A national E. coli outbreak has reached Georgia, the Georgia Department of Public Health announced.

The DPH and the U.S. Centers for Disease Control and Prevention said late Thursday that a metro Atlanta teenager was hospitalized with the bacteria. He or she is among 98 Americans sickened so far in the outbreak, traced to romaine lettuce grown in the Yuma area, near the southwestern tip of Arizona.

The teen was not identified in the news release and has been released from the hospital.

The CDC has confirmed cases from the outbreak in 22 states, most heavily in Idaho and Pennsylvania; but no deaths.

It is the most serious E. coli outbreak since 2006, when the bacterium spread from spinach. This year’s strain of E. coli is more harmful than usual, since it binds more strongly to blood vessels. E. coli binds to the blood vessels that line organs such as the gut, the kidneys or even the brain. It can then disrupt the blood flow to those organs, causing anything from severe indigestion to organ damage or death.

On Friday, federal officials added Mississippi, Tennessee and Wisconsin to the list of states with confirmed infections. They said that doesn’t necessarily mean the illness is spreading south, since there can be lag times between the onset of illness and a particular state’s laboratory confirming that illness and reporting it.

The CDC’s advice to consumers right now is simple: Don’t eat romaine lettuce unless you can be sure it didn’t come from Yuma-area farms.

“If in doubt, don’t buy it or don’t eat it,” Matt Wise, deputy branch chief for outbreak response at the CDC, told reporters on a conference call Friday.

It doesn’t matter whether it’s romaine hearts, whole heads, chopped or salad mixes. The warning now applies to all types of romaine bought at the store or eaten at a restaurant. And since the health investigators have not zeroed in on a particular brand or grower, the key concern is simply the place where it was grown. They have identified the farm source of just one part of the outbreak, among inmates in a correctional facility in Alaska, but not others.

The Georgia victim had recently consumed romaine at a number of metro restaurants as well as bagged romaine bought at a store.

Signs and symptoms of E. coli infection usually set in about three to four days after eating the bug. They can include bloody diarrhea, stomach cramps and vomiting.

Getting sick can take up to a week, and recovery usually happens within another week.

For some, however, the infection gets very serious, and the kidneys start to fail. Symptoms of this are tricky:

  • Diarrhea is improving.
  • But urination becomes less frequent.
  • The person feels very tired.
  • The inside of the lower eyelids and the cheeks lose pink color.

These people should be treated. They may recover, but the condition can also be fatal.