A salmonella outbreak that’s sickened at least 21 people across 13 states is linked to pet turtles, the Centers for Disease Control and Prevention (CDC) announced this week.

At least seven people have been hospitalized as a result of the Salmonella Oranienburg outbreak, though no deaths have been reported to date.

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“Epidemiologic and traceback evidence indicate that contact with pet turtles is the likely source of this outbreak,” the CDC said in a Wednesday announcement. Twelve of the 17 people interviewed said they had contact with a pet turtle prior to falling ill, further supporting the suspected link.

Six cases were reported in California. Illinois, New York, and Washington state have each seen two cases. Colorado, Georgia, Indiana, Iowa, Michigan, Nebraska, New Jersey, Tennessee, and Vermont have also seen at least one case, according to the CDC’s map of reported cases.

“Ill people reported contact with red-eared sliders and other turtles that were larger than four inches in length. Previous Salmonella outbreaks have been linked to turtles with a shell length [of] less than four inches,” officials said, noting the U.S. Food and Drug Administration has since “banned the sale and distribution external icon of turtles with shells less than four inches long as pets.”

Turtle droppings are often a source of salmonella bacteria, according to the CDC, which notes these germs can spread to other areas within the turtle’s water tank or habitat.

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“People can get sick after they touch a turtle or anything in their habitats,” the CDC says, warning turtle owners against “kissing or snuggling” the reptiles.

Thorough hand washing, cleaning habitats outside the home and not letting turtles roam freely in areas where food is prepared are all ways to prevent illness.

Salmonella infections can cause diarrhea, vomiting, fever and abdominal cramps. Illnesses are more likely to be severe in the elderly and infants, according to the CDC, which estimates salmonella causes about 1.2 million illnesses in the U.S. each year.