In all, almost 30 states have now reported illnesses.
The CDC said the current outbreak is unrelated to the multi-state outbreak of E. coli in leafy greens in November and December, because the two strains of E. coli O157:H7 bacteria have different DNA fingerprints.
On Wednesday, the footprint of the romaine lettuce E. coli outbreak became more extensive than the historic and deadly 2006 fresh spinach outbreak.
Sixty-four percent of the people who have been infected are female and those infected range in age from 1 to 88 years old, with a median age of 30.
The Minnesota Department of Health cautioned Minnesotans against eating romaine lettuce unless they are able to ascertain that it is not from the Yuma region, an area that includes western Arizona and southeastern California.
The 2006 spinach outbreak of E. coli O157: H7 was one of the critical events in the lead-up to Congress passing the Food Safety Modernization Act (FSMA), which President Obama signed into law on January 4, 2011. But there is a 21-day shelf life for romaine, the agency says, so there might still be lettuce in the supply chain. Ninety-one person of 112 people interviewed reported eating romaine lettuce in the week before their illnesses started, compared with 46 percent of healthy people. People who get sick from toxin-producing E. coli come down with symptoms about three to four days after swallowing the germ, with many suffering bloody diarrhea, severe stomach cramps and vomiting. There has also been one death recorded, in California, according to the U.S. Centers for Disease Control and Prevention.
However, the agency confirmed that no other types of lettuce or any other growing region for romaine are involved in the outbreak.
"This advice includes whole heads and hearts of romaine, chopped romaine, baby romaine, organic romaine, and salads and salad mixes containing romaine lettuce", the CDC said.
Update: An earlier version of this story mentioned an E. coli outbreak that caused concern back in January of 2018.
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IPL: Mumbai Indians beat Kolkata Knight Riders by 13 runs
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