One person has died in California from an expansive E. coli outbreak connected to tainted romaine lettuce. So far, a total of 121 people in 25 states have been poisoned, the U.S. Centers for Disease Control and Prevention announced on Wednesday.
The California Public Health Department declined to provide additional details on the victim, citing confidentiality rules. Of those sick, 52 have been admitted to a hospital.
Since the last update on Friday, the CDC has updated the infected count by 23 and added Massachusetts, Kentucky and Utah to the list of affected states. It's now considered the largest outbreak in the United States since 2006.
Canada has also been grappling with an E. coli outbreak, which has also claimed one life. Symptoms of E. coli can include severe stomach aches and cramps, vomiting and diarrhea.
"Although today we do not have a grip on a specific source, we have various leads that we're exploring with rigor," Dr. Jasmine Hasselback, medical officer of health for the Edmonton zone, told CBC news on April 20.
Along with the CDC, the Food and Drug Administration is still trying to pinpoint the source of the outbreak, although it is believed to be from the Yuma, Arizona, growing region. The health organizations issued a stern warning for people not to consume the leafy vegetable without knowing where it came from.
"[Use caution with] whole heads and hearts of romaine, chopped romaine, baby romaine, organic romaine, and salads and salad mixes containing romaine lettuce," the CDC said. "If you do not know if the lettuce in a salad mix is romaine, do not eat it."
The number of people sick with E. coli could be higher than current estimates because of a delay in reporting, the CDC also cautioned.
"Illnesses that occurred in the last two to three weeks might not yet be reported because of the time between when a person becomes ill with E. coli and when the illness is reported to CDC."
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