CBS Local — A warning from the CDC is urging people to be cautious of eating romaine lettuce after nearly 60 people were infected by E. coli bacteria. Health officials say the illnesses were reported in Canada and 13 states including New York, California, Illinois, Michigan, and Ohio.

According to Consumer Reports, the dangerous bacteria has sent five to the hospital and killed one person in America. Another patient died of the illness in Canada, where the source of the bacteria was tracked down to the leafy greens.

“Even though we can’t say with 100 percent certainty that romaine lettuce is the cause of the E. coli outbreak in the U.S., a greater degree of caution is appropriate given that lettuce is almost always consumed raw,” Consumer Report’s director of food safety and research James Rogers said.

The CDC’s report adds that the outbreak began in mid-November and is still being tested to see if the Canadian E. Coli cases are linked to the patients in the U.S. The organization stopped short of issuing a full ban on eating romaine lettuce until it finishes its investigation into the illnesses.

“Vegetables can be contaminated if animal feces are in the field or in irrigation or washing water,” Rogers explains. “The bacteria can also be transmitted if a person who is carrying the bacteria doesn’t wash his or her hands after using the bathroom.” While washing any greens may help avoid some illnesses, Consumer Reports warns that it may not get rid of all E. Coli bacteria present.

The illness usually takes one to three days before symptoms begin to show, which include severe stomach cramps, diarrhea, and vomiting.

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