Health officials have found no other lettuce aside from romaine to be impacted by the outbreak.
People with HUS should be hospitalized because their kidneys may stop working.
No deaths have been linked to the outbreak to date.
Illnesses have now been reported in Mississippi, Tennesse\e, and Wisconsin and 19 other states, including OH and Pennsylvania.
Most of the patients said they ate romaine lettuce in a salad at a restaurant. That includes whole heads, hearts, chopped romaine, salads and salad mixes containing romaine. The symptoms include loss of appetite, fatigue, severe abdominal cramping, diarrhea and fever.
Three major grocery store chains in Berks County - Giant Food Stores, Weis Markets and Redner's Markets - said they get their romaine from suppliers in California and Florida, so their lettuce is safe.
People who have become sick with E. coli will begin to feel the symptoms between two and eight days after consumption of the contaminated food. Attorney Fred Pritzker recently won $7.5 million for young client whose kidneys failed after he developed hemolytic uremic syndrome because of an E. coli infection.
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