The Centers for Disease Control and Prevention said Friday that new information about the illnesses in Alaska led them to expand a warning beyond chopped romaine to include any type of romaine lettuce, including whole heads and hearts of romaine.
The agency has traced the outbreak to romaine lettuce grown in the Yuma region of Arizona.
Consumers as well as restaurants and retailers are advised to throw away any lettuce if they can't confirm where it's from. This includes whole heads and hearts of romaine, chopped romaine, pre-packaged salads, and salad mixes containing romaine lettuce.
While the current cases are connected to the Yuma, Arizona, area, the CDC warns that package labels do not often identify growing regions.
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On Friday afternoon the CDC reissued another warning after an outbreak in Alaska, and cases reported in CT and NY.
People usually get sick from Shiga toxin-producing E. coli (STEC) 2-8 days (average of 3-4 days) after swallowing the germ. To date, 31 people have been hospitalized, including five who have developed a type of kidney failure called hemolytic uremic syndrome, according to the CDC. The latest update comes after state and local officials in Alaska interviewed sick people at a correctional facility regarding the foods that they consumed as well as the possible exposures they had before they got sick.
Most people infected with E. coli develop diarrhea that can be bloody, severe stomach cramps, and vomiting.
More cases of E. Coli infection may be reported in the coming weeks, since some people may not immediately report the illness.
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Romaine lettuce is sometimes packed in the field and shipped directly to restaurants or grocery stores.
Earlier this year, romaine was the source of a major E. coli scare in Canada.
The CDC has not listed any brand or product names affected, just the location, saying "no common grower, supplier, distributor, or brand has been identified".
Kidney failure can occur, typically in children under 5 or seniors over 65.
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One person died as a result of the outbreaks in 2017.