In what Cyclospora lawyer Ryan Osterholm describes as a key development in the McDonald’s outbreak investigation, the FDA says it found Cyclospora in a bag of Fresh Express brand salad sold to McDonald’s. Osterholm and his colleagues Brendan Flaherty and Lindsay Lien Rinholen are representing clients in this outbreak which has sickened 395 people in 15 states.
Laboratory-confirmed cases have been reported from Connecticut, Florida, Iowa, Illinois, Indiana, Kentucky, Michigan, Minnesota, Missouri, Nebraska, Ohio, South Dakota, Tennessee, Virginia and Wisconsin. Health officials note that case-patients from Connecticut, Tennessee, and Virginia purchased salads while they were in Illinois; the Florida case-patient bought a McDonald’s salad while traveling in Kentucky.
During interviews with state and federal health officials, case-patients reported eating several different kinds of salad from McDonald’s before they became ill. The Centers for Disease Control and Prevention (CDC) announced this outbreak on July 13 and McDonald’s immediately stopped selling the salads at restaurants n the states affected by the outbreak.
Since that time, outbreak investigators have been working to determine where in the food production chain the contamination may have occurred. “On July 26, 2018, the made a key discovery,” Osterholm said. That’s the date the U.S. Food and Drug Administration (FDA) found Cyclospora in an unused package of romaine lettuce and carrot mix distributed to McDonald’s by the Fresh Express processor in Streamwood, IL. The FDA told Fresh Express about the results on July 27, 2018,
Looking through records, Fresh Express reported back to the FDA that the carrots in the mix were only distributed to McDonald’s restaurant locations but that the romaine lettuce in the mix that was distributed to other locations but was not packaged for direct retail sale to consumers. However, “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.”
The U.S. Department of Agriculture’s Food Safety and Inspection Service (USDA FSIS) issued a public health alert about pre-made salads and wraps distributed by Caito on July 30, 2018. The salads and wraps in question were produced between July 15 and July 18, 2018, and were marked with “Best By,” “Enjoy by,” Best if Sold By,” or “Sell By” dates ranging from July 18 to July 23, 2018. Consumers who ate these products should be aware that they may have been exposed to Cyclospora and should monitor themselves for symptoms.
Symptoms of a Cyclospora infection, called cyclosporiasis, can take up to two weeks to develop. Once they do begin, they can come and go in waves over a period of months. The main symptom of a Cyclospora infection is profuse, watery and often explosive, diarrhea. Many Pritzker Hageman Cyclospora clients report that the diarrhea is so intense they can’t leave the house and are unable to go to work. Other symptoms include abdominal cramps, vomiting, bloating, gas, nausea, and flu-like symptoms such as fatigue, loss of appetite, weight loss, body aches and low-grade fever. Treatment with antibiotics can ease some of these symptoms.
Update: This post was updated August 3 with new case count totals.