As of February, at least 165 people were sickened with salmonella infections tied to products from Raw Farm, of Fresno, California, according to the records. It is the largest reported salmonella outbreak linked to raw milk in the U.S. in the past decade, according to health officials.

The disclosure of the outbreak’s size comes as health officials warn the public to avoid unpasteurized milk due to a bird flu virus circulating in U.S. dairy cows. The bird flu, known as Type A H5N1, has been detected in more than 140 U.S. dairy herds, and federal health officials say the virus has been detected in high levels in raw milk.

State and local health officials hadn’t updated the public about the full scope of the salmonella outbreak since October, when officials in San Diego reported about a dozen cases. At the time, Raw Farm issued a voluntary recall of milk and heavy cream sold between Oct. 11 and Nov. 6.

Cases continued to mount, however, according to documents obtained by Bill Marler, a Seattle food safety lawyer who shared the records with The Associated Press. Marler said he represents 16 clients allegedly sickened in the outbreak.

Investigators matched samples from sick people to samples from the farm and a retail store, the documents said. More than 60% of the people with confirmed infections who were interviewed reported consuming Raw Farm products. People from four states were infected, though the vast majority — 162 — were from California. Four of the people with salmonella were also infected with campylobacter and/or dangerous E. coli bacteria, the documents said.

Nearly 40% of illnesses were reported in children younger than 5, officials said. Twenty people were hospitalized. No deaths were reported.

California health officials said Wednesday that they had conducted a “robust” investigation in partnership with local teams and state agriculture officials and notified the public about the outbreak through the October recall notice and social media posts in October, November and December. The outbreak ended May 4, officials said. It’s not clear whether more cases were reported after February.

Mark McAfee, owner of Raw Farm, acknowledged that his products were part of the outbreak. He said that a single cow was infected with salmonella last fall and later removed from the herd. He said he put additional testing protocols in place in response to the outbreak.

Jessie McGee, 35, of San Pedro, California, said she plans to sue Raw Farm because her 6-year-old daughter was hospitalized in October with a confirmed infection tied to the outbreak. McGee said she had read about supposed health benefits of raw milk online and started drinking Raw Farm products and feeding them to her daughter and her 2-year-old twins. All three children and McGee fell ill, she said, but her older daughter’s symptoms of high fever and stomach cramps were most severe.

After the ordeal, McGee said she’ll no longer drink unpasteurized milk.

“None of the possible benefits you could maybe get from the milk is worth any of that,” she said.