A third person died and 10 more people have been hospitalized in connection to an outbreak of listeria tied to Boar’s Head deli meats, said the U.S. Centers for Disease Control and Prevention (CDC).

Since late July, 43 people have been hospitalized with listeria across 13 states including Indiana, Georgia, North Carolina, Missouri, Minnesota, Illinois, Virginia, Wisconsin, New Jersey, New York, Pennsylvania, Maryland, and Massachusetts, the agency said. The recall includes more than 70 products, including liverwurst, ham, beef salami, and bologna. They were made the company’s facility in Jarratt, Virginia.

Boar’s Head faces two lawsuits over the outbreak, one in a Missouri court and the other a class action suit in federal court in New York. “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 said. “This is because some people recover without medical care and are not tested for Listeria.

” The meat was distributed to stores nationwide, as well as to the Cayman Islands, the Dominican Republic, Mexico, and Panama, said the U.S. Department of Agriculture (USDA).

“People who are at higher risk for getting sick with listeria, such as those who are pregnant, are aged 65 or older, or have a weakened immune system, should always avoid eating meats sliced at deli counters, unless heated to an internal temperature of 165 degrees F or until steaming hot.