Multistate Outbreak of Cyclospora Infections Linked to Bagged Salad Mix

The Wisconsin Department of Health Services (DHS), the Wisconsin Department of Agriculture, Trade, and Consumer Protection (DATCP), and local health departments continue to work with the Centers for Disease Control and Prevention (CDC) and the U.S. Food and Drug Administration (FDA) to investigate a multistate outbreak of cyclosporiasis infections linked to the consumption of bagged salad mix containing iceberg lettuce, carrots, and red cabbage produced by Fresh Express.

As of July 24, 2020, a total of 641 people with laboratory-confirmed Cyclospora infections associated with this outbreak have been reported from 11 states. 37 people have been hospitalized and no deaths have been reported.

Wisconsin has 36 confirmed cases linked to this outbreak. None have been hospitalized.

Epidemiologic and trackback evidence indicates that bagged salad mix containing iceberg lettuce, carrots, and red cabbage produced by Fresh Express is a likely source of this outbreak.

  • The Public Health Agency of Canada is investigating an outbreak of Cyclospora infections occurring in 3 Canadian provinces. Exposure to certain Fresh Express salad products containing iceberg, red cabbage, and carrots is the likely source of their outbreak.
  • 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.
  • On June 25, 2020, Fresh Express recalled 12- and 24-ounce bagged Walmart Marketside Classic Iceberg Salad, sold in Walmart stores.
  • On June 22, 2020, ALDI recalled 12-ounce bagged Little Salad Bar Garden Salad produced by Fresh Express.
  • On June 20, 2020, Hy-Vee issued a recall for Hy-Vee brand 12-ounce bagged Garden Salad produced by Fresh Express.
  • Evidence shows that Jewel-Osco brand Signature Farms Brand Garden Salad may be another source of this outbreak, but this product was not distributed to stores in Wisconsin. Jewel-Osco, in cooperation with Fresh Express, has recalled this product due to the association with illnesses in other Midwestern states.

Wisconsin DHS, the CDC, and FDA are advising people not to eat, sell, or serve any products that have been recalled for potential Cyclospora contamination.

The recalled products have use-by dates through July 14, 2020. A full list of recalled products can be found here.

  • Check your home for any of these salad products. Throw any remaining salad away, even if some of it has been eaten and no one has gotten sick.
  • If you live in Wisconsin and don't know whether the bagged garden salad blend you have in your home is one of these recalled salads, don't eat it and throw it away.

This investigation is ongoing and additional retailers and products may be impacted by this outbreak. Wisconsin DHS will continue provide updates as information becomes available.

See the DHS cyclosporiasis fact sheet for more information on common symptoms and treatment of cyclosporiasis. If you have any symptoms of cyclosporiasis, please contact your doctor.

Additional information can be found on the following websites:


Cyclosporiasis is an illness that causes diarrhea and stomach pain. It is caused by the Cyclospora cayetanensis parasite, which is so small it can only be seen with a microscope. The parasite is common in tropical countries. In the U.S., people can get sick by traveling to or eating fresh produce imported from tropical countries.

The Cyclospora parasite is spread when people eat or drink something that has been contaminated with poop, especially fresh produce (herbs, vegetables, berries) and untreated water. Cyclospora cannot be spread from person-to-person. 


Additional Info Group

Last Revised: August 21, 2020