While the CDC is still gathering information on persistent cases of infections and related health problems, the numbers from last autumn’s fungal meningitis outbreak show 588 confirmed infections spread across 18 states. Among those were 17 cases in North Carolina, and one of the nation’s 17 deaths from the outbreak occurred in North Carolina.

As has been widely reported, it appears contaminated batches of back pain medication from the New England Compounding Center in Framingham, Mass., were to blame. A number of media reports and government probes have found, to the public’s outrage, that the facility had less than ideal cleanliness, and in fact conditions there have been described in a manner that would be appalling to many.

However, we wonder if North Carolina health officials should be no less a target for outrage with a just released Associated Press investigation that found state officials were alerted by the CDC on Thursday, Sept. 27 of the problem with the steroid treatments mixed at the compounding center, and that there was at least one link to the outbreak.

North Carolina officials, however, waited a full four days before alerting the public.

According to the AP, state health department officials “wanted to have all the facts,” before releasing any information to the public. “We were trying hard not to promote hysteria in the general public,” according to spokeswoman Julie Henry.

Sorry, but this doesn’t wash, particularly when considered with additional information uncovered by the Associated Press.

The news organization found that the state health department knew by Friday morning, Sept. 28, that at least three clinics in North Carolina had received the tainted medicine, yet still did not issue a warning to the public.

The department did send a warning through its N.C. Health Alert Network, but that only goes to health care providers in the state. Incredibly, the department waited until late on Friday afternoon and sent the alert as a “low priority.” Given most people’s propensity to spend the waning hours of the workweek thinking more about the upcoming weekend than any tasks at hand, combined with the “low priority” nature of the e-mail alert, it’s likely many of these health care professionals never saw the warning until the following Monday, a full four days after North Carolina learned of the problem.

And it wasn’t until late Monday afternoon, with up to 90 potential patients presenting symptoms of being infected and one on death’s door (she later did die), that state health officials finally went public with the information.

Because early treatment for the infection was vital, it is hard to understand any justification for the delay. State officials say they were trying to avoid a public panic, but it wasn’t as if there would be rioting in the streets — at worst, physicians treating patients for back pain would have been subject to a higher number of calls from worried patients, some of whom would have had their mind put at ease and others, those who may have received the injections, would have gotten treatment earlier.

Now, however, we’re left with questions about the effectiveness of the state’s health department system and the judgement of those in charge.