U.S. health officials say five people have now died from an E. coli outbreak involving romaine lettuce.
The U.S. Centers for Disease Control and Prevention announced Friday that another four people had died from the outbreak. The patients who died were from Arkansas, California, Minnesota and New York.
The agency said 197 patients from 35 states have become ill from eating contaminated romaine lettuce or from coming into contact with those who did. At least 89 people have been hospitalized.
The CDC said many of the new cases involved people who became ill two to three weeks ago, when contaminated romaine lettuce, which is popular in salads, was still being sold.
Health officials have linked the E. coli outbreak to romaine lettuce grown in Yuma, Arizona. Officials urged people to throw away all romaine lettuce after the first outbreak was reported in March and now officials say the growing season in Arizona has ended.
While the danger has mostly passed, reports of the illness are still coming in because of the time it takes officials to collect hospital information.
Most E. coli bacteria are not harmful, but some produce poisonous substances known as Shiga toxins, which can cause severe stomach cramps, bloody diarrhea and vomiting.