Bagged Salad Cyclospora Outbreak Now Tied to 500+ Infections

Marketside Classic Iceberg Salad 12 Oz Front Updated 0

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.

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

On June 27, Fresh Express recalled Fresh Express brand and private label brand salad products produced at its Streamwood, IL facility that contain iceberg lettuce, red cabbage, and/or carrots due to possible Cyclospora contamination.

How to identify recalled products:

  • Products were sold in many states under either the brand name Fresh Express or the store brand labels ALDI Little Salad Bar, Giant Eagle, Hy-Vee, Jewel-Osco Signature Farms, ShopRite Wholesome Pantry, and Walmart Marketside.
  • You can identify the recalled products by looking for the Product Code, located in the upper right-hand corner of the front of the package.
    • The recall includes products marked with the letter “Z” at the beginning of the Product Code, followed by the number “178” or lower.
  • A full listing of recalled products is available on the Fresh Express recall page.

What to do if you have recalled products:

  • Do not eat, sell, or serve recalled salad products.
  • 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 don’t know whether the bagged salad mix you have in your home is one of the 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.

At a Glance

  • Reported laboratory-confirmed cases: 509
  • States: 8
  • Deaths: 0
  • Hospitalizations: 33
  • Recall: Yes

Latest Outbreak Information

  • 509 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 to July 1.
    • 33 people have been hospitalized. No deaths have been reported.
  • The Public Health Agency of Canadaexternal icon is investigating an outbreak of Cyclospora infections occurring in three Canadian provinces. Exposure to certain Fresh Express brand salad products containing iceberg lettuce, carrots and red cabbage, has been identified as a likely source of the outbreak.
  • 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.
  • CDC and FDA continue to investigate to determine which ingredient or ingredients in the salad mix was contaminated and whether other products are a source of illnesses.
  • CDC will provide updates when more information is available.

Investigation Details

As of July 9:

Since the last case count update on June 26, 303 new laboratory-confirmed Cyclospora infections have been reported.

As of July 8, 2020, a total of 509 people with laboratory-confirmed Cyclospora infections associated with this outbreak have been reported from 8 states: Illinois (151), Iowa (160), Kansas (5), Minnesota (63), Missouri (46) Nebraska (48), North Dakota (6), and Wisconsin (30).

Illnesses started on dates ranging from May 11, 2020 to July 1, 2020. Ill people range in age from 11 to 92 years with a median age of 60 and 53 percent are female. Of 506 people with available information, 33 people (7 percent) 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.

Additionally, the Public Health Agency of Canadaexternal icon is investigating an outbreak of Cyclospora infections occurring in three Canadian provinces where exposure to certain Fresh Express brand salad products containing iceberg lettuce, carrots and red cabbage, has been identified as a likely source of the outbreak.

Investigation of the Outbreak

Epidemiologic and traceback evidence continues to indicate that bagged salad mix containing iceberg lettuce, carrots, and red cabbage produced by Fresh Express is a likely source of this outbreak.

In interviews, ill people answered questions about the foods they ate and other exposures in the two weeks before they became ill. Ill people reported eating a variety of brands of bagged salad mix containing iceberg lettuce, carrots, and red cabbage. Salad mixes eaten by ill people were purchased from ALDI, Hy-Vee, Jewel-Osco, and Walmart stores in the Midwest.

Traceback investigations by FDAexternal icon suggest that the Streamwood, Illinois Fresh Express production facility is the likely producer of the bagged salad mixes eaten by ill people. FDA has begun an inspection at this facility. CDC and FDA continue to investigate to determine which ingredient or ingredients in the salad mix was contaminated and whether other products are a source of illnesses.

This investigation is ongoing.

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