U.S. health officials say a food-poisoning outbreak tied to alfalfa sprouts and involving multiple germs has sickened people in 15 states. State officials announced the outbreak earlier this week, saying they documented more than three dozen cases in Minnesota and Wisconsin. On Friday, the U.S. C enters for Disease Control and Prevention said the agency is aware of 55 cases nationally, including four people who have been hospitalized. The CDC said cases are also reported in Florida, Indiana, Iowa, Kansas, Michigan, New Hampshire, New York, Pennsylvania, North Carolina, South Carolina, North Dakota, South Dakota and Washington. Of 34 sick people interviewed, 26 reported eating alfalfa sprouts, according to the U.S. Food and Drug Administration. Food poisoning outbreaks tend to be defined by one type of germ, but this outbreak involves people with salmonella and different strains of E. coli. Shiga toxin-producing E. coli — or STEC — can cause stomach cramps and bloody diarrhea. Infections can lead to a severe complication that involves acute kidney failure. Salmonella poisoning can cause diarrhea, fever, severe vomiting, dehydration and stomach cramps. Officials are linking cases to alfalfa sprouts produced by Everything Sprouts, a Minnesota grower, and sold under the Calco and Everything Sprouts brands to restaurants and grocery stores. The company has yet to issue a recall, the FDA said. Last year, the FDA sent a warning letter to Everything Sprouts, saying inspections the year before identified several points of concern, including a leaking roof that was dropping water onto bean sprouts and workers’ smocks. The Associated Press left messages for Everything Sprouts seeking comment. The CDC said in a notice Friday that anyone with affected sprouts in their home should throw them out or return them to where they were purchased. They also advised people to wash items and surfaces that may have touched the sprouts using hot soapy water or a dishwasher. The agency said anyone with the following symptoms who suspects they may have been exposed to affected sprouts should call their healthcare provider right away: Diarrhea and a fever higher than 102°F Diarrhea for more than 2 days that is not improving Bloody diarrhea So much vomiting that you cannot keep liquids down Signs of dehydration, such as: Not peeing much Dry mouth and throat Feeling dizzy when standing up ...read more read less