Cyclospora Outbreak Connected to McDonald's Salads Continues to Grow

Health officials across the United States are investigating an increase in Cyclospora cases reported in a multistate outbreak which has been linked back to salads sold at McDonald’s locations throughout the country.

The final case counts reveal that there have been 511 confirmed cases of cyclosporiasis related to this outbreak spanning 15 states; the majority of cases, or 246, have been reported in Illinois.

As of September 12, 2018, the US Centers for Disease Control and Prevention (CDC) reported that all illnesses associated with the Cyclospora outbreak between May 20 to July 23, 2018. The cases have been confirmed in individuals between the ages of 14 and 91; the median age of those infected is 52. Additionally, the CDC reports that 66% of those affected in the outbreak are female. There have been 24 hospitalizations, but no deaths have been reported. As of September 12, 2018, this outbreak appears to be over.

On July 14, McDonald’s issued a statement announcing that the chain would voluntarily stop selling salads until a new supplier could be found. As a result, salads were pulled off of the menu from 3000 McDonald’s locations in the Midwest.

In an update to the statement on July 20, McDonald’s indicated that the salad products would return to the menu as salads sold at affected McDonald’s locations were now being produced by a new supplier.

On July 26, 2018, the US Food and Drug Administration (FDA) completed a “final analysis” of an unused package of Fresh Express salad mix which had been distributed to McDonald's stores. The analysis confirmed the presence of Cyclospora in an expired salad mix containing romaine lettuce and carrots.

According to the FDA, Fresh Express reported that the carrots used in the salad mix were only sent to McDonald's stores; however, the romaine lettuce had been distributed to other distribution companies. Fresh Express has communicated to the FDA that all companies that received romaine lettuce from the contaminated sample will be informed in accordance with recall procedures.

On July 30, 2018, The US Department of Agriculture's Food Safety and Inspection Service (FSIS) issued a public health alert for beef, pork, and poultry salad and wrap products distributed by Caito Foods LLC, of Indianapolis, Indiana, the same supplier of pre-cut melon that sickened 77 individuals across 9 states with Salmonella Adelaide in June. According to the alert, the affected products were produced between July 15 to 18, 2018 and contained expiration dates ranging from July 18 through July 23.

This recall was issued out of an abundance of caution because the products contain recalled chopped romaine lettuce from the same lot that tested positive for Cyclospora and had been processed by Fresh Express.

At this time, there is no evidence to suggest that the cluster of illnesses associated with the Cyclospora salad outbreak is linked to the multistate outbreak of Cyclospora linked to Del Monte fresh produce vegetable trays.

The CDC declared the outbreak over on September 12, 2018.

For the final case counts associated with the multistate Cyclospora outbreak linked to McDonald’s salads, check out the Contagion^® Outbreak Monitor.