According to an official report from the U.S. Centers for Disease Control and Prevention (CDC) on April 23, a total of 156 people in 10 states have contracted E. coli after eating spoiled ground beef at home and in restaurants since the beginning of March this year.

There were no deaths, but 20 people were hospitalized after infection with E. coli strain O103. The Centers for Disease Control and Prevention said an investigation is ongoing to determine the source of the contaminated ground beef, which has been delivered to grocery stores and restaurants, but so far “no common suppliers, distributors or brands of ground beef have been identified.”

The investigation began March 28 when officials in Kentucky and Georgia notified the CDC of an outbreak. Since then, about 65 cases have been reported in Kentucky, 41 in Tennessee and 33 more in Georgia. Cases of Escherichia coli have also been reported in Florida, Illinois, Indiana, Minnesota, Mississippi, Ohio, and Virginia.

People infected with bacteria get sick two to eight days after a microbe enters the body, and sometimes infection can be complicated by the development of renal failure. According to the CDC, many of the infected people bought ground beef at grocery stores and used meat to cook dishes such as spaghetti sauce and slope jo.

The Centers for Disease Control and Prevention said it does not recommend consumers avoid eating ground beef at this time, but consumers and restaurants should safely handle ground beef and cook it carefully to avoid foodborne illnesses.