The US Centers for Disease Control and Prevention said the total number of those infected has climbed to 24. Two people developed hemolytic uremic syndrome, a type of kidney failure. At least 41 people were sickened in that country, with one death.
Maryland and New Jersey now join California, Connecticut, Illinois, Indiana, Michigan, Nebraska, New Hampshire, New York, Ohio, Pennsylvania, Vermont, Virginia and Washington, which all previously reported cases of illness.
While the cause of contamination has not been identified, there have been no illnesses beyond December 12, 2017, the agency says.
This is about the same timing of an outbreak of E. coli in Canada, which health officials declared over on Wednesday. One person has died in California.
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Based on the investigation findings to date, the agency says exposure to romaine lettuce has been identified as the source of the outbreak, but the cause of contamination has not been determined.
The CDC did whole genome sequencing on the bacteria that caused the outbreak and found they were genetically similar to those implicated in a similar outbreak in Canada.
The U.S. Food & Drug Administration said its outbreak investigation team is working with CDC and state and local officials to determine what ill people ate, where they bought it and the distribution chain - all with the goal of learning where these foods were produced, to see if there is any common food or point where the food might have become contaminated.
While the outbreak does appear to be associated with leafy greens, according to CDC and FDA statements released yesterday, US health officials have not confirmed a specific type, nor have any food recalls been issued.
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Over ten countries have been designated level 4 countries, including Afghanistan , Somalia , Iran , Syria, and North Korea. Perennial US adversary Russian Federation was listed as a Tier 3 country, due to the risk of "terrorism and harassment".
However, officials indicated the outbreak in the United States may also be over soon. Leafy greens typically have a short shelf life, and since the last illness started a month ago, it is likely that contaminated leafy greens linked to this outbreak are no longer available for sale. Canada pointed to romaine lettuce as the source of its outbreak.
"There appears to be an ongoing risk of E. coli infections associated with the consumption of romaine lettuce in Canada's eastern provinces", Canada said on December 28.
The symptoms of an E. coli O157:H7 infection include severe and painful stomach and abdominal cramps, diarrhea that is bloody and/or watery, and mild fever.
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