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After weeks of illnesses being reported across 25 US states, a person in California has died due to an outbreak of Escherichia coli bacteria linked to romaine lettuce. The US Centers for Disease Control and Prevention (CDC) has now reported 121 cases of infection in people age 1 to 88.

This strain of bacteria causes diarrhea, vomiting and severe stomach cramps, and can lead to kidney failure, which has been reported in 14 of the 52 people who have been hospitalised during the outbreak.

��ҹ����1000���� officials have tied the food poisoning to lettuce grown in the Yuma, Arizona region, which supplies the US with most of its romaine in the winter months. A farm there was the source of whole heads of lettuce sold to an Alaskan prison where eight inmates became ill after eating it. But that doesn’t account for the rest of the outbreak.

Peter Cassell at the US Food and Drug Administration’s Food Safety division says the agency is investigating the source of the illnesses in the other states. “We are working to identify multiple distribution channels that can explain the entirety of the nation-wide outbreak, and are tracing back from multiple groupings of ill people located in diverse geographic areas,” he says.

Cassell says the Arizona Department of Agriculture confirmed that romaine lettuce is no longer being produced and distributed from the Yuma growing region. “However, due to the 21-day shelf life, we cannot be certain that romaine lettuce from this region is no longer in the supply chain,” he says.

The agency is investigating dozens of other fields as potential sources of the contaminated lettuce, he added.

The CDC has warned against eating any romaine lettuce unless it can be confirmed that it wasn’t grown in the Yuma, Arizona region, including whole heads and hearts of romaine, as well as bagged salad mixes.