The romaine lettuce E. coli outbreak shows little sign of slowing with 28 people confirmed ill in the last week and four states, including Florida and Texas, recording their first cases.
While the numbers have changed, the advice from the Centers for Disease Control and the Food and Drug Administration remains the same: Avoid all romaine lettuce from the Yuma, Arizona region as well as any romaine lettuce you can't confirm is not from that area.
Last week, the FDA and Arizona's Department of Agriculture said that Yuma's romaine lettuce growing season has ended, but the 21-day shelf life means romaine might still be in the supply chain.
Wednesday's update from the Centers for Disease Control says there are now 149 cases in 29 states, the most recent person falling ill on April 25. Of those 149, the CDC has information on 129 and 64 of those 129 people (49.6 percent) have been hospitalized.
As far as hemolytic uremic syndrome (HUS), the kidney failure that can make E. coli infections fatal, that count is up to 17. There remains just one death, in California, which has the most cases, with 30.
From the states with their first cases, Florida and Texas each have one case, but Minnesota has 10 and North Dakota has two. On a per capita basis, that means there's a cluster across the Canadian border states of Minnesota (10), North Dakota (two), Montana (eight), Idaho (11) and Washington (seven). Another cluster in a more densely populated area would comprise Pennsylvania (20) and New Jersey (eight).
The geographic disparity in the clusters has helped confound officials in tracking the source of the outbreak deeper than the Yuma region.
The sick count in the states not mentioned above: Alaska and Arizona, eight each; Georgia, five; Michigan and New York, four each; Ohio and Massachusetts, three each; Colorado, Connecticut, Illinois and Wisconsin, two each; Kentucky, Louisiana, Mississippi, Missouri, South Dakota, Tennessee, Utah and Virginia, one each.
E. coli strikes between two and 10 days after eating the contaminated food, but tends to most often hit in three or four days. Most people develop bloody diarrhea and cramps for five to seven days. Others develop HUS.