That brings the total death count from the recent E. coli outbreak to five.
The Centers for Disease Control and Prevention (CDC) said 25 more people had been infected since its last report on 16 May. But there can be a lag in reporting, and reports of illnesses have continued to come in. The new CDC report announces four more deaths - one in Arkansas, two in Minnesota and one in NY.
Four more deaths were reported from Arkansas (1), Minnesota (2), and NY (1).
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Of 158 patients interviewed by state and local health officials, all but 18 reported eating romaine lettuce in the week before their illness started.
Officials also noted that some of the individuals who became ill never actually consumed the contaminated lettuce but were in close contact with someone else who had done so.
Romaine lettuce from the Yuma growing region in Arizona is thought to be the source of the latest outbreak, although the Food and Drug Administration said no single grower, distributor or region could account for the spread.
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Numerous new cases were people who became ill two to three weeks ago, when contaminated lettuce was still being sold.
"Any contaminated product from the Yuma growing region has already worked its way through the food supply and is no longer available for consumption", said FDA Commissioner Scott Gottlieb.
But since the growing season has ended, and affected lettuce is now off the shelves, the FDA may never get their answer.
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Symptoms, which begin about three to four days after consuming the bacteria, can include watery or bloody diarrhea, fever, abdominal cramps, nausea and vomiting, according to the CDC. There have been 89 people hospitalized, and 26 who developed a type of kidney failure due to the infection.