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(WJW) – More illnesses have been reported in an E. coli outbreak across four states, including Ohio.

According to the Centers for Disease Control and Prevention, 47 more illnesses have been reported since Friday.

In all, the CDC has reported 84 people infected by the outbreak, including 23 in Ohio. There’s also been reports across Indiana, Michigan and Pennsylvania.

Thirty-eight people have been hospitalized and eight patients in Michigan developed a type of kidney failure called hemolytic uremic syndrome.

No deaths have been reported in the outbreak.

While it is not confirmed as the source of the outbreak, the CDC says many people who got sick ate sandwiches with romaine lettuce at regional Wendy’s restaurants.

As a precaution, Wendy’s is removing the romaine lettuce being used in its sandwiches at restaurants in affected areas.

Symptoms include a fever higher than 102˚F, bloody diarrhea or intense vomiting.

The CDC says the true number of sick people in this outbreak is likely higher than the number reported.