INDIANAPOLIS (AP) – A state health official says Indiana now has 11 cases of fungal meningitis linked to a tainted back pain medication.

State Department of Health spokesman Ken Severson said Monday the latest total is up from eight known cases previously. There have been no Indiana deaths.

Indiana’s cases involve patients at six Indiana health facilities that received a recalled steroid produced by a specialty pharmacy in Massachusetts.

Elkhart’s OSMC Surgery Center is one of the six clinics. CEO Don Hammond says the “anxiety of our patients is pretty high” as they wait to learn whether they have meningitis. He said previously two of its patients have been hospitalized with it.

The outbreak has spread to at least 105 people in nine states. At least eight have died. The disease isn’t contagious.