Foodborne Illness Outbreaks

Public Health is investigating an outbreak of salmonellosis (caused by Salmonella bacteria) associated with Burien Fresh Smoothies in Burien. At this time, the source of the illness has not been identified.

Since August 15, 2018, seven people from three separate meal parties reported becoming ill after consuming food and beverage from Burien Fresh Smoothies from August 6–8, 2018. Two of the ill people were hospitalized and have since recovered. There is no indication that any employees of the restaurant have had any symptoms consistent with salmonellosis.

As part of the Public Health investigation, Environmental Health investigators visited the restaurant on August 15, 2018. Investigators found that the restaurant was serving cooked pork prepared at the restaurant owner’s home, which is not an approved food safety practice. The restaurant was directed to immediately stop serving pork-based food items and to remove them from their menu.

However, on August 16, 2018, we identified a fourth ill person diagnosed with salmonellosis after eating at Burien Fresh Smoothies on August 7, 2018. This person did not eat any pork-based food items. On August 16, 2018, our Environmental Health investigators revisited the establishment and suspended its permit.

On August 17, 2018, an additional three ill people were identified (one person with lab-confirmed salmonellosis, two people with symptoms consistent with salmonellosis).

Burien Fresh Smoothies will not be allowed to reopen until Public Health confirms they complete a thorough cleaning and disinfection of their establishment, adopt safe food handling practices to minimize cross contamination risks, and any remaining processed ready-to-eat food products are discarded.

Additionally, Environmental Health investigators are working closely with Burien Fresh Smoothies owners to educate them about using only approved food sources. The restaurant will be allowed to sell pork-based foods once our food safety team determines the owners have secured an alternative approved source.

Five of the seven people who got sick tested positive for Salmonella Braenderup by a healthcare provider. We are still waiting for genetic fingerprint results.

Food samples were collected from the establishment for laboratory testing; results are pending.

This investigation is ongoing and we will provide more information as it becomes available.

Salmonella can cause serious illness. Anyone who ate at Burien Fresh Smoothies from August 7, 2018 to August 16, 2018, and developed diarrhea (especially bloody diarrhea) within 5 days, should consult with their healthcare provider promptly to determine if testing is necessary.

Salmonella:  Marler Clark, The Food Safety Law Firm, is the nation’s leading law firm representing victims of Salmonella outbreaks. The Salmonella lawyers of Marler Clarkhave represented thousands of victims of Salmonella and other foodborne illness outbreaks and have recovered over $650 million for clients.  Marler Clark is the only law firm in the nation with a practice focused exclusively on foodborne illness litigation.  Our Salmonella lawyers have litigated Salmonella cases stemming from outbreaks traced to a variety of foods, such as cantaloupe, tomatoes, ground turkey, salami, sprouts, cereal, peanut butter, and food served in restaurants.  The law firm has brought Salmonella lawsuits against such companies as Cargill, ConAgra, Peanut Corporation of America, Sheetz, Taco Bell, Subway and Wal-Mart.

If you or a family member became ill with a Salmonellainfection, including Reactive Arthritisor Irritable bowel syndrome (IBS), after consuming food and you’re interested in pursuing a legal claim, contact the Marler Clark Salmonella attorneys for a free case evaluation.

As of August 16, 2018 (3pm EDT), a total of 476 laboratory-confirmed cases of Cyclospora infection were reported in people who consumed salads from McDonald’s restaurants; the cases were reported by 15 states. Note, the Connecticut, Tennessee, and Virginia case-patients purchased salads while traveling in Illinois; the Florida case-patient purchased a salad while traveling in Kentucky.  Illnesses started on or after May 20, 2018. The median illness onset date is June 29, 2018 (range: May 20 to July 20). Ill people range in age from 14 to 91 years old, with a median age of 53. Sixty-six percent (66%) are female. At least 21 people have been hospitalized; no deaths have been reported.

Epidemiologic evidence indicates that salads purchased from McDonald’s restaurants are one likely source of these infections. The investigation is ongoing, and FDA is working to determine the sources of the ingredients that were in common to the salads served at McDonald’s.

On July 26, 2018, FDA completed analysis of an unused package of romaine lettuce and carrot mix distributed to McDonald’s by the Fresh Express processor in Streamwood, IL. The analysis confirmed the presence of Cyclospora in that mix. On July 27, 2018, FDA informed Fresh Express of these results.

Fresh Express reported to FDA that the carrots in the mix went to McDonald’s restaurant locations only, and that the romaine lettuce was the only ingredient in the mix that was distributed to other locations. 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. Fresh Express also reported that no romaine lettuce from the lot that was positive for Cyclospora was packaged for direct retail sale to consumers.

On July 30, 2018, The U.S. Department of Agriculture’s Food Safety and Inspection Service (FSIS) issued a public health alert about pre-made salads and wraps containing romaine lettuce that were distributed by Caito Foods LLC of Indianapolis, IN. The pre-made salads and wraps were shipped to distribution centers nationwide. The pre-made salads and wraps were produced July 15 to July 18, 2018 and have a “Best By,” “Enjoy by,” “Best if Sold By,” or “Sell By” date ranging from July 18 through July 23, 2018. See the product labels here. The pre-made salads and wraps have establishment number “EST. 39985” or “P-39985” inside or next to the USDA mark of inspection. See the full list of products, product labels, UPC code numbers, and other identifying information here.

What is Cyclospora?

Cyclospora is a parasite composed of one cell, too small to be seen without a microscope. The organism was previously thought to be a blue-green alga or a large form of cryptosporidium. Cyclospora cayetanensis is the only species of this organism found in humans. The first known human cases of illness caused by cyclospora infection (that is, cyclosporiasis) were first discovered in 1977. An increase in the number of cases being reported began in the mid-1980s, in part due to the availability of better diagnostic techniques. Over 15,000 cases are estimated to occur in the United States each year. The first recorded Cyclospora outbreak in North America occurred in 1990 and was linked to contaminated water. Since then, several cyclosporiasis outbreaks have been reported in the U.S. and Canada, many associated with eating fresh fruits or vegetables. In some developing countries, cyclosporiasis is common among the population and travelers to those areas have become infected as well.

Where does Cyclospora come from?

Cyclospora is spread when people ingest water or food contaminated with infected stool. For example, exposure to contaminated water among farm workers may have been the original source of the parasite in raspberry-associated outbreaks in North America.

Cyclospora needs time (one to several weeks) after being passed in a bowel movement to become infectious. Therefore, it is unlikely that Cyclospora is passed directly from one person to another. It is not known whether or not animals can be infected and pass infection to people.

What are the typical symptoms of Cyclospora infection?

Cyclospora infects the small intestine (bowel) and usually causes watery diarrhea, bloating, increased gas, stomach cramps, and loss of appetite, nausea, low-grade fever, and fatigue. In some cases, vomiting, explosive diarrhea, muscle aches, and substantial weight loss can occur. Some people who are infected with Cyclospora do not have any symptoms. Symptoms generally appear about a week after infection. If not treated, the illness may last from a few days up to six weeks. Symptoms may also recur one or more times. In addition, people who have previously been infected with Cyclospora can become infected again.

What are the serious and long-term risks of Cyclospora infection?

Cyclospora has been associated with a variety of chronic complications such as Guillain-Barre syndrome, reactive arthritis or Reiter’s syndrome, biliary disease, and acalculous cholecystitis. Since Cyclospora infections tend to respond to the appropriate treatment, complications are more likely to occur in individuals who are not treated or not treated promptly. Extraintestinal infection also appears to occur more commonly in individuals with a compromised immune system.

How is Cyclospora infection detected?

Your health care provider may ask you to submit stool specimen for analysis. Because testing for Cyclospora infection can be difficult, you may be asked to submit several stool specimens over several days. Identification of this parasite in stool requires special laboratory tests that are not routinely done. Therefore, your health care provider should specifically request testing for Cyclospora if it is suspected. Your health care provider might have your stool checked for other organisms that can cause similar symptoms.

How is Cyclospora infection treated?

The recommended treatment for infection with cyclospora is a combination of two antibiotics, trimethoprim-sulfamethoxazole, also known as Bactrim, Septra, or Cotrim. People who have diarrhea should rest and drink plenty of fluids. No alternative drugs have been identified yet for people with Cyclospora infection who are unable to take sulfa drugs. Some experimental studies, however, have suggested that ciprofloxacin or nitazoxanide may be effective, although to a lesser degree than trimethoprim-sulfamethoxazole. See your health care provider to discuss alternative treatment options.

How can Cyclospora infection be prevented?

Avoiding water or food that may be contaminated is advisable when traveling. Drinking bottled or boiled water and avoiding fresh ready-to-eat produce should help to reduce the risk of infection in regions with high rates of infection. Improving sanitary conditions in developing regions with poor environmental and economic conditions is likely to help to reduce exposure.

Washing fresh fruits and vegetables at home may help to remove some of the organisms, but Cyclospora may remain on produce even after washing.

Marler Clark, The Food Safety Law Firm, is the nation’s leading law firm representing victims of Cyclospora outbreaks. The Cyclospora Attorneys and Lawyers have represented victims of Cyclospora and other foodborne illness outbreaks and have recovered over $650 million for clients.  Marler Clark is the only law firm in the nation with a practice focused exclusively on foodborne illness litigation.

If you or a family member became ill with a Cyclospora infection after consuming food and you are interested in pursuing a legal claim, contact the Marler Clark Hepatitis A attorneys for a free case evaluation.

  • COMPLAINT
  • As of August 9, 2018, a total of 436 laboratory-confirmed cases of Cyclospora infection were reported in people who consumed salads from McDonald’s restaurants; the cases were reported by 15 states. The investigation is ongoing and the FDA is currently reviewing distribution and supplier information for romaine and carrots.
  • On July 30, 2018, the U.S. Department of Agriculture’s Food Safety and Inspection Service (FSIS) issued a public health alert on beef, pork and poultry salad and wrap products potentially contaminated with Cyclospora that were distributed by Caito Foods LLC, of Indianapolis, IN. The products were produced between July 15 and 18, 2018, with either “Best By,” “Enjoy by,” “Best if Sold By” or “Sell By” dates ranging from July 18 through July 23, 2018. Caito Foods had received notification from Fresh Express that the chopped romaine in these products was being recalled.
  • On July 26, 2018, the FDA completed final analysis of an unused package of Fresh Express salad mix containing romaine lettuce and carrots, which had been distributed to McDonald’s. The analysis confirmed the presence of Cyclospora in that sample, though the expiration date for that product, July 19, had already passed. On July 27, the FDA informed Fresh Express of the results.
  • FDA instructed Fresh Express to determine whether potentially contaminated product may still be on the market. Fresh Express reported to FDA that the romaine from the same lot as the positive sample was not packaged for direct retail sale by Fresh Express and had already expired. Fresh Express committed to using recall procedures to inform those companies that received this romaine about the sample result. Fresh Express also reported that carrots used in the mix were only sent to McDonald’s locations.
  • Fresh Express reported to FDA that the romaine from the same lot as the positive sample was not packaged for direct retail sale by Fresh Express and had already expired. Fresh Express committed to using recall procedures to inform those companies that received this romaine about the sample result.
  • Fresh Express reported that the carrots in the mix only went to McDonald’s.
  • As of July 13, 2018, McDonald’s decided to voluntarily stop selling salads at impacted restaurants in IL, IA, IN, WI, MI, OH, MN, NE, SD, MT, ND, KY, WV, and MO. The company has since reported that it has replaced the supplier of salads in those states. More information can be found in McDonald’s Statement.

Marler Clark, The Food Safety Law Firm, is the nation’s leading law firm representing victims of Cyclospora outbreaks. The Cyclospora Attorneys and Lawyers have represented victims of Cyclospora and other foodborne illness outbreaks and have recovered over $650 million for clients.  Marler Clark is the only law firm in the nation with a practice focused exclusively on foodborne illness litigation.

If you or a family member became ill with a Cyclospora infection after consuming food and you are interested in pursuing a legal claim, contact the Marler Clark Hepatitis A attorneys for a free case evaluation.

A lawsuit was filed today in U.S. District Court against Hy-Vee, Inc. on behalf of Margaret Reiner, Tyler Rogers, and Kami Rogers who were all infected with Salmonella after eating Hy-Vee Pasta Salad. The three plaintiffs are represented by Marler Clark, the Nation’s Food Safety Law Firm, and Jardine, Logan, and O’Brien, a well-respected local firm.  Case No. is 0:18-cv-02379.

“Hy-Vee has always been a leader in food safety,” said Bill Marler, managing partner at Marler Clark. “We hope through the lawsuit to understand how this event happened and the do what we can to make sure something like this never happens again, added Marler.

On July 5, 2018, Ms. Reiner’s daughter, Kami Rogers, purchased pasta salad from a Hy-Vee store located at 1475 W. Service Drive, Winona, Minnesota. Ms. Reiner consumed the product the same day. Six days later, she began experiencing symptoms of diarrhea, body aches, and headaches. On July 19, her symptoms became so severe that she sought medical attention at Olmsted Medical Center where she tested positive for Salmonella. She remains under professional care through today.

Tyler Rogers consumed the same Hy-Vee Pasta Salad that his grandmother, Ms. Reiner. ate. He began experiencing symptoms on July 11, forcing him to miss three days of work. He continues to recover from his symptoms.

Kami Rogers consumed the Hy-Vee Pasta Salad on July 5th, 6th, and 7th.  She began experiencing symptoms on July 8th and four days later sought medical attention. Ms. Rogers consulted with her physicians regarding her symptoms through August 1, during which time she tested positive for Salmonella.

On July 17, the CDC and Hy-Vee announced an outbreak and recall of Hy-Vee Spring Pasta Salad for Salmonella contamination. To date, there are 79 cases across 9 states. 18 people have been hospitalized.

Marler Clark, The Food Safety Law Firm, is the nation’s leading law firm representing victims of Salmonella outbreaks. The Salmonella lawyers of Marler Clark have represented thousands of victims of Salmonella and other foodborne illness outbreaks and have recovered over $650 million for clients.  Marler Clark is the only law firm in the nation with a practice focused exclusively on foodborne illness litigation.  Our Salmonella lawyers have litigated Salmonella cases stemming from outbreaks traced to a variety of foods, such as cantaloupe, tomatoes, ground turkey, salami, sprouts, cereal, peanut butter, and food served in restaurants.  The law firm has brought Salmonella lawsuits against such companies as Cargill, ConAgra, Peanut Corporation of America, Sheetz, Taco Bell, Subway and Wal-Mart. If you or a family member became ill with a Salmonella infection, including Reactive Arthritis or Irritable bowel syndrome (IBS), after consuming food and you’re interested in pursuing a legal claim, contact the Marler Clark Salmonella attorneys for a free case evaluation.

Perry County Memorial Hospital in Perryville says there have been over 30 cases of Salmonella diagnosed since August 6th. Patient ages range from two to 68.  Three cases have required acute hospital admission, two short-term hospital observation and treatment, and one case has been transferred to a Cape Girardeau hospital.  The others so far are recovering with medication and hydration at home.

The Perry County Health Department says many of the reports of illness come from people who attended the St. Vincent de Paul Parish Seminary Picnic in Perryville from August 3rd through 5th.

The health department has posted a questionnaire for those who attended the event in an attempt to determine the source of the illness and protect the community from further illness.

Sorry Tom Hanks and Meg Ryan

Food Safety News reports – Known for its Chirashi bowl, but called The Fremont Bowl for its Seattle location, a small, but popular Japanese restaurant was forced to close Friday by Public Health. Seattle-King County Public Health closed The Fremont Bowl, located at  4258 Fremont Ave N, Ste #4262, Seattle, WA 98103, at 10:45 a.m., Aug. 10, 2018, due to the following food safety violations:

  • Foodborne illness outbreak.
  • Failure to wash hands as required
  • Improper food temperature control
  • Risk of cross contaminations not eliminated
  • Inadequate fresh produce washing procedure followed

Public Health is investigating an outbreak of salmonellosis, which caused by Salmonella bacteria. At this time, the source of the illnesses has not been identified.

The agency learned on Aug. 8 of four people from three separate meal parties that have reported illness after eating at Fremont Bowl in Seattle from July 27-29, 2018.

Three of the four people who got sick tested positive for Salmonella by a healthcare provider. The fourth person ate at Fremont Bowl prior to becoming ill with symptoms consistent with salmonellosis.

One of the ill people was hospitalized and has since recovered.

Environmental Health investigators completed an inspection at Fremont Bowl on Aug. 9, finding potential risk factors, including inadequate hand washing, lack of temperature controls, and risk of cross-contamination. Fremont Bowl management was informed about corrective measures that were required.

Environmental Health investigators re-visited on Aug. 10  and closed the establishment because many of the corrective actions were not completed.

Fremont Bowl will not be allowed to reopen until Public Health confirms they achieve a thorough cleaning and disinfection of their establishment, adopt safe food handling practices to minimize cross-contamination risks, and any remaining processed ready-to-eat food products are discarded. Furthermore, employees will be required to attend food safety training before being allowed to handle food.

A Chirashi (means scattered) is a big bowl of rice mixed with your choice of fish, vegetables, and other ingredients.

The Tulsa Health Department (THD) in collaboration with the Oklahoma State Department of Health (OSDH), Acute Disease Service (ADS) are investigating an outbreak of cyclosporiasis among residents of Tulsa and surrounding counties. As of August 1, 24 laboratory-confirmed cases of cyclosporiasis have been reported; symptom onsets have occurred from June 24 through July 26, 2018. The epidemiologic investigation suggests this outbreak is likely ongoing with persons currently experiencing illness and new cases being reported. Case ages range from 27 to 67 years (median = 43 years); 67% of cases are females. Nine (38%) cases are of Hispanic ethnicity. Twenty-one (88%) cases are residents of Tulsa County; although the other three cases are residents of Wagoner, Creek, and Rogers counties, case interviews have revealed at least two of these three individuals shopped and dined at establishments in the Tulsa area.

An investigation is underway to determine the source of this outbreak. Even though the epidemiology of this outbreak suggests a geographic cluster among residents in northeast Oklahoma, it is possible that related cases may not have been identified in other areas of the State as cyclosporiasis is not a notifiable condition. Cases of cyclosporiasis may also be associated with international travel. Public health officials are advising clinicians in Oklahoma to consider cyclosporiasis among patients with an acute, afebrile diarrheal illness, particularly in persons with diarrhea persisting > 1 week, and to report laboratory-confirmed cases with onsets since June 1 to the OSDH ADS epidemiologist-on-call at (405) 271-4060 or via the Public Health Investigation and Disease Detection of Oklahoma (PHIDDO) system.

Cyclosporiasis is a diarrheal illness caused by a single-celled parasite called Cyclospora cayetanensis. It is spread by consumption of contaminated food or water, which becomes contaminated after exposure to fecal matter from ill individuals. Cyclospora is not spread person-to-person. Symptoms of cyclosporiasis include watery diarrhea, loss of appetite, weight loss, bloating, stomach cramps, nausea, vomiting, muscle aches, and fatigue. Symptoms begin an average of 7 days after ingestion of the parasite and may last from several days to several weeks. Weight loss can be significant (exceeding 20 pounds in some cases). Some infected persons may not have any symptoms. Persons of all ages are at risk of infection. Treatment includes Bactrim or Septra (trimethoprim-sulfamethoxazole) and rehydration with fluids.

Recommendations for clinicians and laboratories

  • Clinicians should consider cyclosporiasis in patients presenting with an acute diarrheal illness with persisting watery diarrhea.
  • Laboratory testing for suspected cyclosporiasis includes gastrointestinal polymerase chain reaction (PCR) and/or ova and parasite (O&P) fecal examination.
  • Notify the clinical diagnostic laboratory about suspicion of Cyclospora disease to determine what testing is available, instructions for specimen collection and submission, and whether Cyclospora must be specified on the test order.
  • If ordering a gastrointestinal PCR panel, clinicians need to assure the PCR panel includes a target for Cyclospora.
  • If microscopic examination is ordered, stool specimens are typically submitted in an O&P collection kit. Stool specimens should be obtained early in the course of illness; optimum time is 1-3 days after onset of illness, during the early morning hours when the parasite(s) should be present in the greatest numbers. Many parasites are shed intermittently during the course of an infection; therefore, for initial detection,
  • 3 separate specimens should be collected on separate days, at a minimum of 24 hours apart – one every other day (over 5 days) is optimal but collection should not exceed 10 days.

One Kansas resident tests positive with Salmonella after attending dinner

The Kansas Department of Health and Environment (KDHE) and Doniphan County Health Department (DCHD) are currently conducting an outbreak investigation associated with an election day Indian Taco Dinner at the Highland United Methodist Presbyterian Church in Highland, Kan., on Aug. 7.

KDHE and DCHD request that anyone who attended or consumed food from the election day Indian Taco Dinner on Aug. 7 completes an online survey at: https://tinyurl.com/Doniphan . We would like everyone who attended to complete the survey, whether they became ill or not.

Those unable to complete the online survey may call DCHD at 785-985-3591, or the KDHE Epidemiology Hotline at 877-427-7317.

Contact a health care provider if you think you got sick. Most people infected with Salmonella develop diarrhea, fever and stomach cramps usually 12 to 96 hours, but can be as long as seven days, after being exposed to the bacteria. The illness usually lasts four to seven days, and most people recover without treatment. In some people, the diarrhea may be so severe that the patient needs to be hospitalized. Salmonella infection may spread from the intestines to the bloodstream and then to other places in the body. Children younger than five years, adults older than 65 years, and people with weakened immune systems are more likely to have a severe illness.

The CDC, public health and regulatory officials in several states, and the U.S. Food and Drug Administration are investigating a multistate outbreak of Cyclospora infections. As of August 9, 2018 (11am EDT), a total of 436 laboratory-confirmed cases of Cyclospora infection were reported in people who consumed salads from McDonald’s restaurants; the cases were reported by 15 states. Note, the Connecticut, Tennessee, and Virginia case-patients purchased salads while traveling in Illinois; the Florida case-patient purchased a salad while traveling in Kentucky.

Illnesses started on or after May 20, 2018. The median illness onset date is June 29, 2018 (range: May 20 to July 20). Ill people range in age from 14 to 91 years old, with a median age of 53. Sixty-six percent (66%) are female. At least 20 people have been hospitalized; no deaths have been reported.

On July 26, 2018, FDA completed analysis of an unused package of romaine lettuce and carrot mix distributed to McDonald’s by the Fresh Express processor in Streamwood, IL. The analysis confirmed the presence of Cyclospora in that mix. On July 27, 2018, FDA informed Fresh Express of these results.

Fresh Express reported to FDA that the carrots in the mix went to McDonald’s restaurant locations only, and that the romaine lettuce was the only ingredient in the mix that was distributed to other locations. 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. Fresh Express also reported that no romaine lettuce from the lot that was positive for Cyclospora was packaged for direct retail sale to consumers.

On July 30, 2018, The U.S. Department of Agriculture’s Food Safety and Inspection Service (FSIS) issued a public health alert about pre-made salads and wraps containing romaine lettuce that were distributed by Caito Foods LLC of Indianapolis, IN. The pre-made salads and wraps were shipped to distribution centers nationwide. The pre-made salads and wraps were produced July 15 to July 18, 2018 and have a “Best By,” “Enjoy by,” “Best if Sold By,” or “Sell By” date ranging from July 18 through July 23, 2018. See the product labels here. The pre-made salads and wraps have establishment number “EST. 39985” or “P-39985” inside or next to the USDA mark of inspection. See the full list of products, product labels, UPC code numbers, and other identifying information here.

What is Cyclospora?

Cyclospora is a parasite composed of one cell, too small to be seen without a microscope. The organism was previously thought to be a blue-green alga or a large form of cryptosporidium. Cyclospora cayetanensis is the only species of this organism found in humans. The first known human cases of illness caused by cyclospora infection (that is, cyclosporiasis) were first discovered in 1977. An increase in the number of cases being reported began in the mid-1980s, in part due to the availability of better diagnostic techniques. Over 15,000 cases are estimated to occur in the United States each year. The first recorded Cyclospora outbreak in North America occurred in 1990 and was linked to contaminated water. Since then, several cyclosporiasis outbreaks have been reported in the U.S. and Canada, many associated with eating fresh fruits or vegetables. In some developing countries, cyclosporiasis is common among the population and travelers to those areas have become infected as well.

Where does Cyclospora come from?

Cyclospora is spread when people ingest water or food contaminated with infected stool. For example, exposure to contaminated water among farm workers may have been the original source of the parasite in raspberry-associated outbreaks in North America.

Cyclospora needs time (one to several weeks) after being passed in a bowel movement to become infectious. Therefore, it is unlikely that Cyclospora is passed directly from one person to another. It is not known whether or not animals can be infected and pass infection to people.

What are the typical symptoms of Cyclospora infection?

Cyclospora infects the small intestine (bowel) and usually causes watery diarrhea, bloating, increased gas, stomach cramps, and loss of appetite, nausea, low-grade fever, and fatigue. In some cases, vomiting, explosive diarrhea, muscle aches, and substantial weight loss can occur. Some people who are infected with Cyclospora do not have any symptoms. Symptoms generally appear about a week after infection. If not treated, the illness may last from a few days up to six weeks. Symptoms may also recur one or more times. In addition, people who have previously been infected with Cyclospora can become infected again.

What are the serious and long-term risks of Cyclospora infection?

Cyclospora has been associated with a variety of chronic complications such as Guillain-Barre syndrome, reactive arthritis or Reiter’s syndrome, biliary disease, and acalculous cholecystitis. Since Cyclospora infections tend to respond to the appropriate treatment, complications are more likely to occur in individuals who are not treated or not treated promptly. Extraintestinal infection also appears to occur more commonly in individuals with a compromised immune system.

How is Cyclospora infection detected?

Your health care provider may ask you to submit stool specimen for analysis. Because testing for Cyclospora infection can be difficult, you may be asked to submit several stool specimens over several days. Identification of this parasite in stool requires special laboratory tests that are not routinely done. Therefore, your health care provider should specifically request testing for Cyclospora if it is suspected. Your health care provider might have your stool checked for other organisms that can cause similar symptoms.

How is Cyclospora infection treated?

The recommended treatment for infection with cyclospora is a combination of two antibiotics, trimethoprim-sulfamethoxazole, also known as Bactrim, Septra, or Cotrim. People who have diarrhea should rest and drink plenty of fluids. No alternative drugs have been identified yet for people with Cyclospora infection who are unable to take sulfa drugs. Some experimental studies, however, have suggested that ciprofloxacin or nitazoxanide may be effective, although to a lesser degree than trimethoprim-sulfamethoxazole. See your health care provider to discuss alternative treatment options.

How can Cyclospora infection be prevented?

Avoiding water or food that may be contaminated is advisable when traveling. Drinking bottled or boiled water and avoiding fresh ready-to-eat produce should help to reduce the risk of infection in regions with high rates of infection. Improving sanitary conditions in developing regions with poor environmental and economic conditions is likely to help to reduce exposure.

Washing fresh fruits and vegetables at home may help to remove some of the organisms, but Cyclospora may remain on produce even after washing.

Marler Clark, The Food Safety Law Firm, is the nation’s leading law firm representing victims of Cyclospora outbreaks. The Cyclospora Attorneys and Lawyers have represented victims of Cyclospora and other foodborne illness outbreaks and have recovered over $650 million for clients.  Marler Clark is the only law firm in the nation with a practice focused exclusively on foodborne illness litigation.

If you or a family member became ill with a Cyclospora infection after consuming food and you are interested in pursuing a legal claim, contact the Marler Clark Hepatitis A attorneys for a free case evaluation.

MINNEAPOLIS, Minnesota – A lawsuit will be filed today in Minnesota District Court against Markon Cooperative, Inc., and Reinhart Foodservice LLC. on behalf of Linda Miller who was diagnosed E. coli O157:H7 after consuming romaine lettuce distributed by Markon Cooperative and produced by Reinhart Foodservice. Ms. Miller is represented by Marler Clark, the food safety law firm, and Jardine, Logan, and O’Brien, a respected local firm. Complaint

Prior to her E. coli O157:H7 infection, Ms. Miller lived at Andrew Residence, a long-term care facility for adults. Markon Cooperative supplied lettuce sourced from the Yuma, Arizona region to Reinhart Foodservice which provided the lettuce to the Andrew Residence where Ms. Miller consumed it. Reinhart Foodservice was the only supplier to Andrew Residence during the time period of Ms. Miller’s E. coli O157:H7 infection.  Ms. Miller has been linked to the outbreak by the CDC and the Minnesota Department of Health.

On April 28, 2018, Ms. Miller began experiencing symptoms of nausea, vomiting, diarrhea, stomach cramps, muscle aches, and fatigue. Her symptoms were so severe, that she required hospitalization at Abbot Northwestern Hospital. At the hospital she tested positive for E. coli O157:H7 and developed a complication called hemolytic uremic syndrome (HUS). Ms. Miller developed central nervous system involvement, resulting in seizures and other neurological injury. Ms. Miller remained in the hospital for six weeks requiring intubation to breathe, and a feeding tube. On June 13, Ms. Miller was transferred to the Ebenezer Care Center in Minneapolis for further care. She continues to struggle with injuries as a result of her infection.

On April 10, 2018, the CDC announced an investigation into an E. coli O157:H7 outbreak stemming from romaine lettuce grown in the Yuma region of Arizona. There were a total of 210 confirmed cases across 36 states, with 96 hospitalizations and 5 deaths.  California was hardest hit with 49 sickened.  Minnesota had 12 illnesses, including Ms. Miller.  The five deaths were reported in Arkansas, California, New York and Minnesota.  Two of the five deaths were from Minnesota.

Marler Clark currently represents 87 people affected in the outbreak and has filed 10 lawsuits associated with the outbreak.

“Although the CDC and FDA declared the outbreak officially over on June 28, 2018 many of our clients are still struggling medically,” said Marler Clark managing partner, William Marler. “In addition, federal authorities have been less than forthcoming about where the E. coli O157:H7 – tainted romaine was sold,” continued Marler.

Marler Clark, The Food Safety Law Firm, is the nation’s leading law firm representing victims of E. coli O157:H7 outbreaks and hemolytic uremic syndrome (HUS). The  E. coli O157:H7 lawyers of Marler Clark have represented thousands of victims of E. coli O157:H7 and other foodborne illness infections and have recovered over $650 million for clients. Marler Clark is the only law firm in the nation with a practice focused exclusively on foodborne illness litigation.  Our E. coli O157:H7 lawyers have litigated E. coli O157:H7 and HUS cases stemming from outbreaks traced to ground beef, raw milk, lettuce, spinach, sprouts, and other food products.  The law firm has brought E. coli O157:H7 lawsuits against such companies as Jack in the Box, Dole, ConAgra, Cargill, and Jimmy John’s.  We have proudly represented such E. coli O157:H7 victims as Brianne KinerStephanie Smith and Linda Rivera.

For more information contact Lauren Fricke at lfricke@marlerclark.com or 1-206-346-1888.

f you or a family member became ill with an E. coli O157:H7 infection or HUS after consuming food and you’re interested in pursuing a legal claim, contact the Marler Clark E. coli O157:H7 attorneys for a free case evaluation.