Packaged salads produced at a Dole Fresh Vegetables Inc. facility in Ohio have been linked to a multistate outbreak of Listeria monocytogenes infections, including one death in Michigan, according to the CDC which reported the ongoing investigation last week.

In all, 12 people in six states—Indiana, Massachusetts, Michigan, New Jersey, New York and Pennsylvania—have been infected beginning in July 2015. All of those infected were hospitalized with many reporting eating packaged salad in the days before becoming ill.

Concurrently, the Public Health Agency of Canada is working with federal and provincial health partners to investigate the source of an ongoing outbreak of seven Listeria monocytogenes infections that have been spread across five of the country’s provinces—Ontario, Quebec, New Brunswick, Prince Edward Island and Newfoundland and Labrador. Health officials say the illnesses began in September 2015 and have continued through January. The majority of the cases (71 percent) have been female, with an average age of 81 years. All the affected individuals have been hospitalized; one person died, but it has not been determined if Listeria contributed to the death. Despite no confirmed source, officials say their investigation is focusing on prepackaged leafy greens, salad blends and salad kits.

Eric Hoskins, minister of health and long-term care, and David Williams, acting chief medical officer of health, issued a joint statement:

“We are working with Public Health Ontario and our provincial partners to investigate current cases of Listeria monocytogenes infections. Some of these cases are also part of a federally led national investigation. To date, the source of these Listeriosis infections has not been confirmed. We will continue to work closely with our partners and will provide additional updates as more information becomes available. The safety of Ontarians is our top priority.”

Through its investigation, the CDC says the source of the outbreak likely points toward packaged salads produced by Dole under the names Dole, Fresh Selections, Simple Truth, Marketside, The Little Salad Bar and President’s Choice. CDC linked the outbreak to Dole after Ohio Department of Agriculture officials tested salad manufactured at the Dole Springfield, OH plant that was purchased from a retail location. The results of this test revealed listeria that was “highly related genetically” to the strain of the bacteria that made people sick.

After the CDC made its announcement, the Public Health Agency of Canada released an update announcing it is working with US officials at CDC and FDA to investigate the outbreak. The Canadian health authority issued a food recall warning to all citizens urging them not to eat any Dole products linked to the outbreak.

As a result of the outbreak, Dole has temporarily suspended all operations at the Springfield plant and is recalling all Dole branded and private label packaged salads processed at the facility from more than 20 states and three provinces in Canada. No other Dole products or facilities have been linked to the outbreak.