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Fresh Express Bagged Salad Cyclospora Outbreak

Marler Clark is investigating a multistate Cyclospora outbreak linked to Fresh Express bagged salad. Currently, food safety lawyers at Marler Clark represent over 100 of the victims in this outbreak.

On June 26, 2020, the FDA and CDC and several local health officials, announced a multi-state investigation of a Cyclospora outbreak connected to bagged "garden salads", sold at Walmart, ALDI, Hy-Vee and Jewel-Osco grocery stores.

According to the US FDA and CDC, as of July 20, 2020, 690 laboratory-confirmed Cyclospora infections associated with this Fresh Express outbreak had been reported from 13 states: Georgia (1), Illinois (209), Iowa (206), Kansas (5), Massachusetts (1), Minnesota (86), Missouri (57), Nebraska (55), North Dakota (6), Ohio (4), Pennsylvania (2), South Dakota (13), and Wisconsin (45). The ill person from Georgia purchased and ate a bagged salad product while traveling in Missouri. Illnesses started on dates ranging from May 11, 2020, to July 20, 2020. Ill people ranged in age from 10 to 92 years with a median age of 57; 51% were female. Of 680 people with available information, 37 people (5%) had been hospitalized.

In Canada, as of July 8, 2020, there were 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 was hospitalized. No deaths were reported. Individuals who became ill are between 21 and 70 years of age. The majority of cases (76%) were female.

Epidemiologic and traceback investigations indicated that bagged salad mix containing iceberg lettuce, carrots, and red cabbage produced by Fresh Express was the likely source of this outbreak. Fresh Express recalled several varieties of coleslaw salad sold in retail grocery stores from June 6, 2020 to June 26, 2020.

Bagged salad mix potentially contaminated with Cyclospora was 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.

Additionally, the Public Health Agency of Canada investigated an outbreak of Cyclospora infections occurring in three Canadian provinces where exposure to certain Fresh Express brand salad products containing iceberg lettuce, carrots and red cabbage, had been identified as a likely source of the outbreak.

Traceback investigations by FDA suggested that the Streamwood, Illinois Fresh Express production facility was the likely producer of the bagged salad mixes eaten by ill people. FDA has performed an inspection at this facility. CDC and FDA continue to investigate to determine which ingredient or ingredients in the salad mix was contaminated and whether other products are a source of illnesses.

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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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