An outbreak of illness linked to recalled Pillsbury brand Pizza Pops has now spread to Newfoundland and Labrador.

A total of five people have been hospitalized, most of them in Ontario, as 23 people in seven provinces – including NL – have gotten sick with the bacterial illness.

The Canadian Food inspection Agency recalled several pepperoni and bacon Pizza Pops on Sunday due to an E. coli contamination.

The Public Health Agency of Canada says for every case that is lab confirmed, there are an estimated 32 more undetected in the community.

Symptoms can include nausea, vomiting, headache, mild fever, stomach cramps, and diarrhea.

Most people recover after a few days without treatment but the young, the old and those who are immunocompromised are at risk of severe illness.