OKLAHOMA CITY (KFOR) — With a deadly E. coli outbreak leading McDonald’s to pull its Quarter Pounder from stores in states, including Oklahoma, News 4 is looking into how the Oklahoma State Department of Health goes about testing for cases. The E. coli outbreak, linked to onions McDonald’s includes on its Quarter Pounder burger, has spread to at least 49 patients in 10 states, with one reported death according to the CDC. What to know about E. coli and the McDonald’s outbreak So far, the Oklahoma State Department of Health says nobody in Oklahoma has tested positive. How exactly the Oklahoma State Department of Health tests for cases of E. coli and other foodborne illnesses is a bit unclear, depending on who you ask. This week, Dr. George Monks, a past president of the Oklahoma State Medical Association, pointed out on social media the Oklahoma State Department of Health (OSDH) has outsourced foodborne illness testing to a medical lab in Nebraska ever since OSDH privatized its Public Health lab and relocated it to Stillwater. “In Oklahoma, unfortunately, we are the only state in the United States that doesn't have the ability to do foodborne illness tracking, testing,” Monks told News 4. “This new lab was built without a properly vented room for lab workers to safely perform this type of testing— we've been having to outsource that testing to Nebraska.” Monks said, that has been the case for the past four years, and as far as he’s been told, it’s still the case now. CDC: McDonald’s Quarter Pounder linked to deadly E. coli outbreak He said the practice of outsourcing to other states slows the testing process down, and is not ideal during fast-growing outbreaks like the current one. He said Oklahoma has experienced problems in the past when the state has outsourced testing. “We had another foodborne illness associated with red onion testing that went out of state, and apparently those results were lost and so it delayed identifying people that could have been sick with that earlier outbreak,” Monks said. News 4 reached out to OSDH on Wednesday and asked a spokesperson if the state still depends on out-of-state labs for E. coli testing. In their response to News 4, the OSDH spokesperson seemed to indicate that was no longer the case. Quarter Pounders are off the menu at 20% of McDonald’s in US as E. coli cases are investigated “No reported cases of E. coli O157:H7 related to McDonald's have been reported in Oklahoma,” the spokesperson said. “The CDC’s post, which mentions Oklahoma, clearly states, ‘McDonald’s removed slivered onions and beef patties.’ The Oklahoma Public Health Laboratory tests for foodborne illnesses, including E. coli O157:H7. The OSDH continues to monitor the outbreak and will investigate any reported potential cases.” News 4 reached back out to the spokesperson Wednesday afternoon and asked if they could clarify if the Oklahoma Public Health Laboratory can perform all steps of an E. coli test within its walls, without depending on an out-of-state-lab for any portion of the test. “Yes, we test at the PHL,” the spokesperson told News 4 Wednesday evening. The spokesperson additionally told News 4 they were working to figure out how long that has been the case. News 4 asked the spokesperson about a page in document on OSDH’s website, which appears to indicate OSDH still depends on out-of-state labs for certain tests. The spokesperson told News 4 they would work to find an answer to that and get back with News 4 on Thursday. News 4 will follow up on this report when OSDH additional information. As for Dr. Monks, he says if the state truly isn’t outsourcing E. coli tests anymore, that would be news to him and many of his Oklahoma medical colleagues. “My understanding is we are the only state not able to perform this type of testing,” Monks said.