Cases of a rare form of meningitis have risen to 26 in 5 states and more cases are expected. Four people have died.
All of the cases appear to be linked to a steroid injection for back pain.
Eighteen of the cases -- and two deaths -- are in Tennessee where a Nashville clinic received the largest shipment of the steroid suspected in the outbreak. A health official said the steroid came from a specialty pharmacy in Massachusetts.
According to the Centers for Disease Control and Prevention, the other cases are 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. Investigators have not ruled out contamination in other products.
According to the CDC, meningitis is a disease caused by the inflammation of the protective membranes covering the brain and spinal cord known as the meninges. The inflammation is usually caused by an infection of the fluid surrounding the brain and spinal cord.
Meningitis may develop in response to a number of causes, usually bacteria or viruses, but meningitis can also be caused by physical injury, cancer or certain drugs.
The severity of illness and the treatment for meningitis differ depending on the cause. Thus, it is important to know the specific cause of meningitis.
The Food and Drug Administration identified the maker of the steroid as New England Compounding Center. Last week, the company issued a recall of three lots of the steroid — methylprednisolone acetate. In a statement, the company said it had voluntarily suspended operations and was working with regulators to identify the source of the infection.
Federal officials did not release condition reports or details on all the patients in the five states.
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