FDA and CDC Update Cyclospora Outbreak Associated with Bagged Produce, Organism Found in Irrigation Water

FDA and CDC provided an update on the Cyclospora outbreak associated with produce items sold by Fresh Express.  The outbreak, centered in the upper midwest, now has 690 total illness and 37 hospitalizations.

In the investigation of farms, FDA did find the parasite in irrigation water samples taken near Port St. Lucia, FL.  "FDA investigated multiple farms identified in the traceback. In Florida, FDA analyzed water samples from two public access points along a regional water management canal (C-23), located west of Port St. Lucie, Florida. These samples tested positive for Cyclospora cayetanensis using FDA’s validated testing method."   

At this point, this may be as good as it gets for finding the source.  When in irrigation water, this can be a very difficult organism to control.

https://www.fda.gov/food/outbreaks-foodborne-illness/outbreak-investigation-cyclospora-bagged-salads-june-2020
Outbreak Investigation of Cyclospora: Bagged Salads (June 2020)

CDC reports additional cases. FDA finds Cyclospora in irrigation canal.

The FDA, along with CDC and state and local partners continue to investigate a multistate outbreak of Cyclospora infections potentially linked to salad products that were made by Fresh Express containing iceberg lettuce, red cabbage, and carrots and that were sold in several regions of the United States. The investigation includes Fresh Express branded products as well as products made by Fresh Express for retail store brands sold at ALDI, Giant Eagle, Hy-Vee, Jewel-Osco, ShopRite, and Walmart.

Case Counts
Total Illnesses: 690
Hospitalizations: 37
Deaths: 0
Illness Onset Date Range: 5/11/2020 – 7/20/2020
States with Cases: GA (1), IA (206), IL (209), KS (5), MA (1), MN (86), MO (57), NE (55), ND (6), OH (4), PA (2), SD (13), WI (45)

Recommendations

On June 27, 2020, Fresh Express recalled products containing either iceberg lettuce, red cabbage or carrots and displaying the product code Z178, or a lower number. The “Best by” date on the products run through July 14, 2020.

The recalled products are now well beyond expiration and likely no longer on the market or in consumers’ homes.

Investigation Update

August 14, 2020

FDA’s traceback investigation identified several farms in the U.S. that may have provided product used in the Fresh Express salads that were recalled. FDA investigated multiple farms identified in the traceback. In Florida, FDA analyzed water samples from two public access points along a regional water management canal (C-23), located west of Port St. Lucie, Florida. These samples tested positive for Cyclospora cayetanensis using FDA’s validated testing method. Given the emerging nature of genetic typing methodologies for this parasite, the FDA has been unable to determine if the Cyclospora detected in the canal is a genetic match to the clinical cases, therefore, there is currently not enough evidence to conclusively determine the cause of this outbreak. Nevertheless, the current state of the investigation helps advance what we know about Cyclospora and offers important clues to inform future preventive measures.

FDA is working with the state of Florida and the local water district in the area to try to determine the source and impact of Cyclospora in the canal.

As of August 14, 2020, CDC is reporting a total of 690 cases across 13 states.

FDA’s traceback investigation is complete, however the cause or source of the outbreak has not yet been determined via traceback. Based on the traceback, carrots are no longer being investigated for this outbreak. Two of the salad ingredients, red cabbage and iceberg lettuce, continue to be items of interest in the investigation. As this outbreak investigation continues, the FDA will provide additional updates to this advisory.

Product Recall

On June 27, 2020, Fresh Express recalled products containing either iceberg lettuce, red cabbage or carrots and displaying the product code Z178, or a lower number. The “Best by” date on the products run through July 14, 2020. These products were either branded with the Fresh Express label, or with a number of retail store brand labels. The recalled retail store brands were ALDI Little Salad Bar, Giant Eagle, Hy-Vee, Jewel-Osco Signature Farms, ShopRite Wholesome Pantry, and Walmart Marketside. 

The recalled products displaying 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.

The recalled products were made in the Fresh Express production facility in Streamwood, Illinois and have the potential to be contaminated with Cyclospora. The recent Fresh Express recall also includes previously recalled store brands

See the following press releases for complete details on the recalled products:

Fresh Express

Hy-Vee Inc.

Little Salad Bar

Signature Farms

Marketside

Hy-Vee