The CDC has warned people not to eat romaine lettuce due to an a multi-state outbreak of E. coli, including three cases in New Jersey.

The CDC's alert covered all types or uses of romaine lettuce, such as whole heads of romaine, hearts of romaine, and bags and boxes of precut lettuce and salad mixes that contain romaine, including baby romaine, spring mix, and Caesar salad.

The CDC advised consumers not to eat lettuce if you don't know what type it is. Restaurants and retailers are advised not to serve or sell any romaine, including salads and mixes containing romaine.

The state Department of Health said E. coli sickened three people in Bergen, Mercer and Union counties between Oct. 8 and 31.

Authorities said 32 cases of shiga toxin-producing E. coli have been reported in 11 states and two Canadian provinces during the same time period but no deaths have been reported. Thirteen people were hospitalized, including one person who developed hemolytic uremic syndrome, a type of kidney failure.

If you have romaine lettuce, the CDC advised washing and sanitizing drawers or shelves in refrigerators where romaine was stored.

The cause of the outbreak is not yet known. No common grower, supplier, distributor, or brand of romaine lettuce has been identified in this outbreak.

E. coli, or Escherichia coli, is a bacteria that normally lives harmlessly in the intestines. Some types can cause illness through exposure to contaminated food or water, or contact with animals or other people. Symptoms include severe stomach cramps, often bloody diarrhea, and vomiting.

Symptoms develop usually within two to eight days of ingesting the germ.

E. coli can be prevented by thorough hand washing after using the bathroom or changing a diaper, before and after food preparation, and after contact with animals.

It's the second outbreak this involving e coli and romaine lettuce this year. The first outbreak was traced to the Yuma, Arizona, where 90 percent of all the romaine lettuce grown in the United States between November and March. The CDC said the two outbreaks are not related.

Contact reporter Dan Alexander at or via Twitter @DanAlexanderNJ