New cases and new concerns about meningitis in Middle Tennessee have national health experts working to find a cure, and for the first time Saint Thomas Hospital responded to questions about the procedures used in its pain clinic.
The Tennessee Health Department confirmed on Wednesday five new cases of fungal meningitis in the last 24 hours, bringing the total to 18 cases.
Saint Thomas has 16 patients connected to this outbreak, and two of them remain in intensive care.
Patients who received steroid injections from July 1 to Sept. 20 at Saint Thomas Outpatient Neurosurgery Center could find themselves at risk for fungal meningitis.
"They got blindsided by something - they had nothing they could control," said Dr. Robert Latham, an infectious disease physician with Saint Thomas Hospital.
The hospital voluntarily closed its clinic when the problem first surfaced and worked to contact any patients who may be affected by the non-contagious fungal meningitis.
"I hope we're at the end. I suspect we're in the middle. I feel we're at the beginning," Latham said.
Health experts suspect tainted methylprednisolone acetate, a lumbar epidural steroid medicine, from a Massachusetts specialty pharmacy sparked the problem.
It has been more pronounced in Middle Tennessee, because Saint Thomas received more of the vials than any other facility in the country. Other local clinics that have reported cases include the PCA Pain Care Center in Oak Ridge, TN, and the Specialty Surgery Center in Crossville.
"Except for a small outbreak that had something to do in Sri Lanka, none of us have had anything like this ever, experienced or written about before," Latham said.
That makes it tough to track the cause and a cure.
Health experts do not have answers yet and expect more cases to come, especially because it can take up to four weeks for symptoms to arrive.
That is the main reason for vigilance in the epicenter of an outbreak.
"I think they need to be vigilant about symptoms, and if they have any concerns about any symptoms that we've mentioned, they need to be evaluated," Latham said.
This particular type of meningitis is not contagious and cannot be caught from person-to-person contact. And there is no risk to pregnant women or new mothers who received an epidural injection during labor and delivery.
According to the Centers for Disease Control and Prevention, the other cases of fungal meningitis connected to this outbreak are located in Virginia, Maryland, Florida and North Carolina. Virginia and Maryland had one death each.
Health officials said Wednesday that more new cases are almost certain to appear in the coming days, and investigators have not ruled out contamination in other products.
Copyright WSMV 2012 (Meredith Corporation). All rights reserved. The Associated Press contributed to this report.