Public health officials are working to locate multiple distribution channels that can explain why so many are sick in so many states.
So far 52 people have been hospitalized, including 14 with hemolytic uremic syndrome, a potentially fatal kidney complication.
The Centers for Disease Control and Prevention said two cases have been reported in MA but no additional information was immediately available.
The CDC urges people not to eat romaine lettuce unless it can be confirmed it didn't come from the Yuma region. Like that outbreak, which traced back to spinach and was linked to 238 illnesses and five deaths, the CDC says the bacteria strain behind the current outbreak is one that tends to cause more serious illnesses. The newest update includes illnesses that began as recently as April 21. Last week the CDC said is seeing a higher than usual number of hospitalizations in the outbreak, which officials said is a pattern seen in the past with outbreaks involving E coli strains that only produce Shiga toxin type 2 (STX2). Restaurants and retailers should not serve or sell any romaine lettuce from the Yuma, Arizona growing region. However, the agency has not determined where in the supply chain the contamination occurred. The agency is investigating dozens of other fields as potential sources of the chopped romaine lettuce. Numerous people sickened across the country consumed chopped lettuce that had been sold in bagged form to restaurants. The CDC noted there may be a lag time of two to three weeks from the time a person becomes ill with E. coli to when that illness is reported to federal officials.
The FDA recommends that consumers ask restaurants, grocers, and other food service establishments where they got the romaine lettuce they are serving. The CDC advises anyone with these symptoms to seek medical attention as E. coli infection is typically diagnosed via a stool sample.