The Centers for Disease Control and Prevention said Tuesday that it had identified 27 more people who were ill from the recent outbreak of E. coli infection linked to romaine lettuce from Salinas, Calif., bringing the total number of reported cases to 67.

The C.D.C. reported no fatalities but said the outbreak affected 19 states, up from 16 on Friday, and resulted in a total of 39 people being hospitalized, up from 28. Six people also had developed hemolytic uremic syndrome, a type of kidney failure, according to the agency.

The strain involved in the current outbreak, known as E. coli O157:H7 , produces a Shiga toxin that causes vomiting, diarrhea and stomach cramps. The C.D.C. linked the current outbreak to the same strain of E. coli that caused outbreaks linked to leafy greens in 2017 and to romaine lettuce in 2018.

Consumers between the ages of 3 and 89 years became sick between Sept. 24 and Nov. 14, according to the C.D.C. A majority of those infected were in Wisconsin, Ohio, California and Maryland.