Puppy kisses are cute, but they may be dangerous.

At least 30 people have been sickened from a drug-resistant bacteria they most likely picked up after coming in contact with puppies, federal health officials say.

The outbreak of a strain of Campylobacter jejuni, a bacteria commonly associated with food poisoning, has spread to 13 states and caused four hospitalizations, the Centers for Disease Control and Prevention says.

Most of those infected came in contact with puppies, and many were at pet stores. At least 12 people who were infected came in contact with puppies at Petland, a national pet store chain, the CDC says, including some Petland employees.

"Petland takes the health and welfare of our employees, our customers and our pets very seriously," the company said in a statement, adding that no one location has been identified as the originating source.

The bacteria causing the string of illnesses is similar to the bacteria that sickened people in an outbreak from 2016 to 2018 also tied to pet store puppies, the CDC says. The illnesses began in January, the agency says, and people as young as 8 months and as old as 70 have been sickened. No deaths have been reported.

Symptoms of a Campylobacter infection include diarrhea, fever and stomach cramps. Most people recover after a week without antibiotics, but patients at a high risk for disease or with a weakened immune system may need antibiotics, the CDC says.

Even if a puppy appears healthy and clean, it could still carry Campylobacter bacteria, the CDC says.

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The agency advises basic sanitation practices after coming in contact with a puppy, handling its food or cleaning its waste: Wash your hands with soap and water, don’t let dogs lick your mouth or open wounds and take your dog to the vet if it appears sick.

Petland said in a statement that it had implemented new sanitation protocols following the previous outbreak.