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.
- 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.