OMAHA, Neb. (WOWT) – Nine of Nebraska’s E. coli cases linked to McDonald’s Quarter Pounders were reported in three health districts in the eastern part of the state.

The Nebraska Department of Health and Human Services said in an update Tuesday that the nine cases of E. coli were detected in the following public health regions:

• Lincoln-Lancaster County
• Douglas County
• Sarpy Cass

A total of 49 cases — about half of them, including one fatality, in Colorado — have been confirmed in 10 states. Iowa, Kansas, Missouri and Wisconsin were among the states reporting a single case.

The Douglas County Health Department confirmed Tuesday that three adult cases, in people ages 22 to 75, were reported in the Omaha metro — but said there are likely more cases that have not yet been reported.

“We urge the public to contact their healthcare provider if they are experiencing symptoms and are concerned about a possible exposure,” Justin Frederick, deputy director of the Douglas County Health Department, said in a news release.

Local and state health officials have said the CDC does not recommend against eating at McDonald’s, noting that potentially contaminated items have been removed.

McDonald’s said in a statement Tuesday afternoon that the illnesses were traced to grated onions from a single source that supplies three distribution centers. The company has also removed the Quarter Pounder from the menu in affected areas for the time being.

“All other menu items, including other beef items (including the Cheeseburger, Hamburger, Big Mac, McDouble and the Double Cheeseburger) remain unaffected and available,” the statement said.

IF YOU FEEL SICK

If you become ill after eating at McDonald’s with diarrhea or vomiting and a fever above 104°F, you should contact your doctor immediately. For those without a primary care provider, you can call your local health department, or the Nebraska DHHS Office of Epidemiology at 402-471-2937.

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Gray Media contributed to this report.

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