WASHINGTON (WATE) — The Centers for Disease Control and Prevention along with public health officials in several states are investigating a multistate outbreak of Salmonella infections linked to contact with backyard poultry like chickens, ducks, turkeys or any wild birds.

The CDC reported that over 200 cases in 38 states have led to 27 people being hospitalized.

In Tennessee, there have been six reported Salmonella cases and one death linked with backyard poultry contact.

One of four sick people are children younger than five years old. Children younger than 5, adults 65 and older, and people with weakened immune systems are more likely to have severe illness, the CDC said.

“Backyard poultry, like chickens and ducks, can carry Salmonella germs even if they look healthy and clean,” according to the CDC. “These germs can easily spread to anything in the areas where the poultry live and roam.”

The CDC said the true number of sick people is likely much higher than reported, as many people recover without medical care and are not tested for Salmonella.

Officials recommends that people use caution when touching backyard poultry and touching near their mouths or food to prevent accidentally swallowing the Salmonella bacteria.

Here are CDC’s steps for to stay healthy while handling birds:

  • Always wash your hands for 20 seconds after touching birds, their supplies or collecting eggs.
  • Use a pair of dedicated shoes or boots for your coop and don’t wear them inside your house.
  • Keep birds and supplies outside the house to prevent spreading germs into your house.
  • Don’t let children younger than five years touch the birds (including chicks and ducklings) or anything in the area where the birds live and roam. This helps protect young children from getting sick, as their immune systems are still developing, are more likely to put items in their mouths or not wash hands fully.

Most people infected with Salmonella develop diarrhea, fever and stomach cramps six hour to six days after being exposed to the bacteria. Most people recover without treatment and the illness usually lasts 4-7 days.

The investigation of these cases are still active. For more information about the CDC reports, visit cdc.gov/salmonella/backyardpoultry-06-22.