RALEIGH — State and federal officials said Monday that they were notifying even more heath care providers – including three doctors’ offices in Raleigh – that they may have dispensed contaminated medication from the company linked to a national outbreak of fungal meningitis.

The N.C. Department of Health and Human Services is working with state and federal partners to tell health care providers and the public of new recommendations by the federal Food and Drug Administration regarding the safety of medications produced by the New England Compounding Center.

NECC has been tied to a multi-state outbreak of meningitis and other fungal infections among 297 patients identified so far who received a steroid injection with a contaminated NECC product.

Among those were two North Carolina residents, one of whom has died.

All North Carolina patients who received the injectable steroid products have been individually contacted and referred for care if needed.

Eye, heart surgery drugs

On Monday, though, the FDA recommended that providers notify not only patients who have been administered injectable medication, but also those who received certain drugs used in eye surgery or certain kinds of heart surgery. The drugs were produced by NECC on or after May 21.

The state health department and the N.C. Board of Pharmacy are working together to contact providers in North Carolina that received the medications.

“We urge providers to respond to this new guidance from the FDA so that anyone who may be experiencing problems related to these products may be evaluated promptly by a physician,” State Health Director Laura Gerald said in a statement. “At the same time, we want to make the public aware that the Centers for Disease Control has not confirmed any infections caused by exposure to other NECC products.”

All medications produced by NECC were recalled on Oct. 6, following the outbreak. The FDA, the Centers for Disease Control and Prevention and state health officials are working to understand if any other products, beyond the steroid product known to be associated with meningitis and joint infections, were contaminated and pose a risk to patients.

A list of 36 health care facilities in North Carolina that received NECC products produced on or after May 21 is online at www.fda.gov/Drugs/DrugSafety/FungalMeningitis/.

The FDA has also set up an information line at 855-543-3784.