Giant Eagle has pulled dozens of products with romaine from its shelves, though the CDC and FDA have not named a specific source of the outbreak or issued any recalls. ( FSIS )

Health officials in Montana and Arizona have attributed cases of E. coli infection to the multistate outbreak linked to chopped romaine from Arizona.

The Centers for Disease Control and Prevention has already linked 35 illnesses in 11 states to the outbreak, but cases in two more states could bring the total to 45. 

According to the Montana Department of Public Health and Human Services, laboratory testing has confirmed three cases in that state as also connected to the outbreak, with another four cases suspected to be related. Three cases in Arizona are also linked to the outbreak, according to the Arizona Department of Health Services.

In addition, a spokeswoman for the Idaho health department told The Packer on April 17 the state's case total had increased from 8 to 10 since the initial alert on April 13.

The CDC has reported cases in Pennsylvania (9), Idaho (8), New Jersey (7), Connecticut (2), New York (2), Ohio (2), Illinois (1), Michigan (1), Missouri (1), Virginia (1) and Washington (1). The CDC pegged chopped romaine from Arizona as connected to the illnesses because 26 of 28 people interviewed said they ate romaine in the week before they became sick. Romaine from other regions has not been implicated, and produce industry groups state that most romaine is now coming from California.The Food and Drug Administration has not named a specific company as the source of contaminated product.

Even so, numerous retailers have pulled items with romaine off their shelves.

Giant Eagle and Schnucks removed products after receiving a recall notice from Freshway Foods/US Foods. Spokeswoman Sara Matheu said the company issued the notice voluntarily out of an abundance of caution because of the CDC alert regarding romaine from Yuma.

Giant Food Stores also recalled products with romaine, citing the warning from the CDC.

The company listed salads from Westlake Village, Calif.-based Dole and Irwindale, Calif.-based Ready Pac Foods among the products it removed, but neither supplier has issued a recall and neither is aware of any connection between the outbreak and their respective products, spokesmen for the organizations said. 

Consumer Reports has warned people not to eat romaine lettuce at all, despite the fact the CDC focused its investigation on chopped romaine from Arizona.

The FDA and CDC advised retailers, restaurants and consumers to avoid chopped romaine from Arizona specifically.