No deaths have been reported, but according to the CDC, 43 people have been hospitalized and 10 developed hemolytic uremic syndrome, a serious condition that can cause kidney failure. “The actual number of patients in this outbreak is likely higher than the number reported, and the outbreak may not be limited to states with known disease,” the update said. “Additionally, some people recover without medical attention and are not tested for E. coli.” So far, no specific food has been confirmed as the source of the outbreak, according to the CDC. In late August, however, Wendy’s removed romaine lettuce used in sandwiches at its restaurants in Indiana, Michigan, Ohio and Pennsylvania, according to the CDC. The CDC is not advising people to avoid Wendy’s, and the agency notes that there is no evidence that romaine lettuce sold in grocery stores or served at other restaurants is linked to the current outbreak. Those with E. coli symptoms, such as diarrhea and a fever over 102°F, severe vomiting or signs of dehydration, should call their health care provider immediately, according to the CDC. They are also asked to write down what they ate in the previous week and report their illness to their local or state health department.Each year, about 1 in 6 Americans get foodborne illness from at least 31 known pathogens and other unspecified agents, according to the CDC, and about 3,000 lose their lives. CNN’s Kelly Murray also contributed to this story.