Patients became ill after receiving steroid injections linked to steroids prepared at New England Compounding Center Inc., in Framingham, Massachusetts.

Vials of steroids linked to the outbreak were shipped to 76 facilities in 23 states and could have been used to inject thousands of patients, authorities have said.

The steroid was sent to California, Connecticut, Florida, Georgia, Idaho, Illinois, Indiana, Maryland, Michigan, Minnesota, North Carolina, New Hampshire, New Jersey, Nevada, New York, Ohio, Pennsylvania, Rhode Island, South Carolina, Tennessee, Virginia, Texas and West Virginia.

The number of cases includes:

Total case count: 91

Florida: 4 cases

Indiana: 8 cases

Maryland: 3 cases, including 1 death

Michigan: 20 cases, including 2 deaths

Minnesota: 3 case

North Carolina: 2 cases

Ohio: 1 case

Tennessee: 32 cases, including 3 deaths

Virginia: 18 cases, including 1 death

Meningitis is an infection of the membranes covering the brain and spinal cord. The infected patients have shown a variety of symptoms from one to four weeks after their injections, including fever, a new or worsening headache, nausea and neurological problems.