A CDC investigation update of a multistate outbreak of E. coli O157:H7 infections linked to romaine lettuce has been posted https://www.cdc.gov/ecoli/2018/o157h7-04-18/index.html. Updates:Since the last case count update on May 2, 2018, 28 more ill people have been reported, bringing the total to 149 ill people from 29 states.Sixty-four people out of 129 with available information (50%) have been hospitalized, including 17 who developed a type of kidney failure called hemolytic uremic syndrome. One death was reported from California, which was included in the May 2 update.Four more states have reported ill people: Florida, Minnesota, North Dakota, and TexasThe latest reported illness started on April 25, 2018.For the most recent information about the traceback investigation, visit the U.S. Food and Drug Administration website at https://www.fda.gov/Food/RecallsOutbreaksEmergencies/Outbreaks/ucm604254.htm.CDC’s advice remains the same:Do not eat or buy romaine lettuce unless you can confirm it is not from the Yuma growing region. Restaurants and retailers should not serve or sell any romaine lettuce from the Yuma growing region. Ask your suppliers about the source of their romaine lettuce.Romaine lettuce has a shelf life of several weeks, and contaminated lettuce could still be in homes, stores, and restaurants.If you do not know whether lettuce is romaine, do not eat it. This includes lettuce in a salad mix. Package labels often do not identify growing regions. CDC is advising consumers not to eat or buy romaine lettuce if they do not know where it was grown.This advice includes whole heads and hearts of romaine, chopped romaine, baby romaine, organic romaine, and salads and salad mixes containing romaine lettuce.People get sick from Shiga toxin-producing E. coli an average of 3 to 4 days after swallowing the germ. Most people get diarrhea (often bloody), severe stomach cramps and vomiting.Most people recover within a week, but some illnesses can last longer and be more severe.Talk to your doctor if you have symptoms of an E. coli infection and report your illness to your local health department.E. coli infections also can spread from one person to another through germs on hands. To help prevent infection, wash hands after using the restroom or changing diapers, and before and after preparing or eating food.This investigation is ongoing and health officials will provide more information as it becomes available.