Pennsylvania health officials said two clinics dispensed steroid shots that were shipped to the state from Massachusetts, where the national meningitis outbreak began.

The clinics are Allegheny Pain Management in Altoona and South Hills Pain and Rehab Associates.

The South Hills clinic has locations in Jefferson Hills, Bethel Park, Monessen and Brentwood.

Health officials are working with the clinics to contact patients who received the medication.

The outbreak has killed at least five people and sickened nearly 40 others in six states.

The outbreak was linked to a pharmacy in Massachusetts. 

The company recalled the medication last week.

There have been no reports of death or illnesses in Pennsylvania.