The recent update from the U.S. Food and Drug Administration (FDA) has raised alarms over a growing E. coli outbreak linked to McDonald’s quarter pounder hamburgers, with a reported 75 individuals now infected. In an interview with CDC representatives, they noted, “The actual number of those affected may be significantly higher than reported, and the outbreak might extend beyond the currently identified states.”

This newest information reflects a concerning rise in cases since previous reports indicated one death, 49 illnesses, and 10 hospitalizations related to this outbreak, primarily concentrated in the western and midwestern U.S., beginning in Colorado.

On Thursday, health officials pointed to fresh onions as a likely source of the bacteria, contradicting initial assumptions about the burger meat. According to the FDA, out of the 61 individuals for whom data was available, 22 required hospitalization, with two developing hemolytic uremic syndrome, a serious condition that can lead to kidney failure.

Experts described this particular E. coli strain as particularly dangerous, especially for vulnerable populations such as the elderly, children, and those with weakened immune systems. The FDA’s preliminary investigations indicated that slivered onions used in the quarter pounder were sourced from a single supplier, Taylor Farms, which serves three distribution centers.

In response to the outbreak, McDonald’s has initiated a voluntary recall of the affected items and has ceased sourcing onions from the Colorado facility indefinitely. The affected onions were supplied to approximately 900 restaurants across Colorado, Kansas, Wyoming, and parts of other states.

Moreover, the company has temporarily removed the quarter pounder from its menu in numerous states, covering about a fifth of its 14,000 restaurants nationwide, leading to a 2% drop in the company’s shares on Friday morning.

The CDC emphasized that many individuals recover from E. coli without seeking medical attention and may not get tested, contributing to underreporting of illnesses. Historical data shows that similar outbreaks have negatively impacted sales for major fast-food chains, as customers tend to avoid affected locations.

In a precautionary measure, Yum Brands announced on Thursday they would eliminate fresh onions from their KFC, Pizza Hut, and Taco Bell menus. Likewise, Restaurant Brands International, the parent company of Burger King, has also done the same at some locations in Colorado.

Maria Gonzales, a manager at a Burger King in Longmont, Colorado, confirmed, “We’ve been told by corporate not to use any onions moving forward for the foreseeable future. They’re off our menu.” The onset of illnesses related to the affected McDonald’s items reportedly began between September 27 and October 10.