June 29, 2020
On June 27, 2020, Fresh Express recalled Fresh Express brand and private label brand salad products produced at its Streamwood, IL facility that contain iceberg lettuce, red cabbage, and/or carrots due to possible Cyclospora contamination. The recall includes products that are marked with the letter “Z” at the beginning of the product code, followed by the number “178” or lower. Recalled products were sold in many states under either the brand name Fresh Express or the store brand labels ALDI Little Salad Bar, Giant Eagle, Hy-Vee, Jewel-Osco Signature Farms, ShopRite Wholesome Pantry, and Walmart Marketside. CDC urges consumers to check their homes for these recalled products and not eat them. Restaurants and retailers should not serve or sell them.
There are typically multiple clusters of Cyclospora infections that occur each summer. CDC is working with FDA to determine if other recent cases of Cyclospora infection are linked to contaminated ingredients in these bagged salad mixes. This investigation is ongoing.
June 26, 2020
Since the last update on June 23, 2020, 84 new laboratory-confirmed Cyclospora infections have been reported, including 6 from a new state, North Dakota.
Health officials in North Dakota interviewed ill people in their state. In interviews, all six ill people reported eating a salad purchased from a single restaurant location in North Dakota. Health officials determined that the restaurant used Marketside brand bagged garden salad mix purchased from Walmart.
On June 25, 2020, Fresh Express recalled Marketside brand Classic Iceberg Salad sold in 12-ounce and 24-ounce bags at Walmart stores in Iowa, Michigan, Minnesota, Nebraska, North Dakota, South Dakota, and Wisconsin.
As of June 25, 2020, a total of 206 people with laboratory-confirmed Cyclospora infections associated with this outbreak have been reported from 8 states: Illinois (57), Iowa (74), Kansas (1), Minnesota (25), Missouri (10) Nebraska (20), North Dakota (6), and Wisconsin (13).
Illnesses started on dates ranging from May 11, 2020 to June 17, 2020. Ill people range in age from 16 to 92 years with a median age of 60 and 57% are female. Of 198 people with available information, 23 people (12%) have been hospitalized. No deaths have been reported.
Illnesses might not yet be reported due to the time it takes between when a person becomes ill and when the illness is reported. This takes an average of 4 to 6 weeks. If the number of cases reported by CDC is different from the number reported by state or local health officials, data reported by local jurisdictions should be considered the most up to date. Any differences may be due to the timing of reporting and website updates.
There are typically multiple clusters of Cyclospora infections that occur each summer. CDC is working to determine if other recent cases of Cyclospora infection are linked to contaminated ingredients in these bagged salad mixes. This investigation is ongoing.
June 23, 2020
On June 20, 2020, Hy-Vee and Jewel-Osco issued recalls for bagged salad products sold in several Midwestern states. Hy-Vee recalledexternal icon Hy-Vee brand 12-ounce bagged Garden Salad produced by Fresh Express. This product was sold in Illinois, Iowa, Kansas, Missouri, Minnesota, Nebraska, South Dakota, and Wisconsin. Jewel-Osco, in cooperation with Fresh Express, recalledexternal icon Signature Farms brand 12-ounce bagged Garden Salad sold in Illinois, Indiana, and Iowa. On June 22, 2020, ALDI recalledpdf iconexternal icon 12-ounce bagged Little Salad Bar Garden Salad sold in Arkansas, Illinois, Indiana, Iowa, Michigan, Minnesota, Missouri, North Dakota, South Dakota, and Wisconsin.
As of June 22, 2020, a total of 122 people with laboratory-confirmed Cyclospora infections associated with this outbreak have been reported from 7 states: Illinois (30), Iowa (54), Kansas (1), Minnesota (13), Missouri (7) Nebraska (8), and Wisconsin (9).
Illnesses started on dates ranging from May 11, 2020 to June 15, 2020. Ill people range in age from 16 to 92 years with a median age of 63 and 45% are female. Of 118 people with available information, 19 people (16%) have been hospitalized. No deaths have been reported.
Illnesses might not yet be reported due to the time it takes between when a person becomes ill and when the illness is reported. This takes an average of 4 to 6 weeks. If the number of cases reported by CDC is different from the number reported by state or local health officials, data reported by local jurisdictions should be considered the most up to date. Any differences may be due to the timing of the reporting and website updates.
There are typically multiple clusters of Cyclospora infections that occur each summer. CDC is working to determine if other recent cases of Cyclospora infection are linked to contaminated ingredients in these bagged salad mixes. This investigation is ongoing.
June 19, 2020
CDC, public health and regulatory officials in several states, and the U.S. Food and Drug Administration are investigating a multistate outbreak of Cyclospora infections linked to consumption of ALDI Little Salad Bar Brand Garden Salad, Hy-Vee Brand Garden Salad, or Jewel-Osco Signature Farms Garden Salad. The investigation is ongoing to determine whether other products are a source of illnesses in this outbreak.
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: IA (28), IL (23), KS (1), MN (10), MO (7) and NE (7).
Illnesses started on dates ranging from May 11, 2020 to June 14, 2020. Ill people ranged in age from 16 to 92 years with a median age of 62 and 59% were female. Of 72 people with available information, 16 people (22%) have been hospitalized. No deaths attributed to Cyclospora have been reported.
Illnesses might not yet be reported due to the time it takes between when a person becomes ill and when the illness is reported. This takes an average of 4 to 6 weeks. Please see the Timeline for Reporting Cases of Cyclospora Infection for more details.
There are typically multiple clusters of Cyclospora infections that occur during a given season. It is unknown at this time if other reported cases of Cyclospora infection in the United States this season are linked to contaminated ingredients in these bagged salad mixes. This investigation is ongoing.
Investigation of the Outbreak
Epidemiologic evidence indicates that ALDI Little Salad Bar Brand Garden Salad, Hy-Vee Brand Garden Salad or Jewel-Osco Signature Farms Garden Salad are likely sources of this outbreak, but does not explain all of the cases.
In interviews, ill people answered questions about the foods they ate and other exposures in the two 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 mix-associated cluster, several ill people reported eating ALDI Little Salad Bar Brand Garden Salad, Hy-Vee Brand Garden Salad, or Jewel-Osco Signature Farms Garden Salad. CDC and FDA, together with state health departments, continue to investigate other potential sources of illnesses in this cluster.
This investigation is ongoing, and CDC will provide updates when more information is available.