CHARLOTTE, N.C. (AP) — Days after investigators linked a deadly cluster of rare fungal meningitis cases in Tennessee to tainted back pain medication, North Carolina officials received an urgent email from the Centers for Disease Control and Prevention.
The federal health agency said North Carolina had a possible fungal meningitis case with links to the Tennessee outbreak. If true, the CDC said it would confirm a "broader contamination issue."
That was Sept. 27. But it wasn't until five days later that the North Carolina Department of Health and Human Services notified the public about the threat, according to documents obtained by The Associated Press.
Hundreds of emails obtained through a public records request show how North Carolina health officials handled the fast-moving crisis.
Working with the CDC, the state health agency wrestled with what to tell the public, including whether to name the clinics suspected of administering the contaminated medication.
Health department spokeswoman Julie Henry said officials wanted to have all the facts before releasing information because it would have raised more questions than answers.
"We were trying hard not to promote hysteria in the general public," she said.
But she said officials also weighed the impact of waiting.
"So the other part of that is if we wait another day, are we going to put somebody at risk because they haven't recognized their symptoms soon enough?" she said.
A tainted steroid made by the New England Compound Center has been linked to a fungal meningitis outbreak that has killed 40 people nationwide and sickened more than 600.
The Framingham, Mass.-based company has been shut down since the outbreak was discovered in September.
When it comes to informing the public about health threats, North Carolina doesn't have a protocol, Henry said. Like many states, decisions about when to publicly release information are made on a case-by-case basis.
In Indiana, the AP found that health officials waited nearly a week before disclosing that six clinics had received the tainted back pain medication.
The CDC warned North Carolina of the meningitis threat by email on Thursday, Sept. 27.
The agency said a doctor called because he suspected a patient — a 77-year-old North Carolina woman — had meningitis-like symptoms after receiving an epidural injection "likely from the lots of interest." The clinic that administered the shot told the CDC that 120 doses of the lot were given out to about 60 patients.
The CDC said other patients from the clinic needed to be "contacted ASAP."
State health agency officials and the CDC continued to exchange emails that night about what to do, and scheduled a conference call for the following morning.
Meanwhile, Zack Moore, an epidemiologist with the state health agency, suggested the state at least provide health providers with information sent out by the state of Tennessee, which said it was notified Sept. 18 that a patient developed the fungal meningitis after the epidural steroid injection.