, Massachusetts.

As of Thursday, October 11, the CDC identified the fungus that contaminated the steroid as the fungus, Exserohilum, while one person was exposed to the fungus, Aspergillus.

Aspergillus fungus under microscope

What do we know about these fungi? Humans come in contact with fungi in a variety of ways. Both the antibiotic penicillin and bread use fungal ingredients, but a fungi can be harmful when it attacks the body as a pathogen. When the fungi is introduced directly into the body through an infected body site or an injection, it can spread through the bloodstream and central nervous system causing symptoms such as fever, nausea, and headache, weakness and a sensitivity to light.

Ironically, fungal meningitis is opportunistic and invasive when the immune system is weak. Medications that can weaken your immune system include steroids, such as prednisone, organ transplant medication or anti-TNF medications given to treat autoimmune conditions or rheumatoid arthritis.

Unlike a viral or bacterial meningitis, fungal meningitis is not contagious. If you feel you may have been exposed, it is recommended you monitor your condition for up to 42 days. If confirmed, the CDC recommends IV antifungal agents delivered in a hospital.

Aspergillosis is the infection that comes from the common fungus Aspergillus. It is found both indoors and outdoors and is found in the air we breathe every day. The disease impacts people who have weakened immune systems or lung disease, have allergic reactions, or are carrying an infection in another organ.

It is still not known how the ingredients mixed into the injection became contaminated. A multi-state investigation is currently underway. On its website, the CDC has a list of healthcare facilities that received three lots of the tainted Methylprednisolone Acetate (PF) which was recalled by the New England Compounding Center on September 26.

Eight of those centers are in Florida, more than any other state.