ROCHESTER, N.Y. (AP) Contaminated fresh ground beef caused a possible E. coli outbreak that killed two people and sent 16 others to hospitals, federal health officials said Monday.

Twenty-eight people may have become ill after eating beef produced by Fairbank Farms of Ashville, N.Y., the Centers for Disease Control and Prevention reported. All but three of the suspected infections are in the northeastern U.S. and 18 are in New England, said CDC spokeswoman Lola Scott Russell.

Fairbank Farms recalled almost 546,000 pounds of fresh ground beef that had been distributed in September to stores from North Carolina to Maine. The U.S. Department of Agriculture's recall notice, dated Saturday, said the possibly tainted meat had been sold in numerous ways, from meatloaf and meatball mix to hamburger patties.

One of the deaths was an adult from Albany County, N.Y., who had several underlying health conditions, according to the state Health Department. The other fatality was previously reported by New Hampshire, where health officials said a patient died of complications.

The CDC did not specify the states where people were hospitalized. Kidney failure is found in the most severe cases of E. coli. In less serious cases, the potentially deadly bacterium can cause bloody diarrhea and dehydration.

Some of the ground beef was sold at Trader Joe's, Price Chopper, Lancaster, Wild Harvest, Shaw's, BJ's, Ford Brothers and Giant stores in packages that carried the number "EST. 492" on the label. Those products were packaged Sept. 15-16 and may have been labeled with a sell-by date from Sept. 19 through Sept. 28, meaning they're no longer being sold as fresh product in supermarkets, Fairbank Farms said.

The rest of the ground beef, packaged in wholesale-sized containers under the Fairbank Farms name, was distributed to stores in Maryland, Massachusetts, North Carolina, New Jersey, New York, Pennsylvania and Virginia. That meat was likely repackaged for sale and would likely have differing package and sell-by dates.

The USDA was urging customers with concerns to contact the stores where they bought the meat.

Ron Allen, Fairbank's CEO, urged consumers to check their freezers for the recalled ground beef.

Companies subject to such recalls are allowed to cook tainted meat to kill the bacteria and then use it in other products, a common practice in the food industry.

That won't happen in this case, the company said.

"At the end of the day, this product ... is going in the garbage," said company spokeswoman Agi Schafer.

Located in the southwestern corner of New York a few miles from the Pennsylvania line, Fairbank Farms has had two other voluntary recalls over the last two years, according to the USDA's Food Safety and Inspection Service.

In September 2007, the company recalled 884 pounds of ground beef products because they may have been contaminated with E. coli, the agency said. And in May 2008, it recalled 22,481 pounds of ground beef products that may have contained pieces of plastic.

Symptoms of E. coli infections usually show up three to four days after a person eats contaminated food, although in some cases it can be as long as eight days. Officials said anyone having symptoms should immediately contact a doctor.

Russell, the CDC spokeswoman, said the E. coli strain involved in the recall, 0157:H7, infects about 70,000 Americans a year and kills 52.

After dropping for a few years, annual recalls of ground beef and other beef products contaminated with E. coli have rebounded, with at least a dozen recalls through October 2009, according to USDA data.

Sen. Kirsten Gillibrand of New York wants federally mandated E. coli inspections of all ground beef.

"This is a stark reminder that food is still going straight to our kitchens and grocery stores without being properly tested to ensure its safety," Gillibrand said. "It's spreading too many diseases and costing too many lives. ... It's time to address the gaps in the inspection process."