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701 in the US, 37 in Canada with Cyclospora tied to Fresh Express

CDC, public health and regulatory officials in 14 states, and the U.S. Food and Drug Administration investigated a multistate outbreak of Cyclospora infections.

In Canada, 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.

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 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.

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Cyclospora Food Poisoning

What is Cyclospora cayetanensis? Cyclospora cayetanensis is a unicellular, microscopic parasite that can cause food- or water-related gastrointestinal illness. The oocyst form of the parasite is chlorine-resistant and must sporulate...

Epidemiology of Cyclospora

Cyclosporiasis is an intestinal illness caused by the protozoan parasite Cyclospora cayetanensis, which is transmissible by ingestion of food or water contaminated with sporulated oocysts. Most cases of cyclosporiasis occur...

Cyclospora’s Mode of Infection

The modes of transmission of C. cayetanensis are still not completely understood. Direct person-to-person transmission is unlikely because the oocysts are not infectious when initially shed (unlike Cryptosporidium, another foodborne...

Symptoms of Cyclospora Infection

What are the typical symptoms of Cyclospora infection? Cyclospora infects the small intestine (bowel) and usually causes watery diarrhea, bloating, increased gas, stomach cramps, flatulence, loss of appetite, nausea, low-grade...

How is Cyclospora Diagnosed?

Cyclosporiasis is usually diagnosed symptomatically in clinical settings, including the presence of watery diarrhea, abdominal cramping, and bloating. In untreated, immunocompetent people, the diarrhea can last from days to weeks...

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