Meningitis bacteria (Sanofi Pasteur, Creative Commons)

Investigators from the Food and Drug Administration are looking at 23 states to track a meningitis outbreak that already killed five people. The outbreak is confirmed in six states, and now the FDA wants to see if it is spreading across the United States.

The outbreak is believed to be caused by steroid injections used to treat back pains in patients. The first cases originated in Tennessee, which is where three of the five fatal cases were in. The other two deaths occurred in Maryland and Virginia, respectively. The Center for Disease Control says that there are a total of 35 cases.

The FDA is investigating the New England Compounding Center, which makes the injections linked to the outbreak. The company recalled its injections, but Massachussetts' Health Department said that tens of thousands of vials were shipped out since July. The investigation is now looking into states around the continental United States to see if there are any cases of meningitis there.

Meningitis is a disease caused when the membranes around the brain and spinal cord are inflamed. This can be fatal in certain cases. The disease can come from viral, fungal and bacterial infections. Investigators believe that the steroids were contaminated with a fungal strain which led to the inflammations in those injected. They also found a “foreign material” in another sample of the steroid, according to the Guardian.

The FDA and doctors are trying to contact any patient who was injected with the steroid. The CDC called the type of meningitis that the steroids are linked to “severe” and said it is taking precautionary measures to prevent further outbreak.

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