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PHILADELPHIA (CBS) — The Centers for Disease Control and Prevention has issued a new warning to consumers following an E. coli outbreak linked to romaine lettuce.

The CDC is reminding consumers and businesses not to sell, buy or eat romaine lettuce if you don’t know where it’s from.

“Do not buy, serve, sell, or eat romaine lettuce from the following California counties: Monterey, San Benito, and Santa Barbara,” the CDC says. “If the romaine lettuce is not labeled with a harvest growing region and county, do not buy, serve, sell, or eat it.”

Romaine lettuce labeled with a harvest region outside of the three identified counties of the Central Coastal growing regions of northern and central California is not linked to the outbreak. Areas not linked to this outbreak include the desert growing region near Yuma, Arizona; the California desert growing region near Imperial County and Riverside County; the state of Florida; and Mexico.

So far, 59 people in 15 states, including New Jersey and Pennsylvania, have been infected as a result of the outbreak. Illnesses started on dates ranging from Oct. 5 to Nov. 16.

Symptoms of an E. coli infection, which usually begin about three or four days after consuming the bacteria, can include watery or bloody diarrhea, fever, abdominal cramps, nausea and vomiting, according to the CDC.