Updated

Two more people in the United States have died from a listeria outbreak caused by tainted cantaloupes linked to a Colorado farm, bringing the death toll to 23 across 12 states, health officials said.

Deaths from the largest U.S. food-borne listeria outbreak in over two decades have now reached Louisiana where the Centers for Disease Control and Prevention said two people had died. Deaths had previously been reported in Colorado, Indiana, Kansas, Maryland, Missouri, Nebraska, New Mexico, New York, Oklahoma, Texas and Wyoming.

The death toll from the outbreak now exceeds the number who died from a multi-state listeria outbreak linked to hot dogs and deli turkey from a Michigan processor that started in 1998 and stretched into 1999.

Prior to that in 1985, listeriosis killed 48 people in a California outbreak linked to inadequately pasteurized soft cheese in the largest outbreak on record.

Some 116 people from 25 states have been sickened in the current outbreak. Because listeria can cause illness as long as two months after a person has consumed contaminated food, health officials have warned that the cases of illness related to the cantaloupes likely will rise through October.

The Food and Drug Administration announced that Jensen Farms in Colorado had issued a voluntary recall of its Rocky-Ford brand cantaloupes in mid-September.

"Cantaloupes that are known to not have come from Jensen Farms are safe to eat," the CDC said on Wednesday in a statement. Consumers should ask the grocery store if they have doubt about a cantaloupe's source, the agency said.

Listeria monocytogenes is a frequent cause of U.S. food recalls in processed meats and cheeses, but contamination in fresh produce is a new and worrisome development.

People most at risk are the elderly, pregnant woman and people with a weakened immune system, such as those who have had organ transplants or cancer.

Symptoms include fever and muscle aches, sometimes preceded by diarrhea and other gastrointestinal problems.