Romaine lettuce is unsafe to eat … again. The CDC is advising people to throw out and avoid eating all romaine lettuce following an E.coli outbreak that has left 32 people sick and 13 people hospitalized across 11 states in the U.S. so far.

The CDC along with public health officials across the U.S. and Canada are investigating another outbreak of E.coli connected to romaine lettuce. The center said that consumers should not eat any romaine lettuce, and restaurants and retailers should not serve this item until the outbreak has been thoroughly investigated.

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The reported illnesses for this outbreak began on Oct.8, 2018 through Oct. 31, 2018. Thirteen people have been hospitalized, with 32 cases reported altogether at the time of writing. No deaths have been reported. The investigation is still undergoing and no additional information has been reported, but the center advises consumers to throw out all romaine lettuce, even if you have already eaten some and did not get sick.

“This advice includes all types or uses of romaine lettuce, such as whole heads of romaine, hearts of romaine and bags and boxes of precut lettuce and salad mixes that contain romaine, including baby romaine, spring mix and Caesar salad,” the CDC said. “If you do not know if the lettuce is romaine or whether a salad mix contains romaine, do not eat it and throw it away. Wash and sanitize drawers or shelves in refrigerators where romaine was stored. Follow these five steps to clean your refrigerator.”

Watch: CDC declares romaine lettuce an E. coli risk

If you’re worried about the outbreak, here are some symptoms to look for: severe stomach cramps, diarrhea, vomiting and a slight fever. The illness usually begins about two to eight days after swallowing the germ and lasts about a week, but E.coli can cause kidney failure or become life-threatening. Find out more information here.  The CDC is updating consumers on the outbreak and ongoing investigation.

+ CDC

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