The effects of a listeria outbreak that began on July 19 have continued to grow and now include one death in Tennessee.

A total of 18 states have reported cases of listeria. There have been 57 hospitalizations as a result of the outbreak. The most recent update from the Centers for Disease Control included a single case and death in Tennessee among six other deaths.

The outbreak has been tied to Boar’s Head liverwurst products. Of these products, 7.2 million pounds of deli meats have been recalled. There is a class-action suit was filed against the company in early August.

Here is what to know about the outbreak.

Is Tennessee part of the listeria outbreak?

Tennessee is now officially a part of the outbreak. The CDC announced there were six new deaths and 14 new cases from the outbreak. Of these deaths, one occurred in Tennessee.

South Carolina has the most deaths with two. There have been nine deaths in total from this outbreak. According to the CDC, this is the largest listeriosis outbreak since a 2011 outbreak linked to cantaloupe.

States affected by the outbreak are:

• Arizona: 1 case
• Florida: 3 cases, 1 death
• Georgia: 2 cases
• Illinois: 1 case, 1 death
• Indiana: 1 case
• Maryland: 8 cases
• Massachusetts: 3 cases
• Minnesota: 1 case
• Missouri: 3 cases
• New Jersey: 5 cases, 1 death
• New Mexico: 1 case, 1 death
• New York: 17 cases, 1 death
• North Carolina: 1 case
• Pennsylvania: 2 cases
• South Carolina: 2 cases, 2 deaths
• Tennessee: 1 case, 1 death
• Virginia: 4 cases, 1 death
• Wisconsin: 1 case

What brands are involved in the listeria outbreak?

Products under recall will be under the brands Boar’s Head and Old Country labels. The recall was expanded on July 30 to include 71 total products that were produced between May 10 and July 29. Products will have sell by dates ranging from July 29 to Oct. 17, 2024.

The original list of recalled items included these Boar’s Head products.

• Virginia Old Fashioned Ham with sell by date of Aug. 10.
• Italian Cappy Style Ham with sell by date of Aug. 10.
• Extra Hot Italian Cappy Style Ham with sell by date of Aug. 10.
• Bologna with sell by date of Aug. 10.
• Beef Salami with sell by date of Aug. 10.
• Steakhouse Roasted Bacon Heat and Eat with sell by date of Aug. 15.
• Garlic Bologna with sell by date of Aug. 10.
• Beef Bologna with sell by date of Aug. 10.

Boar’s Head facility caused outbreak with insects, mold an mildew

The Department of Agriculture found insects, mold and mildew at the Boar’s Head plant in Virginia linked to the listeria outbreak. There were a total of 69 “noncompliances” filed by the USDA’s Food Safety and Inspection Service inspectors over the past year.

Among the “noncompliances” listed in the records CBS News acquired from the USDA:

• July 25, 2024: A flying insect was spotted near a rack holding 980 pounds of Tavern Ham.
• July 23, 2024: An inspector found what “appeared to be black mold and mildew” and rust underneath hand washing sinks.
• July 17, 2024: Three dead insects found in the Cure Cooler and several more, two of which were alive, in the facility.
• June 10, 2024: “Approximately 15-20 flies were observed going in and out of the 4 vats of pickle left in the room” (on the plant’s “raw side”). Also found in other parts of the plant were “small flying gnat like insects were observed crawling on the walls and flying around the room,” plus “a steady line of ants … traveling down the wall floor junction on the right side of the room” and 7 ladybugs, 1 beetle-like insect and 1 cockroach-like insect.
• February 21, 2024: “Ample amounts of blood in puddles on the floor” in the Raw Receiving cooler. “There was also a rancid smell in the cooler.”

What are the symptoms of listeria?

Symptoms of listeria typically start one to four weeks after eating contaminated foods. The people at most risk from listeria are those who are pregnant, over 65 or have a compromised immune system.

According to the USDA, symptoms include:

• Fever
• Muscle aches
• Headache
• Stiff neck
• Confusion
• Loss of balance
• Convulsions
• Diarrhea
• Other gastrointestinal symptoms
• Miscarriage, stillbirth, premature delivery and/or life-threatening infection of newborn infants
• Death

What foods are most likely to be contaminated with listeria?

The foods most likely to develop listeria are:

• Unpasteurized soft cheeses
• Unheated cheeses sliced at a deli
• Unheated deli meat such as cold cuts, hot dogs and fermented or dried sausages
• Premade deli salads such as coleslaw and potato, tuna or chicken salad
• Refrigerated pate or meat spreads
• Refrigerated smoked fish
• Raw or lightly cooked sprouts
• Cut melon left out for more than two hours
• Cut melon in the refrigerator for more than a week
• Raw or unpasteurized milk, yogurt and ice cream

USA TODAY contributed to this report.