If you have store-bought chopped romaine lettuce at home — whether in a salad mix or on its own — health officials suggest throwing it out in the wake of an E. coli outbreak that might include Lincoln County.

“Even if some of it was eaten and no one has gotten sick,” states a news release from Montana Department of Public Health and Human Services. “If you do not know if the chopped lettuce is romaine, do not eat it and throw it away.”

Lab tests have confirmed that three cases of E. coli O157 illnesses in Montana are linked “to a multi-state outbreak, and four more are suspected and further testing is pending,” the news release states. “Confirmed and suspected cases have been identified in Missoula, Flathead, Lincoln and Ravalli counties and include three hospitalizations.”

Officials say the illnesses are “likely linked to chopped romaine lettuce sourced from the winter growing areas in Yuma, Arizona.”

According to the Centers for Disease Control and Prevention, authorities have identified an additional 35 cases, including 22 hospitalizations, in 11 states.

Officials also ask consumers to confirm the source of chopped romaine lettuce, and not to purchase or eat any if the source cannot be confirmed.

Symptoms of E. coli infection vary, but include severe stomach cramps, diarrhea and vomiting, the news release states.

“Some people may have a low fever,” it continues. “Most people get better within five to seven days. Some infections are very mild, but others are severe or even life-threatening. Most people start feeling sick three to four days after eating or drinking something that contains the bacteria. However, illnesses can start anywhere (within) 10 days after exposure.”

For more information, visit dphhs.mt.gov.