In the middle of the holiday season, the Centers for Disease Control has revealed more nine more cases of people sickened by the E. coli outbreak linked to romaine lettuce.

According to the CDC alert, there have already been 52 reported cases of E. coli linked to this outbreak across 15 states. You can find the number of cases in each state here.

Nineteen people so far have been hospitalized in the U.S., including one person who developed a type of kidney failure, the alert said.

The Public Health Agency of Canada has also reported some people infected with the same E. coli strain.

Last month, the CDC advised consumer to throw out any romaine lettuce they have and to wash and sanitize drawers or shelves in refrigerators where it was stored.

These latest illnesses are not related to a previous E. coli outbreak linked to romaine lettuce in the spring. The CDC said the bacteria in the spring outbreak had a different DNA fingerprint.

The CDC said that illnesses occurred after November 14 may not have been reported yet because it takes an average of two to three weeks between an E. coli infection and when the illness is reported.

Although the Food and Drug Administration has yet identify the source of the contamination, the organization has been able to narrow down the origin of the outbreak to California’s Central Coast region.

The FDA urges the public to check the label when buying romaine lettuce as it should have the harvest date and region.