Update at 4:30 p.m.
The Michigan Department of Community Health says six cases of fungal meningitis have now been confirmed in Michigan, and the number of cases nationwide have increased to 49. Five people have died from the disease.
Spokeswoman Angela Minicuci says it has not yet been determined from which health care clinics the patients contracted the meningitis.
Minicuci says fungal meningitis cannot be transmitted from person-to-person.
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Michigan has been added to the recall of a steroid suspected in a nationwide meningitis outbreak.
Four clinics in Michigan received the medication used to treat back pain, but there have been no cases of meningitis reported in the state in connection with the drug.
According to Michigan Department of Community Health spokeswoman Angela Minicuci, the facilities are Michigan Neurological Institute in Grand Blanc, Michigan Pain Specialists in Brighton, Neuromuscular and Rehabilitation in Traverse City and the Southeast Michigan Surgical Hospital in Warren.
"The only residents who might be concerned are people who received an epidural injection at one of those clinics between July and October," Minicuci says. "We are working with the facilities to determine who received a potential injection during that time frame."
The clinics have stopped using the medication.
Minicuci says signs of meningitis can include a worsening headache, fever, stiff neck, sensitivity to light and symptoms associated with stroke, such as numbness, weakness and blurred vision.
Thirty-five cases of meningitis and five deaths have been reported nationwide in connection with the contaminated medicine.