The CDC is recommending that no one eat any romaine lettuce until the investigation into more than thirty E. coli­–caused illnesses is completed.

Step away from the romaine lettuce: The U.S. Centers for Disease Control and Prevention (CDC) is recommending that people not eat any type of romaine lettuce. This includes whole heads of romaine, hearts of romaine, and precut lettuce or salad mixes that may contain any amount of romaine lettuce.

The CDC food safety alert comes after 32 people in 11 states have reported illnesses caused by E. coli infections. The reported illnesses occurred between October 8 and October 31, and 13 people were hospitalized because of their symptoms—one with a type of kidney failure. No deaths have been reported, but an additional 18 people were infected with the same type of Shiga toxin-producing E. coli in Canada. Epidemiologic evidence points to romaine lettuce as a likely source of the E. coli outbreak.

The CDC is working with Canadian public health officials and the U.S. Food and Drug Administration (FDA) to investigate the multiple illnesses. Until the agencies learn more about the outbreak, they are advising that U.S. consumers not eat any romaine and that retailers and restaurants not serve or sell any. No common grower, supplier, distributor, or brand of romaine lettuce has been identified, so any type of romaine lettuce could carry the bacteria.

If you have romaine lettuce in your home, do not eat it and dispose of it immediately. The same goes for salad mixes that may contain romaine (including spring mix, Caesar salad, and baby romaine). If it’s unclear whether a salad contains romaine, the CDC recommends taking the safer course of action and not eating it. Thoroughly clean any areas of your refrigerator where romaine has been stored.

This outbreak may be related to a 2017 outbreak linked to leafy greens—the CDC says people who fell ill in this outbreak were infected with E. coli bacteria that has the same DNA fingerprint as the 2017 strain. The FDA says there is no genetic link between this outbreak and the E. coli outbreak that was linked to romaine in spring 2018.

Symptoms of E. coli infection typically appear three to four days after consuming the germ and include severe stomach cramps, diarrhea, vomiting, and sometimes a low fever. Antibiotics are not recommended for treatment. If you experience symptoms, contact a healthcare provider immediately.

No recall has been issued yet, but the CDC and FDA will provide investigation updates as they are able. Until then, plan to skip the romaine at Thanksgiving this year—these fresh fall salads for the Thanksgiving table are all romaine-free.

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