Nine people are in hospital with salmonella infections after consuming certain brands of pistachios or pistachio-containing products, including viral Dubai brand chocolate bars.

And so far, three-quarters of the people sickened are women, the Public Health Agency of Canada says.

The Canadian Food Inspection Agency said on Tuesday that the recall of a Dubai brand chocolate product was “triggered by test results” and affects pistachio and knafeh milk chocolate from that brand. No illnesses from consuming the product have been reported.

PHAC has also posted a public health notice saying an outbreak of salmonella infections is ongoing and it is investigating.

PHAC says many people became sick after reportedly eating either pistachios or products that contained the food, prompting the added warning that the recalled pistachios may have been used and sold in baked goods.

According to the agency, a total of 52 laboratory-confirmed cases of Salmonella Havana and Salmonella Mbandaka linked to the outbreak have been reported across four provinces in products.

A total of 39 cases have been reported in Quebec, with nine in Ontario, three in British Columbia and one in Manitoba.

People became sick between early March and mid-July of this year. Those ill are between the ages of two and 89, and 75 per cent are female.

PHAC also cautioned that the number only consists of laboratory-confirmed cases and the actual number of sick people in Canada is likely much higher, with researchers estimating that for each case reported there are 26 more not reported.

In recent days, recalls have been posted for Al Mokhtar Food Centre brand of pistachios, Habibi brand of pistachio kernels in addition to the Dubai brand of chocolate bar containing pistachio and khafeh.

The recalled products, which are available online, were distributed to Ontario and Quebec.

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The agency says the outbreak strains of salmonella that made people sick were found in samples of the recalled Habibi brand of pistachios.

PHAC says more recent illnesses could still be reported, as there is a period between when a person becomes sick and when the illness is reported to officials. It can take more than a month after becoming ill for test results to be confirmed.

For this outbreak, the illness reporting period ranges between 15 and 55 days after illness onset.

Dubai-style chocolate, previously touted by some influencers and media, including the Wall Street Journal, as the “next pumpkin spice” food trend, is facing recalls in Canada and the U.S. due to salmonella.

The chocolates, first made in the United Arab Emirates, have gone viral on TikTok, causing a surge in demand, including for its pistachio knafeh-filled bar, and prompting copycat versions across the U.S. and other countries, according to Newsweek.

The bar is filled with knafeh, a regional dessert made from shredded phyllo dough, pistachio paste and tahini, with people on TikTok breaking open the chocolates and taste-testing the gooey bars.

In the U.S., the recall targets the Emek spread pistachio cream with kadayif. The Food and Drug Administration this week updated its voluntary recall to a Class I, its highest level.

Those products were distributed between June 11 and July 9, with a best before date on the label of April 1, 2027. No illnesses have been reported in the U.S. as a result of this recall.

Salmonella is a foodborne bacterial illness that can affect anyone exposed to a contaminated food product.

People infected with the bacteria can spread it to other people several days to several weeks after infection, even if they don’t have symptoms.

Amid the outbreak, Canadians — including retailers and food service establishments — are advised to check to see if recalled products are in the home or establishment by looking for the specific recalled products, including name and size, UPC and codes in the alerts.

If they have the items, they’re asked to throw them out or return them to the place they were purchased.

People are urged not to consumer, serve, use, sell or distribute recalled products or any product made with them.

Salmonella symptoms can be difficult to identify, so if you think you have it, you’re encouraged to speak with a health-care provider.

Salmonellosis has a wide range of symptoms, according to PHAC, including chills, fever, nausea, diarrhea, vomiting, stomach cramps or a sudden headache.

If you do get sick, the agency says symptoms usually start within six to 72 hours after exposure and most end within four to seven days.

Most people with salmonella recover on their own, but PHAC cautions a more serious illness is possible that could require hospital care and may lead to long-lasting health effects.

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