According to the CDC, foodborne outbreaks of Cyclospora cayetanensis have been reported in the United States since the mid-1990s and have been linked to various types of imported fresh produce, including raspberries, basil, snow peas, mesclun lettuce, and cilantro – mostly imports.
In 2017, the CDC created a table that provides information about 39 reported foodborne outbreaks of cyclosporiasis that occurred in the United States during 2000–2017; the total case count was 1,730.
However, there were additional outbreaks, some linked to specific products and some not.
In 2013 a total of 631 persons with cyclosporiasis were reported from 25 states and New York City: Arkansas (16), California (1), Connecticut (2), Florida (33), Georgia (5), Illinois (14), Iowa (140), Kansas (4), Louisiana (3), Massachusetts (3), Michigan (1), Minnesota (3), Missouri (5), Nebraska (87), New Hampshire (1), New Jersey (4), New York City (8), New York State (2), Ohio (3), Pennsylvania (1), South Dakota (1), Tennessee (1), Texas (270), Virginia (4), Wisconsin (18), and Wyoming (1). Illness onset dates ranged from June 1, 2013, to August 29, 2013. Ill persons ranged in age from less than 1 year to 94 years, with a median age of 52 years. Fifty-eight percent (58%) of ill persons were female. Among 596 persons for whom information was available, 49 (8%) reported being hospitalized, and no deaths were reported.
In 2014 a total of 304 ill persons with confirmed Cyclospora infection were reported to CDC in 2014. Of these, 207 occurred in persons who did not travel outside the country in the 2 weeks before onset of illness. Cases were reported from the following states: Arkansas, California, Connecticut, Florida, Illinois, Maryland, Maine, Massachusetts, Michigan, Minnesota, Montana, Nebraska, Pennsylvania, New Jersey, New York (including New York City), Texas, Virginia, Wisconsin, and Washington. Most (133; 64%) cases were reported to CDC in July, and the majority (133; 64%) of the cases were reported from Texas; among Texas cases, 70% were reported in July. Most (176; 85%) illness onset dates occurred in June and July. Among 204 ill persons for whom information is available, age ranged from 3 to 88 years, with a median age of 49 years; 115 (56%) of ill persons are female. Among 183 ill persons for whom information is available, 7 (4%) have reported being hospitalized. No deaths have been reported.
In 2015 a total of 546 ill persons with confirmed Cyclospora infection were reported to CDC in 2015. Most of these persons—319 (58%) of 546—experienced onset of illness on or after May 1, 2015 and did not have a history of international travel within 2 weeks before illness onset. These 319 persons were from the following 23 states: Arkansas (3), California (2), Connecticut (5), Florida (13), Georgia (26), Illinois (9), Iowa (1), Kansas (2), Maryland (1), Massachusetts (12), Michigan (2), Missouri (1), Montana (3), Nebraska (1), New Jersey (7), New Mexico (2), New York (excluding NYC) (10), New York City (22), North Carolina (1), Texas (179), Utah (1), Virginia (3), Washington (2), and Wisconsin (11). Clusters of illness linked to restaurants or events have been identified and investigated in Texas, Wisconsin, and Georgia. Epidemiologic and traceback investigations conducted in Texas, Wisconsin, and Georgia by state and local public health and regulatory officials and the FDA indicated that some illnesses among residents in these states were linked to fresh cilantro from Puebla, Mexico. The vehicle(s) of infection for non-cluster-associated cases has not been identified. The numbers of reported cases of cyclosporiasis in the United States have returned to baseline levels.
In 2017 the CDC was notified of 1,054 laboratory-confirmed cases of cyclosporiasis in persons who became ill in 2017. This number includes persons who reported international travel as well as persons who did not report travel. The reports have come from 40 states. At least 592 (56%) of these persons did not report international travel (i.e., likely were infected in the United States) and became ill on or after May 1, 2017 (a date after which cases tend to increase each year). These 592 persons were from the following 36 states: Arizona (1), California (10), Colorado (6), Connecticut (23), Florida (78), Georgia (13), Illinois (17), Indiana (4), Iowa (14), Kansas (2), Louisiana (12), Maryland (12), Massachusetts (14), Michigan (3), Minnesota (13), Mississippi (1), Missouri (13), Montana (2), Nebraska (5), New Hampshire (4), New Jersey (19), New Mexico (1), New York (excluding NYC) (15), New York City (32), North Carolina (48), Ohio (17), Pennsylvania (2), Rhode Island (2), South Carolina (7), South Dakota (4), Tennessee (4), Texas (172), Utah (1), Virginia (9), Washington (1), West Virginia (2), and Wisconsin (9).
In 2018 the Del Monte outbreak sickened 250 people with Cyclospora reported from 4 states. Illnesses started on dates ranging from May 14, 2018 to June 20, 2018. Ill people ranged in age from 13–79 years with a median age of 45. Among ill people, 52% were female. Eight people (3%) were hospitalized. No deaths were reported.
Also in 2018 the Fresh Express outbreak sickened 511 laboratory-confirmed cases of Cyclospora infections in people from 15 states and New York City who reported consuming salads from McDonald’s restaurants in the Midwest. The Connecticut, New York City, 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 dates ranging from May 20 to July 23, 2018. Ill people ranged in age from 14–91 years with a median age of 52. Among ill people, 66% were female. Out of 472 people with information available, 24 people (5%) were hospitalized. No deaths were reported.
In 2019 basil was linked to a total of 241 people with laboratory-confirmed Cyclospora infections associated with this outbreak were reported from 11 states: CT (1), FL (62), GA (2), IA (2), MA (1), MN (33), NY (131), OH (3), RI (1), SC (1), and WI (4). Exposures were reported in 5 states (Florida, Minnesota, New York, Ohio, and Wisconsin). Illnesses started on dates ranging from June 10, 2019 to July 26, 2019. Ill people ranged in age from 15 to 98 years with a median age of 49 and 70% were female. Six (2%) people were hospitalized. No deaths attributed to Cyclospora were reported in this outbreak.
Currently in 2020, 122 people with laboratory confirmed Cyclospora infections and who reported eating bagged salad mix before getting sick have been reported from 7 Midwestern states (Illinois, Iowa, Kansas, Missouri, Minnesota, Nebraska, and Wisconsin). Illnesses started on dates ranging from May 11, 2020 to June 15, 2020. 19 people have been hospitalized. No deaths have been reported. These cases are linked to ALDI Little Salad Bar brand Garden Salad, Hy-Vee brand Garden Salad, or Jewel-Osco brand Signature Farms Brand Garden Salad.