The Centers for Disease Control, the U.S. Food and Drug Administration and public health and regulatory officials in several states are investigating a multi-state outbreak of E. coli linked to romaine lettuce harvested from the Salinas, California growing region, according to the CDC.

Forty people from 16 states have fallen ill, the CDC said, including one person in Virginia. Twenty-eight of those people were hospitalized.

The CDC advises that consumers not eat and retailers not sell any romaine lettuce harvested from Salinas, California.

If you have romaine lettuce at home, throw away any packaging that says “Salinas” on the label or is not labeled with a growing region. Wash and sanitize drawers or shelves in refrigerators where romaine lettuce was stored.

Certain salad kits produced by Missa Bay and sold in stores nationwide were also recalled due to possible contamination. Some of the affected brands were Little Salad Bistro, Ready Pac Bistro, Bonduelle Fresh, Signature Cafe, Marketside, Giant Eagle and Good & Gather.

No common grower, supplier, distributor or brand of romaine lettuce has been identified.

The outbreak is caused by the same strain of E. coli that caused outbreaks linked to leafy greens in 2017 and to romaine lettuce in 2018, the CDC said.