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    Two more die in nationwide meningitis outbreak

    The Centers for Disease Control and Prevention said Saturday that two more people have died and an additional 13 people have been diagnosed with fungal meningitis in the United States, bringing the death total to 23 and the number of cases to 284.

    The two new deaths were in North Carolina and Tennessee, according to the agency, which did not identify the victims.

    In New Hampshire, two more people were diagnosed, bringing the number of those diagnosed in the state to 10. Virginia, New Jersey, and Tennessee each saw three additional diagnoses. Indiana now has two additional cases.

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    The outbreak has reached 16 states with 284 cases, including 23 deaths.

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    The victims had received steroid shots, mostly to treat back pain.

    The injectable steroid was were made by a specialty compounding pharmacy in Fram­ing­ham.

    The infection is caused by the inflammation of the protective membranes covering the brain and spinal cord.

    Alli Knothe can be reached at aknothe@globe.com.