Canadian health officials are now investigating 30 cases of E. coli infection as part of an outbreak linked to romaine lettuce.

Nine cases have been added since the outbreak was announced Dec. 11, and one person has died, according to an update from the Public Health Agency of Canada. Twelve people have been hospitalized.

There are still no product recalls associated with the outbreak, and no retail or foodservice locations have been named. The Canadian Food Inspection Agency is working with health officials to determine the source of the lettuce.

New cases include six in Ontario and one in Nova Scotia, provinces that were not listed in the original outbreak alert. There are also 13 cases in Newfoundland and Labrador and five cases each in Quebec and New Brunswick.

Victims reported symptom onset between Nov. 16 and Dec. 2. They range in age from 4 to 80 and include 21 women and nine men.