As of July 8, 2020, there are 37 confirmed cases of Cyclospora illness linked to this outbreak in three provinces: Ontario (26), Quebec (10) and Newfoundland and Labrador (1). Individuals became sick between mid-May and mid-June 2020. One individual has been hospitalized. No deaths have been reported. Individuals who became ill are between 21 and 70 years of age. The majority of cases (76%) are female.
The Public Health Agency of Canada (PHAC) is collaborating with provincial public health partners, the Canadian Food Inspection Agency (CFIA) and Health Canada to investigate an outbreak of Cyclospora infections occurring in three provinces. The outbreak appears to be ongoing, as recent illnesses continue to be reported to PHAC.
Based on the investigation findings to date, exposure to certain Fresh Express brand salad products containing iceberg lettuce, carrots and red cabbage, has been identified as a likely source of the outbreak. Some of the individuals who became sick reported having eaten Fresh Express brand salad products containing these ingredients before their illnesses occurred. The source of illness for the remaining individuals continues to be under investigation. The investigation is ongoing and this public health notice will be updated as the investigation evolves.
On June 28, 2020, the CFIA issued a food recall warning for certain Fresh Express brand salad products containing iceberg lettuce, carrots and red cabbage that were distributed nationally in Canada. The recalled salad products begin with lot code “Z177” or a lower number and have best before dates up to and including 20JUL08 – 20JUL14. For more information on the recalled product, please consult the CFIA’s website.
Canadians are advised not to eat the recalled products. Retailers and food service establishments are advised not to sell or serve the recalled products, or any items that may have been prepared or produced using these products.
The CFIA is continuing its food safety investigation, which may lead to the recall of other products. If additional products are recalled, the CFIA will notify the public through updated food recall warnings.
The U.S. Centers for Disease Control and Prevention and the U.S. Food and Drug Administration are also investigating a multi-state outbreak of Cyclospora infections that has been linked to bagged salad mixes containing iceberg lettuce, carrots, and red cabbage produced by Fresh Express.

206 people with laboratory-confirmed Cyclospora infections and who reported eating bagged salad mix before getting sick have been reported from 8 Midwestern states (Illinois, Iowa, Kansas, Minnesota, Missouri, Nebraska, North Dakota, and Wisconsin).
As of September 5, 2018, 250 people were infected with Cyclospora reported from 4 states.
CDC, public health and regulatory officials in several states, and the U.S. Food and Drug Administration (FDA) are investigating a multistate outbreak of Cyclospora infections linked to bagged salad mix purchased at ALDI, Hy-Vee, and Jewel-Osco stores in Iowa, Illinois, Kansas, Missouri, Minnesota, and Nebraska. As of June 19, 2020, a total of 76 people with laboratory-confirmed Cyclospora infections associated with this outbreak have been reported from 6 states: Iowa (28), Illinois (23), Kansas (1), Minnesota (10), Missouri (7) and Nebraska (7).
Stop Foodborne Illness and the Center for Science in the Public Interest (CSPI) are calling for important changes at the U.S. Department of Agriculture to reduce consistently high burdens of foodborne illness associated with Salmonella and Campylobacter in poultry.
This is not meant as a criticism of my friends at the FDA or the good people at LGMA – California and Arizona – or at Western Growers, United Fresh or PMA. But seriously, since leafy green E. coli O157:H7outbreaks spiked in the early 2000’s, is anyone surprised by the following conclusion by the FDA (only that it was not said out loud sooner).
During the course of these investigations, the FDA determined that: