Almost 60 people in the U.S. and Canada have become sick from a dangerous strain of E. coli bacteria, most likely from romaine lettuce, according to Consumer Reports. The report goes on to state that one person has died in the U.S., and five people have been so ill that they had to be hospitalized.

The outbreak has spread to thirteen states, including two in New England: New Hampshire and Vermont.

Even though investigators are still not sure that romaine lettuce is the cause of the E. coli bacteria contamination in the U.S., Canadian health authorities have identified romaine lettuce as the source, according to Consumer Reports.

Symptoms of E. coli infection include severe stomach cramps, diarrhea vomiting and fever.

The best advice being offered is to avoid eating romaine lettuce until further notice.