One person in California has died as a result of the ongoing E. coli outbreak tied to romaine lettuce, according to health officials. The latest update from the Centers for Disease Control and Prevention reports 23 additional illnesses, bringing the total to 121 cases from 25 states.

Fifty-two people out of the 102 cases with available information have been hospitalized -- an unusually high hospitalization rate of 51 percent. Fourteen of those patients developed a type of kidney failure called hemolytic uremic syndrome. 

Three more states have reported illnesses, including Kentucky, Massachusetts, and Utah.

The current E. coli outbreak is the worst multistate outbreak since 2006. Like that outbreak, which traced back to spinach and was linked to 238 illnesses and five deaths, the CDC says the bacteria strain behind the current outbreak is one that tends to cause more serious illnesses.

Map showing where people have been infected by the E. coli outbreak linked to romaine lettuce. CDC

Health officials continue to advise consumers not to eat any romaine lettuce from the Yuma, Arizona growing region. Every winter, the Yuma region provides most of the romaine sold in the U.S. 

Specifically, the CDC advises consumers and restaurants:

  • Do not eat or buy romaine lettuce unless you can confirm it is not from the Yuma, Arizona, growing region.
  • The warning includes whole heads and hearts of romaine, chopped romaine, and salads and salad mixes containing romaine lettuce.  
  • Product labels often do not identify growing regions; do not eat or buy romaine lettuce if you do not know where it was grown.

Health officials warn that washing your lettuce does not offer enough protection. 

"This bacteria can actually get inside the lettuce leaf," said Ian Williams, chief of the CDC's Outbreak Response and Prevention Branch, CBS SF Bay Area reports. "Washing it doesn't make it safe.

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