There have been 75 cases of E. coli linked to McDonald’s hamburgers in the US.

A deadly outbreak of E. coli linked to McDonald’s Quarter Pounders hamburgers has spread, sickening at least 75 people in 13 states, US health officials said Friday.

A total of 22 people were hospitalized, and two developed a dangerous complication of kidney disease, according to the Centers for Disease Control and Prevention (CDC). One person died in Colorado.

The definitive source of the outbreak has not been determined, Food and Drug Administration (FDA) officials said. Initial data analyzed by the FDA found that raw chopped onions used in hamburgers “are a likely source of contamination.” According to the agency.

Taylor Farms, a California fruit and vegetable producer that supplies raw chopped onions to McDonald’s, this week announced a voluntary recall of yellow onions due to possible E. coli contamination, federal officials said.

McDonald’s confirmed that the recalled Taylor Farms onions were sent to a distribution point and used at restaurants involved in the outbreak.

Taylor Farms did not respond to multiple requests for comment from The Associated Press.

McDonald’s did not disclose the distribution point but removed the burger from menus in several states – mostly in the north-central region of the country and the so-called mountain states of the western US – when the outbreak was announced on Tuesday.

Another company that operates Burger King restaurants said it sources whole onions from Taylor Farms in Colorado. He stopped using them, although no illnesses were reported.

The new McDonald’s cases reported Friday represent a sharp increase from the original number of 49 in 10 states. The majority of cases were reported in Colorado: 26 cases; 13 in Montana, 11 in Nebraska; five in New Mexico and Utah; four in Missouri and Wyoming; There are two in Michigan and one each in Iowa, Kansas, Oregon, Wisconsin and Washington, according to the CDC.

Some people who got sick reported traveling to other states before they developed symptoms. At least three people said they ate at McDonald’s during the trip. The cases were reported between September 27 and October 11.

McDonald’s announced Friday that it had not removed the Quarter Pounder from other restaurants, noting that travel was a factor in some cases.

Other fast food restaurants, including Taco Bell, Pizza Hut, KFC and Burger King, removed onions from some menus in certain regions this week.

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