(CNN) A total of 40 people in 16 states have fallen ill due to an E. coli outbreak in romaine lettuce, according to a report from the Centers for Disease Control and US Food and Drug Administration.

The agencies warn consumers, retailers and restaurants not to purchase or sell romaine lettuce harvested in Salinas, California, about 59 miles south of San Jose. The warning includes all types of romaine lettuce, according to a CDC tweet

So far, 28 people were hospitalized, though no deaths were reported, according to the FDA. Wisconsin has had 10 cases, the most reported from the 16 states, the CDC said

"If romaine lettuce does not have labeling information for its growing area or the source cannot be confirmed, consumers should not eat or use the romaine," said Frank Yiannas, FDA's deputy commissioner for food policy and response. "Restaurants and retailers should not serve or sell romaine lettuce if they cannot confirm it is from outside Salinas."

CDC's warning not to eat romaine lettuce from the Salinas, California, growing region includes ALL types of romaine (whole head, hearts of romaine, salad mixes, organic, etc.). Throw them away. Read more about the investigation: https://t.co/sZvP3yMmqV pic.twitter.com/8AjFzROkXm — CDC (@CDCgov) November 22, 2019

This outbreak was caused by the same E. coli strain that caused outbreaks in 2017 and 2018 , according to Yiannas and the CDC.

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