NEW YORK (AP) — Health officials in the United States and Canada said Tuesday consumers should stop eating romaine lettuce because of a new E. coli outbreak.

The U.S. Food and Drug Administration said it is working with officials in Canada on the outbreak, which has sickened 32 people in 11 states and 18 people in the Canadian provinces of Ontario and Quebec.

The strain identified is different than the one linked to romaine earlier this year but appears similar to last year’s outbreak linked to leafy greens.

FDA Commissioner Scott Gottlieb said the agency does not have enough information to ask suppliers for a recall, but he suggested supermarkets and restaurants withdraw romaine until the source of the contamination is identified.

The contaminated lettuce is likely still on the market, Gottlieb told The Associated Press.

He said the FDA wanted to issue a warning before people gathered for Thanksgiving meals, where the potential for exposure could increase.

“We did feel some pressure to draw conclusions as quickly as we could,” he said.

Most romaine sold this time of year is grown in California, Gottlieb said. The romaine lettuce linked to the E. coli outbreak earlier this year was from Yuma, Arizona. Tainted irrigation water appeared to be the source of that outbreak, which killed five people and sickened about 200.

The FDA’s blanket warning in the current outbreak is broader and more direct than the ones issued in the earlier outbreak, said Robert Whitaker, chief science officer for the Produce Marketing Association. In the earlier outbreak, the warnings about romaine from Yuma might have been confusing, he said.

Whitaker said the industry group told members they should cooperate with the FDA and stop supplying romaine lettuce, especially since people have been told to stop buying it.

No deaths have been reported in the current outbreak, but 13 people in the United States and six in Canada have been hospitalized. The last reported U.S. illness was Oct. 31, while and the most recent illness in Canada was early this month.

Tracing the source of contaminated lettuce can be difficult because it is often repackaged by middlemen, said Sarah Sorscher, deputy director of regulatory affairs at the Center for Science in the Public Interest. That can mean the entire industry becomes implicated in outbreaks, even if not all products are contaminated.

“One of the problems with produce is that it can be very hard to trace back,” she said.

She said washing contaminated lettuce will not ensure harmful germs are killed.

Infections from E. coli can cause symptoms, including severe stomach cramps, diarrhea and vomiting. Most people recover within a week, but some illnesses can linger and be more severe.

Health officials have also been reminding people to properly handle and cook their Thanksgiving birds amid a widespread salmonella outbreak linked to raw turkey. Last week, Hormel recalled packages of Jennie-O ground turkey that regulators were able to tie to an illness.

But unlike with romaine lettuce, regulators are not warning people to avoid turkey. Salmonella is not prohibited in raw meat and poultry, and the U.S. Department of Agriculture, which overseas raw meat, said cooking should kill any salmonella.

Food regulators say Americans should not eat romaine lettuce because of a new food poisoning outbreak. The FDA says it is investigating an E. coli outbreak that has sickened more than two dozen people in several states. The FDA is working with officials in Canada, where officials are also warning against eating romaine lettuce. (Associated Press file photo)