New Jersey was the 10th state to report at least one illness. The other states involved in the outbreak are Tennessee, Michigan, Virginia, Indiana, Florida, Maryland, Minnesota, North Carolina and Ohio.
Officials tied the outbreak of rare fungal meningitis to steroid shots for back pain. The steroid was made by a specialty pharmacy in Massachusetts, the New England Compounding Center of Framingham.
Some 600 patients in California received the steroid shots, but so far, there have been no fungal meningitis cases in the state. Clinics in Encino, Palmdale and Ukiah have been contacting patients who were given the steroid for back pain.
The Central California clinic says four patients were treated for mild symptoms after receiving shots from a recalled batch, but since their symptoms could be flu, their spinal fluid is being tested.
The New England Compounding Center has recalled everything it makes.
The Associated Press contributed to this report.