The most recent E. coli outbreak linked to romaine lettuce—which caused thousands of stores and restaurants to remove potentially affected product from their shelves in November—has now been reported across 25 states.
On Thursday, the Centers for Disease Control and Prevention confirmed that there have been 138 cases of E. coli across 25 states, resulting in 72 hospitalizations. According to the statement, the most recent case of an ill patient occurred on Dec. 1.
Additionally, 13 people have developed a type of kidney failure called hemolytic uremic syndrome, according to the CDC. No deaths have been reported.
In their updated statement, the CDC advised against eating or selling all types of romaine lettuce from Salinas, California, where investigators have identified a common grower.
Consumers, as well as restaurants and retailers, should double-check the label on any romaine lettuce products they may have to see if the label says “Salinas” on it. If it does, or if there is no growing region listed, the CDC recommends not eating the product and immediately throwing it away.
However, they went on to clarify that romaine lettuce “harvested from other sources outside of Salinas or labeled as indoor, or hydroponically- and greenhouse-grown,” are still considered safe to consume.
The Food and Drug Administration will also be investigating the outbreak.
“This investigation involves assessing and sampling soil, animal droppings, compost, water, and other potential environmental sources at the ranches of this grower. The samples and information collected during the farm investigations will be analyzed,” the FDA reported Thursday.
Symptoms of the particular strand of E. coli found in the lettuce — which is caused by the same strain that was linked to leafy greens in 2017 and romaine in 2018 — include cramping, bloody diarrhea, and vomiting.