More than 20 people, including Minnesotans, have been sickened by Salmonella infections traced to Hy-Vee Spring Pasta Salad.

Hy-Vee recalled the store-branded pasta salad and the U.S. Food and Drug Administration, along with the Centers for Disease Control and Prevention (CDC) and state and local agencies, opened an investigation into the outbreak Wednesday.

The Des Moines-based grocer pulled the product from all 244 stores Monday night after being notified of illnesses linked to the salad in five states. The company is voluntarily recalling both its 1-pound and 3-pound containers produced between June 1 and July 13, according to the FDA.

Salmonella is a bacteria that can cause serious and sometimes fatal infections in young children, elderly people or those with weakened immune systems, the CDC said. Healthy people infected with the bacteria often develop a fever, diarrhea, nausea, vomiting and stomach pain.

Symptoms usually appear within 12 to 72 hours and the illness typically lasts four to seven days, according to the FDA.

The pasta salad was sold across Hy-Vee’s eight-state region of Minnesota, Iowa, Illinois, Missouri, Kansas, Nebraska, South Dakota and Wisconsin. So far, five people have been hospitalized, and no deaths have been reported. Illness linked to the pasta salad have been reported in Iowa, Minnesota, Missouri, Nebraska and South Dakota.

CDC estimates Salmonella causes about 1.2 million illnesses and 450 deaths in the U.S. every year.

It’s the second most common intestinal infection, said Bill Marler, a food-safety advocate and Seattle-based attorney specializing in food-borne illness lawsuits. “We are seeing less outbreak linked to meat — especially hamburger — but more involving fresh-cut fruits and vegetables — romaine lettuce and the recent salad outbreaks,” Marler said.

Five people, including two in Minnesota, died earlier this summer from E. coli, a different food-borne bacteria, linked to romaine lettuce from Arizona.

Salmonella infection usually comes from food contaminated with animal or human feces carrying the bacteria. Outbreaks of its kind are often associated with eggs, meat and poultry, Marler said. He warned that foods most likely to contain Salmonella are raw or undercooked eggs, raw milk, contaminated water and raw or undercooked meats.

Hy-Vee customers who bought the product are encouraged to discard or return the items to their local store for a refund. The item comes in a plastic container with a plastic lid. Those containers within the recalled batch have an expiration date range of June 22 to Aug. 3, which is listed on the side of the container.

Customers can contact Hy-Vee’s customer service with any questions at 1-800-772-4098.