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The number of E. coli cases linked to McDonald’s Quarter Pounders has climbed, and health officials are focusing on onions sold to the fast-food chain as the likely source of the outbreak, the U.S. Food and Drug Administration (FDA) said Wedensday.

The FDA said in an update that 90 confirmed cases of the E. coli O157:H7 strain have now been identified across 13 states, and hospitalizations have climbed to 27. Two victims have developed hemolytic uremic syndrome, a serious condition that can cause kidney failure. One death was linked to the outbreak early on.

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MCD MCDONALD’S CORP. 291.57 -3.46 -1.17%

HOW MCDONALD’S PLANS TO BRING BACK CUSTOMERS

The FDA believes raw onions served as a topping on Quarter Pounders are the most likely source of the outbreak after beef was ruled out as a likely source. The agency said it has launched inspections at the Colorado processing plant of Taylor Farms, which supplied recalled onions to McDonald’s, and an unnamed onion farm in Washington state. 

After removing Quarter Pounders from the menu at 900 of its restaurants after the outbreak was discovered, McDonald’s will resume serving the hamburgers in the affected areas this week. But the sandwiches will not be served with onions at those locations.

The areas affected by the E. coli outbreak are in Colorado, Kansas and Wyoming, as well as portions of Idaho, Iowa, Missouri, Montana, Nebraska, Nevada, New Mexico, Oklahoma and Utah.

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