Federal health officials are warning consumers who have eaten sprouts on sandwiches from restaurant chain Jimmy John's to be on the lookout for E. coli symptoms, with a new outbreak striking more than a dozen people in five states.

"We are advising consumers who may have recently eaten sprouts at Jimmy John's to monitor for symptoms of an E. coli infection, and consumers should contact their health care provider if they have experienced common foodborne illness symptoms," Frank Yiannas, the U.S. Food and Drug Administration's deputy commissioner for food policy and response, said in a statement.

Jimmy John's said it had removed sprouts from its 2,800 restaurants nationwide as of Monday. The latest outbreak has sickened 14 people in five states — Illinois, Iowa, Missouri, Texas and Utah.

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People typically get sick from Shiga toxin-producing E. coli, as the illness is known, two to eight days (an average of three to four days) after ingesting the germ. Symptoms often include severe stomach cramps, diarrhea (often bloody), vomiting and fever. Some people who come down with illness also could suffer a kind of kidney failure called hemolytic uremic syndrome, and antibiotics could increase that risk, the U.S. Centers for Disease Control and Prevention noted.

The warning issued Wednesday by the FDA and the CDC came a day after the FDA published a letter ordering the fast-food chain to promptly address food-safety violations associated with multiple outbreaks of E. coli and salmonella.

"Adulterated" produce

The FDA's Yiannas stressed the current outbreak was unrelated to the company's prior issues, stating: "These 14 new cases are not associated with the warning letter that the FDA issued to the company yesterday, but they do underscore the seriousness of the issue as we work with Jimmy John's to prevent outbreaks like these in the future."

Jimmy John's had "engaged in a pattern of receiving and offering for sale adulterated fresh produce, specifically clover sprouts and cucumbers," the agency said in its warning letter to the company.

Since 2012, five outbreaks of E. coli and one outbreak of salmonella have been traced back to Jimmy John's. Prior outbreaks sickened nearly 90 people in 17 states, according to the FDA. Another outbreak took place in November and December, with public health officials in Iowa reporting 22 residents infected with E. coli as of January 7. Of those in the state who came down with illness, nearly all reported eating at a Jimmy John's restaurant, the FDA noted.

The multiple incidents of contaminated food show that Jimmy John's system for receiving fresh produce for its restaurants is inadequate, the FDA said. The agency's letter, dated February 15, gave Jimmy John's President Jim North 15 days to provide information or an explanation about why changes haven't been made to operations at the 43-state network of restaurants.

Reached for comment, Jimmy John's said it was removing the offending greens from its restaurants.

"Food safety is our top priority," North stated in an email sent by Inspire Brands, which acquired Jimmy John's last year. "Sprouts present particular challenges, given our unwavering commitment to world-class food safety standards. Therefore, we made the decision to permanently remove sprouts from all restaurants and acted swiftly to do so. As of Monday, February 24, sprouts are no longer being served in any restaurant, and they will remain out of our restaurants permanently."