At least nine people died from a listeria infection from Boar’s Head sausages, which was linked to a massive recall Last month, federal health officials said Wednesday.

The number of deaths from food poisoning is two in South Carolina and one each in Florida, New Mexico, Tennessee and New York, the US Centers for Disease Control and Prevention said. Three deaths among people were previously confirmed in Illinois, New Jersey and Virginia.

At least 57 people have been sickened and hospitalized as a result of the outbreak. Cases of illness were reported beginning in late May and continued into August, the agency said. It is the largest listeria outbreak in the U.S. since 2011, and Boar’s Head has recalled more than 7 million pounds of deli products.

Listeria infections are caused by a hardy strain of bacteria that can survive and even thrive in refrigeration. An estimated 1,600 people get Listeria food poisoning each year and about 260 die from it, according to the CDC. Infections can be difficult to pinpoint because symptoms can appear quickly — or up to 10 weeks after eating contaminated food.

The infections are particularly dangerous for elderly people, pregnant women or people with weakened immune systems.

The problem was discovered when a sample of Boar’s Head liver sausage collected by health officials in Maryland tested positive for listeria. Further testing showed it was the same strain of bacteria that causes illness in people.

Boar’s Head officials originally recalled liverwurst and other products intended for slicing at delis with expiration dates between July 25 and August 30. On July 29, the recall was expanded to include all food products manufactured at the company’s Jarratt, Virginia, plant. The products included those sliced ​​at deli counters as well as some prepackaged retail sausages, frankfurters and bacon.

All recalled delicatessen meat have been removed from stores and are no longer available, Boar’s Head officials said on the company’s website. The products were distributed to stores nationwide, as well as in the Cayman Islands, Dominican Republic, Mexico and Panama, U.S. Department of Agriculture officials said.

CDC officials urged consumers to check their refrigerators for the recalled products. Look for EST. 12612 or P-12612 within the USDA inspection mark on product labels, some of which have expiration dates extending into October. Discard recalled foods and thoroughly clean and disinfect the refrigerator and other surfaces they have touched.

Many illnesses caused by food poisoning are short-lived, but an infection with listeria can have devastating consequences.

In Virginia, Gunter “Garshon” Morgenstein of Newport News died on July 18 from a brain infection caused by listeria bacteria, an illness proven to be linked to the contaminated Boar’s Head products.

Morgenstein, 88, was a German-born Holocaust survivor who moved to Canada and then the United States as a young man and later became a flamboyant hairdresser, according to his son, Garshon Morgenstein. During his 70-year career, his father styled celebrities such as singer Tom Jones and was known for his fun, outgoing personality, Garshon Morgenstein said.

Gunter Morgenstein enjoyed liverwurst, usually on bagels, and bought it regularly. He insisted on the Boar’s Head brand because he considered it to be top quality, his son said.

He became ill in early July and was hospitalized on July 8. Eventually he became so ill that doctors said he had permanent brain damage and was unlikely to recover. Family members stopped life support, his son said.

After Morgenstein’s death, a review of receipts revealed that he had purchased the recalled deli meat linked to the outbreak on June 30. The family has hired an attorney, Houston-based Ron Simon.

“It’s really just a senseless accident and a tragedy for something that just should never have happened,” his son said. “He had many good years ahead of him.”

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