The known number of people with fungal meningitis in a multistate outbreak that has already killed seven rose to 91 on Sunday from 64 on Saturday, according to data provided by the U.S. Centers for Disease Control and Prevention.

Fungal meningitis is both noncontagious and quite rare, the CDC said.

The current outbreak is associated with epidural steroid injections, the U.S. Food and Drug Administration said on Friday. “Investigation into the exact source of the outbreak is still ongoing,” the FDA said, “but the outbreak is associated with a potentially contaminated medication.”

This medication is preservative-free methylprednisolone acetate (80mg/ml), an injectable steroid compounded and distributed by the New England Compounding Center, or NECC, in Framingham, Mass., the FDA said.

The CDC’s interim data indicate all infected patients were injected with this medication, the FDA said.

The medication is commonly employed as a painkiller, Bloomberg News reported.

The outbreak led the privately held New England Compounding Pharmacy Inc. to announce on Saturday a voluntary recall of all products currently in circulation that were compounded at and distributed from its NECC. “This action is being taken out of an abundance of caution due to the potential risk of contamination,” the company said in a statement.

According to the CDC, the NECC’s preservative-free methylprednisolone acetate (80mg/ml) has been distributed to health-care facilities in 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. (Click here for a list of these facilities.)

Because Massachusetts Department of Public Health data indicate the NECC shipped 17,676 vials of the product to these facilities between July and September, authorities have said the steroid could have already been injected in thousands of patients, Reuters reported.

Below is the CDC’s breakdown of known cases of fungal meningitis (and deaths) linked to epidural steroid injections state by state, as of Sunday:

Tennessee: 32 cases (3 deaths)

Michigan: 20 cases (2 deaths)

Virginia: 18 cases (1 death)

Indiana: 8 cases

Florida: 4 cases

Maryland: 3 cases (1 death)

Minnesota: 3 cases

North Carolina: 2 cases

Ohio: 1 case