For those entangled in the deadly meningitis outbreak tearing through the U.S., there’s no shortage of bad news. Three more patients have been declared dead—two from Michigan and one from Tennessee—bringing the total death toll to 28, reports Reuters. According to a report from the Centers for Disease Control released Tuesday, total cases of fungal meningitis have risen to a staggering 356 people. The source of the infection, steroid injections supplied by the New England Compounding Center, means there could be more cases yet discovered. Investigations are underway of the conditions in the facility, where the steroids originated, which recent reports have deemed unsanitary.