COLUMBUS, Ohio (AP) — The fast-food chain Wendy’s says it is pulling lettuce from sandwiches in its restaurants in Michigan, Ohio and Pennsylvania after people eating them there reported falling ill.

The CDC announced it has received reports of 47 more cases Thursday, bringing the total number of cases reported to 84 in at least four states. Thirty-eight patients have been hospitalized.

According to the CDC, 52 people reported eating sandwiches at Wendy's restaurants the week before they got sick. The agency is looking at the romaine lettuce on those sandwiches to see if it could be the source of the outbreak.

The CDC said one person was also sickened in Indiana. A message was left with Wendy's about lettuce on sandwiches in that state.

The CDC said there is no evidence that romaine sold in grocery stores is linked to the E. coli outbreak. The agency also said it is not advising people to stop eating at Wendy’s or not to eat romaine lettuce.

Wendy’s says lettuce used in its salads is different and not affected by its decision to pull the lettuce from sandwiches. The company said it is cooperating with the CDC.

“As a company, we are committed to upholding our high standards of food safety and quality,” Wendy's said in a statement.