Frozen supplemental shakes have been linked to a nationwide Listeria outbreak that have led to 38 illnesses and 12 deaths.

A nationwide recall has been issued for frozen nutritional shakes linked to a deadly listeria outbreak, according to the Food and Drug Administration. The shakes were sold to hospitals and long-term care institutions, including nursing homes.

A deadly listeria outbreak linked to frozen supplement shakes has spread across 21 states, leaving 12 dead and 38 hospitalized, prompting an FDA investigation and nationwide recall.

A listeria outbreak linked to frozen shakes has killed 12 and sickened 38 people in the US across 21 states. According to the Centers for Disease Control and Prevention, the shakes were distributed to hospitals and care facilities,

A listeria outbreak linked to frozen nutritional milkshakes is to blame for 12 deaths and dozens of hospitalizations, the U.S. Food and Drug Administration confirmed Monday following an investigation that spanned years.

Supplemental shakes have been linked to a deadly listeria outbreak. They were distributed in hospitals and long-term care facilities.

“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.”

The supplemental shakes are labeled under the brands Lyons ReadyCare and Sysco Imperial and were sold to institutional customers, including hospitals and long-term care facilities, officials said.