USA – Outbreak of Cyclospora Infections in the Midwestern U.S. Linked to Bagged Salad Mix

CDC

CDC, public health and regulatory officials in several states, and the U.S. Food and Drug Administrationexternal icon (FDA) are investigating a multistate outbreak of Cyclospora infections linked to bagged salad mix containing iceberg lettuce, carrots, and red cabbage produced by Fresh Express and purchased at ALDI, Hy-Vee, Jewel-Osco, and Walmart stores in the Midwestern United States.

Advice to Consumers, Restaurants, Retailers, and Suppliers/Distributors

CDC has important advice for consumers and retailers in Arkansas, Illinois, Indiana, Iowa, Kansas, Michigan, Minnesota, Missouri, Nebraska, North Dakota, South Dakota, and Wisconsin:

  • Do not eat, sell, or serve:
    • Recalled Marketside brand Classic Iceberg Salad
      • Sold at Walmart stores in Iowa, Michigan, Minnesota, Nebraska, North Dakota, South Dakota, and Wisconsin
      • 12-ounce and 24-ounce bags
      • Use-by dates of 05/19/2020 through 07/04/2020
    • Recalled Little Salad Bar brand Garden Salad
      • Sold at ALDI stores in Arkansas, Illinois, Indiana, Iowa, Michigan, Minnesota, Missouri, North Dakota, South Dakota and Wisconsin
      • 12-ounce bags
      • Use-by dates of 05/01/2020 through 06/29/2020
    • Recalled Hy-Vee brand Garden Salad
      • Sold at Hy-Vee stores in Illinois, Iowa, Kansas, Minnesota, Missouri, Nebraska, South Dakota, and Wisconsin
      • 12-ounce bags
      • Any use-by date
    • Recalled Jewel-Osco Signature Farms brand Garden Salad
      • Sold at Jewel-Osco stores in Illinois, Indiana, and Iowa
      • 12-ounce bags
      • Use-by dates of 05/16/2020 through 07/04/2020
  • Check your home for any of these recalled salads. Throw any remaining salad away, even if some of it has been eaten and no one has gotten sick.
  • If you live in Arkansas, Illinois, Indiana, Iowa, Kansas, Michigan, Minnesota, Missouri, Nebraska, North Dakota, South Dakota, or Wisconsin and don’t know whether the bagged salad mix you have in your home is one of these recalled salads, do not eat it. Throw it away.

Take action if you have symptoms of a Cyclospora infection:

  • Talk to your healthcare provider.
  • Write down what you ate in the two weeks before you started to get sick.
  • Report your illness to the health department.
  • Assist public health investigators by answering questions about your illness.

Latest Outbreak Information

  • 206 people with laboratory-confirmed Cyclospora infections and who reported eating bagged salad mix before getting sick have been reported from 8 Midwestern states (Illinois, Iowa, Kansas, Minnesota, Missouri, Nebraska, North Dakota, and Wisconsin).
    • Illnesses started on dates ranging from May 11, 2020 to June 17, 2020.
    • 23 people have been hospitalized. No deaths have been reported.
  • Epidemiologic and traceback evidence indicates that bagged salad mix containing iceberg lettuce, carrots, and red cabbage produced by Fresh Express is a likely source of this outbreak.
  • Bagged salad mixes purchased at ALDI, Hy-Vee, Jewel-Osco, and Walmart do not explain all of the illnesses in this outbreak. CDC and FDA continue to investigate to determine whether other products are a source of illnesses.
  • CDC will provide updates when more information is available.

Investigation Details

June 26, 2020

Since the last update on June 23, 2020, 84 new laboratory-confirmed Cyclospora infections have been reported, including 6 from a new state, North Dakota.

Health officials in North Dakota interviewed ill people in their state. In interviews, all six ill people reported eating a salad purchased from a single restaurant location in North Dakota. Health officials determined that the restaurant used Marketside brand bagged garden salad mix purchased from Walmart.

On June 25, 2020, Fresh Express recalled Marketside brand Classic Iceberg Salad sold in 12-ounce and 24-ounce bags at Walmart stores in Iowa, Michigan, Minnesota, Nebraska, North Dakota, South Dakota, and Wisconsin.

As of June 25, 2020, a total of 206 people with laboratory-confirmed Cyclospora infections associated with this outbreak have been reported from 8 states: Illinois (57), Iowa (74), Kansas (1), Minnesota (25), Missouri (10) Nebraska (20), North Dakota (6), and Wisconsin (13).

Illnesses started on dates ranging from May 11, 2020 to June 17, 2020. Ill people range in age from 16 to 92 years with a median age of 60 and 57% are female. Of 198 people with available information, 23 people (12%) have been hospitalized. No deaths have been reported.

Illnesses might not yet be reported due to the time it takes between when a person becomes ill and when the illness is reported. This takes an average of 4 to 6 weeks. If the number of cases reported by CDC is different from the number reported by state or local health officials, data reported by local jurisdictions should be considered the most up to date. Any differences may be due to the timing of reporting and website updates.

There are typically multiple clusters of Cyclospora infections that occur each summer. CDC is working to determine if other recent cases of Cyclospora infection are linked to contaminated ingredients in these bagged salad mixes. This investigation is ongoing.

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