OTTAWA - The Public Health Agency of Canada is investigating an outbreak of E. coli illnesses in Quebec, Ontario and New Brunswick, and says several of the sick individuals reported consuming raw shelled walnuts.

It says 13 cases of illness have been reported.

Nine patients have been hospitalized and two people developed haemolytic uremic syndrome, an illness associated with E. coli infections that could result in kidney failure.

Meanwhile, the Canadian Food Inspection Agency is warning the public not to consume certain bulk and prepackaged raw out-of-the-shell walnut products because they may be contaminated with E. coli.

Quebec-based Amira Enterprises Inc. issued the recall and says the walnuts were imported from the U.S., and have been available since Jan. 1.

All package sizes -- including halves and crumb packs -- all lot codes and all best before dates are affected by the recall.

The products -- which may not all be marked with the brand name -- have been distributed in Atlantic Canada, Quebec, and Ontario, but may have also been sold in other provinces.

Until further notice, the public health agency says consumers who have raw shelled walnuts in their home can reduce the risk of E. coli infection by roasting the walnuts prior to eating them.

Consumers should place the nuts on a cooking sheet and bake them in a 180 C (350 F) oven for 10 minutes, turning the nuts over once after five minutes.

Infection from E. coli may cause serious and potentially life-threatening illness. Symptoms include severe abdominal pain and bloody diarrhea.

"Although most people recover within seven to 10 days, pregnant women, people with compromised immune systems, young children, and the elderly are most at risk for developing serious complications," the agency said in a statement Monday.

"Complications may include seizures, strokes and some people may need blood transfusions and kidney dialysis. Others may live with permanent kidney damage. In severe cases of illness, people may die."

The recall notice also mentions Mistral Mix containing walnuts, and Salad booster containing walnuts, with the brand names Amira and Tia.

The recalled products are:

• Amira Raw shelled walnuts sold from a bulk bin*

• Amira Prepackaged raw shelled walnuts (Halves/Pieces/Crumbs)

• Tia Prepackaged raw shelled walnuts (Halves/Pieces/Crumbs)

• Merit Selection Prepackaged raw shelled walnuts (Halves/Pieces/Crumbs)

• Amira Mistral Mix containing walnuts

• Tia Mistral Mix containing walnuts

• Amira Salad booster containing walnuts

• Tia Salad booster containing walnuts

* The brand name Amira may not be marked on the raw walnuts sold from the bulk bins.