An outbreak of pneumococcal disease has infected more than 400 patients in six states in New York, New Jersey, New Hampshire, Connecticut and Rhode Island, according to a report from the Centers for Disease Control and Prevention.
In New York City, a patient infected with the pneumococcus was hospitalized with septic shock.
Another New York patient was treated with antibiotics and later released, but the CDC said two more patients remain hospitalized with the disease.
Another case of pneumonic meningitis was reported in the New Jersey city of Camden on Friday, according the Associated Press.
A New Jersey health department spokesman said two patients with pneumonic pneumonia were treated with Tb and one patient was taken to the hospital with severe pneumonia.
An additional three cases of pneumonitis were reported in New Hampshire on Friday.
New Hampshire has been the site of several outbreaks in recent years, including an outbreak of meningococcal meningitidis in 2016.
The New Hampshire Department of Health said it has been working with state health departments to help patients and their families.
It is asking people to stay away from the city.
A doctor in Philadelphia told ABC News he believes there could be many more cases.
“I think that there’s a good chance that we have more cases in Philadelphia,” Dr. Jeffrey Schleifer told ABC affiliate WHYY.
“It’s hard to say at this point.”
Philadelphia Health and Hospitals said the hospital system has seen a significant increase in cases in the last week.
The CDC reported a total of 6,838 people have been infected with pneumococci, and more than 2,000 have died.
Of those, 1,898 have died, and the CDC estimates more than 9,000 people in the United States are at risk for pneumonic illness.
In California, health officials said an infection is not expected to be transmitted through direct contact with a patient, but a patient can still become infected through direct exposure.
Pneumonic disease can be spread through contact with fluids and mucus in the lungs.
A person with pneumonia can also spread the disease through coughing or sneezing.