Add Maryland to the list of states hit by a deadly nationwide outbreak of Salmonella Poona bacteria linked to imported cucumbers. The outbreal has sparked recalls and led to four known deaths. A resident of Maryland was recently confirmed to have the bacteria, the Baltimore Sun reported Wednesday. So far, 732 people have been sickened by the bacteria, and 150 have been hospitalized, according to the U.S. Centers for Disease Control and Prevention.

The outbreak began in September after Custom Produce Sales recalled all cucumbers sold under the label of “Fat Boy" dating back to Aug. 1, 2015, saying the produce “may be contaminated with Salmonella.” At the time, it said the recall was “associated” with a Salmonella Poona outbreak that had struck 341 people and killed two.

The company Andrew & William Fresh Produce also recalled cucumbers sold under the label of “Limited Edition.” Some of those cucumbers had been sold to Custom Produce Sales.

The cucumber in question is often known as a slicer or an American cucumber, and the recalled versions were grown in the Mexican state of Baja California. It is typically dark green and seven to 10 inches long. These cucumbers were distributed in at least 35 states, although “further distribution to other states may have occurred,” the CDC said. Cucumbers grown in the United States were not believed to have caused cases of salmonella in this outbreak, the agency said.

Salmonella are bacteria that can cause diarrhea, fever, vomiting and abdominal cramps. In people with weaker immune systems, or in young children and the elderly, it can be fatal. It is estimated to cause some 380 deaths in the U.S. every year, according to the CDC.

Although the outbreak began in September, cases continue to emerge because testing to confirm the illness takes time. "There is often a delay from when someone is exposed to when they get symptoms and they get tested," Dr. Lucy Wilson, a physician at the Maryland Department of Health and Mental Hygiene, told the Baltimore Sun.