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Fresh Express Bagged Lettuce Cyclospora Outbreak and Litigation - Multistate (2020)

Marler Clark represented 30 of the victims in this Cyclospora bagged salad outbreak. All cases were successfully settled.

The Centers for Disease Control and Prevention (CDC), along with health departments in 14 states and the Food and Drug Administration (FDA), investigated a national outbreak of Cyclospora, connected to bagged "garden salads", sold at Walmart, ALDI, Hy-Vee and Jewel-Osco grocery stores, in the summer of 2020.

CDC epidemiological curve of people with Cyclospora infections included in the outbreak investigation, by illness onset date, as of September 23, 2020*

As of September 23, 2020, a total of 701 lab-confirmed cases were found to be associated with this outbreak from 14 states (GA (1), IL (211), IA (206), KS (5), MA (1), MI (4), MN (86), MO (57), NE (55), ND (6), OH (7), PA (2), SD (13), WI (47). Exposures were reported in 13 states (IL, IA, KS, MA, MI, MN, MO, NE, ND, OH, PA, SD, WI). Cases reported illness from May 11, 2020, to July 24, 2020. Five percent were hospitalized, and no deaths were reported. Cases ranged from 11 to 92 years of age (median of 57). Fifty-one percent of cases were female.

In Canada, as of November 4, 2020, 370 confirmed cases of Cyclospora illness were reported in the following provinces and territories: British Columbia (1), Ontario (255), Quebec (105), New Brunswick (1), Newfoundland and Labrador (6), and Nunavut (2). Individuals became sick between mid-May and late August 2020. Ten individuals were hospitalized. No deaths were reported. Individuals who became ill are between 0 and 83 years of age. The illnesses are distributed equally among men (50%) and women (50%).

Bagged salad mix potentially contaminated with Cyclospora were distributed in the following states: 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.

Epidemiological and traceback evidence indicated that bagged salad mix containing iceberg lettuce, carrots and red cabbage by Fresh Express was the likely source of this outbreak. Further traceback efforts by the FDA led to the investigation of a farm in southern Florida. The FDA detected Cyclospora in a regional water management canal (C-23), located west of Port St. Lucie, Florida. However, the FDA has been unable to determine if this Cyclospora was a genetic match to cases associated with the outbreak. Nevertheless, the presence of Cyclospora in a canal that had previously supplied irrigation water in the region, and specifically to a farm identified in the traceback, was suspicious and requires the need for further investigation and response from the FDA and it’s investigating partners.

Fresh Express recalled salad products produced at its Streamwood, Illinois facility on June 27, 2020. The Fresh Express recall included only those salads products containing the ingredients iceberg lettuce, red cabbage and/or carrots AND displaying the Product Code Z178, or a lower number. Recalled products were distributed to select retail stores – including ALDI, Giant Eagle, Hy-Vee, Jewel-Osco, ShopRite, and Walmart – between June 6 and June 26 in various states. The recalled retail store brands were ALDI Little Salad Bar, Giant Eagle, Hy-Vee, Jewel-Osco Signature Farms, ShopRite Wholesome Pantry, and Walmart Marketside. The “Best by” date on the recalled products ran through July 14, 2020. As of September 23, 2020, the outbreak was considered over.

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Related Resources
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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