LOS ANGELES (CBSLA) — An outbreak of E. coli linked to lettuce that has sickened more than 50 people across more than a dozen states has spread to California.

According to the Centers For Disease Control and Prevention, 53 people from 16 states have been sickened from chopped Romaine lettuce from the Yuma, Ariz. growing region. No brand has been identified, so no recall has been issued.

No one has died, but 31 people have been hospitalized. In five cases, the patient developed a type of kidney failure called hemolytic uremic syndrome, according to the CDC.

Idaho and Pennsylvania have been hardest hit by this outbreak, with 10 and 12 cases of E. coli, respectively.

Federal officials say restaurants and retailers should question their suppliers about the source of their chopped romaine lettuce before serving or selling it. Consumers who have purchased pre-made salad, but aren’t sure where the romaine lettuce is from, were advised to throw it away.