The Centers for Disease Control and Prevention said on Wednesday one person from California died related to an E. coli outbreak linked to romaine lettuce, providing an update on the multi-state outbreak of the disease.
Twenty-three more people fell ill since the last update on April 27, bringing the total to 121 people from 25 states, the CDC said.
Three more states – Kentucky, Massachusetts and Utah- have reported cases, the CDC said in an email.
Fifty-two people out of 102 with available information (or 51 percent) have been hospitalized, including 14 patients who developed hemolytic uremic syndrome, a type of kidney failure.
The reported strain of E. coli, which produces poisonous substances known as Shiga toxins, can cause severe stomach cramps, bloody diarrhea and vomiting.
The Food and Drug Administration said most people reported eating a salad at a restaurant, and romaine lettuce was the only common ingredient identified among the salads eaten. The restaurants reported using bagged, chopped romaine lettuce to make salads.
The FDA is continuing to investigate the source of the chopped romaine lettuce that caused these illnesses and has identified dozens of other fields as possible sources.
The CDC reiterated its advice of not eating or buying romaine lettuce, normally used in salads, unless the source of the lettuce can be confirmed. Health officials have tied the E. coli outbreak to romaine lettuce grown in Yuma, Arizona, which provides most of the romaine sold in the United States during the winter.