Dozens of people in multiple states had contracted infections from puppies sold through the national pet store chain Petland, the Centers for Disease Control and Prevention announced this week.

As of Oct. 3, 55 people in the U.S. have fallen ill due to a Campylobacter infection and thirteen have been hospitalized.

The outbreak was first reported by the CDC on Sept. 11. Last month, 39 people reported having the infection in Florida, Kansas, Missouri, Ohio, Pennsylvania, Tennessee, and Wisconsin. The number of states has now risen to 12: Florida, Kansas, Maryland, Missouri, New Hampshire, New York, Ohio, Pennsylvania, Tennessee, Utah, Wisconsin and Wyoming.

Out of the 55 cases, 14 involved petland employees in five states, while 35 people got sick after buying a puppy at Petland, visiting the store or visiting or living in a home with a dog purchased through the pet store chain. One person contracted the infection after sexual contact with an individual who was already sick, four others fell ill after being exposed to puppies from various sources and one person got sick from an unknown puppy exposure, the CDC said.

The ages of those who got sick range from a baby less than one-year-old to 86 years. The infection has not killed anyone affected in the outbreak, the CDC said.

The CDC, along with the U.S. Department of Agriculture Animal and Plant Health Inspection Service, the Ohio Department of Health and several other states are still investigating the matter.

Petland said it is cooperating with the CDC’s investigation. In a statement the company said:

“The CDC has no new recommendations for Petland but continues to advise that Petland reinforces proper hand sanitization before and after playing with any of our puppies with the many sanitation stations in each store and continues to follow Petland’s strict kennel sanitation procedures and protocols put in place by consulting veterinarians. Since the initial contact, Petland has re-doubled its efforts in educating staff and customers about proper hand sanitization.”

Symptoms Of Campylobacter Infection

Campylobacter can cause violent diarrhea, fever, stomach cramps, nausea and vomiting. Most people with the infection begin showing symptoms two to five days after being exposed to the bacteria and could continue their symptoms for about a week.

People with weak immune systems, children younger than five years, the elderly and pregnant women could suffer a severe infection when exposed to the bacteria.

The infection can spread through contact with a dog’s poop. Campylobacter usually doesn’t transfer from one person to another, but it can be passed on in some instances, like sexual contact and changing the diaper of an infected individual.

The CDC warns that the infection can be passed from dogs regardless of where they have been purchased or adopted.

The agency recommends that people who are looking to buy or adopt a dog:

  • Pick a puppy or dog that is bright, alert, and playful. Puppies and dogs should have shiny, soft fur that is free of poop (feces).

  • Take your new puppy or dog to the veterinarian for a health check-up within a few days to a week after adoption.

To prevent the infection, people should wash their hands frequently, take their dog to the vet regularly and pick up after their canine, especially in areas where children might be in. People shouldn’t let pets lick around their mouth, face, open wounds or areas with broken skin, the CDC recommends.