FDA Investigation of Multistate Outbreak of Cyclospora Illnesses Linked to Del Monte Vegetable Trays Ends

The FDA, CDC, along with state and local officials investigated a multi-state outbreak of cyclosporiasis illnesses associated with Del Monte vegetable trays recalled from Kwik Trip/Kwik Star locations in the United States.

Update – September 6, 2018

As of September 6, 2018, a total of 250 laboratory-confirmed cases of Cyclospora infection were reported in people who reportedly ate recalled pre-packaged Del Monte vegetable trays. CDC reports that the numbers of reported cases of cyclosporiasis in the United States have returned to baseline levels.

FDA evaluated and reviewed the distribution and supplier information for each component of the recalled vegetable trays as part of the traceback investigation. The investigation did not identify a single source or potential point of contamination for any of the items that comprised the recalled vegetable trays. The traceback investigation is complete.

Recommendations

Consumers who have symptoms of cyclosporiasis should contact their health care provider to report their symptoms and receive care.

Case Counts

Total Illnesses: 250
Hospitalizations: 8
Deaths: 0
Last illness onset: 6/14/2018
States with Cases: IA, MN, WI, MI

Note: The Michigan cases purchased their vegetable trays in Wisconsin.

Who to Contact

Consumers who have symptoms should contact their health care provider to report their symptoms and receive care.

To report a complaint or adverse event (illness or serious allergic reaction), you have three choices:

Call an FDA Consumer Complaint Coordinator if you wish to speak directly to a person about your problem.
Complete an electronic Voluntary MedWatch formonline.
Complete a paper Voluntary MedWatch form that can be mailed to FDA.

Visit www.fda.gov/fcic for additional consumer and industry assistance.

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What's the Problem and What's Being Done?

As of September 6, 2018, a total of 250 laboratory-confirmed cases of Cyclospora infection were reported in people who reportedly ate recalled pre-packaged Del Monte vegetable trays. CDC reports that this outbreak appears to be over. FDA evaluated and reviewed the distribution and supplier information for each component of the recalled vegetable trays as part of the traceback investigation. The investigation did not identify a single source or potential point of contamination for any of the items that comprised the recalled vegetable trays. The traceback investigation is complete.
As of June 15, 2018, Del Monte recalled 28oz vegetable trays that were distributed to IL and IN. Del Monte reports the recalled products included broccoli, cauliflower, carrots, celery and dill dip and were distributed to: Kwik Trip, Kwik Star, Demond’s, Sentry, Potash, Meehan’s, Country Market, FoodMax Supermarket and Peapod in Illinois, Indiana, Iowa, Michigan, Minnesota, and Wisconsin and had “Best If Enjoyed By” date of June 17, 2018 or earlier.
On June 8, 2018, Del Monte withdrew their 6oz and 12oz vegetable trays that contained broccoli, cauliflower, carrots and dill dip from retail market locations. The expiration date for the recalled product was June 17, 2018 or earlier.

What is Cyclospora?

Cyclospora cayetanensis is a microscopic parasite of humans. This parasite, when it contaminates food or water and is then ingested, can cause an intestinal illness called cyclosporiasis. The Cyclospora parasite needs time (days to weeks) after being passed in a bowel movement to become infectious for another person. Therefore, it is unlikely that cyclosporiasis is passed directly from one person to another.

What are the Symptoms of cyclosporiasis?

Most people infected with Cyclospora develop diarrhea, with frequent, sometimes explosive, bowel movements. Other common symptoms include loss of appetite, weight loss, stomach cramps/pain, bloating, increased gas, nausea, and fatigue. Vomiting, body aches, headache, fever, and other flu-like symptoms may be noted. Some people who are infected with Cyclospora do not have any symptoms. If not treated, the illness may last from a few days to a month or longer. Symptoms may seem to go away and then return one or more times (relapse).

Who is at Risk?

People can become infected with Cyclospora by consuming food or water contaminated with the parasite. People living or traveling in countries where cyclosporiasis is endemic, including certain tropical or subtropical regions of the world, may be at increased risk for infection.

What Do Restaurants and Retailers Need To Do?

Based on current information available Cyclospora may be resistant to routine chemical disinfection methods such as those using chlorine. However, restaurants and retailers should still follow basic food safety practices:

Retailers, restaurants, and other food service operators should always practice safe food handling and preparation measures. It is recommended that they wash hands, utensils, and surfaces with hot, soapy water before and after handling food. Wash and sanitize display cases and refrigerators where potentially contaminated products were stored.
Wash and sanitize cutting boards, surfaces, and utensils used to prepare, serve, or store potentially contaminated products.
Wash hands with warm water and soap following the cleaning and sanitation process.
Regular frequent cleaning and sanitizing of food contact surfaces and utensils used in food preparation may help to minimize the likelihood of cross-contamination.

What Do Consumers Need To Do?

Consumers who have symptoms of cyclosporiasis should contact their health care provider to report their symptoms and receive care. Most people infected with Cyclospora develop diarrhea, with frequent, sometimes explosive, bowel movements. Other common symptoms include loss of appetite, weight loss, stomach cramps/pain, bloating, increased gas, nausea, and fatigue. Vomiting, body aches, headache, fever, and other flu-like symptoms (relapse).