At least 10 people across four states — California, Colorado, Texas and Utah — have been made ill from an E. coli outbreak linked to raw cheddar cheese from the brand Raw Farm, according to health officials.

The Centers for Disease Control and Prevention said Friday that at least four people have been hospitalized and one person has developed hemolytic uremic syndrome, which can cause kidney failure.

“The true number of sick people in this outbreak is likely much higher than the number reported, and the outbreak may not be limited to the states with known illnesses,” the CDC said.

Raw Farm, based in Fresno, Calif., agreed to initiate a recall on a number of its cheddar cheese products, according to the Food and Drug Administration.