New Hampshire health officials on Tuesday advised consumers not to eat a particular ready-to-eat pasta due to possible contamination with listeria.

Twelve-ounce Marketside linguine with beef meatballs and marinara sauce by FreshRealm, which is subject to a recall, is distributed to Walmart stores in the Granite State, the N.H. Department of Health and Human Services said in a news release.

The recalled products have best-by dates of Sept. 22, 24, 25, 29 and 30 and Oct. 1, the news release says. The department advises people to check their freezers and refrigerators for these products and avoid eating or serving them, even if the food looks or smells normal.

The recall is part of a multistate outbreak of listeria infections that has been linked to products manufactured by FreshRealm, the release says. As of Tuesday afternoon, 20 people had gotten sick and four had died, the Centers for Disease Control and Prevention said. The state health department said that to date, no listeria infections had been reported in New Hampshire as a result of the contamination.

Nationwide, the recall is also linked to certain FreshRealm ready-to-eat pasta products sold at Trader Joeโ€™s, Albertsons and Kroger stores, according to the FDA.

Listeria is a bacterial infection that can spread through contaminated food, according to the Mayo Clinic.

Symptoms of listeria infection include fever, muscle aches, and sometime nausea and vomiting. If the infection spreads to the nervous system, symptoms can also include stiff neck, confusion, loss of balance or convulsions, according to the CDC.

Listeria infections are sometimes fatal in young children, older adults and people with weakened immune systems. Listeria infections can also cause miscarriage, stillbirth or preterm labor, the state health department said.

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