ST. PAUL — The Minnesota Health Department says patients at several Twin Cities clinics were given a steroid product now linked to a widening national outbreak of a rare kind of meningitis.

The agency said in a release Thursday that it is working with Medical Advanced Pain Specialists in Edina, Fridley, Shakopee and Maple Grove, and the Minnesota Surgery Center in Edina and Maple Grove to contact the patients. The department says they are the only providers known to have used the product in Minnesota.

State officials haven’t identified any cases of the meningitis so far.

The outbreak has sickened 35 people in six states. Five have died. All had gotten steroid shots for back pain.

Federal officials are warning doctors and hospitals to avoid any product from the New England Compounding Center of Framingham, Mass.