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WASHINGTON — An E. coli outbreak possibly linked to tainted lettuce has sickened at least 19 people in Ohio, New York and Michigan, including students on three college campuses, prompting a recall throughout much of the country. Freshway Foods of Sidney, Ohio, said it was recalling romaine lettuce sold under the Freshway and Imperial Sysco brands in 23 states and the District of Columbia because of a possible link to E. coli. Twelve of those sickened were hospitalized, three of them with life-threatening symptoms, the Food and Drug Administration said. The federal Centers for Disease Control and Prevention said it was looking at 10 other cases probably linked to the outbreak. College students at the University of Michigan in Ann Arbor, Ohio State in Columbus and Daemen College in Amherst, N.Y., are among those affected, according to local health departments in those states. The FDA is focusing its investigation on lettuce grown in Arizona as a possible source for the outbreak, according to two people who have been briefed by the agency. Donna Rosenbaum, director of the food safety advocacy group Safe Tables Our Priority and one of those briefed, said the agency held a phone call with public health advocates Thursday. Rosenbaum and other public health advocates have long been pushing for stronger food safety laws. The House passed a bill last year that would give the agency much more authority to police food production, but the Senate has not acted on it. The New York state Public Health Laboratory in Albany discovered the contamination in a bag of Freshway Foods shredded romaine lettuce on Wednesday after local authorities had been investigating the outbreak for several weeks. The bag of lettuce came from a processing facility that was also linked to the illnesses, the FDA said. The agency would not disclose the name of that facility or its location but said an investigation was under way. E. coli infection can cause mild diarrhea or more severe complications, including kidney damage. The three patients with life-threatening symptoms were diagnosed with hemolytic uremic syndrome, which can cause bleeding in the brain or kidneys. It was not immediately clear why students on college campuses were sickened. Freshway Foods said the lettuce was sold to wholesalers, food service outlets, in-store salad bars and delis.

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