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This story originally appeared on 6abc.
The Centers for Disease Control and Prevention (CDC) is warning Americans about a listeria outbreak that has sickened more than two dozen people across 12 states, believed to be linked to deli meat.
As of Friday, 28 people have fallen ill — all of whom have been hospitalized — and two people have died, one from Illinois and one from New Jersey, according to the federal health agency.
New York is the state with the most cases at seven, followed by Maryland with six. States that have also reported cases include Illinois, Georgia, Massachusetts, Minnesota, Missouri, New Jersey, North Carolina, Pennsylvania, Virginia and Wisconsin.
“The true number of sick people in this outbreak is likely higher than the number reported, and the outbreak may not be limited to the states with known illnesses,” the CDC wrote in its update on Friday. “This is because some people recover without medical care and are not tested for Listeria. In addition, recent illnesses may not yet be reported as it usually takes 3 to 4 weeks to determine if a sick person is part of an outbreak.”
The CDC said it and its partners, including the U.S. Department of Agriculture’s Food Safety and Inspection Service (USDA-FSIS), are collecting data to determine the source of the outbreak. Many of the patients in this outbreak reported eating meats sliced at deli counters before falling ill.
There is currently no information indicating that people are getting sick from prepackaged deli meats.
“Of the 18 people able to be interviewed, 16 reported eating meats sliced at a deli, most commonly deli-sliced turkey, liverwurst and ham. Meats were sliced at a variety of supermarket and grocery store delis,” the CDC wrote.
Cases have been reported between May 29 and July 5, CDC data shows. Patients’ ages range from 32 years old to 94 years old with a median age of 75. A total of 72% of patients identify as white with 23% identifying as Black or African American and 5% as Asian.
When people eat food contaminated with the bacterium Listeria monocytogenes, it can cause a serious infection known as listeriosis. This can progress to invasive listeriosis, when the bacteria spread beyond the gut to other parts of the body, according to the CDC.
Symptoms of severe illness usually begin one to four weeks after eating the contaminated food but can start as early as the same day or as late as 70 later, the CDC said.
An estimated 1,600 people get listeriosis annually and about 260 people die. Those most at risk include pregnant people and newborns, adults aged 65 or older and people with weakened immune systems.
Those who are not pregnant are likely to experience symptoms such as fever, headache, muscle aches, fatigue, stiff neck, confusion or loss of balance. Those who are pregnant are likely to experience just a fever and flu-like symptoms.
The CDC recommends those at higher risk of listeriosis to avoid eating meat sliced at deli counters unless heated to an internal temperature of 165 degrees Fahrenheit or until steaming hot just before serving. The agency also recommends calling your health care provider if you have symptoms of listeriosis and recently ate meat sliced at a deli counter.