Seven more people have fallen ill and two more have died in an ongoing listeria outbreak linked to prepared pasta meals, according to federal health officials.

As of Oct. 30, 27 people across 18 states have been infected with listeriosis, with 25 going to the hospital. Six people have died, according to the Centers for Disease Control and Prevention (CDC), which is working alongside the Food and Drug Administration (FDA) and Department of Agriculture’s Food Safety and Inspection Service (FSIS).

The reported deaths occurred in Hawaii, Illinois, Michigan, Oregon, Texas and Utah. One pregnancy-associated illness resulted in a fetal loss.

However, the number of sick people in this outbreak is “likely higher than the number reported” due to the fact that some people recover without medical c

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