LANSING, Mitch. (AP) - Officials say there are at least 20 confirmed cases of meningitis in Michigan, including two deaths.

The number of cases reported Sunday was up from eight reported Saturday. The Michigan Department of Community Health says it's unable to release details about the deaths until after the weekend.

The meningitis outbreak has been linked to a steroid produced by a specialty pharmacy in Massachusetts. The steroid has been recalled, and officials have been scrambling to notify anyone who may have been injected with it.

At least four places in Michigan received shipments of the medication: Michigan Neurosurgical Institute in Grand Blanc; Michigan Pain Specialists in Brighton; Neuromuscular & Rehabilitation in Traverse City; and Southeast Michigan Surgical Hospital in Warren.

The Centers for Disease Control and Prevention reports 91 cases nationally.

The pharmacy that distributed a steroid linked to an outbreak of fungal meningitis has issued a voluntary recall of all of its products.

The New England Compounding Center announced the recall on Saturday. The company said in a news release that the move was taken out of an abundance of caution because of the risk of contamination. It says there is no indication that any other products have been contaminated.

The Food and Drug Administration had previously told health professionals not to use any products distributed by the center.

The Centers for Disease Control and Prevention say there are now more than 90 confirmed cases of the rare form of fungal meningitis. The outbreak spans nine states and has killed at least seven people.

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