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.