U.S. federal health officials say 11 people have now died from a rare fungal meningitis outbreak linked to steroid injections.

Updating its figures Tuesday, the Centers for Disease Control and Prevention reported 119 cases of meningitis associated with the deadly outbreak.

The CDC says 13,000 people in 23 states may have been injected with the contaminated steroid suspected of causing the outbreak. But officials say they do not know how many people will actually become sick.

Patients injected with the steroid for back pain are in the greatest danger, while the CDC says those who received the shots in their joints are not believed to be at risk.

A total of 10 states have now reported at least one case of the disease. It can take as long as one month for symptoms to appear.

The CDC is working with local authorities to try to identify everyone who may have gotten the tainted steroid.

The company that made the steroid, the New England Compounding Center in Massachusetts, has recalled all of its products and shut down operations.

Meningitis is a disease infecting membranes protecting the brain and spinal cord. There are five different types. Fungal meningitis is the rarest form. Other types are caused by bacteria, a virus or a parasite.