In an update on the multistate outbreak of Cyclospora infections, the Centers for Disease Control and Prevention (CDC) reported a total of 395 laboratory-confirmed cases of Cyclospora infection in people who consumed salads from McDonald’s restaurants; the cases were reported by 15 states.


On July 26, 2018, FDA completed analysis of an unused package of romaine lettuce and carrot mix distributed to McDonald’s by the Fresh Express processor in Streamwood, IL. The analysis confirmed the presence of Cyclospora in that mix. On July 27, 2018, FDA informed Fresh Express of the results.

Fresh Express reported to FDA that the carrots in the mix went to McDonald’s restaurant locations only, and that the romaine lettuce was the only ingredient in the mix that was distributed to other locations. Romaine lettuce from the same lot that was positive for Cyclospora was distributed in pre-made salads and wraps distributed by Caito Foods LLC of Indianapolis, IN. Fresh Express also reported that no romaine lettuce from the lot that was positive for Cyclospora was packaged for direct retail sale to consumers.

On July 30, 2018, The U.S. Department of Agriculture’s Food Safety and Inspection Service (FSIS) issued a public health alert about pre-made salads and wraps containing romaine lettuce that were distributed by Caito Foods LLC of Indianapolis, IN. The pre-made salads and wraps were produced between July 15 to July 18, 2018, with either a “Best By,” “Enjoy by,” Best if Sold By,” or “Sell By” date ranging from July 18 through July 23, 2018.

Consumers who purchased one of these pre-made salads or wraps and have not eaten it should not eat it. They should throw it away or return it to the place of purchase. Consumers who have eaten one of these pre-made salads or wraps and developed diarrhea should see a healthcare provider to be tested for Cyclospora infection and to be treated if they are sick.

The investigation is ongoing.