NASHVILLE (AP) - Tennessee health officials reported that the number of cases of rare fungal meningitis has increased by five to 49 cases.

The number of deaths in Tennessee from the outbreak remained at six, according to an update posted on the state Department of Health website on Thursday. Nationwide the number of cases reported in 11 states increased to 170 cases, including 14 deaths nationwide.

The CDC has said the outbreak is among patients who received epidural steroid injections that were made by the New England Compounding Center, a specialty pharmacy in Massachusetts that has issued a recall for all its products.

This form of meningitis is not contagious and symptoms include fever, new or worsening headache, neck stiffness, sensitivity to light, increasing pain, and redness or swelling of the injection site.