The U.S. Food and Drug Administration (FDA), along with the U.S. Centers for Disease Control and Prevention (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 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, as we reported earlier. Investigators continue to look into whether other retail brands may be impacted.

In response, Fresh Express has issued a voluntary recall of branded and private label salad products that contain these ingredients due to a possible health risk from Cyclospora. According to CDC, over 200 illnesses have been reported in connection with a current outbreak of Cyclospora occurring in primarily Midwest states. The Fresh Express recall includes only those salads that are clearly marked with the letter Z at the beginning of the product code, which is located in the upper right-hand corner of the front of the package. Products containing the ingredients iceberg lettuce, red cabbage, and/or carrots and displaying the product code Z178, or a lower number, are recalled.

Cyclosporiasis is an intestinal infection caused by the Cyclospora parasite. A person may become infected after ingesting contaminated food or water. Common symptoms include severe abdominal pain, diarrhea, nausea and vomiting, body aches, and fatigue. The infection is treated with antibiotics and most people respond quickly to treatment.

​Recalled products were distributed to select retail stores between June 6 and June 26 in Arkansas, Connecticut, Delaware, Iowa, Illinois, Indiana, Kansas, Kentucky, Massachusetts, Maryland, Maine, Michigan, Minnesota, Missouri, Montana, North Carolina, North Dakota, Nebraska, New Jersey, New York, Ohio, Oklahoma, Pennsylvania, Rhode Island, South Dakota, Tennessee, Virginia, Vermont, Wisconsin, West Virginia, and the District of Columbia.