Romaine lettuce, served to Larimore school students on Monday and Tuesday, Nov. 25-26, may have been infected with E. coli, according to a letter dated Wednesday, Nov. 27, from Superintendent Steve Swiontek to the district's parents.

A national outbreak of E. coli infections has resulted in 67 cases in 19 states, according to data from the Centers for Disease Control and Prevention. Thirty-nine patients have been hospitalized. The outbreak has been linked to romaine lettuce grown in the Salinas, Calif., area. As of Tuesday, Nov. 26, no cases have been reported in North Dakota. Three cases have been reported in Minnesota.

The school district received mixed messages when first, CWD, the district's food supplier, notified the district on Monday, Nov. 25, that the romaine lettuce from California was OK to serve. However, information received from the North Dakota Department of Public Instruction on Tuesday, Nov. 26, informed school officials that the lettuce may, in fact, be infected.

Swiontek reported that all the lettuce was immediately discarded.

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"We have not seen any reaction yet," Swiontek told parents in his letter.

Reaction to E. coli can take up to 72 hours. Symptoms include stomach cramps, diarrhea and vomiting. Some people may get a fever. Most patients get better within five to seven days.

On the national level, the CDC reports that illnesses started on dates ranging from Sept. 24 to Nov. 14. Ill people range in age from 3 to 89 years, with a median age of 25. Sixty-seven percent of ill people are female. Of 50 ill people with information available, 39 hospitalizations have been reported, including six people who developed hemolytic uremic syndrome (HUS), a type of kidney failure. No deaths have been reported.