AUGUSTA, Maine — Health officials say four people in Maine have been sickened as part of the salmonella outbreak that has been linked to 474 illnesses and six deaths in 43 states.

The Maine Center for Disease Control and Prevention issued a public heath alert on Sunday regarding the salmonella outbreak. The alert came a day after the federal government advised consumers to avoid eating cookies, cakes, ice cream and other foods with peanut butter until health officials learn more about the contamination.

Officials are focusing on peanut paste, as well as peanut butter, produced at Peanut Corp.’s Georgia facility. Its peanut butter is not sold directly to consumers but distributed to institutions and food companies.