According to a news release from November 26, 2018, the Food and Drug Administration (FDA) says evidence suggests the romaine linked to E. coli illnesses was harvested in the Central Coast growing areas of northern and central California. Last week, health officials advised against eating all romaine lettuce, but now they say it’s safe to eat romaine harvested outside of those regions, according to the release. “Romaine lettuce that was harvested outside of the Central Coast growing regions of northern and central California does not appear to be related to the current outbreak,” said Scott Gottlieb, MD, commissioner for the FDA, in a separate statement on November 26, 2018. “Hydroponically and greenhouse-grown romaine also does not appear to be related to the current outbreak. There is no recommendation for consumers or retailers to avoid using romaine harvested from these sources." RELATED: 17 Sickened, 1 Dead After Eating Ground Beef Contaminated With E. Coli The FDA has not yet issued a recall for the affected romaine because it doesn’t have enough trace-back information, according to the release. But for now, if a product’s label shows it was harvested and grown in northern or central California, the FDA advises retailers and consumers to not eat or use it. Romaine from outside of those regions is likely safe to eat. If you can’t determine the source of your romaine, the FDA urges against eating or using it. To help health officials locate possible outbreak sources in the future, and to help consumers avoid possibly contaminated romaine, the FDA is urging growers, processors, and distributors to use labeling that clearly states where the romaine was grown and when it was harvested. If that’s not possible, the FDA encourages retailers to label the growing region of their romaine products, Dr. Gottlieb said in the statement. “We hope that growers, processors, distributors, and retailers will join us in our effort to protect consumers by applying these labeling recommendations to their products,” Gottlieb adds. “We remain committed to identifying ways to decrease the incidence and impact of foodborne illness outbreaks, and will continue to provide updates on our investigation and changes to our advice on romaine lettuce as more information becomes available.”

Latest Numbers on the E. Coli Outbreak Linked to Romaine Lettuce

As of November 26, a total of 43 people in the United States had been infected with E. coli and 16 had been hospitalized in 12 states. In addition, 22 people in Canada had been sickened. No deaths had been reported. The U.S. cases have been reported in California, Connecticut, Illinois, Massachusetts, Maryland, Michigan, New Hampshire, New Jersey, New York, Ohio, Wisconsin, and Rhode Island. One case has involved hemolytic uremic syndrome (HUS), which is a life-threatening type of kidney failure. Reports of illnesses started between October 8 and October 31, 2018. RELATED: Antibiotic-Resistant Salmonella in Chicken Sickens 100

What to Do if You Have Contaminated Romaine Lettuce

For those who have bought romaine from the source of the outbreak, be sure to dispose of all types of romaine, including whole heads of romaine, hearts of romaine, and bags or boxes of precut lettuce and salad mixes that contain romaine, including baby romaine, spring mix, and Caesar salad. William Schaffner, MD, a professor of preventive medicine and infectious diseases at the Vanderbilt University School of Medicine in Nashville, Tennessee, advises you to disinfect any surfaces or drawers touched by the lettuce, and to thoroughly wash your hands. “E. coli can get on your hands and then you can ingest it when you touch your mouth,” he says.

Why E. Coli Poses a ‘Doubly Serious’ Risk to the Kidneys

Dr. Schaffner notes that the Centers for Disease Control and Prevention (CDC) first made the recommendation to toss all romaine because the illness can be devastating. “You can get intestinal illness, diarrhea, nausea, vomiting, or abdominal cramps. But even more important, a portion of those people can get kidney damage to the point where they have to be on dialysis,” says Schaffner. “The kidney failure aspect of the illness is what makes it doubly serious and gives the CDC’s recommendation such intensity.” According to the CDC, about 5 to 10 percent of those infected with E. coli develop HUS. This syndrome can require blood transfusions and dialysis in an intensive care unit. RELATED: The 13 Most Commonly Contaminated Foods in the U.S.

What to Do if You Have Symptoms of E. Coli Infection

The CDC says that people usually get sick from Shiga toxin–producing E. coli between two and eight days after swallowing the germ. E. coli infection can be diagnosed by testing a stool sample. Typically, healthy adults can recover completely from E. coli within one week without any medication, according to the University of California San Francisco Medical Center. Some people, such as young children under 5 years old and the elderly, are especially susceptible to more serious sickness, such as HUS. Antibiotics are not recommended for patients with suspected E. coli infections. The CDC warns that administering antibiotics may increase the risk of developing HUS. If you develop symptoms of E. coli infection, the CDC recommends taking the following steps:

Talk to a healthcare provider.Track what you ate in the week before getting sick.Report your illness to the health department.

Additional reporting by Melinda Carstensen.