EDINBURG, Texas (Border Report) — Hidalgo County Health Authority Dr. Ivan Melendez is warning anyone who had cosmetic surgery south of the border this year in Matamoros, Mexico, that they could have been exposed to a deadly fungal meningitis.

Melendez on Wednesday told Border Report that four people are currently hospitalized in Hidalgo County for fungal meningitis, which has been identified as fusarium solani.

Three people in Texas have died, and up to 220 people in the United States could have been infected from epidural injections given at two clinics in Matamoros, Melendez said.

In the Rio Grande Valley, there are potentially 23 cases of exposure in Hidalgo County, and 70 in Cameron County, he said.

Melendez says that on Tuesday, one woman who was hospitalized in Hidalgo County left the hospital “against medical advice” even though she tested positive for meningitis.

He says the disease has a 40% fatality rate — based on previous infections in Durango, Mexico, and he says it’s nothing to take lightly.

“We’re having a great difficulty in elevating the awareness of our community to those people at risk of the potential danger,” Melendez said. “We know that the mortality for this disease is between 40 to 45%. So this is one: a highly lethal disease; two: very variable in its presentation, and very slow to come on board.”

Symptoms include fever, headache, stiff neck, nausea, vomiting, sensitivity to light, and confusion, according to the Centers for Disease Control (CDC).

The CDC is warning all patients who were treated at the River Side Surgical Center, or Clinica K-3 from Jan. 1 to May 13 to “go to the nearest emergency room as soon as possible to be evaluated for fungal meningitis, even if you do not currently have symptoms.”

Melendez says symptoms can take several weeks to develop. But once they do, they can become severe and life-threatening.

Part of the reluctance of patients to seek medical help, he said, is because a lumbar puncture is necessary to definitively diagnose meningitis. The punctures are usually done in hospitals and involve inserting a needle in the lower back.

He said the symptoms often don’t present as severe, at least at first.

“This disease can be very insidious, the symptoms are very vague — headache, fever, neck pain, myalgias — things that you can easily explain away as being tired or something else,” he said. “I can understand why some people would be hesitant or lack trust, but I’m here to tell you that we’ve had already three people die, and that the lethality of this disease is about 40%. So in our opinion, and the CDC’s opinion, and the State Health Department’s opinion, it’s better to be safe than to be sorry. So the message is that if you’re in that risk group, please go get checked.”

The treatments also involve lengthy hospital stays, and he says if everyone tests positive then the region could need to send for more medication from other parts of the country.

Melendez says Mexican health officials are working to spread the word about the outbreaks from these clinics, which have now been closed. But he says they have not released data on how many Mexican nationals could have been infected or died from it, so far.