Four times more people in twice as many states have been infected with salmonella in less than a month, the Centers for Disease Control and Prevention in Atlanta reported this week.

The CDC has linked the infections to contact with backyard poultry, namely chickens and ducklings.

On May 16, 52 people in 21 states had been infected, the CDC announced. Thursday, the CDC said 227 more people in 20 additional states have been added to its investigation. Four salmonella serotypes have also been added.

» Salmonella outbreak in 21 states linked to backyard chickens

Of the 279 now infected, 40 have been hospitalized, but no deaths have been reported. Seventy cases affect children younger than 5, the CDC said.

So far, infections have been found in all states except Georgia, Alaska, Delaware, Florida, Hawaii, New Hampshire, New Jersey, New York and North Dakota.

In interviews, people said they got their chicks and ducklings from agricultural stores, websites and hatcheries.

This is not the first time a salmonella outbreak has been linked to our feathered friends. In July 2018, the CDC discovered 212 salmonella cases in 44 states linked to backyard poultry.

» More people infected with Salmonella from pet hedgehogs, CDC warns

There are many ways people can be infected by fowl.

Poultry might have salmonella germs in their droppings, and on their feathers, feet and beaks, even when they appear healthy and clean, the CDC states on its website. The germs can get on cages, coops, feed and water dishes, hay, plants, and soil. Germs also can get on the hands, shoes and clothes of people who handle or care for poultry.

» Can you raise chickens in your Atlanta backyard?

Infection can be prevented, however. The CDC recommends the following safety tips:

  • Always wash your hands with soap and water right after touching backyard poultry or anything in the area where they live and roam. Adults should supervise handwashing by young children. Use hand sanitizer if soap and water are not readily available.
  • Don't let backyard poultry inside the house, especially in areas where food or drink is prepared, served, or stored.
  • Set aside a pair of shoes to wear while taking care of poultry and keep those shoes outside of the house.
  • Children younger than 5, adults over 65, and people with weakened immune systems shouldn't handle or touch chicks, ducklings, or other poultry.
  • Don't eat or drink where poultry live or roam.
  • Don't kiss backyard poultry or snuggle them and then touch your face or mouth.
  • Stay outdoors when cleaning any equipment or materials used to raise or care for poultry, such as cages, or feed or water containers.
  • For a complete list of recommendations, visit the Healthy Pets, Healthy People website section on backyard poultry.

» CDC warns consumers not to wash raw chicken

» E. coli outbreak sickens dozens in 5 states, including Georgia, CDC says