Another patient has died in Virginia after contracting fungal meningitis from potentially tainted steroid injections supplied by a Massachusetts company, the U.S. Centers for Disease Control and Prevention said on Wednesday, bringing the death toll from the outbreak to 29 nationwide.

The latest death brings to three the number of fatalities reported in Virginia. Tennessee has reported the most deaths at 11, followed by Michigan with seven.

The number of cases of fungal meningitis reported across the United States rose to 368 on Wednesday, up 12 from Tuesday, the CDC said. Nineteen of 23 states that received shipments of the steroid have reported cases.

There were also nine reported cases of infections after the steroid was injected into a joint such as a knee, hip, shoulder or elbow, bringing the total number of infections to 377.

The steroid was supplied by New England Compounding Center of Framingham, Massachusetts, which faces multiple investigations. Health authorities have said its facility near Boston failed to make medications in sterile conditions.