A warning to not consume romaine lettuce grown in the Salinas, California, because of E. coli fears remains in effect as federal authorities continue to look for a cause of the outbreak.

The Centers for Disease Control and Prevention and the U.S. Department of Agriculture’s Food Safety and Inspection Service issued a warning in November against consuming any wraps, sandwiches, prepackaged salad or other product containing romaine lettuce harvested from the region. The warning includes any whole heads of romaine, organic romaine and hearts of romaine.

The number of cases of people infected with E. coli has grown to 138 cases in 25 states including nine in New Jersey. Three cases have been reported in in Burlington County, two in Ocean County and one each in Atlantic, Camden, Cumberland and Monmouth counties.

No deaths have been reported among the 72 people hospitalized nationwide. Thirteen people have developed hemolytic uremic syndrome, a type of kidney failure, but none in New Jersey.

The bottom line from the CDC: If you don't know where your romaine lettuce was grown don't eat it.

E. coli is a potentially deadly bacterium that can cause dehydration, bloody diarrhea and abdominal cramps two to eights days after exposure.

While most people recover within a week, some develop a type of kidney failure called hemolytic uremic syndrome. This condition can occur among people of any age but is most common in children under 5 years old and in older adults. It is marked by easy bruising, pallor and decreased urine output. People who experience these symptoms should seek emergency care immediately.

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