The number of suspected Salmonella infections associated with pastries made by a Rhode Island bakery is up to 47, the state’s health department reported Wednesday.

Health officials said 23 of the cases have been lab-confirmed and 24 people have been hospitalized. Two people who went to emergency rooms were not admitted for further treatment. 

Of the 47 suspected Salmonella cases, 42 are Rhode Island residents, one person was from Massachusetts, and four case patients’ residences are unknown.

On Tuesday, health officials said a man who tested positive with the outbreak strain of Salmonella died on March 23. Health officials still haven’t confirmed whether the man had eaten any of the implicated pastries.

Most of those who have been sickened reported eating zeppole made by DeFusco’s Bakery and sold or served at multiple locations.  Zeppole are traditional Italian pastries associated with the celebration of St. Joseph’s Day, March 19.

All pastries made by DeFusco’s Bakery were recalled and the bakery has been shuttered until further notice. An inspection of the Johnston-based bakery by the Rhode Island Department of Health Office of Food Protection on March 25 found multiple violations, including:

— the person in charge did not assure compliance with critical food-code requirements

— no designated hand-washing sink and no soap or paper towels near a three-bay sink used by staff to wash their hands

— the bathroom sink did not have running water (hot or cold)

— baked pastry shells for zeppole, eclairs and cream puffs were stored in boxed used previously for raw shell eggs

— staff failed to sanitize equipment and utensils after washing and rinsing them

— the dough mixer paddle, knives, pastry bag tips, trays and other equipment were covered with accumulated food and debris

— pastry cream prepared at 10 a.m. was put into 5-gallon buckets to cool on the floor. By the 4 p.m. inspection, the light cream was 125 degrees F and the chocolate cream was 119 degrees F

— calzones made with cooked meat, deli meats, vegetables and cheese were on display for sale at 70-72 degrees F, rather than the required 41 degrees F

— floors and walls in the kitchen had an accumulation of soil residue and food debris