Story highlights The multistate outbreak has claimed the lives of five people

Most of the newly reported sick people became ill when contaminated lettuce was still available

(CNN) An additional 25 people have become ill from eating lettuce contaminated with E. coli, the US Centers for Disease Control and Prevention reported Friday.

In total, 197 people across 35 states have become ill since March 13 , including five people who died.

Symptoms, which begin about three to four days after consuming the bacteria, can include watery or bloody diarrhea, fever, abdominal cramps, nausea and vomiting, according to the CDC. Most people infected by the bacteria get better within five to seven days.

Of the total 187 patients for whom information was available, 89 (or 48%) were hospitalized, including 26 who developed a type of kidney failure called hemolytic uremic syndrome. Symptoms of this syndrome include fever, abdominal pain, fatigue, small unexplained bruises or bleeding, and pallor. Most people recover within a few weeks, but some suffer permanent damage or die.

To avoid E. coli infections, experts advise thoroughly cooking meat, avoiding unpasteurized dairy products and juices, avoiding swallowing water while swimming and washing hands regularly.

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