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The Public Health Agency of Canada is reporting a fifth hospitalization in an E. coli outbreak linked to recalled Pillsbury brand Pizza Pops.

The federal agency says 23 people in seven provinces got sick with the bacterial illness after eating or handling certain flavours of the frozen snack between early October and late November.

The Canadian Food Inspection Agency recalled several pepperoni and bacon Pizza Pops on Sunday due to an E. coli contamination that is under investigation.

The outbreak has now reached Alberta, Ontario, British Columbia, New Brunswick, Manitoba, Saskatchewan and Newfoundland and Labrador.

The health agency says that for every case that is confirmed in a lab, there are an estimated 32 more undetected in the community.

E. coli symptoms can include nausea, vomiting, headache, mild fever, severe stomach cramps and watery or bloody diarrhea.

Most people will fully recover after a few days without treatment, but those who are pregnant, under the age of five, over the age of 60 or have weakened immune systems are at a higher risk of severe illness.

The affected products are Pizza Pops Pepperoni + Bacon, Pizza Pops Supremo Extreme Pepperoni + Bacon and Pizza Pops FRANK’s RedHot Pepperoni + Bacon, all with best before dates in June 2026.

Freezers, microwaves aren’t enough to kill bacteria

Lawrence Goodridge, a professor and Canada Research Chair in foodborne pathogen dynamics at the University of Guelph, said freezers stop the growth of bacteria, but they don’t kill it.

That means if the product got cross-contaminated or there was a sanitation failure when it was made, the freezer would actually preserve the bacteria.

Goodridge said the reason heat didn’t kill E. coli in this case is because microwaves don’t heat food equally and leave patches of cold spots where the bacteria can survive.

Microwaves vary and their power weakens over time, which means heating a Pizza Pop on high for one minute is different for each person.