Wendy's lettuce removed in Ohio after E. coli outbreak

There are five additional E. coli cases in Ohio, the state health department reported, as the Centers for Disease Control and Prevention investigates romaine lettuce from Wendy's as a possible source of the outbreak.

According to the CDC , Ohio now has 19 cases of the bacteria, the most of any state so far. Along with Michigan, Indiana and Pennsylvania, there is a total of 37 cases across the U.S. Per the Ohio Department of Health, the 19 cases in Ohio were located in the following counties: Wood (7), Lorain (3), Cuyahoga (2), Lucas (2), Mahoning (2), Clermont (1), Franklin (1), and Summit (1).

Only four have been hospitalized so far, said the health department, and no deaths have been reported. The individuals in Ohio range in age from 8 to 82 years old. There are 11 men and eight women.

The bacteria, which typically spreads through contaminated food, still hasn't been tied to a definitive source, the CDC said, but many of the affected people have reported eating sandwiches with romaine lettuce at Wendy's restaurants.

Investigators are "working quickly" to confirm whether that romaine lettuce is the source and whether the lettuce served at Wendy’s restaurants was served or sold at other businesses, said the Ohio Department of Health.

Wendy's said as a precaution, it will remove the romaine lettuce used in sandwiches from the affected states. The fast food chain uses a different type of romaine lettuce for its salads.

The chain is "fully cooperating with public health authorities on their ongoing investigation of the regional E. coli outbreak reported in certain Midwestern states," it said in a statement. "As a company, we are committed to upholding our high standards of food safety and quality."

Despite the pending investigation, a lawsuit was filed in Wood County by a Ohio woman against the company for failing to eliminate the risk of its food being contaminated with E. coli.

Health officials are not currently advising that people avoid eating at Wendy's or purchasing romaine lettuce.

The state health department says it continues assisting the CDC, local health departments, and other state and federal agencies in investigating the outbreak.

People should call their health care providers if they have severe E. coli symptoms, which can include diarrhea, a fever higher than 102 degrees, bloody diarrhea, signs of dehydration and more.

Symptoms usually begin three to four days after swallowing the bacteria, and most people recover within five to seven days, the CDC says.

Marina Pitofsky of USA TODAY contributed.

Titus Wu is a reporter for the USA TODAY Network Ohio Bureau, which serves The Columbus Dispatch, Cincinnati Enquirer, Akron Beacon Journal and 18 other affiliated news organizations across Ohio.

This article originally appeared on The Columbus Dispatch: Wendy's lettuce potentially linked to 19 E. coli cases in Ohio