The Food and Drug Administration (FDA) and the Centers for Disease Control and Prevention (CDC) are investigating the source of an outbreak of Cyclospora infections that has sickened at least 641 people in 11 states, and have narrowed their focus to salad ingredients including iceberg lettuce, carrots and red cabbage. The investigation has led to a recall of certain bagged lettuce mixes under the brand Fresh Express, as well as the store brand labels ALDI Little Salad Bar, Giant Eagle, HyVee, Jewel-Osco Signature Farms, ShopRite Wholesome Pantry, and Walmart Marketside. A full list of recalled products and states where they were sold can be found here.
Illnesses were reported beginning May 5, 2020, through July 5, 2020, in 11 states including Georgia, Illinois, Iowa, Kansas, Minnesota, Missouri, Nebraska, North Dakota, Pennsylvania, South Dakota and Wisconsin. At least 37 people have been hospitalized. No deaths have been reported to date.
The Public Health Agency of Canada is also investigating an outbreak of Cyclospora infections in three Canadian provinces, as well. Fresh Express brand salad products containing iceberg lettuce, carrots and red cabbage have also been identified as the likely culprit.
Cyclospora infection begins anywhere from two days to two weeks after ingestion of sporulated oocysts, the infective form of the parasite. The average time for symptom onset is seven days. Symptoms may include watery diarrhea, loss of appetite, weight loss, cramping, bloating, increased gas, nausea and fatigue. Other less common symptoms include vomiting and low-grade fever.
If left untreated, symptoms can persist for several weeks to a month or more. Some symptoms, such as diarrhea, may return, and some, like fatigue, may continue after gastrointestinal symptoms have gone away. The infection is usually not life threatening. Some people experience no symptoms.
Anyone who has the recalled lettuces should not eat them. If you have symptoms of Cyclospora infection, talk to your doctor. Also, write down any foods that you have eaten in the two weeks before you got sick, and notify the health department. This information will help public health officials identify the specific source of infection.