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The US Centers for Disease Control and Prevention is urging residents to throw out all romaine lettuce amid an E.coli outbreak. The agency previously had advised consumers to avoid chopped romaine, salads and salad mixes that contained the lettuce. It is important to toss or refrain from eating the lettuce because lettuce labels do not often identify the source of origin.

Basically, if you can't confirm romaine lettuce didn't come from near Yuma, don't buy, sell or eat it. This includes whole heads and hearts of romaine, chopped romaine, pre-packaged salads, and salad mixes containing romaine lettuce.

The area around Yuma, Arizona where 90 percent of the nation's romaine lettuce comes from, and although the exact source hasn't been identified, the CDC strongly suspects that region is the culprit.

There have been reported cases in Pennsylvania, Idaho, New Jersey, Connecticut, Illinois, Michigan, Missouri, New York, Ohio, Virginia, Washington, California, Alaska, Arizona, Louisiana and Montana.

About 53 people have been reported sickened in 16 states since March 13, the CDC said. None of the cases were in Hawaiʻi. People get sick within two to eight days of swallowing the germ, which causes diarrhea, stomach cramps and vomiting.

To keep yourself and your family safe, the CDC recommends avoiding any romaine lettuce products that could be contaminated.

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Romaine lettuce is sometimes packed in the field and shipped directly to restaurants or grocery stores.

The initial outbreak was reported April 10, with 17 people from seven states affected. So far, at least 31 people have been hospitalized, and five of these have developed hemolytic uremic syndrome, a potentially life-threatening type of kidney failure. Most recover within one week but there is a chance of kidney failure.

Most E. coli are harmless and actually are an important part of a healthy human intestinal tract.

HUS can occur in people of any age but is most common in children younger than 5 years, adults aged 65 years and older, and people with weakened immune systems.

One person died as a result of the outbreaks in 2017.