RALEIGH — The Centers for Disease Control and Prevention is investigating a meningitis outbreak that has been confirmed in one patient in North Carolina and in 11 patients in Tennessee, two of which have died.

N.C. Department of Health and Human Services, which is assisting the CDC, said the outbreak is suspected to be Aspergillus meningitis, a fungal infection involving patients treated with spinal steroid injections at outpatient surgical centers and pain management clinics.

Aspergillus is not transmitted from person to person, and the source for the outbreak is not yet known. DHHS’ Division of Public Health is working with outpatient facilities to contact all North Carolina patients who received epidural steroid injections since July 1, using the same medication used in the Tennessee clinic.

The patients in the investigation were found to have negative results for the most common types of bacterial meningitis.

“We are working diligently to determine the cause of the infections and prevent additional cases,” said State Health Director Laura Gerald. “In the meantime, we strongly encourage anyone who has had this type of procedure since July 1st that may be experiencing symptoms, however mild, to talk with their doctor or other health care provider right away.”

Symptoms of meningitis may appear gradually and include headache, especially one that worsens; nausea or vomiting; sensitivity to light; fever; stiff neck; changes in mental status and confusion.

Epidural steroid injections are a common treatment for inflammation associated with low back pain, leg pain, neck pain, or neck-related arm pain and are typically given on an outpatient basis. The circumstances of this outbreak suggest a possible contamination of one of the steroid injection products, and this product has been voluntarily recalled. From staff reports