An E. coli outbreak that health investigators believe is linked to chopped romaine lettuce has expanded, with 53 cases now reported in 16 states, and almost three dozen hospitalized, at least five of whom suffered kidney failure.
No one has died, but 31 people have been hospitalized. No common grower, supplier, or distributor has been identified yet.
Symptoms of E. coli include severe stomach cramps, diarrhea and vomiting.
Yuma is about 185 miles (298 kilometers) southwest of Phoenix.
An investigation by the state agencies has confirmed that the romaine lettuce eaten by the Nome patients was grown in Yuma. Pennsylvania has the most (12) in this outbreak, followed by Idaho (10).
"This is a higher hospitalization rate than usual for E. coli O157:H7 infections, which is normally around 30 percent", the CDC said in a statement.
The C.D.C. learned that others infected by that particular breed, E. coli O157:H7, 'd consumed chopped romaine lettuce until getting ill, " she explained.
The agency was first alerted to the outbreak by health officials in New Jersey, who had noticed an increase in E. coli cases in the state, said Dr. Laura Gieraltowski, an epidemiologist at the C.D.C. Do not eat it if it is from the Yuma, Ariz region, or if the restaurant or retailer can't confirm its origin, the CDC says.
The lettuce may appear in bagged salads or sold by the head at grocery stores.
Usually, illness sets in "an average of three to four days after swallowing the germ".
This story previously said the state recommended throwing out only chopped romaine lettuce.
Forty-one of 43 people interviewed by health officials reported eating romaine lettuce in the week before their illness started.
They are advising people anywhere in the United States to toss their store-bought romaine lettuce in the trash, even if they've eaten some of it already and not gotten sick.
But because of the short shelf life of lettuce and the time it takes for an outbreak to be identified, obtaining such a sample may prove hard.