The day after federal health officials announced a recall of select salad products, they issued a safety alert to include romaine lettuce harvested from Salinas, California.

On Friday, the Centers for Disease Control and Prevention advised consumers not to eat and retailers not to sell the lettuce harvested in the California region, including "whole heads of romaine, hearts of romaine, and packages of precut lettuce and salad mixes which contain romaine, including baby romaine, spring mix, and Caesar salad."

Most romaine lettuce products are labeled with a harvest location showing where they were grown, according to the CDC.

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A total of 28 hospitalizations have been reported. Five people developed hemolytic uremic syndrome, a type of kidney failure. No deaths have been reported.

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The Food and Drug Administration and the CDC are investigating a multistate outbreak of E. coli O157:H7 infections linked to the lettuce. Forty people have been infected from 16 states, according to the alert.

“We are concerned about the potential for contaminated lettuce on store shelves and in people’s refrigerators," said Dr. Robert Tauxe, director of the CDC's Division of Foodborne, Waterborne and Environmental Diseases, in a statement sent to USA TODAY. "Heading into the Thanksgiving holiday, it is critically important to avoid buying or eating romaine lettuce from the Salinas growing area so you can protect yourself and your family.”

The CDC said the illnesses started Sept. 24, and it saw cases through Nov. 10. The ages of those sickened range from 3 to 89 years, with a median age of 22.

Wisconsin has the most cases with 10, followed by Ohio with five and California with four. Idaho, Maryland and Pennsylvania each had three cases. Arizona and New Mexico each had two cases.

The following eight states had one reported case each as of Friday: Colorado, Illinois, Michigan, Minnesota, Montana, New Jersey, Virginia and Washington.

"At this time, romaine lettuce that was harvested outside of the Salinas region has not been implicated in this outbreak investigation," the FDA said in a statement Friday. "Hydroponically- and greenhouse-grown romaine, which is voluntarily labeled as 'indoor grown,' from any region does not appear to be related to the current outbreak. There is no recommendation for consumers or retailers to avoid using romaine harvested from these other sources."

Friday's warning comes almost one year after a similar outbreak led to a blanket warning about tainted romaine.

This breaking story will be updated.

Contributing: Jessica Guynn

Follow USA TODAY reporter Kelly Tyko on Twitter: @KellyTyko

This article originally appeared on USA TODAY: E. coli outbreak alert: Do not eat any romaine lettuce from Salinas, California, CDC says