Nebraska health officials have confirmed the state’s first case of E. coli linked to spinach.

Nebraska will also be reinvestigating 17 other known cases of E. coli that have occurred in the state since August. In each of those cases, local health authorities will ask people whether they had eaten fresh, store-bought spinach within 10 days before becoming ill. The state also will reanalyze specimens taken at the time of those illnesses.

Nebraska’s confirmed case brings to 20 the number of states where the particular strain of E. coli has been verified. On Saturday, the CDC released a report saying that the illness has been confirmed in 102 people in 19 states, with the worst outbreak occurring in Wisconsin. Nationwide, more than half of those who became ill have required hospitalization, and 16 percent have suffered kidney failure. One death has been confirmed.

Nebraska typically records 50 to 75 instances of E. coli annually. In most instances, no connection between the cases is found.