Nine more people have been diagnosed with fungal meningitis linked to possibly tainted vials of a steroid medication, the U.S. Centers for Disease Control and Prevention said on Monday, bringing the total number of cases to 212.

The CDC said there were two additional cases of infection in joints after a steroid injection but these were not confirmed as meningitis, bringing the total number of infections nationwide to 214.

The death toll from the unprecedented outbreak was unchanged at 15, the CDC said.

Pennsylvania was the latest state to report an initial case of meningitis, bringing to 15 the number of states with cases.

The nine new cases included five in Michigan, two in Ohio, one in Minnesota and the first cases in Pennsylvania.

The outbreak has turned into a major health scandal after a company based in Massachusetts shipped vials that may have been tainted to 23 states and 76 medical facilities. The scare has prompted multiple investigations and the company, New England Compounding Center, has recalled the product and suspended operations.

(Reporting by David Bailey; Writing by Greg McCune; Editing by Paul Thomasch)

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(Reuters)