MONDAY, July 2, 2018 (HealthDay News) — Tainted irrigation water is likely to blame for a 36-state Escherichia coli outbreak linked to romaine lettuce that sickened 200 people and caused five deaths, U.S. health officials say.

The illnesses were previously connected with romaine lettuce grown in Yuma, Ariz., which supplies most of the romaine sold in the United States during the winter, the Associated Press reported. Further investigation revealed the outbreak strain of E. coli bacteria in an irrigation canal in the Yuma area, officials said. They did not provide the location of the canal or any other details about it and are still trying to determine how the bacteria got into the canal and if there are other locations with E. coli contamination.

“More work needs to be done to determine just how and why this strain of E. coli O157:H7 could have gotten into this body of water and how that led to contamination of romaine lettuce from multiple farms,” FDA Commissioner Scott Gottlieb, M.D., said in a statement.

The outbreak started in the spring and is now over, according to the U.S. Centers for Disease Control and Prevention. This was the largest E. coli food poisoning outbreak in the United States in more than a decade. The last large E. coli outbreak similar to this one was in 2006 and was caused by spinach grown in California. It’s believed that cattle contaminated a nearby stream, and wild pigs spread the contamination to fields, the AP reported.

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