(The Center Square) - Colorado is facing an E. coli outbreak likely stemming from McDonald’s quarter pounder hamburgers, leading to one death in the state.

Eighteen of the state’s 26 cases are in Mesa County, health officials there confirmed, including the death. According to the Centers for Disease Control and Prevention, there are 49 cases total in 10 states.

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The CDC, the Colorado Department of Health and Public Safety, Mesa County Public Health, and the food chain are coordinating response efforts and investigating.

“A specific ingredient has not yet been confirmed as the source of the outbreak, but most sick people report eating McDonald’s Quarter Pounder burgers,” the U.S. Food and Drug Administration said. “Investigators are working to determine if the slivered onions or beef patties on Quarter Pounder burgers are the likely source of contamination.”

McDonald’s ceased selling the burgers in the affected states, the FDA added.

The individual who died in Mesa County was an “older person with underlying conditions,” CDPHE said.

“We have local experts on hand with an efficient system in place to handle these situations. This helps with the speed of investigations to help prevent additional people from becoming sick,” Mesa County Public Health Deputy Director Erin Minnerath said in a statement. “The system remains in place for residents in Mesa County to have food that’s safe to eat.”

Symptoms of E. coli infection include cramps, vomiting, diarrhea and fever.

“If you recently ate a McDonald’s Quarter Pounder and are experiencing these symptoms, contact a health care provider and local public health agency,” CDPHE said.