Twenty-eight more people in four states (Florida, Minnesota, North Dakota, and Texas) have been sickened by E. coli-tainted romaine lettuce, the Centers for Disease Control and Prevention (CDC) said Wednesday.
Two Canadians reported travelling to the US before getting sick and eating romaine lettuce while they were there.
The U.S. Food and Drug Administration says romaine lettuce from the Yuma growing region in Arizona and California is no longer being produced and distributed, so the potential for exposure to contaminated lettuce is reduced.
A total of 64 people have been hospitalized in the outbreak, including 17 who developed a type of kidney failure called hemolytic uremic syndrome.
The total number of cases by state are: Alaska, 8; Arizona, 8; California, 30; Colorado, 2; CT, 2; Florida, 1; Georgia, 5; Idaho, 11; IL, 2; Kentucky, 1; Louisiana, 1; MA, 3; MI, 4; Minnesota, 10; MS, 1; Missouri, 1; Montana, 8; New Jersey, 8; NY, 4; North Dakota, 2; OH, 3; Pennsylvania, 20; South Dakota, 1; Tennessee, 1; Texas, 1; Utah, 1; Virginia, 1; Washington, 7; Wisconsin, 2.
Last week, the CDC announced that one person had died from the E. coli outbreak; the death, in California, was the first known fatality from this outbreak. That outbreak led to three deaths and sickened 199 people in 26 states, according to CDC's final update dated October 6, 2006. At this rate, the E. coli outbreak is expected to worsen overtime.
Symptoms of E. coli typically begin three to four days after the bacteria is ingested.
Scientists have identified a link to romaine lettuce grown in the Yuma, Arizona region.
"Antibiotics are not recommended for patients with suspected E. coli O157 infections until diagnostic testing can be performed and E. coli O157 infection is ruled out", the CDC said.
In April, health officials warned consumers to toss out any romaine lettuce they might have purchased in stores.