By The Associated Press

Published: Wednesday, October 3, 2012, 7:45 p.m.
Updated: Wednesday, October 3, 2012

NASHVILLE — An outbreak of a rare and deadly form of meningitis has sickened 26 people in five states who received steroid injections, said health officials on Wednesday. Four people have died.

Eighteen of the cases are in Tennessee, where a Nashville clinic received the largest shipment of the steroid suspected in the outbreak. The drug — commonly prescribed for back pain —was manufactured by New England Compounding Center in Massachusetts, which has issued a recall.

Three cases have been reported in Virginia, two in Maryland, two in Florida and one in North Carolina. Two of the deaths were in Tennessee; Virginia and Maryland had one each, said the Centers for Disease Control and Prevention.

More cases are expected to surface, said Tennessee Department of Health.

Investigators have been looking into at least three products used for the back injections that could have been tainted by the fungus that appears to be behind the illnesses.

None of the products have been ruled out, they said.

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