BOSTON (October 29, 2012)—A total of 354 cases of a rare fungal meningitis have now been confirmed in 19 states and at least 25 of the victims have died, the U.S. Centers for Disease Control and Prevention said Monday.

Just one case has been confirmed in Texas.

Most of the infections are linked to steroid shots for back pain.

The medication was produced by New England Compounding Center, a specialty pharmacy in Massachusetts.

Massachusetts has also shut down another compounding pharmacy over sterility concerns after a surprise inspection prompted by the nationwide meningitis outbreak.

State officials say inspectors went to the Waltham location of Rhode Island-based Infusion Resource last week and found significant issues with the environment in which drugs were being mixed.