( CNN ) -- Massachusetts health officials on Tuesday ordered 11 compounding pharmacies to completely or partially shut down , after unannounced inspections were conducted in the wake of a fungal meningitis outbreak . The state 's Department of Public Health began inspecting 40 sterile compounding pharmacies after the multistate outbreak last fall was linked to steroid injections distributed by the Massachusetts-based New England Compounding Center ( NECC ) . `` Over the course of the unannounced inspections , partial or complete cease and desist orders were issued to 11 pharmacies for a range of violations , '' the health department said Tuesday . Eight of the 11 have submitted corrective plans , officials said . They must implement the corrective measures , including renovations if necessary , and pass re-inspection . Twenty-one other pharmacies were cited for minor deficiencies that have since been corrected or were `` being addressed through corrective measures , '' the department said in a statement . Some 696 illnesses and 45 deaths in 20 states were blamed on the injections as of Monday , the Centers for Disease Control and Prevention said , noting the deaths are from `` all causes among persons who meet the case definition and may not be directly attributed to a fungal infection . '' FDA warns patients to be vigilant about drugs from compounding center . The public health department in October permanently revoked NECC 's license to operate as well as the licenses of its three principal pharmacists . According to its report , state and federal investigators `` identified serious deficiencies and significant violations of pharmacy law and regulations that clearly placed the public 's health at risk . '' Federal authorities also launched a criminal investigation into practices at the company . A second compounding pharmacy surrendered its license after inspectors reported `` significant '' issues that could affect sterility , state health officials said . Following the outbreak , Massachusetts Gov . Deval Patrick 's administration launched `` a series of aggressive initiatives '' aimed at preventing a recurrence . Those include new regulations requiring sterile compounding pharmacies to report volume and distribution to the state for the first time ; the hiring of additional inspectors ; and legislation filed earlier this month creating additional regulations and requirements .
The pharmacies must partially or totally stop operations . In the case of a pharmacy that is not in compliance with this law, it can be fined up to $ 50,000 per day for each violation and face criminal prosecution if they continue operating after being Nearly 700 cases and 45 deaths are blamed on the outbreak , the CDC says .