The Center for Disease Control said 23 more cases have been reported in 13 states.
Romaine lettuce has a shelf life of about 21 days.
Since 1995, there have been 78 outbreaks linked to leafy greens, he said.
"Romaine lettuce from the Yuma growing region is past its shelf life and is probably no longer being sold in stores or served in restaurants", the CDC said in a news release.
The 32 states involved in the outbreak are: Alaska (8), Arizona (8), California (39), Colorado (3), CT (2), Florida (1), Georgia (4), Idaho (11), IL (2), Iowa (1), Kentucky (1), Louisiana (1), MA (3), MI (5), Minnesota (12), MS (1), Missouri (1), Montana (8), Nebraska (1), New Jersey (8), NY (5), North Dakota (2), OH (6), OR (1), Pennsylvania (21), South Dakota (1), Tennessee (3), Texas (1), Utah (1), Virginia (1), Washington (7), Wisconsin (3).
"It takes two to three weeks between when a person becomes ill with E. coli and when the illness is reported to CDC".
The person could have consumed the romaine lettuce at home, at a local restaurant or somewhere outside the area, Rooney said.
In total, 172 people got sick in 32 states. One death has been reported. 48 percent of those people with available information have been hospitalized, including 20 who developed kidney failure, according to the latest report from the CDC.
The reported strain of E. coli, which produces poisonous substances known as Shiga toxins, can cause severe abdominal cramps, bloody diarrhea and vomiting.
The CDC and Food and Drug Administration have struggled for more than a month to pinpoint a source for the contamination, which became evident in early April.
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