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A listeria outbreak linked to Boar's Head deli meat products has become America's largest since 2011, according to the Centers for Disease Control and Prevention (CDC).

At least nine deaths have now been tied to the outbreak, and 57 people have been hospitalised.

Last month, Boar's Head recalled certain products made at its plant in Jarratt, Virginia.

A company spokesperson told ���˿���'s US news partner CBS News that food safety was the "absolute priority", and that the team at the plant immediately addressed the issues they found.

Boar's Head pointed out that it was inspected by the United States Department of Agriculture (USDA), and that inspectors visited the plant every day.

"If at any time inspectors identify something that needs to be addressed, our team does so immediately, as was the case with each and every issue raised by USDA in this report," spokesperson Elizabeth Ward said in her statement.

The recall started with ready-to-eat liverwurst products and expanded to include all deli meats including sliced hams, sausages and meatloaves manufactured at the Virginia facility.

The 57 hospitalisations linked to the outbreak have occurred in 18 states, the CDC said in a statement of its own on Wednesday.

Those states are Arizona, New Mexico, Minnesota, Missouri, Wisconsin, Illinois, Indiana, Tennessee, Florida, Georgia, North Carolina, South Carolina, Virginia, Maryland, Pennsylvania, New Jersey, New York and Massachusetts.

"This is the largest listeriosis outbreak since the 2011 outbreak linked to cantaloupe (melons)," the CDC said in a statement on Wednesday.

Department of Agriculture officials found dozens of violations at the Boar's Head plant in Virginia.

Officials found dozens of "non-compliances" at the Boar's Head plant over the course of a year, according to Department of Agriculture records that were obtained by CBS News.

Among the 69 violations were mould and mildew building up in the facilities at the hand-washing sinks and in holding coolers between smokehouses.

The records also indicated leaking and pooling water with "green algal growth" in one puddle, and condensation water dripping over products.

There were also reports of insects flying around the meat.

The Virginia plant has ceased operations since the recall for disinfection work to take place.

Listeria is a germ that can remain on surfaces like meat slicers and foods, even at refrigerated temperatures.

The CDC says some infected people can take up to 10 weeks to experience symptoms, though most usually appear within two weeks of eating contaminated food.

Symptoms include fever, muscle aches and tiredness as well as headaches, stiff neck, confusion, loss of balance or seizures.

The CDC warns some of the Boar's Head products have sell-by dates of October 2024.