Tennessee health officials have found two new cases of fungal meningitis, bringing the total in the Nashville area to 13. The state has also begun using the word “outbreak” to describe the situation.

All of the patients identified so far received steroid injections at a St. Thomas Hospital outpatient clinic, which has closed as a precaution.

Chief Medical Officer David Reagan says only one case has been absolutely verified to be the deadly pathogen, but he says suspicions continue to be confirmed.

“We feel like we have enough cases and enough commonality between the cases. We’ve had 24 more hours to look at the information we have available, and we feel comfortable at this point saying it’s an outbreak.”

Health officials still aren’t sure what’s to blame, but they’re assuming it’s the injectable steroid. A pain clinic in Crossville was also using the same steroid, raising the total number of potentially exposed to nearly a thousand in Tennessee.

The drug-maker has not been identified, but state officials say the company has voluntarily issued a recall.

CDC on the Ground

Officials from the Centers for Disease Control have arrived in Nashville to get a handle on the outbreak.

Dr. Marion Kainer with the Tennessee Department of Health says the CDC pathogen experts will support what has become a round-the-clock investigation.

“They will also be looking as to the course of the illness and the medications to see if we can learn anything from that to assist other patients here in Tennessee or if there should be other patients elsewhere.”

State health officials say those who did not receive epidural steroid injections have nothing to worry about.

Those who’ve been infected are being treated at hospitals around the Nashville area. Some are in critical condition, but others are improving. At least one has gone home from the hospital.