MINNEAPOLIS (WCCO) — Several hundred Minnesotans got injected with a steroid linked to fungal meningitis. Dozens of them are showing meningitis symptoms, though no cases have been confirmed in our state.

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The steroid is actually a liquid that doctors inject into a patient who is suffering from chronic neck, back or knee pain.

Some 700 people in the Twin Cities got the drug from clinics between July and September. The clinics are Medical Advanced Pain Specialists and Minnesota Surgery Center Clinics.

At least 40 patients nationwide have gotten sick and five have died, and the numbers are expected to go up.

“I think the message is to take the warning seriously,” said Marsha Thiel, CEO of Medical Pain Clinics. “We’re definitely concerned about our patients. We want to be sure they have the appropriate screening. If they need to, they need to have further evaluation.”

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Staff is now calling and informing patients, along with help from the Minnesota Department of Health.

Symptoms can be subtle, like pain, fevers and headaches. They can also be stroke-like, including slurred speech, weakness and numbness. Redness and pain can also occur at the injection-site.

New England Compounding Center in Massachusetts supplied the steroids. It has recalled 18,000 vials and voluntarily shut down its manufacturing center. The Food and Drug Administration is telling doctors not to use any company products.

Fungal meningitis is a non-contagious form of meningitis. Health officials say that patients with symptoms should be evaluated promptly for potential infection. They should see their primary care doctors. Symptoms start showing a week to four weeks after injection.

“I would not be surprised if the number of cases grow as people individually talk to patients and do follow-up,” said Dr. Ruth Lynfield, State Epidemiologist.

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Someone who’s sick would get a high dose of medicine in the hospital. The earlier they’re diagnosed, the better their chance of survival.