The U.S. Department of Agriculture’s Food Safety and Inspection Service (FSIS) is issuing a public health alert out of an abundance of caution due to concerns about contamination with Cyclospora. The beef, pork and poultry salad and wrap products were distributed by Caito Foods LLC, an Indianapolis, Ind. establishment.

The beef, pork and poultry salad and wrap items were produced between July 15 to 18, 2018, with the either “Best By,” “Enjoy by,” Best if Sold By” or “Sell By” dates ranging from July 18 through July 23, 2018. [View Label (PDF only)]

The complete list of products, product labels, the UPC code numbers and other identifying information can be found here.

The products bear establishment number “EST. 39985 or P-39985” inside or next to the USDA mark of inspection. These items were shipped to distribution centers nationwide.

The problem was discovered when Caito Foods LLC received notification from their lettuce supplier, Fresh Express, that the chopped romaine that is used to manufacture some of their salads and wraps was being recalled.

FSIS is concerned that some product may be in consumers’ refrigerators and that consumers may be at risk due to the length of the Cyclospora incubation period. Consumers who have purchased these products are urged not to consume them. These products should be thrown away or returned to the place of purchase. Caito Foods LLC and FSIS are working together to remove the products from commerce.

Anyone concerned about an illness should contact a health care provider. Cyclospora infection is an illness cause by the intestinal parasite, Cyclospora cayetanensis. The incubation period for Cyclospora ranges from two to 14 days, which would include the dates of July 25 through August 6, 2018. Illnesses might not have been reported yet due to the time it takes between when a person becomes ill and when the illness is reported. For Cyclospora infections this could take up to six weeks.

IDPH, CDC, Iowa Department of Inspections and Appeals, the State Hygienic Laboratory and local public health agencies are investigating an outbreak caused by Cyclospora.

• The epidemiologic investigation completed by local public health departments in Iowa and IDPH has implicated a prepackaged salad mix as the source of the outbreak. The food trace back investigation performed by DIA determined that at least 80 percent of these cases had been exposed to the same prepackaged salad mix.

o The salad mix contained iceberg and romaine lettuce, carrots and red cabbage.

o This salad mix is no longer in Iowa’s food supply chain.

• Onset dates of the illness suggest the ill people had eaten the contaminated food in mid-June. This is a very good indication the food which was the source of the outbreak has already been consumed or discarded, since fresh vegetables have a limited shelf life.

• At no time was an Iowa-grown fruit or vegetable suspected to be the cause of the outbreak.

o Bagged salads and all other vegetables are safe to eat.

o Public Health encourages Iowans to make fruits and vegetables part of their daily diet. It is always a good idea to wash all fresh fruits and vegetables thoroughly before eating.

• As of today, 145 cases of Cyclospora infections have been reported to IDPH. Case counts with county breakdown are posted to the IDPH website every weekday at approximately 10:00 a.m. at www.idph.state.ia.us/EHI/Issue.aspx?issue=Cyclospora Outbreak Investigation&pg=Cyclospora Case Count Updates

o IDPH continues to receive reports of confirmed cases of Cyclospora infection and interview those who are ill, but numbers are decreasing.

o Cyclospora is a rare parasite.

o People become infected with Cyclospora by consuming food or water contaminated with the parasite.

• CDC updates on the Cyclosporiasis outbreak, which includes Iowa and several other states, can be found at www.cdc.gov/parasites/cyclosporiasis/outbreaks/investigation-2013.html.

• Cyclospora infection causes a watery diarrhea that lasts an average of 57 days, if untreated.

o Specific laboratory testing (not commonly ordered) must be done to detect Cyclospora.

o Specific treatment (not typically used to treat more common diarrheal illnesses) can be prescribed.

• If you are experiencing diarrhea, or have recently had a long bout with diarrhea, you should contact your health care provider and see if you should be tested for Cyclospora infection.

o Additional symptoms of cyclosporiasis (the infection caused by Cyclospora) include:

• Watery diarrhea

• Fatigue (severe tiredness)

• Loss of appetite

• Weight loss

• Bloating

• Increased gas

• Stomach cramps

• Nausea

• Vomiting

• Muscle aches

• Low-grade fever