The number of patients in a Salmonella outbreak traced to cantaloupe has doubled since Nov. 30, and one more person has died.

As of today, Dec. 7, 230 people across 38 states have been infected. Of the people with information available, 96 have required hospitalization. Three people have died, two from Minnesota and one from Oregon. The outbreak strains of Salmonella are particularly virulent because Salmonella infections usually don’t require hospitalization.

Illnesses started on dates ranging from Oct. 16 to Nov. 20. The sick people range from less than 1 to 100 years old.

“The true number of sick people in this outbreak is likely much higher than the number reported, and the outbreak may not be limited to the states with known illnesses. This is because many people recover without medical care and are not tested for Salmonella. In addition, recent illnesses may not yet be reported as it usually takes 3 to 4 weeks to determine if a sick person is part of an outbreak,” according to today’s update from the Centers for Disease Control and Prevention.

For every confirmed patient in a Salmonella outbreak, there are generally 28 unconfirmed cases. That means almost 6,500 people could be sick in this outbreak.