Atlanta (CNN) — The death toll from an outbreak of meningitis linked to contaminated steroid injections has risen to seven, the Centers for Disease Control and Prevention said Saturday.
The total number of cases has also grown to 64 people in nine states, the CDC said. That is 17 more cases and two more states than the day before.
Patients contracted the deadly meningitis after being injected in their spine with a preservative-free steroid called methylprednisolone acetate that was contaminated by a fungus. The steroid is used to treat pain and inflammation.
Health officials say around 75 medical facilities in 23 states received the contaminated products, which were manufactured by New England Compounding Center in Framingham, Massachusetts.
NECC voluntarily recalled three lots of the injectible steroid last week. As a precaution, the Food and Drug Administration is asking doctors, clinics, and consumers to stop using any products made by NECC.
The FDA is investigating the scope and cause of the outbreak.
The CDC raised the death toll Saturday after two people died in Michigan. Other deaths have been reported in Maryland, Tennessee, and Virginia.
Tennessee is reporting the most number of overall cases — 29 — which includes three deaths, according to the CDC.
Confirmed cases have also been found in Florida, Indiana, Minnesota, North Carolina and Ohio.
The other states that received the contaminated products from NECC are California, Connecticut, Georgia, Idaho, Illinois, New Hampshire, New Jersey, Nevada, New York, Pennsylvania, Rhode Island, South Carolina, Texas and West Virginia.
Nearly 10% of drugs administered in the United States come from compound pharmacies, according to a 2003 Government Accountability Office report.
Drugs manufactured by compound pharmacies do not have to go through FDA-mandated pre-market approval. Instead, oversight and licensing of these pharmacies comes from state health pharmacy boards.
Compound pharmacists create customized medication solutions for patients for whom manufactured pharmaceuticals won’t work, according to the International Academy of Compounding Pharmacists.
Fungal meningitis is “quite a rare infection,” said Dr. Benjamin Park, from the CDC’s Division of Foodborne, Waterborne, and Environmental Disease. But it’s not a required reportable illness, so it’s unclear how often these types of infections occur.
Dr. William Schaffner, chairman of the Department of Preventive Medicine at Vanderbilt University Medical Center, told CNN that fungal infections are not usually mild. He said when funguses invade small blood vessels they can cause them to clot or bleed, which can lead to symptoms of small strokes.
Other symptoms of meningitis to look out for include fever, chills, new or worsening headache and stiff neck, said Schaffner.
If someone is experiencing any symptoms, they should seek medical attention immediately. The earlier a patient gets treatment, the more likely he or she will survive.
Patients are treated with anti-fungal medication, which is given intravenously so patients have to be admitted to the hospital — at least in the beginning, said Park. He added that patients may need to be treated for months.
The FDA is urging anyone who has experienced problems following an injection with the NECC product, to report it to MedWatch, the FDA’s voluntary reporting program, by phone at 1-800-FDA-1088 or online at www.fda.gov/medwatch/report.htm.
CNN’s Miriam Falco contributed to this report.