A strain of E. coli suspected to be from Wendy’s lettuce, infected around 97 people in 6 different states and 43 people hospitalized. The affected states are Michigan, Indiana, Ohio, Kentucky, Pennsylvania, and New York, with Michigan having the most cases of E. coli.

Consumer Reports is advising the public to avoid any Wendy’s sandwiches with lettuce in them until they find the source of the bacteria and can address the issue.

It is unclear what the source is, but the CDC reported that over half of the people who contracted E. coli recently had eaten Wendy’s items containing romaine lettuce before feeling sick. Wendy’s has specified that the lettuce they use in their salads is different than the kind used on their sandwiches and should be uninfected.

Lettuce is a major source of E. coli as are many different produce foods. Often growers confront issues with their crops coming into contact with contaminated irrigation water, exposing them to pathogens like E. coli. After a series of E. coli outbreaks relating to lettuce in 2019, regulators realized that the irrigation system was carrying water downstream to the crops, but carrying with it cow feces.

However, the CDC stated that they do not recommend that individuals stop eating at Wendy’s or stop eating romaine lettuce, as there is no conclusive evidence as of yet. Wendy’s in the affected areas have in the meantime ceased using their romaine lettuce on sandwiches.

There are likely more people sickened than the 97 the CDC reported, as the more mild cases probably went unreported.

10 out of the 97 developed a type of kidney disease (hemolytic uremic syndrome). A quarter of those who develop this disease may have ongoing kidney problems and less than 5% may die.