Public health officials say four people in New Hampshire have been diagnosed with fungal meningitis.

The cases involve three men and one woman, all between the ages of 40 and 60. Officials said all cases are under care and are being monitored.

WMUR-TV says New Hampshire's cases are related to the nationwide fungal meningitis outbreak, which has been linked to a steroid medication produced by the New England Compounding Center in Framingham, Mass.

New Hampshire Public Health Director Dr. JosDe Montero says it's been a very difficult time for patients and health care providers affected by the outbreak

In New Hampshire, the medication believed to be related to the outbreak was distributed to Pain Care LLC's locations in Somersworth, Merrimack and Newington