San Diego County health officials are investigating a Salmonella outbreak linked to Ramona Family Naturals Market after recording 13 confirmed and probable cases since June 21, according to the County News Center. Four people were hospitalized, and those who became ill ranged in age from 27 to 60.

Investigators believe the outbreak is connected to mayonnaise made with raw, unpasteurized eggs. County officials said the market owner has been working with Environmental Health and Quality and Public Health Services and has stopped using raw, unpasteurized eggs in its food products.

The county said this strain is not connected to the separate Midwest shell egg Salmonella outbreak. Salmonella infection can cause nausea, vomiting, diarrhea, abdominal cramps and fever, with symptoms typically beginning 12 to 72 hours after eating contaminated food.

For Santee and East County residents who shop, work or visit Ramona, the county’s advice is straightforward: anyone who ate food from the market or deli and develops symptoms should contact a health care provider. People who are still ill or have recovered after eating there can report the illness to the County Department of Environmental Health Quality.