The Fresh Express cyclospora outbreak has ended with 701 sick, according to an update by the FDA. Thirty eight people have been hospitalized; there were no deaths reported.
The case count by state is: Georgia (1), Illinois (211), Iowa (206), Kansas (5), Massachusetts (1), Michigan (4), Minnesota (86), Missouri (57), Nebraska (55), North Dakota (6), Ohio (7), Pennsylvania (2), South Dakota (13), and Wisconsin (47). Illness onset dates range from May 11, 2020 through July 24, 2020.
The outbreak was linked to Fresh Express salad products that were made with iceberg lettuce, red cabbage, and carrots. Many products were recalled, including Fresh Express branded products as well as products made by Fresh Express for retail store brands including ALDI, Giant Eagle, Hy-Vee, Jewel-Osco, ShopRite, and Walmart.
The recalled products all had product code Z178 or a lower number. The best by dates on the recalled salads ran through July 14, 2020. Since those recalled products are well beyond the expiration date, they are likely no longer on the market or in consumer’s homes.
The recalled products with the product code Z178 or lower were sold in Arkansas, Connecticut, Delaware, Iowa, Illinois, Indiana, Kansas, Kentucky, Massachusetts, Maryland, Maine, Michigan, Minnesota, Missouri, Montana, North Carolina, North Dakota, Nebraska, New Hampshire, New Jersey, New York, Ohio, Oklahoma, Pennsylvania, Rhode Island, South Dakota, Tennessee, Virginia, Vermont, Wisconsin, West Virginia, and the District of Columbia.
FDA’s traceback investigation of the outbreak is complete, but they did not determined the source of the outbreak. The agency is still working with state agriculture and regional water boards.
Multiple farms identified during traceback were investigated. Officials conducted environmental samples around a farm in south Florida. They did find cyclospora in a regional water management canal located west of Port St. Lucie, Florida.
But because of the nature of genetic typing methodologies for the cyclospora parasite, FDA has not been able to determined if the cyclospora in the canal is a genetic match to the clinical cases. But, finding the parasite in a canal that had previously supplied irrigation water in the region, and specifically to a farm identified in traceback, suggests that state, federal, and industry partners need to identify appropriate risk mitigation measures.
Symptoms of cyclosporiasis include explosive diarrhea that can last for months, along with abdominal cramps, gas, bloating, fatigue, nausea, weight loss, loss of appetite, vomiting, body aches, and fever. The treatment for this infection is a sulfa drug.
If you have been experiencing these symptoms, see your doctor and ask for a cyclospora stool test. This test is not routinely prescribed. You may be part of this Fresh Express cyclospora outbreak