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Two more people have become ill after being exposed to salmonella-tainted dry dog food, bringing the total to 16, federal health officials reported Friday.

That includes one more case in the United States, where people in nine states have been sickened. Another case was detected in Quebec, Canada. Five people have been hospitalized.

All of the illnesses follow a recall of at least 11 brands of dry dog food manufactured at a Gaston, S.C., plant operated by Diamond Pet Foods of Meta, Mo. They include the store brand pet food sold by Costco, Kirkland Signature and Kirkland Signature Domain.

Lab tests have confirmed that those sick were infected with a rare strain of salmonella Infantis, which was detected only after a routine test of dry dog food revealed contamination, a report from the Centers for Disease Control and Prevention said.

Public health investigators used DNA fingerprints of the bacteria to identify past cases of illness linked to the outbreak. People infected with the outbreak strain became sick between Oct. 8, 2011 and April 22, 2012.

Cases included three each in North Carolina and Missouri, two each in Ohio and Pennsylvania and one each in Alabama, Connecticut, Michigan, New Jersey and Virginia.

Diamond Pet Foods has voluntarily expanded its recall of certain brands of dry dog and cat food manufactured at the South Carolina site between Dec. 9, 2011 and April 7, 2012 because of potentially salmonella contamination. The federal Food and Drug Administration posted recalls as well, here.

People can become sick by handling the tainted pet food or through contact with an animal that has eaten the contaminated food.

Consumers should discard any of the recalled product. Those who think they may have become sick after contact should consult a health care provider.

Consumers should be sure to wash their hands after feeding or handling a pet, or after picking up after an animal. Cat litter boxes should be scooped daily.

Salmonella infections can cause diarrhea, fever and abdominal cramping 12 to 72 hours after infection. The illness can last up to a week and most people recover without treatment. In some cases, severe diarrhea can require treatment in a hospital.

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