The Centers for Disease Control and Prevention now recommends consumers, retailers and restaurants avoid all romaine lettuce from Arizona.
The agency initially limited its advisory to chopped romaine from the Yuma region but has expanded it in light of new information.
Health officials in Alaska have reported eight illnesses at the Anvil Mountain Correctional Center in Nome, and people who became sick had eaten whole head romaine, according to the CDC. The Alaska health department said there have been no cases in the state outside the facility.
The CDC has not updated its case counts since April 18, but the additional Alaska cases will be added in the next update, a spokeswoman said.
That change will bump the total number of illnesses from 53 to at least 60. None of the people in Alaska have been hospitalized, per the state.
