Health officials blame the growing meningitis outbreak on tainted steroid shots used for pain relief. They say the shots are now responsible for 105 meningitis cases. The death toll has now reached eight, after another person died in Tennessee. The contaminated shipments from a compounding pharmacy in Massachusetts have gone to 23 states. So far, Missouri is not known to have received any of the tainted drugs, but experts say they would not be surprised if more victims come forward. Compounding pharmacies combine medicines to make customized drugs, and those shops are not rare. In fact, more then ten percent of drugs given at home come from compound pharmacies that are not regulated by the Food and Drug Administration. The U.S. Centers for Disease Control's confirmed meningitis cases do not include Missouri, but concern for the outbreak has hit home here. Doctors at Columbia Orthopaedic Group said Monday, patients are calling, concerned they could be at risk for the outbreak. That company gets its spinal injections from a national pharmaceutical company that is subjected to FDA guidelines, and doctors say that means there is less room for error. Dr. J. Camp Newton is a pain specialist at Columbia Orthopaedic Group who gives between ten and 15 spinal injections every day. He says these injections are generally very safe. "Once it's manufactured and put into a sterile bottle, there's nothing getting in there," Newton said. But risks do exist when drugs come from a compounding pharmacy. "If it's preservative-free, it needs to be single-dose, because once a needle has entered the vile, you can potentially introduce a contaminate in there," Newton said. Preservative-free injections, like the contaminated batch of steroids, are more likely to become infected. "Mold and fungus like water... in an aqueous environment, it's possible that it'll grow without preservatives," said Ann Bromstedt, a pharmacist at Kilgore's Medical Pharmacy in Columbia. She says her drug store is compliant with one of the country's most-regulated pharmacy boards. According to Bromstedt, pharmacists at Kilgore's take lengthy steps to prevent any potential contamination. "We quarantine it, and we send a sample off to one of our laboratories," she said. Being highly regulated, their compounded medicines are tested for bacteria, fungus, mold potency before being given to patients. Bromstedt said, "in approximately a week's time, we get our results back, and that tells us whether or not we can dispense it." Right now, guidelines for compound pharmacies vary from state to state. Bromstedt says those procedures have prevented Kilgore's from ever having to recall a medicine. The pharmacy where the contaminated shots originated has voluntarily surrendered its license to operate until the FDA completes its investigation into the contamination. Over the weekend, the number of meningitis cases jumped by nearly 30 people in just one day. Thousands of patients were potentially infected, so the number of cases is expected to grow. Fungal meningitis is unlike viral and bacterial meningitis, and it is not contagious. The symptoms, like headache, fever, nausea and stiffness of the neck are similar.