(NBC) — It appears as though 13 people have been sickened by a rare fungal infection never before seen in the United States.

The fungus is Cdida Auris, which resists antifungal drug treatments and usually spreads in the health care settings like hospitals and nursing homes.

Seven of the cases were reported in four states – Illinois, Maryland, New Jersey, and New York.

All of those patients had underlying health problems and had been hospitalized. Four died, although it’s unclear whether the fungal infection played a role in their deaths.

Six other cases are still under investigation.

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