One Texas resident is dead and four others were hospitalized in suspected cases of fungal meningitis after receiving surgery in Matamoros, Mexico, according to the Texas Department of State Health Services.

An ongoing public health investigation found the affected patients, according to a news release.

“All five patients traveled from Texas to Matamoros to get surgical procedures that involved an epidural,” a news release stated. “Health authorities in the United States and Mexico are investigating the source of the infections, whether the cases are linked, and whether there are more cases.”

The DSHS is urging those who had medical procedures in Mexico to self-monitor for symptoms of meningitis, and asks others to postpone or cancel any elective surgery involving an epidural in Matamoros.

Fungal meningitis infections are not contagious and are not transmitted person to person, according to the Centers for Disease Control and Prevention.

The news release stated meningitis is swelling of the protective covering of the brain and spinal cord that can be caused by bacteria, virus, fungus or trauma. Common symptoms include fever, headache, stiff neck, nausea, vomiting, confusion and sensitivity to light. 

“In these cases, symptoms began three days to six weeks after surgery in Matamoros, the news release added. “The patients range in age from their 30s to their 50s.”

The CDC issued a travel advisory urging those traveling to Matamoros to take enhanced precautions and avoid medical procedures involving an epidural.