Nearly half a million Americans are infected by a deadly stomach bug every year, according to a recent report.

A study funded by the Centers for Disease Control and Prevention (CDC) found that an estimated 453,000 cases of Clostridium difficile, or C. diff, infection in the United States in 2011, which resulted in 29,000 deaths. That’s almost double prior infection estimates.

C. diff bacteria release toxins that drugs can’t fight; those infected usually contract it from hospitals or health care related settings, though sickness typically occurs after one leaves the hospital. A new, more severe strain of the bacteria was discovered in 2000. Ordinary antibiotics and hand sanitizers are considered no match for the bug, which causes severe diarrhea, inflammation and sepsis.

The CDC says that soap and water are essential to stopping its spread, NBC News reports. The Department of Health and Human Services will begin punishing hospitals that fail to reduce rates of C. diff in their facilities by 2017.

Read next: Measles Outbreak in U.S. Tops 150 Cases

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