An additional 27 people have reportedly been infected with the outbreak strain of E. coli O157:H7 linked to Romaine lettuce harvested in the Salinas, CA, growing region. The number of people, now 67, was first reported as 40 when the Centers for Disease Control & Prevention issued an advisory Nov. 22. Over the past few days the number of states affected has increased from 16 to 19.

A total of 39 hospitalizations have now been reported, including six people who have developed hemolytic uremic syndrome, a type of kidney failure.

Epidemiologic, laboratory, and traceback evidence collected to date indicate that romaine lettuce from the Salinas growing region may be contaminated with E. coli O157:H7 and is making people sick.

The Centers for Disease Control & Prevention and public health and regulatory officials from several states are investigating the multi-state outbreak.

As a precaution, the CDC issued an advisory Nov. 22 warning consumers not to eat -- and retailers not to sell -- Romaine lettuce from the Salinas Valley. There have been no deaths reported.

Data provided by CDC show that Wisconsin has 21 reported cases; followed by 12 in Ohio; four each in California and Maryland; three each in Pennsylvania, Minnesota, Idaho and Arizona; two each in New Mexico, Texas and Virginia; and one each in Washington, Oregon, New Jersey, Nebraska, Montana, Michigan, Illinois and Colorado.

CDC said all types of Romaine fall under the advisory, including whole heads, hearts, packaged and salad mixes containing Romaine. It most Romaine products are labeled with the harvest location where they were grown, and it urged consumers to check labels and throw away any that list Salinas as the harvest location.