Health officials say the number of people sickened by a deadly meningitis outbreak has risen again. There are now 49 cases in seven states.
The number of deaths -- five -- has remained the same.
Tennessee, Virginia, Maryland, Florida, North Carolina and Indiana had previously reported cases. On Friday, Michigan joined the list, with six cases.
Earlier Friday, state health officials say a steroid medication suspected of causing a meningitis outbreak was shipped to four facilities in Michigan.
One of those facilities was the Michigan Neurological Institute in Grand Blanc.
While no cases of the rare kind of meningitis linked to the outbreak in six states have been reported in Michigan, state Department of Community Health spokeswoman Angela Minicuci said Friday MDCH is working with the four clinics to reach out to patients "out of an abundance of caution."
Authorities said the medication was given as an epidural and were given between July and October of 2012. Medical staff have since stopped giving out the medication to patients.
The shot was given to treat back pain. The steroid was custom-made by a specialty pharmacy in Massachusetts.
Signs of meningitis from the shot include headache, stiff neck, signs of a stroke, and fever or sensitivity to light. So far, there are no confirmed cases in Michigan at this point. The symptoms take between one and four weeks to show up. Fungal meningitis is not transmitted person-to-person.
According to Minicuci, the three other facilities that received a shipment of the medication involved in the investigation are Michigan Pain Specialists in Brighton, Neuromuscular & Rehabilitation in Traverse City and Southeast Michigan Surgical Hospital in Warren.
Nationwide, hundreds, and perhaps thousands, of people who got the shots between July and September could be at risk.
Copyright 2012 by WNEM (Meredith Corporation) and Associated Press. All rights reserved.