Six Washington state residents are among people in 40 states sickened by salmonella infections after close contact — such as kissing and cuddling — with live poultry, a practice discouraged by health officials.

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Six Washington state residents are among at least 181 people in 40 states sickened by salmonella infections linked to close contact with backyard-poultry flocks. One man was hospitalized.

Many of the ill people reported allowing live birds into their homes and “kissing or cuddling” with the pet fowl, according to a report by the Centers for Disease Control and Prevention (CDC).

The agency warned that four large, multistate outbreaks of separate types of salmonella have been detected, with the earliest cases starting in January.

The cases have been linked to chicks, ducklings and other poultry from at least 17 hatcheries in several states. At least 33 people have been hospitalized.

The six Washington cases included a woman in her 50s in King County, a woman in her 40s in Kitsap County, a boy in his teens in Pacific County, a young girl in Skagit County and a girl in her teens in Yakima County. A Pierce County man in his 40s was hospitalized.

Three of the Washington state cases involved two outbreak strains of Salmonella Enteritidis detected between Jan. 6 and June 29. The three other cases were linked to a single strain of Salmonella Hadar detected between Feb. 24 and June 11.

The two further outbreaks involve strains of Salmonella Indiana and Salmonella Muenchen, the CDC reported.

Health officials warned that close contact with poultry can spread salmonella infections, which can cause serious illness in children, the elderly and those with compromised immune systems. Symptoms typically include diarrhea, fever and abdominal cramps.

Backyard-flock owners should take steps to protect themselves and their families:

• Always wash hands thoroughly with soap and water right after touching live poultry or anything in the area where birds live and roam.

• Do not let live poultry inside the house.

• Heed instructions from hatcheries and other poultry retailers about preventing salmonella infections. The recommendations apply to all live poultry, regardless of the age of the birds or where they were purchased.

The new outbreaks are only the latest of several recent salmonella outbreaks linked to live poultry. In 2014, for instance, 383 people in 43 states were sickened after contact with chicks, ducklings and other birds from an Ohio hatchery.