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Frozen supplemental shakes are linked to a listeria outbreak in 21 states that has sickened dozens and killed 11, according to the FDA.

The FDA has issued a recall on frozen supplemental shakes that were found to have been contaminated with Listeria monocytogenes.

The FDA and CDC, in collaboration with state and local partners, are investigating illnesses in a multistate outbreak of  Listeria monocytogenes  infections lin

The frozen shakes were served at hospitals and long-term care facilities, sickening 38 people and resulting in 11 deaths in 21 states, according to the FDA.

“Listeria is especially harmful to pregnant women, people 65 or older, and people with weakened immune systems,” the CDC wrote on its website. “This is because Listeria is more likely to spread beyond their gut to other parts of their body, resulting in a severe condition known as invasive listeriosis.”

A total of 38 listeria monocytogenes infections have been reported in New York, California and about 20 other states, according to the FDA.

Recalled shakes were sent to nursing homes and hospitals. No San Diego County cases have been reported so far.