North Dakota Department of Health Investigates Outbreak of Cyclosporosis Associated with Bagged Salad Mixes

The North Dakota Department of Health (NDDoH) reports six cases of Cyclospora infection associated with bagged salad mixes.

“The cases in North Dakota are part of a larger epidemic in the Midwest states,” said Laura Cronquist, epidemiologist at NDDoH. “The six people ate Marketside brand salad. The NDDoH continues to work with the Centers for Disease Control and Prevention (CDC), the U.S. Food and Drug Administration (FDA), and other public health agencies in this ongoing investigation. “

The disease is associated with the consumption of bagged salad mixes distributed in the Midwest. Salads sold in ALDI, Hy-Vee, Jewel-Osco and Walmart stores have been recalled from stores in Arkansas, Illinois, Indiana, Iowa, Kansas, Michigan, Missouri, Minnesota, Nebraska, North Dakota, North Dakota, South Dakota and Wisconsin.

Consumers in these 12 states should check their homes for the recalled salads and discard the remaining salad. The salads recalled include:

-Classic Iceberg Salad in 12-ounce and 24-ounce bags from Marketside brand (sold in Walmart stores in Iowa, Minnesota, Michigan, Nebraska, North Dakota, South Dakota and Wisconsin).
– Little Salad Bar brand garden salad in 12-ounce bag (sold in ALDI stores in Arkansas, Illinois, Indiana, Iowa, Michigan, Minnesota, Missouri, North Dakota, South Dakota and Wisconsin).
– Hy-Vee brand garden salad in 12-ounce bag (sold in Hy-Vee stores in Illinois, Iowa, Kansas, Missouri, Minnesota, Nebraska, South Dakota and Wisconsin).

According to the CDC, as of June 26, 206 cases from eight states have been reported in the United States. Twenty-three cases were hospitalized. None of the North Dakota cases were hospitalized.

Cyclosporosis is a disease caused by Cyclospora, a single-celled parasite. Symptoms include nausea, watery diarrhea, loss of appetite, weight loss, fatigue, abdominal cramps and body aches. Symptoms usually develop about a week after infection, although the incubation period can range from two days to two weeks. Healthy people generally recover without treatment. In the United States, most infections are linked to the consumption of contaminated fruits and vegetables. People traveling abroad and drinking untreated water or eating local products are also at risk. Direct person-to-person transmission does not occur. People who get sick after eating salad should consult their health care provider.

To reduce the risk of cyclosporosis, people should:

-Wash your hands before and after handling fresh produce.
-Wash fresh products before consuming them.
-Refrigerate cut, peeled or cooked fruits and vegetables as soon as possible or within two hours. Keep fruits and vegetables away from raw meat, poultry, and seafood.
-Avoid drinking contaminated water.
-Use separate cutting boards for fresh produce and raw meats and poultry.
-Clean and disinfect food preparation work surfaces.

For more information on the cyclosporosis epidemic related to bagged salad mixes, please visit the CDC website at www.cdc.gov/parasites/cyclosporiasis/outbreaks/2020/index.html. More information on cyclosporosis can be found at www.health.nd.gov/diseases-conditions/foodborne-and-gastrointestinal-illness/cyclosporiasis.

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