E. coli O157:H7 has beset the foodservice industry for decades.

The strain of E. coli O157:H7, suspected in the McDonald’s foodborne illness cases this week, has beset the foodservice industry for decades. E. coli O157:H7 was the strain that in 1992‑93 led to an outbreak that sickened 732 people across four U.S. states. The outbreak was linked to 73 Jack in the Box restaurants in California, Idaho, Nevada, and Washington. Four children died and 178 others were left with permanent injury.

Other brands have dealt with E. coli infections. In 2020, Chipotle Mexican Grill Inc. agreed to pay a record $25 million criminal fine to institute a comprehensive food safety program to resolve criminal charges that it adulterated food that sickened more than 1,100 people across the United States from 2015 to 2018, part of which was related to E. coli. Taco Bell, the division of Yum Brands Inc., in December 2006 ordered the removal of green onions from its 5,800 restaurants nationwide after samples taken by investigators appeared to contain E. coli. The outbreak sickened at least 71 people in Delaware, New Jersey, New York, and Pennsylvania. Eight people developed a type of kidney failure called hemolytic‑uremic syndrome. In October 2022, the CDC closed an outbreak case with Dublin, Ohio‑based The Wendy’s Co. in which romaine lettuce was suspect. Investigators could not confirm the source of E. coli infections in six states.

Slivered yellow onions from the California‑based processor Taylor Farms are suspect in the recent McDonald’s cases. As of Oct. 24, the Centers for Disease Control and Prevention said it tallied 75 people infected with the outbreak strain of E. coli O157:H7 in 13 states, centered mostly in Colorado and Nebraska. “The most recent illness started on Oct. 10,” the CDC said. “Taylor Farms has initiated a voluntary recall of some onions sent to foodservice operators. Due to the product actions taken by both companies, CDC believes the risk to the public is very low.”

McDonald’s stores in Colorado, Kansas, Utah, Wyoming, and portions of Idaho, Iowa, Missouri, Montana, Nebraska, Nevada, New Mexico, and Oklahoma temporarily stopped using their supply of Quarter Pounder slivered onions and beef patties. A number of other brands, from Yum Brands’ KFC, Pizza Hut and Taco Bell, to Burger King, a division of Toronto‑based Restaurant Brands International Inc., pulled onions from their menus. Of 61 people with information available, 22 had hospitalized, and two people developed hemolytic uremic syndrome. One death was reported from an older adult in Colorado. This person was not one of those who developed HUS. “The true number of sick people in this outbreak is likely much higher than the number reported, and the outbreak may not be limited to the states with known illnesses,” the CDC warned. “This is because many people recover without medical care and are not tested for E. coli. In addition, recent illnesses may not yet be reported as it usually takes three to four weeks to determine if a sick person is part of an outbreak.”

State and local public health officials interviewed people about the foods they ate in the week before they got sick. Of the 42 people interviewed, all 42 (100%) report eating at McDonald’s, and 39 people report eating a beef hamburger. “Of 36 people who remember the specific beef hamburger they ate at McDonald’s, 31 (86%) report eating a Quarter Pounder hamburger. Some people in this outbreak reported traveling to other states before their illness started,” the CDC said. “At least three people ate at McDonald’s during their travel.”

Bill Marler, a personal injury lawyer, national expert on foodborne illness litigation and founder of Food Safety News in 2009, began representing victims of foodborne illness in 1993, when he represented Brianne Kiner, a survivor of the Jack in the Box E. coli O157:H7 outbreak, resulting in a landmark $15.6 million settlement. He wrote in a Food Safety News publisher’s note Thursday:

“Clearly, at least as it relates to ground beef, the beef industry, restaurants and government have made great strides in preventing E. coli illnesses and outbreaks. As I have said before, in the decade after Jack in the Box, 90% of my law firm’s revenue came from E. coli cases linked to hamburger. That percentage in now near zero,” Marler wrote. “Interventions at slaughter and increased cook temperatures and times, along with E. coli O157:H7 being considered an adulterant by the USDA/FSIS, have all helped. But E. coli has now found its way into foods as varied as onions, spinach, lettuce, cookie dough, apple juice and cheese, and it has become an ever‑increasing problem at water parks and petting zoos.”

The CDC said McDonald’s has stopped using fresh slivered onions and quarter pound beef patties in several states to protect its customers during the investigation. Symptoms of E. coli O157:H7 infection include:

- Diarrhea and a fever higher than 102°F.
- Diarrhea for more than three days that is not improving.
- Bloody diarrhea.
- So much vomiting that liquids cannot be kept down.
- Signs of dehydration, such as not urinating much, dry mouth and throat, and feeling dizzy when standing up.

“Most people infected with Shiga toxin‑producing E. coli experience severe stomach cramps, diarrhea (often bloody), and vomiting,” the agency said. “Symptoms usually start three to four days after swallowing the bacteria. Most people recover without treatment after five to seven days. Some people may develop serious kidney problems (hemolytic uremic syndrome, also called HUS) and would need to be hospitalized.”

What is E. coli O157:H7, connected to the McDonald’s case?

The article explains the history and recent outbreak of the E. coli O157:H7 strain linked to McDonald’s, detailing past incidents at other fast‑food chains, the current CDC investigation, the voluntary recall by Taylor Farms, and the public health response. It also covers legal repercussions and the broader impact on the foodservice industry.