The Centers for Disease Control reported Wednesday that the number of rare fungal meningitis cases in Tennessee has increased by five more cases to 44, but the number of deaths in the state remains at six.

Nationwide, the number of cases reported in 10 states increased to 137 cases, including 12 deaths nationwide since the outbreak was first discovered in September.

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The CDC has said the outbreak is among patients who received epidural steroid injections that were made by the New England Compounding Center, a specialty pharmacy in Massachusetts that has issued a recall for all its products.

This form of meningitis is not contagious and symptoms include fever, new or worsening headache, neck stiffness, sensitivity to light, increasing pain, and redness or swelling of the injection site.

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