Twenty-eight people have died from fungal meningitis they contracted after using suspected tainted steroid injections blamed for a growing national outbreak, a US health monitor said Tuesday.
Three more deaths were blamed on the disease since the previous update issued by the US Centers for Disease Control and Prevention (CDC) on Monday. They include two patients in Michigan and a third in Tennessee.
Nationwide, the CDC said the number of reported fungal meningitis cases rose to 356. Another seven were blamed on peripheral joint infections affecting such joints as the knee, hip, shoulder or elbow, bringing the total number of infections overall to 363.
Nineteen of the 23 states that received potentially tainted doses of the steroid from the New England Compounding Center (NECC) have reported cases. Some 14,000 people are at risk.
Authorities are investigating the NECC, saying its now defunct facility outside Boston made medications in unsanitary conditions with bacteria and mould so prevalent it could be seen with the naked eye.
Officials have said that due to the disease's long incubation period, it could be weeks or even months before authorities have a final tally of the infections from the unprecedented outbreak.
The southern state of Tennessee remains the hardest hit with 74 cases and 11 deaths, followed by Michigan with 93 cases and seven fatalities.
Other states hit badly include Florida, Indiana, Maryland, New Jersey and Virginia.
The outbreak has led to calls for tighter regulation of the loosely controlled pharmaceutical compounding industry. Federal investigators have launched a criminal probe into the case.
Critics say drug manufacturers have found a way to sidestep costly and strict oversight by classifying themselves as pharmacies, which are given freer rein to mix drug compounds for patients.