(LANSING) – One of the 43 reported cases of E. coli in Michigan has been discovered in Southern Michigan.

The Michigan Department of Health and Human Services has issued an updated public health alert regarding additional illnesses of shiga toxin producing E. coli, associated with the multi-state outbreak.

Of the 43 confirmed E. coli cases matched with the outbreak strain, one has been reported in Branch County. Other counties that have reported outbreaks include Allegan, Clinton, Genesee, Gratiot, Jackson, Kent, Macomb, Midland, Monroe, Muskegon, Oakland, Ogemaw, Ottawa, Saginaw, Washtenaw and Wayne Counties, along with the City of Detroit.

The illness onset dates range from late July through early August, and the age range of those affected are 6 to 94. In Michigan, 56 percent of those affected have been hospitalized.

It’s believed that romaine lettuce from Wendy’s Restaurant may to blame for the outbreak. While a specific food item has not yet been identified as the source of the illnesses, the investigation is continuing.

Dr. Alexis Travis, Senior Deputy Director of Public Health Administration with the Department of Health and Human Services says they are reminding Michigan residents to seek medical attention if they experience symptoms of E. coli illness. That includes severe stomach cramps, diarrhea, vomiting or other gastrointestinal distress. Travis also wants to remind people to take proper precautions when handling food and practice safe food preparation.