Boar’s Head is recalling an additional 7 million pounds of meat and poultry products over possible listeria contamination after a Missouri couple's lawsuit say the Virginia-based company's deli meats made one of them "deathly ill."

The recall includes 71 Boar’s Head and Old Country products made between May 10 and July 29, according to the U.S. Department of Agriculture. The items range from beef, bologna, ham, liverwurst and salami, among others.

More than 200,000 pounds of Boar's Head products were already included in a Friday recall ranging from packaged meat and poultry products to meat meant to be sliced at the deli.

The recall comes as investigators look into a multi-state listeria outbreak that has caused two deaths, reported in Illinois and in New Jersey. The outbreak has also left 33 people hospitalized across 13 states, federal health officials revealed earlier this month.

View the full list of recalled products here.

More about expanded recall

The recall was expanded after the Maryland Department of Health collected a liverwurst sample that tested positive for the same listeria strain tied to a recent outbreak, according to the USDA.

"These items include meat intended for slicing at retail delis as well as some packaged meat and poultry products sold at retail locations," the agency said.

The products were distributed nationwide and exported to various nations, including the Cayman Islands, Dominican Republic, Mexico, and Panama. The products have the establishment number “EST. 12612” or “P-12612” inside the USDA mark of inspection on the product labels.

The recalled products have sell-by dates between July 29 and Oct. 17. See the full product list and view labels.

Lawsuit claims 88-year-old's infection led to 'intensive treatment'

Patrick and Sue Fleming of High Ridge, Missouri filed a complaint on Friday alleging that Sue endured a "life-threatening listeria infection" after the older couple bought Boar's Head liverwurst in June. Sue, 88, required a long hospital stay and rehab as she experienced nausea, diarrhea, stomach cramping, and, "most disturbingly, intense whole-body aches, shaking, and muscle weakness," the complaint says.

The complaint says that she continues to suffer "neurological symptoms, fatigue, and overall weakness.”

The suit accuses Boar's Head and Shnucks of multiple counts of negligence, as well as manufacturing defects and breach of implied warranty. Sue and Patrick, 76, are seeking $25,000 in injuries and damages.

"Unfortunately, we've seen this before with deli meats," attorney Ryan Osterholm said in a press statement. "It gets in the facility, and if you're not doing deep cleans often enough, it sticks around. That's how Listeria proliferates. From there, it gets in the food and it makes people very sick. Then people get hospitalized, and sometimes—far too often—people die."

USA TODAY has reached out to Boar's Head for comment.

Multi-state listeria outbreak expands to 13 states

A listeria outbreak linked to sliced deli meat has sickened 34 in 13 states, causing 33 hospitalizations and two deaths, according to an ongoing investigation by the USDA and Centers for Disease Control (CDC).

The ages of the sick people range between 32 and 94 with the median being 75, CDC data showed.

The CDC and USDA are currently aware of 13 states with infections as a result of the outbreak.

These states include:

• New York: 12
• Maryland: 6
• Massachusetts: 2
• Missouri: 2
• New Jersey: 2
• Virginia: 2
• Georgia: 2
• Minnesota: 1
• Wisconsin: 1
• Illinois: 1
• Pennsylvania: 1
• North Carolina: 1
• Indiana: 1

Listeriosis or listeria poisoning symptoms

Listeriosis, or listeria poisoning, is a foodborne bacterial infection most commonly caused by the bacterium Listeria monocytogenes. It is considered a serious condition and can be dangerous or life-threatening, especially to older adults, people with weak immune systems and pregnant women.

According to the USDA, symptoms include:

• Fever
• Muscle aches
• Headache
• Stiff neck
• Confusion
• Loss of balance
• Convulsions
• Diarrhea
• Other gastrointestinal symptoms
• Miscarriage, stillbirth, premature delivery and/or life-threatening infection of newborn infants
• Death

People in higher-risk categories who experience flu-like symptoms within two months after eating contaminated food should seek medical care and tell the health care provider about eating the contaminated food, said the USDA.

What to do to stay safe

The CDC advises that people who are pregnant, are aged 65 or older, or have a weakened immune system take extra precautions to avoid becoming ill.

At-risk individuals should do as follows:

• Do not eat recalled deli meats. Throw them away or contact stores about returns.
• In addition, do not eat any other deli meats you get sliced at deli counters, unless it is reheated to an internal temperature of 165°F or until steaming hot. Let it cool before you eat it.
  • Listeria can grow on foods kept in the refrigerator, but it is easily killed by heating food to a high enough temperature.
• Clean your refrigerator, containers and surfaces that may have touched sliced deli meats.
  • This is especially important if you purchased any of the recalled deli products.
• Call your healthcare provider right away if you have any of these symptoms:
  • People who are not pregnant usually have fever, muscle aches, and tiredness. They may also get a headache, stiff neck, confusion, loss of balance, or seizures.
  • Pregnant people usually have fever, muscle aches, and tiredness. However, Listeria can cause pregnancy loss or premature birth. It can also cause serious illness or death in newborns.