Chicago's health department urged anyone who has eaten a McDonald's Quarter Pounder hamburger and experienced E. coli symptoms to seek medical attention amid a multistate outbreak that has sickened dozens and led to at least one death.
The Chicago Department of Public Health said while no cases of E. coli related to the outbreak have been reported in Chicago or Illinois so far, it is aware of cases being reported across the U.S.
"McDonald's is no longer serving Quarter Pounder hamburgers in some areas to protect their customers, but CDPH recommends seeking medical attention if you ate a McDonald's Quarter Pounder hamburger and experience E. coli symptoms such as a fever higher than 102 degrees F, excessive vomiting or diarrhea, or bloody stool (poop)," the department said Wednesday. "Most people recover from infection without treatment, but some may develop serious kidney problems. People at increased risk for E. coli infection include children under the age of 5, older adults over the age of 65, and people with weakened immune systems."
McDonald's spokespeople said Wednesday that E. coli is a difficult pathogen to trace, but they're working with the Centers for Disease Control and Prevention to investigate the ongoing outbreak.
In a message to customers, the company said it was removing certain ingredients from its menus in some locations "out of an abundance of caution" as investigators work to determine the exact source.
In total, 49 people have been sickened so far across 10 U.S. states, including in Iowa, Missouri and Wisconsin. Ten people have been hospitalized and at least one death has been reported.
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"Everyone interviewed has reported eating at McDonald’s before their illness started, and most specifically mentioned eating a Quarter Pounder hamburger," the CDC said in an alert Tuesday, calling it a "fast-moving outbreak investigation."
Investigators have centered their investigation on two ingredients so far: fresh, slivered onions, and fresh beef patties.
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The Food and Drug Administration said the outbreak is likely from slivered onions on Quarter Pounders from a supplier that serves three distribution centers.
"McDonald’s has pulled ingredients for these burgers, and they won’t be available for sale in some states," the CDC reported.
In the two-week window illnesses have been reported so far, McDonald's spokespeople said about one million Quarter Pounder burgers could have been sold in the impacted locations.
Joe Erlinger, president of McDonald's USA, told TODAY on Wednesday that "food safety is a top priority."
“It's the top priority for our suppliers as well. This is something that we talk about as being everyone's business," he said.
What to know about the outbreak:
Which states have been impacted so far?
The outbreak has been reported in at least 10 U.S. states so far, with most cases reported in Colorado and Nebraska, though several Midwest states have also reported cases.
Of the cases reported so far, 26 have been reported in Colorado, plus one death, and nine have been reported in Nebraska. Other states to report cases include Iowa, Kansas, Missouri, Montana, Oregon, Utah, Wisconsin and Wyoming.
The CDC warns, however, that the outbreak may not be limited to the states with illnesses discovered so far "and the true number of sick people is likely much higher than the number reported." This is because illnesses can take time to report and many people recover from E. coli without needing treatment.
Here's the full number of people sickened by state so far:
(Note: the death in Colorado is not included in the numbers below)
| Colorado | 26 |
| Iowa | 1 |
| Kansas | 1 |
| Missouri | 1 |
| Montana | 1 |
| Nebraska | 9 |
| Oregon | 1 |
| Utah | 4 |
| Wisconsin | 1 |
| Wyoming | 4 |
Of those sickened, ages range from 13 to 88 years, the CDC noted.
Which ingredients are behind the outbreak and which locations are removing them?
The exact source of the outbreak remains unclear, but investigators believe it is likely tied to either fresh, slivered onions or the fresh beef patties used in the Quarter Pounder.
McDonald's said in its statement the removal of ingredients was "out of an abundance of caution," but includes locations in Colorado, Kansas, Utah and Wyoming, as well as portions of Idaho, Iowa, Missouri, Montana, Nebraska, Nevada, New Mexico, and Oklahoma.
"Preliminary traceback and distribution information reviewed by FDA shows that slivered onions served on Quarter Pounders are a likely source of contamination," the CDC stated. "FDA is working quickly to confirm that these onions are a source of this outbreak and to determine if these onions were served or sold at other businesses."
Symptoms to watch for
The CDC urged anyone who experiences E. coli symptoms after eating at McDonald's to call their healthcare provider.
According to the CDC, most people infected with E. coli experience severe stomach cramps, diarrhea, and vomiting. Symptoms typically appear within three to four days of ingesting the bacteria, and most people recover between five and seven days.
Symptoms include:
- Diarrhea and a fever higher than 102°F
- Diarrhea for more than 3 days that is not improving
- Bloody diarrhea
- So much vomiting that you cannot keep liquids down
- Signs of dehydration, such as:
- Not peeing much
- Dry mouth and throat
- Feeling dizzy when standing up
Some people may also develop serious kidney problems known as hemolytic uremic syndrome, or HUS, which requires hospitalization. The CDC noted that at least one child experienced that symptom in connection with this outbreak.
What is E. coli?
According to the Mayo Clinic, E. coli stands for Escherichia coli, a bacteria that normally lives "in the intestines of healthy people and animals."
"Most types of E. coli are harmless or cause relatively brief diarrhea. But a few strains ... can cause severe stomach cramps, bloody diarrhea and vomiting," the clinic reported.
People can be exposed to the bacteria from contaminated water or food, particularly raw vegetables or undercooked ground beef.
Food safety concerns
The McDonald's outbreak comes amid a number of large recalls recently, including one involving multiple brands of frozen waffles and another involving hundreds of meat and chicken products.
So how concerning is it?
“It is very concerning for people like myself who’ve spent 35 years doing research," said Trevor Suslow is a food safety expert at the University of California, Davis. “There’s so many different recalls and outbreaks going on at the moment and each one is somewhat unique but they often share common characteristics of deficiencies in awareness and prevention around cleaning and sanitation.”
Experts recommend keeping up to date on the latest news and recalls from the USDA, FDA and CDC.
"It’s usually a bacterial recall and those are the ones that we are most concerned with. It can be as simple as a breach of protocol," said James Oehmke, an economist and Northwestern University professor.
Oehmke says government agencies have improved over the years to identify outbreaks more quickly.
“The food supply chain in the United States serves over a billion meals a day, or about a billion meals a day, and overwhelmingly these are safe meals," Oehmke said.
