FAYETTEVILLE, Ark. (KNWA/KFTA) — Centers for Disease Control and Prevention officials are continuing to investigate a multi-state outbreak of Salmonella linked to contact with backyard poultry flocks, according to an update released on Thursday.

195 people from 38 states, including nine in Arkansas, have contracted Salmonella from touching or carrying backyard ducks or chickens, as of May 23.

The investigation began on May 23 with 109 cases in 29 states initially reported. Arkansas has seen 4 new cases since the initial report.

No deaths have been reported, however, 50 people have been hospitalized, a jump of 17 since May 23. The CDC says 41% of those infected were under the age of 5.

Missouri has seen the highest number of cases with 23. Texas has 21, 16 in Oklahoma, and Alabama, Washington and Nebraska have 10.

Cases have yet to be reported in Alaska, Hawaii, Nevada, Michigan, Kentucky, West Virginia, Delaware, New Jersey, Connecticut, Maine, New Hampshire and Vermont. All other states have confirmed at least one case.

The CDC says Salmonella can cause symptoms that include fever, diarrhea, abdominal pain, nausea and vomiting.

The agency also said to not let children under five years touch chicks, ducklings, or other backyard poultry as younger children are more likely to get Salmonella.

For more information on what to know about the outbreak, visit the CDC’s website.