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- Four more deaths have been linked to a national food poisoning outbreak blamed on tainted lettuce, bringing the total to five.

"Most of the newly reported cases are people who became sick two to three weeks ago, still within the window when contaminated romaine was available for sale", said the CDC statement.

In the past two weeks an additional 25 people have also become ill from eating the contaminated lettuce, the CDC announced. Deaths have been confirmed in Arkansas, California, Minnesota and NY with two of those deaths happening in Minnesota.

Health officials have tied the E. coli outbreak to romaine lettuce grown in Yuma, Arizona.

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The first illnesses occurred in March, and the most recent began on May 12, according to the Centers for Disease Control and Prevention.

Romaine lettuce from the Yuma growing region in Arizona is thought to be the source of the latest outbreak, although the Food and Drug Administration said no single grower, distributor or region could account for the spread.

Almost half of those who became ill had to be hospitalized.

Of the total 187 patients for whom information was available, 89 (or 48 per cent) were hospitalised, including 26 who developed a type of kidney failure called hemolytic uremic syndrome.

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But since the growing season has ended, and affected lettuce is now off the shelves, the FDA may never get their answer.

Those infected with E. coli typically experience severe stomach cramps, diarrhea and vomiting.

The recent E. coli outbreak is the most severe to hit the US since 2006, when three people died in an outbreak linked to uncooked spinach.

While most people recover within a week, some illnesses can last longer and be more severe, the CDC cautioned.

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