The U.S. Centers for Disease Control and Prevention said on Thursday that public health officials are investigating multi-state outbreaks of salmonella linked to contact with backyard poultry.

The CDC said that 109 people from 29 states have gotten sick from salmonella after touching or caring for backyard poultry such as chickens and ducks.

The states with the highest number of cases are Missouri, Texas and Oklahoma.

No deaths have been reported while 33 people have been hospitalized.

The true number of sick people is likely much higher than the number reported because many recover without medical care and are not tested for salmonella, the CDC said.

In this outbreak, 43 per cent of those infected are under 5 years old, the CDC said.

Symptoms for salmonella include diarrhea, fever and stomach cramps, but children under age 5 may experience more severe illnesses that require medical treatment or hospitalization.

The health agency advised people to wash their hands with soap and water immediately after touching backyard poultry, their eggs, or anything in the area where they live and roam.

The CDC also advised stores selling backyard poultry to clean and sanitize poultry display areas and source them from hatcheries that take steps to reduce salmonella contamination.

(Reporting by Sneha S K in Bengaluru; Editing by Shailesh Kuber and Alan Barona)