Now that winter has settled into applicable parts of the United States, romaine lettuce crops have transitioned to desert regions in California and Arizona, as well as Florida.
Also safe are romaine lettuces grown hydroponically, those grown in greenhouses as well as those grown in Mexico during the winter months and smaller quantities in other states.
Investigators have been tracing back the romaine eaten by people sickened in the outbreak.
The growing and harvesting of romaine lettuce has shifted to the winter growing regions of California's Imperial Valley, the desert region of Arizona in and around Yuma, and Florida.
In the US, the FDA is advising people not to eat romaine that doesn't have clear labelling information stating where the produce is from.
The FDA said on Monday that all romaine lettuce entering the market should now be labeled with a harvest location and date and that consumers should not buy or eat it if that information is missing.
"If consumers, retailers and food service facilities are unable to identify that romaine lettuce products are not affected - which means determining that the products were grown outside the California regions that appear to be implicated in the current outbreak investigation - we urge that these products not be purchased, or if purchased, be discarded or returned to the place of purchase". An industry group said people can expect to start seeing labels as early as this week.
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"The FDA also has commitments from the romaine lettuce industry that such labelling will continue into the future and become standard for their products", Gottlieb said. It noted the labels are voluntary, and that it will monitor whether to expand the measure to other leafy greens and produce.
The FDA still hasn't identified a source of contamination in the latest outbreak.
An additional 22 people in Canada are also ill, so the FDA is coordinating their investigation with the Canadian health and food safety authorities, the agency said. US investigators never specified which salad green might be to blame for those illnesses, which happened around the same time of year as the current outbreak.
The agency's announcement follows a stern warning issued two days before Thanksgiving, by the CDC, telling consumers nationwide not only to stop eating romaine lettuce, but also to scrub and sanitize drawers or shelves where it has been stored.
McEntire said the industry is considering multiple theories, including whether there is something about romaine that makes it more susceptible to contamination.
"Those who are experiencing food poisoning symptoms after consuming Romaine lettuce are advised to seek immediate medical attention at the nearest clinic or hospital."
The FDA said that the ongoing outbreak is linked to the "end of season" harvest in some parts of California.