In a follow-up on the multistate outbreak of Cyclospora infections linked to bagged salad mix containing iceberg lettuce, carrots, and red cabbage produced by Fresh Express, the Centers for Disease Control and Prevention (CDC) now reports 690 laboratory-confirmed Cyclospora infections and in people who reported eating bagged salad mix before getting sick have been reported from 13 states (Georgia, Illinois, Iowa, Kansas, Massachusetts, Minnesota, Missouri, Nebraska, North Dakota, Ohio, Pennsylvania, South Dakota, and Wisconsin).


More than 500 cases have been reported from Illinois, Iowa and Minnesota.

37 people have been hospitalized. No deaths have been reported.

In addition, the Public Health Agency of Canada (PHAC) is collaborating with provincial public health partners, the Canadian Food Inspection Agency (CFIA) and Health Canada to investigate an outbreak of Cyclospora infections occurring in three provinces.

As of July 8, 2020, there are 37 confirmed cases of Cyclospora illness linked to this outbreak in three provinces: Ontario (26), Quebec (10) and Newfoundland and Labrador (1).

The US Food and Drug Administration (FDA) said Friday their 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.

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.

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.

Products were sold in many states under either the brand name Fresh Express or the store brand labels ALDI Little Salad Bar, Giant Eagle, Hy-Vee, Jewel-Osco Signature Farms, ShopRite Wholesome Pantry, and Walmart Marketside.

The contaminated bagged salad products that made people sick in this outbreak are past their shelf-life and should no longer be available.  The affected salads had best-before dates up to and including July 14, 2020.

A full listing of recalled products is available on the Fresh Express recall page.