(RNN) – An E. coli outbreak traced to romaine lettuce has been linked with nine more illnesses, bringing the total number of people infected nationwide to 52.
That’s according to an update the Centers for Disease Control and Prevention posted Thursday, which said E. coli infections for nine people have been reported since the agency gave an update on Nov. 26.
Overall, 19 people have been hospitalized, including two people who developed hemolytic uremic syndrome, a type of kidney failure.
The CDC said no deaths have been reported.
Cases of infection have been reported in 15 states: California, Connecticut, Florida, Illinois, Louisiana, Massachusetts, Maryland, Michigan, New Hampshire, New Jersey, New York, Ohio, Pennsylvania, Rhode Island and Wisconsin.
The U.S. Food and Drug Administration said six counties in the Central Coastal growing regions of northern and central California have been linked to the outbreak: Monterey, San Benito, San Luis Obispo, Santa Barbara, Santa Cruz and Ventura.
The CDC and the FDA warn people not to eat or serve romaine harvested in those counties, and to check the label on their romaine to make sure it wasn’t grown there.
If the lettuce isn’t labeled, the CDC warns people not to “buy, serve, sell or eat it.”
Though the agencies have traced the E. coli outbreak to a handful of California counties as the likely source, “no common grower, supplier, distributor, or brand of romaine lettuce has been identified,” the CDC said.
Symptoms of E. coli infection include “severe stomach cramps, diarrhea (often bloody) and vomiting,” according to the CDC.
People who suspect they’ve been infected should contact their doctor.