The U.S. Centers for Disease Control (CDC) has expanded its definition of the products under scrutiny in a multistate E. coli outbreak that has so far affected 53 people but to date has not led to any deaths.

Previous warnings only linked the outbreak to chopped romaine lettuce from Yuma, Arizona, but since its last update the CDC has now included whole heads and hearts of romaine lettuce, in addition to chopped romaine and salads and salad mixes containing romaine from the same origin.

"Do not buy or eat romaine lettuce at a grocery store or restaurant unless you can confirm it is not from the Yuma, Arizona, growing region," the CDC said.

"Unless the source of the product is known, consumers anywhere in the United States who have any store-bought romaine lettuce at home should not eat it and should throw it away, even if some of it was eaten and no one has gotten sick.

"Product labels often do not identify growing regions; so, throw out any romaine lettuce if you’re uncertain about where it was grown."

The CDC said the expanded warning was based on information fromnewly reported illnesses in Alaska. Ill people in Alaska reported eating lettuce from whole heads of romaine lettuce from the Yuma, Arizona growing region.

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