(Colorado Newsline) One person in Colorado is dead as the result of an E. coli outbreak that involves 49 cases and is linked to McDonald’s Quarter Pounder hamburgers sold in multiple states, according to federal and state health officials.

The person who died, who was not identified by Colorado health officials, was an “older person with underlying conditions,” the Colorado Department of Public Health and Environment said in announcement Tuesday.

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The outbreak also involves 10 hospitalizations and other cases in 10 states — Oregon, Montana, Utah, Wyoming, Nebraska, Kansas, Iowa, Missouri and Wisconsin, in addition to Colorado.

Colorado, with 26 cases associated with multiple McDonald’s locations, is the worst-hit state.

“Based on case interviews and supplier information, McDonald’s has temporarily stopped producing the item at McDonald’s in some states, including Colorado,” CDPHE said in a press release. “Early information from the Food and Drug Administration indicates onions may be a source of this outbreak. Fresh-slivered onions are primarily used on Quarter Pounder hamburgers and not other menu items.”

Investigators are also examining beef patties used in Quarter Pounders.

The CDC said the number of sick people is “likely much higher than the number reported.”

E. coli are common bacteria. Most are harmless, but some can cause illness. Symptoms can include diarrhea, fever, vomiting and dehydration.

The CDC recommends that people who ate a McDonald’s Quarter Pounder and have severe E. coli symptoms should contact their health care provider.

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