U.S. health officials say an outbreak of E. coli that has sickened at least 19 people in seven states has been linked to rotisserie chicken salad sold at Costco stores.

An investigation by the Center for Disease Control and Prevention and state health officials has not yet identified what ingredient in the chicken salad is the source of the E. coli that has seen people become ill in California, Colorado, Missouri, Montana, Utah, Virginia and Washington.

"We take E. coli very seriously in Washington," State Epidemiologist Dr. Scott Lindquist said. "We are working with the CDC and state partners to determine the source."

The outbreak has seen five people hospitalized, two of them with a rare kind of kidney failure known as hemolytic uremic syndrome, officials said, although no fatalities have been reported.

Costco says it halted sales of the chicken salad on Nov. 20, as soon as federal health officials notified it of the link between the product and E. coli cases.

"The epidemiologic evidence available at this time suggests that rotisserie chicken salad made and sold in Costco Wholesale stores in several states is a likely source of this outbreak," the CDC said.

Consumers who have Costco chicken salad in their refrigerators bought in late October or early November are being urged to check their purchase; if it displays item number 37719, it should be discarded immediately, officials said.

Symptoms of E. coli infections, including abdominal cramps and diarrhea, usual start between two to eight days after consumption of food contaminated with the bacteria. If symptoms appear, officials cautioned, people should call their doctor.

While most people can recover from an E. coli infection within a week, children, the elderly and those with compromised immune systems can experience more severe symptoms and sometimes require hospitalization.

Last year, Costco was linked to an outbreak of salmonella in chicken products it sold in stores in at least nine states, with the contaminated chicken provided to the warehouse club operator by Foster Poultry Farms, located in California.

Officials say the current E. coli outbreak is not related to a similar case involving the Chipotle restaurant chain that made at least 40 people ill in six states.

Seattle attorney Bill Marler, representing some people affected in the Chipotle outbreak, said the latest incident amply demonstrates why food safety is so crucial.

"Costco has always been a leader in food safety at retail, it just goes to show you how important controlling your supply chain is," Marler says.

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