Raleigh, N.C. — Eighty healthcare facilities in North Carolina have been identified as customers of a Massachusetts pharmacy linked to a nationwide meningitis outbreak, according to a list of more than 3,000 clinics made public Wednesday by the U.S. Food and Drug Administration.

About 20 percent of the clinics in North Carolina are in the greater Triangle area, including seven in Durham, three in Raleigh, two in Roanoke Rapids and one each in Oxford, Southern Pines, Pinehurst and Wilson.

The outbreak of fungal meningitis, an inflammation of the lining of the brain and spinal cord, has sickened 317 people, including 24 who have died, in 17 states, including North Carolina.

Health officials say the outbreak has to do with a steroid made by New England Compounding Company, which makes custom-mix solutions in doses or forms generally not commercially available.

Elwina Shaw, 77, of Denton, died Friday at High Point Regional Health System, where she spent nearly four weeks being treated for meningitis that, her family said, likely came from a steroid injection for back pain she received in August.

She is the only person in North Carolina to die from meningitis, but the FDA wants all customers of NECC to notify patients about any products that came from the pharmacy between May and October.

"They are approaching this with what they call an 'abundance of caution,' said Jay Campbell, executive director of the North Carolina Board of Pharmacy. "They have not identified any infections associated with any NECC product other than the initially recalled steroid lot."

State health officials say patients associated with the affected clinics should call their doctors if they have concerns and if they are not feeling well, to let their health providers know.

"I think it would be human nature to be concerned," Campbell said. "I certainly would be, but I think (patients) should, to the maximum extent possible, approach it with a calm frame of mind."

NECC, meanwhile, is under investigation by the state of Massachusetts and the federal government.

State inspectors found a number of problems at the company's facility during a preliminary investigation, including license violations and "several health and safety deficiencies."

The state has moved to permanently revoke the company's operating license, as well as the licenses of its top three pharmacists.