An outbreak of salmonella and E. coli linked to alfalfa sprouts sickened at least 55 people across 15 states, according to health officials. Four individuals have been hospitalized.

Forty-six people contracted E. coli, seven were infected with salmonella, and two individuals had both pathogens. Illnesses began on dates ranging from May 31 to Aug. 8. Health officials said the actual number of sick individuals is likely higher than reported.

The Minnesota Department of Health identified the source as alfalfa sprouts produced by Everything Sprouts, a Minnesota grower. The sprouts were sold under the Calco and Everything Sprouts brands to restaurants and grocery stores.

On Aug. 19, the FDA initiated an inspection and sample collection at the Everything Sprouts facility. Following this inspection, the FDA recommended the company recall its products.

The FDA is warning consumers and retailers to avoid eating or serving alfalfa sprouts from Calco or Everything Sprouts.

The FDA had previously issued a warning to Everything Sprouts last year for serious violations following an inspection. Inspectors determined the company maintained insanitary conditions that could have led to produce contamination with filth or rendered products injurious to health.

Documented problems at the facility included roof leaks with water dripping onto produce and clean employee smocks, and a build-up of black organic matter on a hose within the overhead irrigation system used for produce.