A popular US fast food chain is pulling all lettuce from its sandwiches after dozens of people got sick across three states.

At least 37 people from Pennsylvania, Michigan and Ohio have gotten ill with E.coli after eating at Wendy’s, the Centers for Disease Control (CDC) has said.

The agency has not determined what specific food is the source of the outbreak. Officials did note that many of the people who got sick reported eating romaine lettuce on Wendy’s sandwiches.

Wendy’s said it is fully cooperating with the CDC’s investigation, and that it is ‘committed to upholding our high standards of food safety and quality’.

As a precautionary measure, Wendy’s locations in the region are removing the vegetable from their sandwiches.

‘While the CDC has not yet confirmed a specific food as the source of that outbreak, we are taking the precaution of discarding and replacing the sandwich lettuce at some restaurants in that region,’ stated Wendy’s.

The fast food chain said that the lettuce used in its salads was different and unaffected by the recall.

In the meantime, the CDC is not advising people to avoid eating at Wendy’s or eating romaine lettuce elsewhere.

‘At this time, there is no evidence to indicate that romaine lettuce sold in grocery stores, served in other restaurants, or in people’s homes is linked to this outbreak,’ the CDC stated on Friday.

The agency does advise consumers to monitor for E.coli symptoms and call a healthcare provider if any appear. These include severe stomach cramps, diarrhea for more than three days, vomiting, a fever over 102 degrees Fahrenheit, or severe dehydration.

This is not the first major foodborne disease outbreak this year. In April, a mass salmonella outbreak linked to chocolate Kinder Eggs got 70 children sick across Europe.

In the UK, a major salmonella outbreak in May caused supermarkets to pull chicken from their shelves.

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