(Gray News) – At least one person has died and dozens more have gotten sick from E. coli that has been linked to McDonald’s Quarter Pounders.

According to the Centers for Disease Control and Prevention, an investigation into the illnesses began Tuesday.

The CDC said 49 people from 10 states have gotten sick, with about half of them being from Colorado.

One older person in Colorado has died and 10 people have been hospitalized.

The CDC said everyone they interviewed has reported eating at McDonald’s before their illness started, and most specifically mentioned eating a Quarter Pounder hamburger.

The specific ingredient in the Quarter Pounders that was contaminated with E. coli is still unknown, but investigators have narrowed it down to either the slivered onions or beef patties.

McDonald’s has removed the onions and beef patties from restaurants in the affected states. As a result, Quarter Pounders may be temporarily unavailable in some states.

McDonald’s said the beef patties and onions are only used on Quarter Pounders and not on other menu items.

As of Tuesday afternoon, the confirmed illnesses have been reported in the following states:

  • Colorado: 26 people
  • Nebraska: 9 people
  • Utah: 4 people
  • Wyoming: 4 people
  • Iowa: 1 person
  • Kansas: 1 person
  • Missouri: 1 person
  • Montana: 1 person
  • Oregon: 1 person
  • Wisconsin: 1 person

The first illness was reported on Sept. 27. The CDC said many illnesses may not be reported yet as it usually takes a few weeks to determine if a sick person is part of an outbreak.

The true number of sick people in this outbreak is also likely much higher than the number reported, the CDC said.

The McDonald’s corporate office issued the following statement late Tuesday:

Most people infected with E. coli experience severe stomach cramps, diarrhea (often bloody), and vomiting.

According to the CDC, symptoms usually start three to four days after swallowing the bacteria. Most people recover without treatment after five to seven days.

The CDC urges anyone with symptoms of an E. coli infection after eating at McDonald’s to contact their doctor and report what they ate.

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