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 Nov. 20, 2018, 8:12 PM GMT By Maggie Fox 
 
 Federal health officials are warning about a fresh outbreak of E.coli linked to romaine lettuce Tuesday and cautioned people not to eat any romaine lettuce. 
 
 At least 32 people are sick, and 13 hospitalized in the outbreak, the Centers for Disease Control and Prevention said. No one has died. 
 
 “Consumers who have any type of romaine lettuce in their home should not eat it and should throw it away, even if some of it was eaten and no one has gotten sick,” the CDC said in a notice on its website. 
 
 “This advice includes 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 added. 
 
 “If you do not know if the lettuce is romaine or whether a salad mix contains romaine, do not eat it and throw it away.” 
 
 It’s the second outbreak of E. coli in romaine lettuce this year. An outbreak lasting several weeks in the spring killed five people and sickened 210 people in 36 states. It was eventually traced to contaminated canal water in a farming area in Yuma, Arizona. 
 
 This outbreak does not appear to be linked to the Yuma outbreak, the Food and Drug Administration said. 
 
 "While the strain of E. coli 0157:H7 seen in this outbreak is different than the one identified in the large outbreak in spring 2018 linked to romaine from the Yuma growing region, it does appear to be similar to the strain that caused a smaller outbreak linked to leafy greens that occurred in the fall of 2017 in both the U.S. and Canada," the FDA said. 
 
 "Since these prior outbreaks were identified, the FDA has been working closely with the leafy greens industry and other state and federal partners to implement safety practices that can help further reduce the risk of these types of outbreaks. As a direct response to the outbreaks we have seen, the agency will also begin a special effort to sample and test romaine lettuce for contamination throughout the market." 
 
 There's not enough information to identify a specific supplier yet, the FDA said, so it's safest to just thrown out all romaine lettuce for now. 
 
 E. coli is a common bacteria but there is a strain called 0157:H7 that can make people sick. Most patients suffer stomach cramps but the 0157 strain produces a toxin that can damage the kidneys and cause a potentially deadly condition called hemolytic uremic syndrome. ||||| Breaking News Emails Get breaking news alerts and special reports. The news and stories that matter, delivered weekday mornings. 
 
 / Updated By Maggie Fox 
 
 Contaminated irrigation canals may have helped spread the E. coli bacteria that spoiled fields of romaine lettuce and made the crunchy salad green off-limits to millions of Americans for weeks this spring, the government said on Thursday. 
 
 The outbreak of E. coli disease killed five people and sickened at least 210 in 36 states, making it the largest outbreak of the killer bacterial infection in a decade. 
 
 It was traced to romaine lettuce grown around Yuma, Arizona. The Centers for Disease Control and Prevention and the Food and Drug Administration cautioned people to avoid romaine lettuce unless they could be sure that it wasn’t grown in the Yuma area. 
 
 The CDC and the FDA said the outbreak was over weeks ago, but the investigation into how so much lettuce got contaminated will take months. No single farm was implicated in the outbreak. 
 
 The FDA and CDC said Thursday that they found one possible explanation — contaminated canal water. 
 
 “To date, CDC analysis of samples taken from canal water in the region has identified the presence of E. coli O157:H7 with the same genetic fingerprint as the outbreak strain,” the FDA said. 
 
 “Analysis of additional samples is still ongoing, and any new matches to the outbreak strain will be communicated publicly and with industry in the region.” 
 
 The last person to become ill got sick on June 6, the CDC said. "Some people who became sick did not report eating romaine lettuce, but had close contact with someone else who got sick from eating romaine lettuce," the CDC said. 
 
 Most E. coli bacteria are harmless, but one strain, called E. coli O157:H7, can cause severe disease, including a type of kidney failure called hemolytic uremic syndrome, as well as stomach cramps, bloody diarrhea and vomiting. 
 
 E. coli thrives in the digestive tract of animals. It can get into meat at slaughterhouses and it gets into the soil, into water and onto crops from manure. 
 
 Manure could get into canal water and that would spread bacteria across any fields it was sluiced into. 
 
 FDA Commissioner Dr. Scott Gottlieb said the outbreak is clearly over. 
 
 “More work needs to be done to determine just how and why this strain of E. coli O157:H7 could have gotten into this body of water and how that led to contamination of romaine lettuce from multiple farms,” he said in a statement. 
 
 The CDC and the FDA are working on several recent outbreaks, Gottlieb noted. These include outbreaks of salmonella associated with Kellogg's Honey Smacks cereal, precut melons and eggs, and cyclospora illnesses associated with Del Monte vegetable trays. 
 
 Although food outbreaks seem to be in the news more lately, Gottlieb said the food supply is not necessarily any less safe than it has been in the past. 
 
 “We don’t believe we are seeing more outbreaks,” he said. 
 
 “What’s happening is that our ability to identify outbreaks has dramatically improved due to new information technologies and laboratory techniques,” he added. 
 
 The complex food supply makes it difficult to track contamination even as it creates more opportunities for germs to spread. 
 
 “As food moves through supply chain, it often touches many different suppliers and distributors before it reaches the American consumer. This supply chain is even more complex if food is imported,” Gottlieb said. 
 
 “The breadth of this sourcing and distribution means that when a contamination event happens, an outbreak can affect people from Alaska to Florida and everywhere in between.” 
 
 The CDC estimates that foodborne illnesses affect 47.8 million people in the U.S. every year, putting 127,000 into the hospital and killing more than 3,000. ||||| A farmworker carries heads of romaine lettuce. (Gregory Bull/Associated Press) 
 
 The largest outbreak of E. coli in more than a decade is over, federal authorities said Thursday, after five people died and more than 200 others were sickened in three dozen states. 
 
 Although investigators determined that the E. coli came from contaminated romaine lettuce grown in Arizona's Yuma region near the border with Southern California, the Food and Drug Administration has not been able to link the outbreak to one farm, processor or distributor. New evidence showed bacteria taken from several canal water samples in the Yuma growing region to be a genetic match to the strain of bacteria that caused the outbreak, according to a statement from FDA Commissioner Scott Gottlieb on Thursday. 
 
 “More work needs to be done to determine just how and why this strain of E. coli 0157:H7 could have gotten into this body of water and how that led to contamination of romaine lettuce from multiple farms,” he said. FDA officials, who have been investigating the source of the outbreak since mid-March, are trying to determine whether canal water was used to irrigate the lettuce fields. The Yuma region — which includes farms across the Colorado River in southeastern California — grows the overwhelming majority of the lettuce and other leafy greens consumed in the United States in the winter months. The harvest season there has ended, and contaminated lettuce that made people sick in this outbreak should no longer be available, authorities said. 
 
 Bill Marler, a prominent food-safety lawyer who represents 105 patients sickened by the lettuce, said he was not surprised that the probable link was broad environmental contamination, such as by water, given the number of people sickened and the number of unnamed farms and fields implicated. 
 
 The illnesses began in mid-March. The latest tally from the Centers for Disease Control and Prevention says 96 people were hospitalized, including 27 who developed a type of severe kidney failure that can be life-threatening to people with weak immune systems, such as young children and the elderly. Single deaths were reported from Arkansas, California and New York, and two people died in Minnesota. The latest reported illness started June 6. Some people who became sick did not report eating romaine lettuce but had had close contact with someone who fell ill from eating it. 
 
 Authorities initially said that only bagged and pre-chopped romaine lettuce that had been distributed to retailers across the country was contaminated with E. coli, but a number of inmates at a prison in Alaska also became ill after eating whole-head lettuce. 
 
 The outbreak is the worst E. coli outbreak since 2006, when 205 people became ill and five died after contracting E. coli from baby spinach. 
 
 E. coli is a type of bacteria found in undercooked beef, raw milk, soft cheeses made from raw milk, raw fruits and vegetables, and contaminated water. The infection can also spread from person to person through germs on hands. Most E. coli bacteria is not harmful, but one type, known as E. coli O157: H7, produces a toxin called Shiga, which destroys red blood cells and causes kidney failure and bloody diarrhea. Other kinds of E. coli cause urinary tract infections, respiratory illness and pneumonia. 
 
 Read more: 
 
 Why E. coli keeps getting into our lettuce 
 
 This public health corps deploys to disasters, disease outbreak. The White House wants to cut it by 40 percent 
 
 Why it's so hard to find that new shingles vaccine
– One thing you'll want to avoid on Thanksgiving—or at any time in the near future—is romaine lettuce. The CDC issued an alert two days before the holiday warning that no romaine is safe to eat as an E. coli outbreak spreads, reports NBC News. It doesn't matter where the romaine is from or even if you or a loved one has eaten some and not gotten sick. The advice from the CDC is the same: Toss it. A bag of mixed salad that includes romaine? Toss it. In fact, the alert includes advice on how to clean your refrigerator if romaine has been inside it recently. So far, 32 people in 11 states have gotten sick, and 13 required hospitalization. No deaths have been reported. "This advice includes 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 said. "If you do not know if the lettuce is romaine or whether a salad mix contains romaine, do not eat it and throw it away." (Tainted water was blamed in a different outbreak involving romaine earlier this year.)