The Centers for Disease Control and Prevention is expanding its warning to consumers to avoid all types of romaine lettuce from the Yuma, Arizona growing region due to a growing E. coli outbreak that has sickened people in 16 states. The warning now includes whole heads and hearts of romaine lettuce, as well as chopped romaine and salads and salad mixes containing romaine.

Health officials say if you can't confirm where the lettuce came from, don't eat it.

The update comes after new reports from Alaska health and corrections officials who say eight inmates at the Anvil Mountain Correctional Center got sick after eating lettuce from whole heads of romaine from the Yuma, Arizona growing region. None of the eight Alaska patients have been hospitalized and none have died.

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In addition to the eight Alaska inmates, the outbreak of E.coli O157:H7 has sickened at least 53 other people, 31 of whom had to be hospitalized, the CDC said in an updated posted Friday. No deaths have been reported.

The CDC says the hospitalization rate for this outbreak is higher than normal and officials are working to figure out why.

Symptoms of E. coli

Symptoms of E. coli infection include diarrhea, which can be bloody, severe stomach cramps and vomiting. E. coli infections typically clear up within a week. However, more serious cases can lead to a type of kidney failure called hemolytic uremic syndrome (HUS).

Five people sickened in the current outbreak have developed hemolytic uremic syndrome.

Symptoms of HUS include fever, abdominal pain, pale skin tone, fatigue and irritability, unexplained bruises or bleeding from the nose and mouth, and decreased urination. These complications are more common in young children under 5, older adults, and people with weakened immune systems.

Anyone experiencing these symptoms should seek medical care immediately.

Rob Philippou from Garden City, New York, is one of those sickened in the outbreak.

"There have been nights where I've been really nauseous, times when I've had really bad abdominal pain, terrible cramps," he told CBS News.

Romaine lettuce warning

CBS News' Don Dahler reports that 90 percent of the romaine grown in the U.S. between November and March comes from the Yuma region, and while the exact source of the outbreak hasn't been identified, the CDC strongly suspects that region is the culprit.

To keep yourself and your family safe, the CDC recommends avoiding any romaine lettuce products that could be contaminated.

"Unless the source of the product is known, consumers anywhere in the United States who have any store-bought romaine lettuce at home should not eat it and should throw it away, even if some of it was eaten and no one has gotten sick," the CDC states.

"Product labels often do not identify growing regions; so, throw out any romaine lettuce if you're uncertain about where it was grown. This includes whole heads and hearts of romaine, chopped romaine, and salads and salad mixes containing romaine lettuce."

Restaurants and retailers are also being urged not to serve or sell any romaine lettuce from the Yuma growing region and to check with suppliers about the source of their romaine lettuce.