Cyclospora – Salads
As of September 23, 2020, a total of 701 people with laboratory confirmed Cyclospora infections associated with this outbreak were reported from 14 states: GA, IL, IA, KS, MA, MI, MN, MO, NE, ND, OH, PA, SD, WI. Exposures were reported in 13 states (IL, IA, KS, MA, MI, MN, MO, NE, ND, OH, PA, SD, WI).
Illnesses started on dates ranging from May 11, 2020 to July 24, 2020. Ill people ranged in age from 11 to 92 years with a median age of 57; 51% were female. 38 (5%) people were hospitalized. No deaths were reported in this outbreak.
Epidemiologic evidence and product traceback indicated that bagged salad mix containing iceberg lettuce, carrots, and red cabbage produced by Fresh Express was a likely source of this outbreak.
Fresh Express recalled Fresh Express brand and private label brand salad products produced at its Streamwood, IL facility that contained iceberg lettuce, red cabbage, and/or carrots on June 27, 2020.
In interviews, ill people answered questions about the foods they ate and other exposures in the 2 weeks before they became ill. An illness cluster is defined as two or more people who do not live in the same household who report eating at the same restaurant location, attending a common event, or shopping at the same location of a grocery store in the week before becoming ill. Investigating illness clusters provides critical clues about the source of an outbreak. If several unrelated ill people ate or shopped at the same location of a restaurant or store within several days of each other, it suggests that the contaminated food item was served or sold there. In this bagged salad-associated cluster, there were several situations in which people reported purchasing the product from the same stores.
The FDA and regulatory officials in several states collected records to determine the source of the bagged salad that ill people ate in the affected areas. Product distribution information indicated that the Streamwood, Illinois Fresh Express production facility is the likely producer of the bagged salad mixes eaten by ill people.