Nearly 400 people across 15 states have become ill after eating salads from McDonald’s, including 16 patients who had to be hospitalized.

The Food and Drug Administration (FDA) confirmed the presence of Cyclospora in an unused package of Fresh Express salad mix distributed to McDonald’s in late July.

Fresh Express, which is based in Salinas, Calif., tracked the tainted lettuce from the same facility and lot number to Caito Foods, which is currently involved in another recall that affected salads and wraps sold at Trader Joe's, Walgreens and Kroger, The LA Times reported.

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The FDA provided the updated 395 case count on August 2, which follows a July 20 statement from McDonald’s that announced the fast-food conglomerate had removed affected products from shelves at impacted locations, and replaced it with a lettuce blend from a different supplier. A July 13 statement had noted that the outbreak had affected approximately 3,000 McDonald’s locations across the U.S.

Symptoms of Cyclospora infection can include diarrhea, explosive bowel movements, loss of appetite, weight loss, stomach cramps, bloating, increase gas, nausea and fatigue. Flu-like symptoms may also be noted. Symptoms can last from several days for up to a month.

The FDA said it does not believe the McDonald’s-linked outbreak is connected to the Del Monte vegetable trays recall.