PHOENIX (CBSNewYork/AP) — The U.S. Centers for Disease Control has expanded its warning surrounding a multistate E. coli outbreak tied to tainted romaine lettuce from Arizona, which has now sickened more than 50 people.

The agency said information from new cases of illness prompted them to caution against eating any forms of romaine lettuce that may have come from Yuma. Previously, CDC officials had only warned against chopped romaine by itself or as part of salads and salad mixes. But they are now extending the risk to heads or hearts of romaine lettuce.

People at an Alaska correctional facility recently reported feeling ill after eating from whole heads of romaine lettuce. The vegetable was traced to lettuce harvested in the Yuma region, according to the CDC.

So far, the outbreak has infected 53 people in 16 states. At least 31 have been hospitalized, including five with kidney failure. No deaths have been reported.

“This particular strain of E. coli is really nasty. It’ll cause terrible stomach cramping, vomiting and lots and lots of diarrhea, which can go on for a week or sometimes even longer,” CBS2’s Dr. Max Gomez explained.

Here in the Northeast, 12 people have been infected in Pennsylvania, seven people have gotten sick in New Jersey and two cases have been reported in both Connecticut and New York.

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

The CDC’s updated advisory said consumers nationwide should not buy or eat romaine lettuce from a grocery store or restaurant unless they can get confirmation that it did not come from Yuma.

Restaurants and retailers are also being warned not to serve or sell romaine lettuce from the area.

Some consumers told CBS2’s Valerie Castro they are taking precautions.

“I’ll just stick to another type of lettuce for now until they resolve whatever the existing issues are,” said Jackie Taveras, of Kew Gardens Hills.

Others said they weren’t too worried – for now.

“It hasn’t happened to anybody that I know personally,” Nicole Blazeski, also of Kew Gardens Hills, said.

According to the Produce Marketing Association, romaine grown in coastal and Central California, Florida and central Mexico is not at risk.

Yuma is roughly 185 miles (298 kilometers) southwest of Phoenix and close to the California border. The region, referred to as the country’s “winter vegetable capital,” is known for its agriculture and often revels in it with events like a lettuce festival.

Steve Alameda, president of the Yuma Fresh Vegetable Association which represents local growers, said the outbreak has weighed heavily on him and other farmers.

“We want to know what happened,” Alameda said. “We can’t afford to lose consumer confidence. It’s heartbreaking to us. We take this very personally.”

Growers in Yuma typically plant romaine lettuce between September and January. During the peak of the harvest season, which runs from mid-November until the beginning of April, the Yuma region supplies most of the romaine sold in the U.S., according to Alameda. The outbreak came as the harvest of romaine was already near its end.

While Alameda has not met with anyone from the CDC, he is reviewing his own business. He is going over food safety practices and auditing operations in the farming fields.

For more information from the CDC, click here.

(© Copyright 2018 CBS Broadcasting Inc. All Rights Reserved. The Associated Press contributed to this report.)