The CDC reports that as of August 12, 2020, a total of 690 people with laboratory-confirmed Cyclospora infections associated with this outbreak have been reported from 13 states: Georgia (1), Illinois (209), Iowa (206), Kansas (5), Massachusetts (1), Minnesota (86), Missouri (57) Nebraska (55), North Dakota (6), Ohio (4), Pennsylvania (2), South Dakota (13), and Wisconsin (45). The ill person from Georgia purchased and ate a bagged salad product while traveling in Missouri.

Illnesses started on dates ranging from May 11, 2020 to July 20, 2020. Ill people range in age from 10 to 92 years with a median age of 57; 51% are female. Of 680 people with available information, 37 people (5%) 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.

As of July 8, 2020, there are 37 confirmed cases of Cyclospora illness linked to this outbreak in three provinces: Ontario (26), Quebec (10) and Newfoundland and Labrador (1). Individuals became sick between mid-May and mid-June 2020. One individual has been hospitalized. No deaths have been reported. Individuals who became ill are between 21 and 70 years of age. The majority of cases (76%) are female.

According to the FDA, FDA’s traceback investigation identified several farms in the U.S. that may have provided product used in the Fresh Express salads that were recalled. FDA investigated multiple farms identified in the traceback. In Florida, FDA analyzed water samples from two public access points along a regional water management canal (C-23), located west of Port St. Lucie, Florida. These samples tested positive for Cyclospora cayetanensis using FDA’s validated testing method. Given the emerging nature of genetic typing methodologies for this parasite, the FDA has been unable to determine if the Cyclospora detected in the canal is a genetic match to the clinical cases, therefore, there is currently not enough evidence to conclusively determine the cause of this outbreak. Nevertheless, the current state of the investigation helps advance what we know about Cyclospora and offers important clues to inform future preventive measures.

The number of reported cases of domestically acquired cyclosporiasis has increased from the previous month and has been elevated since May 1, 2020.

As of July 29, 2020, 779 laboratory-confirmed cases of cyclosporiasis have been reported to CDC by 28 states and New York City since May 1, 2020 in people who had no history of international travel during the 14-day period before illness onset.

The median illness onset date was June 8, 2020 (range: May 1–July 20, 2020).

At least 49 people have been hospitalized; no deaths have been reported.

Total Domestically Acquired Cases

The total number of laboratory-confirmed cases reported since May 2020 includes cases from an ongoing multistate outbreak of Cyclospora infections linked to bagged salad mix (641 sick in 11 states with 37 hospitalized) containing carrots, red cabbage, and iceberg lettuce.

Total Cases Linked to Fresh Express

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.

Since the last case count update on July 9, 2020, 132 new laboratory-confirmed Cyclospora infections have been reported, including 16 from three new states: Georgia, Pennsylvania, and South Dakota.

As of  July 22, 2020, a total of 641 people with laboratory-confirmed Cyclospora infections associated with this outbreak have been reported from 11 states: Georgia (1), Illinois (198), Iowa (195), Kansas (5), Minnesota (73), Missouri (57) Nebraska (55), North Dakota (6), Pennsylvania (2), South Dakota (13) and Wisconsin (36). The ill person from Georgia purchased and ate a bagged salad product while traveling in Missouri.

Illnesses started on dates ranging from May 11, 2020 to July 5, 2020. Ill people range in age from 10 to 92 years with a median age of 59 and 52% are female. Of 636 people with available information, 37 people (6%) have been hospitalized. No deaths have been reported.

As of July 8, 2020, there are 37 confirmed cases of Cyclospora illness linked to this outbreak in three provinces: Ontario (26), Quebec (10) and Newfoundland and Labrador (1). Individuals became sick between mid-May and mid-June 2020. One individual has been hospitalized. No deaths have been reported. Individuals who became ill are between 21 and 70 years of age. The majority of cases (76%) are female.

Since the last case count update on June 26, 2020, 303 new laboratory confirmed Cyclospora infections have been reported.

The CDC reported today that 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% are female. Of 506 people with available information, 33 people (7%) have been hospitalized. No deaths have been reported.

Additionally, the Public Health Agency of Canada 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.  Thirty-seven have reported illnesses.

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 FDA 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.

Fresh Express, out of an abundance of caution, has issued a voluntary recall of branded and private label salad products produced at its Streamwood, IL facility that contain iceberg lettuce, red cabbage and/or carrot ingredients due to a possible health risk from Cyclospora. According to the Centers for Disease Control and Prevention, over 200 illnesses have been reported in connection with a current outbreak of Cyclospora occurring in primarily Midwest states.

Cyclosporiasis is an intestinal infection caused by the Cyclospora parasite. A person may become infected after ingesting contaminated food or water. Common symptoms include severe abdominal pain, diarrhea, nausea and vomiting, body aches and fatigue. The infection is treated with antibiotics and most people respond quickly to treatment.

The Fresh Express recall includes only those salads that are clearly marked with the letter Z at the beginning of the Product Code, which is located in the upper right-hand corner of the front of the package. Products containing the ingredients iceberg lettuce, red cabbage and/or carrots AND displaying the Product Code Z178, or a lower number, are recalled.

Recalled products were distributed to select retail stores between June 6 and June 26 in various states including, for example, Arkansas, Connecticut, Delaware, Iowa, Illinois, Indiana, Kansas, Kentucky, Massachusetts, Maryland, Maine, Michigan, Minnesota, Missouri, Montana, North Carolina, North Dakota, Nebraska, New Jersey, New York, Ohio, Oklahoma, Pennsylvania, Rhode Island, South Dakota, Tennessee, Virginia, Vermont, Wisconsin, West Virginia, and the District of Columbia.

Recalled Product Details

Fresh Express Precautionary Recall 06/27/2020
Streamwood IL Facility-Produced Salads Containing Iceberg Lettuce, Red Cabbage or Carrots AND Product Code
of Z178 or a Lower Number
(No other Fresh Express salads are included in this recall)

BRAND/PRODUCT NAME/SIZE SELECT STORE UPC PRODUCTION CODE USE BY OR BEFORE POSSIBLE DISTRIBUTION STATES IN SELECT STORES
Fresh Express America’s Fresh Old Fashioned Cole Slaw™
14 oz		   071279123011   Z178 or Lower   Jul-13 AR, CT, DC, DE, IA, IL, IN, KS, KY, MA, MD,
ME, MI, MN, MO, MT, NC, ND, NE, NH, NJ,
NY, OH, OK, PA, RI, SD, TN, VA, VT, WI, WV
Fresh Express America’s Fresh 3 Color Deli Cole Slaw™ 14 oz   071279123004   Z178 or Lower   Jul-14 AR, CT, DC, DE, IA, IL, IN, KS, KY, MA, MD,
ME, MI, MN, MO, MT, NC, ND, NE, NH, NJ,
NY, OH, OK, PA, RI, SD, TN, VA, VT, WI, WV
Fresh Express Chopped Kit Asian 12 oz   071279302027   Z178 or Lower   Jul-13 AR, CT, DC, DE, IA, IL, IN, KS, KY, MA, MD,
ME, MI, MN, MO, MT, NC, ND, NE, NH, NJ,
NY, OH, OK, PA, RI, SD, TN, VA, VT, WI, WV
Fresh Express Chopped Kit Bacon & Bleu 10.9 oz   071279306063   Z178 or Lower   Jul-12 AR, CT, DC, DE, IA, IL, IN, KS, KY, MA, MD,
ME, MI, MN, MO, MT, NC, ND, NE, NH, NJ,
NY, OH, OK, PA, RI, SD, TN, VA, VT, WI, WV
Fresh Express Chopped Kit BBQ Ranch 11.3 oz   071279309071   Z178 or Lower   Jul-12 AR, CT, DC, DE, IA, IL, IN, KS, KY, MA, MD,
ME, MI, MN, MO, MT, NC, ND, NE, NH, NJ,
NY, OH, OK, PA, RI, SD, TN, VA, VT, WI, WV
Fresh Express Chopped Kit Chipotle Cheddar 11.4 oz   071279306049   Z178 or Lower   Jul-12 AR, CT, DC, DE, IA, IL, IN, KS, KY, MA, MD,
ME, MI, MN, MO, MT, NC, ND, NE, NH, NJ,
NY, OH, OK, PA, RI, SD, TN, VA, VT, WI, WV
Fresh Express Chopped Kit Pomegranate 10.3 oz   071279309101   Z178 or Lower   Jul-14 AR, CT, DC, DE, IA, IL, IN, KS, KY, MA, MD,
ME, MI, MN, MO, MT, NC, ND, NE, NH, NJ,
NY, OH, OK, PA, RI, SD, TN, VA, VT, WI, WV
Fresh Express Chopped Kit Poppyseed 11.7 oz   071279309118   Z178 or Lower   Jul-14 AR, CT, DC, DE, IA, IL, IN, KS, KY, MA, MD,
ME, MI, MN, MO, MT, NC, ND, NE, NH, NJ,
NY, OH, OK, PA, RI, SD, TN, VA, VT, WI, WV
Fresh Express Chopped Kit Southwest 5 oz   071279306025   Z178 or Lower   Jul-12 AR, CT, DC, DE, IA, IL, IN, KS, KY, MA, MD,
ME, MI, MN, MO, MT, NC, ND, NE, NH, NJ,
NY, OH, OK, PA, RI, SD, TN, VA, VT, WI, WV
Fresh Express Chopped Kit Sunflower Crisp 11.1 oz   071279309064   Z178 or Lower   Jul-13 AR, CT, DC, DE, IA, IL, IN, KS, KY, MA, MD,
ME, MI, MN, MO, MT, NC, ND, NE, NH, NJ,
NY, OH, OK, PA, RI, SD, TN, VA, VT, WI, WV
Fresh Express Chopped Kit Thai ‘N’ Cashews 11.7 oz   071279309248   Z178 or Lower   Jul-11 AR, CT, DC, DE, IA, IL, IN, KS, KY, MA, MD,
ME, MI, MN, MO, MT, NC, ND, NE, NH, NJ,
NY, OH, OK, PA, RI, SD, TN, VA, VT, WI, WV
Fresh Express Chopped Kit Thai ‘N’ Cashews 11.7 oz 071279309248 Z178 or Lower Jul-12 AR, IA, IN, IL, MN, MO, SD, WI
Fresh Express Fancy Greens 7 oz   071279241005   Z178 or Lower   Jul-11 AR, CT, DC, DE, IA, IL, IN, KS, KY, MA, MD,
ME, MI, MN, MO, MT, NC, ND, NE, NH, NJ,
NY, OH, OK, PA, RI, SD, TN, VA, VT, WI, WV
Fresh Express Farmer’s Garden 9 oz   071279281025   Z178 or Lower   Jul-9 AR, CT, DC, DE, IA, IL, IN, KS, KY, MA, MD,
ME, MI, MN, MO, MT, NC, ND, NE, NH, NJ,
NY, OH, OK, PA, RI, SD, TN, VA, VT, WI, WV
Fresh Express Gourmet Cafe Creative Classics Chopped Asian 6.25 oz   071279407111   Z178 or Lower   Jul-9 AR, CT, DC, DE, IA, IL, IN, KS, KY, MA, MD,
ME, MI, MN, MO, MT, NC, ND, NE, NH, NJ,
NY, OH, OK, PA, RI, SD, TN, VA, VT, WI, WV
Fresh Express Gourmet Cafe Creative Classics Mediterranean 12 oz   071279407142   Z178 or Lower   Jul-9 AR, CT, DC, DE, IA, IL, IN, KS, KY, MA, MD,
ME, MI, MN, MO, MT, NC, ND, NE, NH, NJ,
NY, OH, OK, PA, RI, SD, TN, VA, VT, WI, WV
Fresh Express Gourmet Cafe Creative Classics Turkey & Bacon Chef 5.75 oz   071279407081   Z178 or Lower   Jul-11 AR, CT, DC, DE, IA, IL, IN, KS, KY, MA, MD,
ME, MI, MN, MO, MT, NC, ND, NE, NH, NJ,
NY, OH, OK, PA, RI, SD, TN, VA, VT, WI, WV
Fresh Express Green & Crisp / Verde y Crujiente 11 oz   071279108049   Z178 or Lower   Jul-11 AR, CT, DC, DE, IA, IL, IN, KS, KY, MA, MD,
ME, MI, MN, MO, MT, NC, ND, NE, NH, NJ,
NY, OH, OK, PA, RI, SD, TN, VA, VT, WI, WV
Fresh Express Green & Crisp / Verde y Crujiente 11 oz   071279108049   Z178 or Lower   Jul-7 AR, CT, DC, DE, IA, IL, IN, KS, KY, MA, MD,
ME, MI, MN, MO, MT, NC, ND, NE, NH, NJ,
NY, OH, OK, PA, RI, SD, TN, VA, VT, WI, WV
Fresh Express Iceberg Garden / Lechuga Repollo 12 oz   071279103020   Z178 or Lower   Jul-10 AR, CT, DC, DE, IA, IL, IN, KS, KY, MA, MD,
ME, MI, MN, MO, MT, NC, ND, NE, NH, NJ,
NY, OH, OK, PA, RI, SD, TN, VA, VT, WI, WV
Fresh Express Iceberg Garden / Lechuga Repollo 24 oz   071279104119   Z178 or Lower   Jul-12 AR, CT, DC, DE, IA, IL, IN, KS, KY, MA, MD,
ME, MI, MN, MO, MT, NC, ND, NE, NH, NJ,
NY, OH, OK, PA, RI, SD, TN, VA, VT, WI, WV
Fresh Express Iceberg Garden / Lechuga Repollo 3 lbs.   071279106014   Z178 or Lower   Jul-11 AR, CT, DC, DE, IA, IL, IN, KS, KY, MA, MD,
ME, MI, MN, MO, MT, NC, ND, NE, NH, NJ,
NY, OH, OK, PA, RI, SD, TN, VA, VT, WI, WV
Fresh Express Iceberg Garden / Lechuga Repollo 12 oz   071279103020   Z178 or Lower   Jul-11 AR, CT, DC, DE, IA, IL, IN, KS, KY, MA, MD,
ME, MI, MN, MO, MT, NC, ND, NE, NH, NJ,
NY, OH, OK, PA, RI, SD, TN, VA, VT, WI, WV
Fresh Express Italian 9 oz   071279211008   Z178 or Lower   Jul-11 AR, CT, DC, DE, IA, IL, IN, KS, KY, MA, MD,
ME, MI, MN, MO, MT, NC, ND, NE, NH, NJ,
NY, OH, OK, PA, RI, SD, TN, VA, VT, WI, WV
Fresh Express Lettuce Trio / Lechuga Trío 9 oz   071279108094   Z178 or Lower   Jul-11 AR, CT, DC, DE, IA, IL, IN, KS, KY, MA, MD,
ME, MI, MN, MO, MT, NC, ND, NE, NH, NJ,
NY, OH, OK, PA, RI, SD, TN, VA, VT, WI, WV
Fresh Express Premium Romaine / Lechuga Romana Especial 9 oz   071279108087   Z178 or Lower   Jul-11 AR, CT, DC, DE, IA, IL, IN, KS, KY, MA, MD,
ME, MI, MN, MO, MT, NC, ND, NE, NH, NJ,
NY, OH, OK, PA, RI, SD, TN, VA, VT, WI, WV
Fresh Express Premium Romaine / Lechuga Romana Especial 9 oz   071279108087   Z178 or Lower   Jul-11 AR, CT, DC, DE, IA, IL, IN, KS, KY, MA, MD,
ME, MI, MN, MO, MT, NC, ND, NE, NH, NJ,
NY, OH, OK, PA, RI, SD, TN, VA, VT, WI, WV
Fresh Express Premium Slaw Salad Kit Asian Avocado 9.7 oz   071279126043   Z178 or Lower   Jul-10 AR, CT, DC, DE, IA, IL, IN, KS, KY, MA, MD,
ME, MI, MN, MO, MT, NC, ND, NE, NH, NJ,
NY, OH, OK, PA, RI, SD, TN, VA, VT, WI, WV
Fresh Express Premium Slaw Salad Kit Smoked BBQ Sriracha 11.1 oz   071279126029   Z178 or Lower   Jul-10 AR, CT, DC, DE, IA, IL, IN, KS, KY, MA, MD,
ME, MI, MN, MO, MT, NC, ND, NE, NH, NJ,
NY, OH, OK, PA, RI, SD, TN, VA, VT, WI, WV
Fresh Express SHREDS Iceberg 14 oz   071279152004   Z178 or Lower   Jul-11 AR, CT, DC, DE, IA, IL, IN, KS, KY, MA, MD,
ME, MI, MN, MO, MT, NC, ND, NE, NH, NJ,
NY, OH, OK, PA, RI, SD, TN, VA, VT, WI, WV
Fresh Express SHREDS 8 oz   071279151014   Z178 or Lower   Jul-10 AR, CT, DC, DE, IA, IL, IN, KS, KY, MA, MD,
ME, MI, MN, MO, MT, NC, ND, NE, NH, NJ,
NY, OH, OK, PA, RI, SD, TN, VA, VT, WI, WV
Fresh Express Veggie Lover’s 11 oz   071279281001   Z178 or Lower   Jul-9 AR, CT, DC, DE, IA, IL, IN, KS, KY, MA, MD,
ME, MI, MN, MO, MT, NC, ND, NE, NH, NJ,
NY, OH, OK, PA, RI, SD, TN, VA, VT, WI, WV
Fresh Express Veggie Spring Mix 7 oz   071279281049   Z178 or Lower   Jun-25 AR, CT, DC, DE, IA, IL, IN, KS, KY, MA, MD,
ME, MI, MN, MO, MT, NC, ND, NE, NH, NJ,
NY, OH, OK, PA, RI, SD, TN, VA, VT, WI, WV
Giant Eagle American (Family
Size) 24 oz		 030034930370 Z178 or Lower Jul-9 MD, OH, PA, WV
Giant Eagle Chopped Asian
Style Salad Kit 12 oz		 030034923310 Z178 or Lower Jul-11 MD, OH, PA, WV
Giant Eagle Chopped BBQ
Ranch Salad Kit 11.3 oz		 030034923303 Z178 or Lower Jul-12 MD, OH, PA, WV
Giant Eagle Chopped Chipotle
Cheddar Salad Kit 11.4 oz		 030034923389 Z178 or Lower Jul-11 MD, OH, PA, WV
Giant Eagle Chopped
Mediterranean Salad Kit 9.9 oz		 030034923372 Z178 or Lower Jul-9 MD, OH, PA, WV
Giant Eagle Chopped Southwest Style Salad Kit
11.5 oz		   030034923327   Z178 or Lower   Jul-11   MD, OH, PA, WV
Giant Eagle Chopped Sunflower
Crisp Salad Kit 11.1 oz		 030034923396 Z178 or Lower Jul-10 MD, OH, PA, WV
Giant Eagle Life’s Getting
Fresher Coleslaw 16 oz		 030034923099 Z178 or Lower Jul-12 MD, OH, PA, WV
Giant Eagle Life’s Getting Fresher Fresh American Blend
11 oz		   030034923105   Z178 or Lower   Jul-11   MD, OH, PA, WV
Giant Eagle Life’s Getting
Fresher Fresh Garden Salad Blend 12 oz		   030034923198   Z178 or Lower   Jul-11   MD, OH, PA, WV
Giant Eagle Life’s Getting
Fresher Fresh Italian Blend 9 oz		 030034923112 Z178 or Lower Jul-11 MD, OH, PA, WV
Giant Eagle Life’s Getting
Fresher Fresh Romaine Garden Salad Blend 12 oz		   030034923167   Z178 or Lower   Jul-11   MD, OH, PA, WV
Giant Eagle Life’s getting
Fresher Fresh Shredded Iceberg Lettuce 8 oz		   030034923150   Z178 or Lower   Jul-10   MD, OH, PA, WV
Giant Eagle Life’s Getting
Fresher Veggie Lovers 11 oz		 030034923280 Z178 or Lower Jul-9 MD, OH, PA, WV
Giant Eagle Shredded Lettuce
16 oz		 030034923204 Z178 or Lower Jul-10 MD, OH, PA, WV
Hy-Vee American Salad Mix
12 oz		 075450120479 Z178 or Lower Jul-12 IA, IL, KS, MN, MO, NE, SD, WI
Hy-Vee Chopped Kit Asian
Salad 13.7 oz		 075450246681 Z178 or Lower Jul-11 IA, IL, KS, MN, MO, NE, SD, WI
Hy-Vee Chopped Kit Avocado
Ranch Salad 12.8 oz		 075450247152 Z178 or Lower Jul-8 IA, IL, KS, MN, MO, NE, SD, WI
Hy-Vee Chopped Kit Chipotle
Cheddar Salad 11.4 oz		 075450246728 Z178 or Lower Jul-8 IA, IL, KS, MN, MO, NE, SD, WI
Hy-Vee Chopped Kit Southwest
Salad 13.4 oz		 075450246698 Z178 or Lower Jul-11 IA, IL, KS, MN, MO, NE, SD, WI
Hy-Vee Chopped Kit Sunflower
Crunch Salad 13.2 oz		 075450246704 Z178 or Lower Jul-11 IA, IL, KS, MN, MO, NE, SD, WI
Hy-Vee Cole Slaw Mix 16 oz 075450120516 Z178 or Lower Jul-9 IA, IL, KS, MN, MO, NE, SD, WI
Hy-Vee Garden Salad 12 oz 075450246742 Z178 or Lower Jul-3 IA, IL, KS, MN, MO, NE, SD, WI
Hy-Vee Greener Supreme Salad
Mix 12 oz		 075450120462 Z178 or Lower Jul-11 IA, IL, KS, MN, MO, NE, SD, WI
Hy-Vee Italian Salad Mix 10 oz 075450120486 Z178 or Lower Jul-11 IA, IL, KS, MN, MO, NE, SD, WI
Hy-Vee Romaine Salad Mix
12 oz		 075450120585 Z178 or Lower Jul-11 IA, IL, KS, MN, MO, NE, SD, WI
Hy-Vee Shredded Lettuce 8 oz 075450120530 Z178 or Lower Jul-6 IA, IL, KS, MN, MO, NE, SD, WI
Hy-Vee Veggie Deluxe Salad
Mix 12 oz		 075450085303 Z178 or Lower Jul-10 IA, IL, KS, MN, MO, NE, SD, WI
Little Salad Bar Asian Chopped
Salad Kit 12 oz		 4099100086966 Z178 or Lower Jul-9 AR, IA, IN, IL, MN, MO, SD, WI
Little Salad Bar Chef Salad
6.2 oz		 4099100107364 Z178 or Lower Jul-9 AR, IA, IN, IL, MN, MO, SD, WI
Little Salad Bar Classic
Coleslaw 14 oz		 0041498302177 Z178 or Lower Jul-11 AR, IA, IN, IL, MN, MO, SD, WI
Little Salad Bar Garden Salad
12 oz		 4099100082975 Z178 or Lower Jul-3 AR, IA, IN, IL, MN, MO, SD, WI
Little Salad Bar Southwest
Chopped Salad Kit 12 oz		 4099100087024 Z178 or Lower Jul-8 AR, IA, IN, IL, MN, MO, SD, WI
Little Salad Bar Sunflower
Chopped Salad Kit 11.1 oz		 04099100087901 Z178 or Lower Jul-12 AR, IA, IN, IL, MN, MO, SD, WI
Marketside Baby Greens Salad
6 oz		 681131027922 Z178 or Lower Jul-7 IA, MI, MN, ND, NE, SD, WI
Marketside Chopped Salad Kit
Asian 13.7 oz		 681131007047 Z178 or Lower Jul-7 IA, MI, MN, ND, NE, SD, WI
Marketside Chopped Salad Kit
Avocado Ranch 9.5 oz		 681131221320 Z178 or Lower Jul-8 IA, MI, MN, ND, NE, SD, WI
Marketside Chopped Salad Kit Cherry Almond Gorgonzola
3.8 oz		   681131148375   Z178 or Lower   Jul-6   IA, MI, MN, ND, NE, SD, WI
Marketside Chopped Salad Kit
Kale Pecan Cranberry		 681131221528 Z178 or Lower Jul-8 IA, MI, MN, ND, NE, SD, WI
Marketside Chopped Salad Kit
Southwest 13.4 oz		 681131007061 Z178 or Lower Jul-10 IA, MI, MN, ND, NE, SD, WI
Marketside Chopped Salad Kit Sunflower Bacon Crunch
13.8 oz		   681131148344   Z178 or Lower   Jul-8   IA, MI, MN, ND, NE, SD, WI
Marketside Chopped Salad Kit Sunflower Bacon Crunch
22.1 oz		   681131276535   Z178 or Lower   Jul-8   IA, MI, MN, ND, NE, SD, WI
Marketside Classic Iceberg
Salad 12 oz		 681131328944 Z178 or Lower Jul-7 IA, MI, MN, ND, NE, SD, WI
Marketside Classic Iceberg
Salad 24 oz		 681131328951 Z178 or Lower Jul-7 IA, MI, MN, ND, NE, SD, WI
Marketside Crisp Greens
12 oz		 681131387552 Z178 or Lower Jul-7 IA, MI, MN, ND, NE, SD, WI
Marketside Kale Slaw 12 oz 681131221573 Z178 or Lower Jul-6 IA, MI, MN, ND, NE, SD, WI
Marketside Premium Romaine
Salad 18 oz		 681131388078 Z178 or Lower Jul-8 IA, MI, MN, ND, NE, SD, WI
Marketside Premium Romaine
Salad 9 oz		 681131387538 Z178 or Lower Jul-10 IA, MI, MN, ND, NE, SD, WI
Marketside Shredded Iceberg
Lettuce 16 oz		 681131532099 Z178 or Lower Jul-10 IA, MI, MN, ND, NE, SD, WI
Marketside Shredded Iceberg
Lettuce 8 oz		 681131328968 Z178 or Lower Jul-9 IA, MI, MN, ND, NE, SD, WI
Marketside Tri-Color Cole Slaw
14 oz		 681131387484 Z178 or Lower Jul-10 IA, MI, MN, ND, NE, SD, WI
Signature Farms Coleslaw
3 Color 14 oz		 021130111961 Z178 or Lower Jul-13 IA, IN, IL
Signature Farms Garden Salad
12 oz		 021130981359 Z178 or Lower Jun-27 IA, IN, IL
Signature Farms Lettuce Shreds
8 oz		 021130112180 Z178 or Lower Jul-3 IA, IN, IL
Signature Farms Green & Crisp
11 oz		 021130419128 Z178 or Lower Jul 14 IA, IN, IL
Signature Farms Premium
Romaine 9 oz		 021130419166 Z178 or Lower Jul 14 IA, IN, IL
Wholesome Pantry Organic Chopped Sesame Asian Salad
Kit 10.9 oz		   041190066308   Z178 or Lower   Jul-12   CT, DE, MD, NJ, NY, PA
Wholesome Pantry Organic
Sesame Asian Salad Kit 13 oz		 041190066292 Z178 or Lower Jul-11 CT, DE, MD, NJ, NY, PA

Cases will likely be in all of these states soon: Arkansas, Illinois, Indiana, Iowa, Kansas, Missouri, Michigan, Minnesota, Missouri, Nebraska, North Dakota, South Dakota and Wisconsin.  Salads contaminated with Cyclospora were sold at other stores (Walmart).  All salads appear to have been manufactured by one processor (Fresh Express)

122 people with laboratory-confirmed Cyclospora infections and who reported eating bagged salad mix before getting sick have been reported from 7 Midwestern states (Illinois, Iowa, Kansas, Missouri, Minnesota, Nebraska, and Wisconsin). Illnesses started on dates ranging from May 11, 2020 to June 15, 2020. 19 people have been hospitalized. No deaths have been reported.

Epidemiologic evidence indicates that ALDI Little Salad Bar brand Garden Salad, Hy-Vee brand Garden Salad, or Jewel-Osco brand Signature Farms Brand Garden Salad are a likely source of this outbreak.

Bagged salad mixes from ALDI, Hy-Vee, and Jewel-Osco 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 in this outbreak.

The CDC and FDA warn do not eat, sell, or serve:

ALDI recalled Little Salad Bar brand Garden Salad sold in Arkansas, Illinois, Indiana, Iowa, Michigan, Minnesota, Missouri, North Dakota, South Dakota and Wisconsin

Hy-Vee recalled Hy-Vee brand 12-ounce bagged Garden Salad sold in Illinois, Iowa, Kansas, Missouri, Minnesota, Nebraska, South Dakota, and Wisconsin.

Jewel-Osco recalled Signature Farms brand 12-ounce bagged Garden Salad sold in Illinois, Indiana, and Iowa.

CDC, public health and regulatory officials in several states, and the U.S. Food and Drug Administration (FDA) are investigating a multistate outbreak of Cyclospora infections linked to bagged salad mix purchased at ALDI, Hy-Vee, and Jewel-Osco stores in Iowa, Illinois, Kansas, Missouri, Minnesota, and Nebraska. As of June 19, 2020, a total of 76 people with laboratory-confirmed Cyclospora infections associated with this outbreak have been reported from 6 states:  Iowa (28), Illinois (23), Kansas (1), Minnesota (10), Missouri (7) and Nebraska (7).

People with laboratory-confirmed Cyclospora infections and who reported eating bagged salad mix before getting sick have been reported from 6 states (Iowa, Illinois, Kansas, Missouri, Nebraska, and Minnesota). Illnesses started on dates ranging from May 11, 2020 to June 14, 2020. Sixteen people have been hospitalized. No deaths attributed to Cyclospora have been reported.

Consumers who have ALDI Little Salad Bar Brand Garden Salad, Hy-Vee Brand Garden Salad, or Jewel-Osco Signature Farms Garden Salad purchased at ALDI, Hy-Vee, and Jewel-Osco stores in Iowa, Illinois, Kansas, Missouri, Minnesota, and Nebraska in their homes should not eat it.

At least 20 people in this cluster shopped at ALDI, and of those, at least 16 (80%) people specifically report purchasing bagged salad mix.  Among people who remembered the specific name of the product, most reported the Little Salad Bar Brand Garden Salad.

At least 37 people in this cluster shopped at Hy-Vee, and of those, at least 16 (43%) people specifically report purchasing bagged salad mix from Hy-Vee.  Among people who remembered the specific name of the product, most reported the Hy-Vee Brand Garden Salad.

At least 6 people in this cluster shopped at Jewel-Osco, and of those, at least 5 (80%) people specifically report purchasing bagged salad mix from Jewel-Osco.  Among people who remembered the specific name of the product, most reported the Signature Farms Brand Garden Salad.

Cyclospora in the United States

While cyclosporiasis cases are reported year-round in the United States, cyclosporiasis acquired in the United States (i.e., “domestically acquired”, or cases of cyclosporiasis that are not associated with travel to a country that is considered endemic for Cyclospora) is most common during the spring and summer months. The exact timing and duration of U.S. cyclosporiasis seasons can vary, but reports tend to increase starting in May. In previous years the reported number of cases peaked between June and July, although activity can last as late as September. The overall health impact (e.g., number of infections or hospitalizations) and the number of identified clusters of cases (i.e., cases that can be linked to a common exposure) also vary from season to season.

Latest Information

  • The number of reported cases of domestically acquired cyclosporiasis has increased from the previous month and remains elevated in the United States since May 1, 2019.
  • As of July 23, 2019, 580 laboratory-confirmed cases of cyclosporiasis were reported to CDC by 30 states, District of Columbia and New York City in people who became ill since May 1, 2019 and who had no history of international travel during the 14-day period before illness onset.
    • The median illness onset date was June 24, 2019 (range: May 3—July 13, 2019).
    • At least 38 people were hospitalized; no deaths were reported.
    • At this time, multiple clusters of cases associated with different restaurants or events are being investigated by state public health authorities, CDC, and FDA.
    • One multistate outbreak of Cyclospora infections has been linked to fresh basil imported from Siga Logistics de RL de CV of Morelos, Mexico . It is unknown at this time if other reported cases of Cyclospora infection in the United States this season are linked to fresh basil. This investigation is ongoing.
    • Many cases of cyclosporiasis could not be directly linked to an outbreak, in part because of the lack of validated molecular typing tools for C. cayetanensis.

In 2019, multiple outbreaks of cyclosporiasis were identified and found to be linked to different produce items, according to a report from the U.S. Centers for Disease Control and Prevention.

About 10 percent of ill people were associated with a multistate outbreak of Cyclospora infections linked to fresh basil imported from Siga Logistics de RL de CV of Morelos, Mexico.

As of Nov. 13, the most recent data shows 2,408 laboratory confirmed cases of cyclosporiasis were reported to the CDC by 37 states, District of Columbia, and New York City. The patients in that count became ill from May 1 to Aug. 31 and had no history of international travel during the 14-day period before their illness onsets. The median illness onset date was July 1.

In 2019, the domestically acquired cases during the so-called cyclospora season of May 1 through Aug. 31  was higher than the number of cases reported for the same period in 2017 and 2018.

At least 144 people were hospitalized; no deaths were reported.

Multiple clusters of cases associated with different restaurants or events were investigated by state public health authorities, the CDC, and the Food and Drug Administration.

Many cases of cyclosporiasis could not be directly linked to an outbreak, in part because of the lack of validated molecular typing tools for C. cayetanensis, the parasite that causes cyclosporiasis.

In 2019, multiple outbreaks of cyclosporiasis were identified and found to be linked to different produce items.

As of November 13, 2019, 2,408 laboratory-confirmed cases of cyclosporiasis were reported to CDC by 37 states, District of Columbia, and New York City in people who became ill during May 1 to August 31, 2019 and who had no history of international travel during the 14-day period before illness onset.The median illness onset date was July 1, 2019 (range: May 1–August 31, 2019).
At least 144 people were hospitalized; no deaths were reported.

Multiple clusters of cases associated with different restaurants or events were investigated by state public health authorities, CDC, and FDA.

Approximately 10% of ill people were associated with a multistate outbreak of Cyclospora infections linked to fresh basil imported from Siga Logistics de RL de CV of Morelos, Mexico.

Many cases of cyclosporiasis could not be directly linked to an outbreak, in part because of the lack of validated molecular typing tools for C. cayetanensis, the parasite that causes cyclosporiasis.

The overall number of domestically acquired cases reported to date for May–August 2019 (i.e., 2,408) is higher than the numbers of cases reported for the same period in 2017 and 2018. This increase may be due, in part, to changes in diagnostic testing practices—namely, increased use of a multiplex molecular test to examine stool specimens. CDC is working with state public health partners to determine whether and to what extent changes in testing practices may have contributed to increased case detection and reporting.

CDC, public health and regulatory officials in multiple states, and the U.S. Food and Drug Administration (FDA) investigated a multistate outbreak of Cyclospora cayetanensis infections.

As of September 11, 2018, CDC was notified of 511 laboratory-confirmed cases of Cyclospora infections in people from 15 states and New York City who reported consuming a variety of salads from McDonald’s restaurants in the Midwest.

Twenty-four (24) people were hospitalized. No deaths were reported.

Epidemiologic and traceback evidence indicated that salads purchased from McDonald’s restaurants were one likely source of this outbreak.

On July 13, 2018, McDonald’s voluntarily stopped selling salads at over 3,000 locations in 14 states. The company has since reported that it has replaced the supplier of salad mix in those states.

On July 26, 2018, the FDA completed final analysis of an unused package of romaine lettuce and carrot mix distributed to McDonald’s by the Fresh Express processor in Streamwood, IL. The analysis confirmed the presence of Cyclospora in that sample.

The FDA investigation reviewed distribution and supplier information for romaine and carrots but did not identify a single source or point of contamination for this outbreak.