Two Washington residents are among those sickened in an E. coli outbreak linked to a General Mills recall of about 10 million pounds of flour.

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Two Washington residents are among those sickened in an outbreak of E. coli illness linked to a General Mills recall of about 10 million pounds of flour, state health officials said Tuesday.

A person from Grant County and another from Spokane County are among 38 people who fell ill in 20 states with infections caused by E. coli O121 between Dec. 21, 2015, and May 3, 2016, according to Julie Graham, a spokeswoman with the Washington State Department of Health.

General Mills officials said in a news release that federal investigators told them half the people who got sick reported eating foods homemade with flour, including General Mills flour. Information also suggests that some of those who got sick ate raw dough or batter.

The company Tuesday announced the recall of several varieties of Gold Medal, Wondra and Signature Kitchens flour sold at Safeway, Albertsons and other stores nationwide. No E. coli has been found in the products or at the company’s flour- manufacturing facility, officials said. General Mills is based in Minneapolis.

Brands and varieties of recalled flour can be found at www.generalmills.com. Or, consumers can call 1-800-230-8103.

Many strains of E. coli are harmless, but E. coli O121 is a Shiga-toxin producing germ that can cause bloody diarrhea and complications including kidney failure.

Flour is not typically thought of as a source of food poisoning, but a 2009 outbreak of E. coli O157:H7 that sickened more than 70 people in 30 states was tied to raw cookie dough — and possibly, the flour.

A spokeswoman with the Centers for Disease Control and Prevention acknowledged the outbreak but said details were not yet ready for release.

Anyone concerned about illness should contact a health-care provider. If E. coli O121 is suspected, contact state and federal health officials as well. Symptoms include watery diarrhea, abdominal cramping, fever, nausea and possible vomiting. Headache, muscle aches and bloating also can occur. Illness occurs between one and three days after exposure.