The Rhode Island outbreak of Salmonella linked to contaminated pastries has claimed a second victim.

A man in his 90s, who had been hospitalized and had tested positive for the outbreak strain of Salmonella, died Thursday, according to a report in the Providence Journal. 

The Rhode Island Department of Health told the newspaper the man had eaten pastry prepared by DeFusco’s Bakery in Johnston, which closed its doors March 25 after recalling zeppole, an Italian pastry, and other baked goods.

As of Friday, the health department said there have been 66 illnesses associated with the outbreak. Twenty eight of those sickened were  so ill they required hospitalization; four remain in the hospital. A man in his 80s died on March 23. 

Health inspectors found multiple food-safety violations at the bakery, including pastry filling stored on the floor at room temperature and cardboard cartons, which previously held eggs, used to hold baked pastry shells. Lab tests later detected Salmonella in the boxes, leading to speculation that egg residue from tainted eggs may have contaminated the pastries.

Although baked goods may seem an unlikely source of foodborne illness, cream and custard-filled pastries, such as zeppole or eclairs, are actually often implicated in outbreaks

Late last year, at least 100 Staphylococcus aureus illnesses were reported in connection with pastries served by an Illinois bakery.

Pathogens can grow in protein-rich, low-acid foods like cream-filled pastries held at room temperature. Outbreaks involving bakeries or catering companies are often the result of food handlers’ poor personal hygiene, cross contamination or temperature abuse.