By CHARLES WILSON

Associated Press

INDIANAPOLIS (AP) - Indiana now has a dozen cases of fungal meningitis linked to a tainted back pain medication, though no deaths have been reported in the state, federal health officials said Tuesday.

The Centers for Disease Control and Prevention said another confirmed case was added to the 11 previously known. Nationwide, the number of people sickened by the outbreak has now reached 119 cases, including 11 deaths, the agency said.

Indiana's cases involve patients at six Indiana health facilities that received a recalled steroid produced by a specialty pharmacy in Massachusetts. The clinics are in Elkhart, Evansville, Fort Wayne, South Bend, Terre Haute and Columbus.

OSMC Surgery Center CEO Don Hammond said last week that two of the Elkhart clinic's patients have been hospitalized with the rare illness.

About 1,500 people in Indiana were known to have received injections of the drug, said Indiana State Department of Health spokeswoman Amanda Turney. But she said she could not divulge further details due to privacy laws.

The steroid is often used to treat back pain. Meningitis is an inflammation of the lining of the brain and spinal cord, and a back injection would put any contaminant in more direct contact with that lining.

Symptoms on meningitis include severe headache, nausea, dizziness and fever. The CDC said many of the cases have been mild and some people had strokes. Symptoms can appear between one and four weeks after patients got the shots.

Retired high school athletic director Joe Dippel said he received a call last week from the Indiana clinic where he received two spinal injections informing him he may have been exposed. Dippel said he got the steroid shots in July and August at St. Mary's Surgicare Cross Pointe clinic, after severe back pain from an unknown injury kept him in bed for weeks.

He went to the hospital Sunday with chills and was given a spinal tap to test for the rare illness, but was told he wouldn't know the results for about two weeks. The clinic told him to contact them if he showed any symptoms, but it could take as long as three months for them to show up.

"They told us, 'Don't come back unless you have those symptoms,'" Dippel said Tuesday. "Because if you don't have symptoms, it would be useless to come in."

He said he has an appointment with an infectious disease specialist Wednesday. But he said he wasn't worried.

"I function normally, but I'm aware of the symptoms and if I have any new symptoms evolve, I'll go back," he said.

The type of meningitis involved in the outbreak is not contagious. It is caused by a fungus often found in leaf mold and is treated with high-dose antifungal medications, usually given intravenously.

The pharmacy involved, the New England Compounding Center of Framingham, Mass., recalled a total of 17,676 single-dose vials of methylprednisolone acetate that was sent to clinics in 23 states, and later recalled everything it makes.