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This investigation is ongoing, and CDC will provide more information as it becomes available. One of the hospitalized people developed hemolytic uremic syndrome, a potentially life-threatening form of kidney failure. People in this outbreak were infected with the same type of E. coli strain that made people sick in a 2017 outbreak linked to leafy greens.
This strain - E. coli O157:H7 - is the same as the one which caused an outbreak past year from romaine and unspecified leafy greens grown in Canada.
No brand names have been identified and no recall was ordered.
It doesn't matter where the romaine is from or even if you or a loved one has eaten some and not gotten sick.
"The most recent illness onset in the U.S.in the current outbreak was October 31, 2018", the FDA said, adding that there are 11 states in the USA with cases.
The warning includes all types of romaine lettuce and any salad mix that contains romaine lettuce.
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Wash and sanitize drawers or shelves in refrigerators where romaine was stored.
No deaths have been reported, but 13 of the people who became sick in the United States were hospitalized.
The Centers for Disease Control and Prevention is urging Americans "not to eat" romaine lettuce and restaurants "not to serve or sell any" until more information is gathered on a new outbreak.
Symptoms of E. coli infection include severe stomach cramps, diarrhea, and vomiting.
The Public Health Agency of Canada has identified an additional 18 people who have become sick with the same strain of of E. coli in Ontario and Quebec.
Individuals should seek medical help if diarrhea lasts for more than three days or if it is accompanied by high fever, blood in the stool or an inability to keep liquids down because of vomiting.