Five people die in US romaine lettuce E. coli outbreak

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Four more people have died from tainted romaine lettuce, federal health officials said Friday, bringing the total to five deaths related to a virulent strain of E. coli whose source has still not been located.

The disease appears to have been spread from romaine lettuce grown in the Yuma region of Arizona. That means it is unlikely that any romaine lettuce from the Yuma growing region is still available in people's homes, grocery stores or restaurants due to its 21-day shelf life. Three more states have reported ill people - Arkansas, North Carolina and Oklahoma. Canadian health officials also recently identified E. coli cases in several provinces that could potentially be linked to the outbreak in the United States.

Previously one death had been reported, in California. On Friday, health officials said they had learned of four more - one in Arkansas, one in NY, and two in Minnesota.

"Some people who became sick did not report eating romaine lettuce, but had close contact with someone else who got sick from eating romaine lettuce".

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Romaine lettuce grown in the Arizona region was last harvested in mid-April. This is the worst multistate outbreak since 2006, when contaminated spinach was linked to 238 illnesses and five deaths.

Of the infected people, 89 have been hospitalised, and 26 have developed a kidney failure type known as hemolytic uremic syndrome.

Symptoms of E. coli vary, but include may include stomach cramps, fevers, bloody diarrhea and vomiting among others.

Officials urge anyone who thinks they may be ill with an E. coli infection to see their doctor.