The death toll in a major U.S. E. coli outbreak linked to Arizona-grown Romaine lettuce has now risen to five, authorities say.

The Centers for Disease Control (CDC) said in a June 1 update the deaths were reported from Arkansas (1), Minnesota (2), and New York (1). One death had previously also been registered in California.

25 more ill people from 13 states were added to this investigation since the last update on May 16.

In total the case count now stands at 197, with 89 hospitalizations. Ill people have been registered over 35 states.

"It takes two to three weeks between when a person becomes ill with E. coli and when the illness is reported to CDC," the organization said.

"Most of the people who recently became ill ate romaine lettuce when lettuce from the Yuma growing region was likely still available in stores, restaurants, or in peoples’ homes. Some people who became sick did not report eating romaine lettuce, but had close contact with someone else who got sick from eating romaine lettuce."

No products have yet been recalled due to problems tracing the source of the outbreak. 

In late May industry created a Leafy Greens Food Safety Task Force to assess and address issues associated with foodborne illnesses, in a direct response to this outbreak.

This is the largest E. coli flare-up in the U.S. since 2006, when tainted spinach sickened 199 people across 26 states.

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