The Fresh Express cyclospora outbreak that is linked to bagged salad mix containing iceberg lettuce, carrots, and red cabbage produced by Fresh Express has now sickened at least 509 people in 8 states, according to the Centers for Disease Control and Prevention (CDC). That is an increase of 303 cases since the last update that was issued on June 29, 2020.
The epi curve, shown above, graphs the illness onset dates in this outbreak. The curve is going down, which is good news. The lag between illness onset date and the date the government is informed about the illness is due to the time the patient gets sick, sees a doctor, is tested, and gets the test results. This takes an average of four to six weeks.
The case count by state is: Iowa (160), Illinois (151), Kansas (5), Minnesota (63), Missouri (46), Nebraska (48), North Dakota (6), and Wisconsin (30). Illness onset dates rate from 5/11/2020 to 7/1/2020. Thirty three people have been hospitalized because they are so ill. The patient age range is from 11 to 92 years.
Epidemiologic and traceback evidence indicates that bagged salad mix containing iceberg lettuce, red cabbage, and carrots that was produced by Fresh Express in its Streamwood, Illinois facility is a likely source of this outbreak. The government is currently inspecting that facility.
That product was bagged and branded for these store brands: ALDI Little Salad Bar, Hy-Vee, Jewel-Osco Signature Farms, Walmart Marketside, Giant Eagle, and ShopRite Wholesome Pantry. These products have been recalled. ALDI, Hy-Vee, Walmart, and Jewel Osco issued individual recalls, while Giant Eagle and ShopRite recalls were included in the overall Fresh Express recall. The recalled salads are marked with the letter “Z” at the start of the product code, followed by the number “178” or lower.
If you purchased any of the recalled salads, don’t eat them, even if someone has already eaten part of the salad and has not been sick. If you aren’t sure if you have one of these specific bagged salads in your refrigerator, discard it.
Food safety attorney Fred Pritzker said, “I have represented many clients who have been sickened with cyclosporiasis in the last few years. Every summer, like clockwork, another huge cyclospora outbreak occurs. Food producers and processors have to do better so they can sell food that doesn’t make people sick.”
The symptoms of cyclosporiasis can occur 2 to 5 days after eating food contaminated with the oocysts. People usually feel fatigued, have loss of appetite, weight loss, stomach and abdominal pain and cramps, and may have a mild fever. The most distinctive symptom of this infection is explosive and watery diarrhea that can occur without warning.
If you have been sick with these symptoms, especially if you ate a bagged salad, please see your doctor. You may be part of this Fresh Express cyclospora outbreak. There is treatment for this illness, but it is a sulfa based drug. Anyone who is allergic to sulfa may not have good choices for treatment.