AlQa'dah 22, 1433, Oct 8, 2012, SPA - U.S. health officials on Sunday reported an additional 27 cases in a fungal meningitis outbreak linked to steroid injections that has killed seven people and now affected 91 in nine states, according to Reuters. The U.S. Centers for Disease Control and Prevention (CDC) reported a new total of 91 cases in an update on its website, up from 64 on Saturday. Most of the new cases were reported in Michigan, where the total increased to 20 from five. Virginia's total increased to 18 from 11. The widening outbreak has alarmed health officials across the United States and focused attention on regulations of pharmaceutical compounding companies like the one that produced the drugs, the New England Compounding Center Inc in Framingham, Massachusetts. The company shipped 17,676 vials of the steroid methylprednisolone acetate to 76 facilities in 23 states from July through September, the Massachusetts Health Department said. The steroid is used as a painkiller, usually for the back, and could have been injected in thousands of patients, authorities have said. Meningitis is an infection of the membranes covering the brain and spinal cord, and affected patients started showing a variety of symptoms from one to four weeks after their injections. The company, which was previously the subject of complaints, said it had suspended its operations while an investigation proceeds and has recalled the three lots of the drug.