The Bradenton Herald in Florida, just 30 minutes from beautiful Anna Maria Island in the Gulf of Mexico where the family and friends have vacationed for years, reported for the second time in three months, there’s a multistate, multi-brand organic basil recall prompted by the possibility of cyclospora after testing done in Florida.
The recall announced by Shenandoah Growers’ last week involves a couple of brands also in November’s massive recall, which was ignited by Florida Department of Agriculture testing. This product pull, according to the company-written, FDA-posted recall notice, followedFDA testing in Miami of basil grown at Puerto Vallarta Herbs SAS farms in Colombia.
Amy Sowder of The Packer reports that Shenandoah Growers of Harrisonburg, Va., has recalled about 15,000 units of organic basil in select packages, due to a possible health risk from cyclospora.
The recall is limited and voluntary, according to a Food and Drug Administration news release.
These items were packed under branded and private label fresh-cut, USDA-certified organic basil clamshells at its Jefferson, Ga., facility and Harrisonburg facilities with 19 lot codes, all with the country of origin of Colombia.
Recalled products were distributed to retail stores between Oct. 20-30 in states including Georgia, Tennessee, Florida, Virginia, Pennsylvania, Maryland, Connecticut, Delaware, New Jersey, New York and Washington, D.C.
No other Shenandoah Growers products are subject to recall, and the company has no knowledge of any illness reported or related to this product, according to the release.
The Shenandoah Growers recall includes only those clamshells of certified-organic basil clearly marked with the affected lot codes. The lot code can be found printed on each clamshell.
This recall stems from a package pulled by the Florida Department of Agriculture on Nov. 2, from a retail store in Florida that indicated the potential presence of cyclospora.
The parasite, Cyclospora, continues to provide illness and intrigue.
Florida-based Southeastern Grocers has issued a voluntary recall for its “SE Grocers Naturally Better Organic Fresh Cut Basil” following the detection of Cyclospora.
The company says the product was delivered through all of its distribution centers and sold in all its stores, including Winn-Dixie, BI-LO, Fresco y Más and Harveys Supermarkets. The basil comes in a 0.5-ounce container with UPC code 6-07880-20230-4.
The latest recall follows a summer outbreak of Cyclospora in the U.S. linked to Fresh Express and private label brand salad products produced at its Streamwood, IL facility that contain iceberg lettuce, red cabbage, and/or carrots.
690 people with laboratory-confirmed Cyclospora infections and who reported eating bagged salad mix before getting sick weren reported from 13 states (Georgia, Illinois, Iowa, Kansas, Massachusetts, Minnesota, Missouri, Nebraska, North Dakota, Ohio, Pennsylvania, South Dakota, and Wisconsin).
Illnesses started on dates ranging from May 11, 2020 to July 20, 2020.
37 people were hospitalized. No deaths were reported.
As of November 4, 2020, 370 confirmed cases of Cyclospora illness were reported in the following provinces and territories: British Columbia (1), Ontario (255), Quebec (105), New Brunswick (1), Newfoundland and Labrador (6), and Nunavut (2). Individuals became sick between mid-May and late August 2020. Ten individuals were hospitalized. No deaths were reported.
This method was used in our current investigation and may be instrumental in our efforts to better understand the dispersion of the parasite in the environment, which could help prevent future outbreaks. The collective work by public health officials to get these new findings demonstrates a commitment to innovation and science in the service of public health and the importance of strong federal and state coordination on food safety work.
Even as our agencies continue to respond to the COVID-19 public health crisis, teams of experts from the FDA and the Centers for Disease Control and Prevention (CDC) have continued to respond to a threat of a different kind – a nationwide outbreak of Cyclospora illnesses. Cyclospora cayetanensis is a parasite that is so small it can only be seen with a microscope. It causes an intestinal illness called cyclosporiasis from the consumption of contaminated food, mainly fresh produce, or contaminated water.
Epidemiology linked the illnesses to bagged salad produced by Fresh Express. The number of reported cases of Cyclospora typically rises during May through August. Although CDC conducts surveillance for cyclosporiasis year-round, during the spring and summer months CDC conducts enhanced surveillance for cases of domestically acquired illness. In this outbreak, CDC has reported 690 cases across 13 states, with 37 hospitalizations and no deaths. Onsets of illness range from May 11, 2020 to July 20, 2020. Salads made by Fresh Express and containing iceberg lettuce, red cabbage, and carrots were identified as the food vehicle responsible for the outbreaks.
Traceback of cases with the strongest sources of information (shopper card info, etc.) revealed that bagged salad codes most likely to have resulted in illness contained iceberg lettuce from California and red cabbage from Florida. The FDA evaluated and investigated each of the ingredients in the bagged salads, identifying red cabbage from Florida and iceberg lettuce from California as those most likely in the bagged salads consumed by people who became ill. Traceback investigations are time-consuming work but are critical. In this instance, in the wake of traceback and collaboration with the retailers to recall product, FDA identified a noticeable decline in illnesses that matched the time period in which cabbage sourcing shifted from Florida to another area, providing a possible clue in the investigation.
Environmental sampling detected the presence of Cyclospora in the surface water of a canal near a farm suspected of being a source of the red cabbage. Two samples collected to the north and south of where the farm accessed canal water for seepage irrigation were found to be positive for Cyclospora cayetanensis. The farm that supplied red cabbage was no longer in production at the conclusion of the growing season, so it was not possible to sample product. Additionally, the farms growing iceberg lettuce in California were investigated and all of the samples collected in California were negative for Cyclospora.
Given the emerging nature of genetic typing methodologies for this parasite, the FDA has been unable to determine if the Cyclospora detected in the canal is a genetic match to the clinical cases, therefore, there is currently not enough evidence to conclusively determine the cause of this outbreak.
The FDA has pioneered ways to detect the parasite that have been employed in this outbreak investigation, developing and validating new methods to test for Cyclospora in produce and agricultural water. The first of these new methods was used in 2018 to confirm the presence of the parasite in a salad mix product tied to an outbreak that sickened hundreds of people.
In July 2019, the FDA made its second major advance in Cyclospora detection, completing studies that resulted in a novel, validated method to test agricultural water for the presence of the parasite. These new methods were developed by the Foodborne Parasitology Research Program that the FDA established in 2014 in our Center for Food Safety and Applied Nutrition, in part to break the cycle of recurring Cyclospora outbreaks.
Strong federal and state coordination on matters of public health are critical. In identifying clinical cases of Cyclospora, assisting in providing traceback records and completing investigations in processing facilities and growing fields, our state partners’ work has proven essential to this investigation. We continue to work to strengthen these vital public health partnerships and federal agencies continue to work together to advance additional tools needed to assist with these investigations. For example, CDC is piloting the use of a genotyping tool to help identify cases of parasitic illness that might be linked to a common source.
While we as public health agencies have gotten better at detecting foodborne illnesses due to Cyclospora, our ability to trace contaminated foods back to their source has lagged, and once again, our ability to trace has been a challenge in this investigation, due in part to the lack of modernized food traceability capabilities.
Moreover, the detection of the parasite in surface waters near where product was grown once again puts a spotlight on the importance of managing the quality of irrigation water used to grow ready to eat crops. We are working closely with our colleagues at the Florida Department of Agriculture and Consumer Services to investigate this issue further to prevent future occurrences.
These findings further emphasize the importance of industry’s role in ensuring that irrigation water is safe to be used on produce. Under the FDA’s recently released New Era of Smarter Food Safety Blueprint, we’ll continue to remain laser focused on prevention. In the coming months, we will be issuing a proposed rule that will aid in achieving our goal of enhancing traceability to greatly reduce the time it takes to identify the origin of a contaminated food or ingredient tied to a recall and/or outbreak.
In addition, we intend to release a proposed rule in late 2020 to revise certain agricultural water requirements in the Produce Safety Rule and to address practical implementation challenges while protecting public health. We also plan to advance detection techniques that will help us pinpoint sources of Cyclospora outbreaks and to continue our research around water treatments for this parasite.
In closing, we believe the entire fresh produce supply chain from farm to fork can do better and we look forward to continuing our work with our public health partners, growers, processors, distributors and retailers in our shared efforts to protect consumers. Together, we’ll make progress on our overarching goal to give consumers the confidence they deserve to have in the safety of fresh produce.
Since the last case count update on July 9, 2020, the U.S. Centers for Disease Control reported 132 new laboratory-confirmed Cyclospora infections have been reported, including 16 from three new states: Georgia, Pennsylvania, and South Dakota.
As of July 22, 2020, a total of 641 people with laboratory-confirmed Cyclospora infections associated with this outbreak have been reported from 11 states: Georgia (1), Illinois (198), Iowa (195), Kansas (5), Minnesota (73), Missouri (57) Nebraska (55), North Dakota (6), Pennsylvania (2), South Dakota (13) and Wisconsin (36). The ill person from Georgia purchased and ate a bagged salad product while traveling in Missouri.
Illnesses started on dates ranging from May 11, 2020 to July 5, 2020. Ill people range in age from 10 to 92 years with a median age of 59 and 52% are female. Of 636 people with available information, 37 people (6%) have been hospitalized. No deaths have been reported.
Illnesses might not yet be reported due to the time it takes between when a person becomes ill and when the illness is reported. This takes an average of 4 to 6 weeks. If the number of cases reported by CDC is different from the number reported by state or local health officials, data reported by local jurisdictions should be considered the most up to date. Any differences may be due to the timing of reporting and website updates.
This investigation is ongoing.
The CDC says that it is specifically examining salad ingredients (iceberg lettuce, carrots, red cabbage) for the purposes of its investigation. The affected products include salad mixes made by Fresh Express, Hy-Vee Inc., Little Salad Bar, Signature Farms, Marketside and Hy-Vee. The products were sold at ALDI, Giant Eagle, Hy-Vee, Jewel-Osco, ShopRite, and Walmart locations.
The products were manufactured in Streamwood, Illinois at a Fresh Express production facility.
“Cyclosporiasis is an intestinal infection caused by the Cyclospora parasite,” the CDC says. “A person may become infected after ingesting contaminated food or water. Common symptoms include severe abdominal pain, diarrhea, nausea and vomiting, body aches and fatigue. The infection is treated with antibiotics and most people respond quickly to treatment.”
Specifically, the CDC says the products with a Z178 code or lower and “Best by” date that runs through July 14, 2020 are the ones potentially affected by the contamination.
However, only Georgia, Illinois, Iowa, Kansas, Minnesota, Missouri, Nebraska, North Dakota, Pennsylvania, South Dakota and Wisconsin have reported cases of Cyclospora related to eating the salad mix. According to the CDC, the dates of the illness range from May 11, 2020 to July 5, 2020, with 37 people hospitalized as of Friday. Patients are ages 10 to 92 years with a median age of 59 years as of Friday’s data. No related deaths have been reported. People can go 4 to 6 weeks before noticing any symptoms of Cyclospora, the CDC says.
Write down what you ate in the two weeks before you started to get sick.
Report your illness to the health department.
Assist public health investigators by answering questions about your illness.
On June 27, 2020, Fresh Express Fresh Express brand and private label brand salad products produced at its Streamwood, IL facility that contain iceberg lettuce, red cabbage, and/or carrots due to possible Cyclospora contamination.
The Public Health Agency of Canada is investigating an outbreak of Cyclospora infections occurring in three Canadian provinces. 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.
Epidemiologic and traceback evidence indicates that bagged salad mix containing iceberg lettuce, carrots, and red cabbage produced by Fresh Express is a likely source of this outbreak.
CDC and FDA continue to investigate to determine which ingredient or ingredients in the salad mix was contaminated and whether other products are a source of illnesses.
CDC will provide updates when more information is available.
Chris Koger of The Packer reports that cases of Cyclospora infection linked to Fresh Express salads continue to rise, according to the Centers for Disease Control and Prevention, and Canada is reporting its first cases.
Lab-confirmed cases thought to be linked to iceberg lettuce, carrots or red cabbage in garden salads were 509 in the U.S, as of July 9, according to the CDC. The Canadian Food Inspection Agency on July 8 reported 37 cases in Ontario, Quebec and Newfoundland and Labrador.
The salads, including private-label bagged garden salads, were processed at Fresh Express’ Streamwood, Ill., facility, according to the FDA.
Fresh Express has recalled salads from the plant containing the three ingredients under investigation, along with Aldi, Giant Eagle, Hy-Vee, Jewel-Osco, ShopRite and Walmart issuing recalls of private label salads.
The Canadian Food Inspection Agency reported on June 28 Fresh Express had recalled products in Canada. They were distributed nationwide by Crescent Multi-Foods, Federated Co-Operatives Ltd., Fresh Express and Walmart Canada Corp., according to the Canadian Agency.
An edited version of the latest CDC update is below:
On June 27, 2020, Fresh Express recalled Fresh Express brand and private label brand salad products produced at its Streamwood, IL facility that contain iceberg lettuce, red cabbage, and/or carrots due to possible Cyclospora contamination.
509 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).
Illnesses started on dates ranging from May 11, 2020 to July 1, 2020.
33 people have been hospitalized. No deaths have been reported.
The Public Health Agency of Canada is investigating an outbreak of Cyclospora infections occurring in three Canadian provinces. 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.
Epidemiologic and traceback evidence indicates that bagged salad mix containing iceberg lettuce, carrots, and red cabbage produced by Fresh Express is a likely source of this outbreak.
CDC and FDA continue to investigate to determine which ingredient or ingredients in the salad mix was contaminated and whether other products are a source of illnesses. CDC will provide updates when more information is available.
Since the last case count update on June 26, 2020, 303 new laboratory-confirmed Cyclospora infections have been reported.
As of July 8, 2020, a total of 509 people with laboratory-confirmed Cyclospora infections associated with this outbreak have been reported from 8 states: Illinois (151), Iowa (160), Kansas (5), Minnesota (63), Missouri (46) Nebraska (48), North Dakota (6), and Wisconsin (30).
Illnesses started on dates ranging from May 11, 2020 to July 1, 2020. Ill people range in age from 11 to 92 years with a median age of 60 and 53% are female. Of 506 people with available information, 33 people (7%) have been hospitalized. No deaths have been reported.
Illnesses might not yet be reported due to the time it takes between when a person becomes ill and when the illness is reported. This takes an average of 4 to 6 weeks. If the number of cases reported by CDC is different from the number reported by state or local health officials, data reported by local jurisdictions should be considered the most up to date. Any differences may be due to the timing of reporting and website updates.
Additionally, the Public Health Agency of Canada is investigating an outbreak of Cyclospora infections occurring in three Canadian provinces where 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.
I keep telling people that certain fresh herbs – like basil – are a ridiculously high percentage of foodborne illnesses.
They look at me like I just fell off the truck.
Sure, I walk with a cane now because I fall too much, but not off trucks.
United Natural Foods, Inc. (UNFI) is initiating a voluntary recall of a limited quantity of Wild Harvest® Organic Basil distributed out of UNFI’s Hopkins, MN distribution center to select retailers in Minnesota between 4/18/2020-5/8/2020. UNFI’s recall is issued out of an abundance of caution because of the potential for the impacted product to be contaminated by Cyclospora cayetanensis. No illnesses, including allergic reactions, involving this product have been reported to date.
This recall includes Wild Harvest® Organic Fresh Basil products sold in .25oz, .75oz, 2oz, and 4oz plastic clam shell containers (UPCs: 0071153550450, 0071153550322, 0071153550762, 0071153550323). Impacted product can be identified by a white sticker with black ink on the back of the container stating: “Product of Colombia” and “112.”
This concern was identified following routine sampling. Cyclospora cayetanensis is a microscopic parasite that can cause an intestinal illness in people called cyclosporiasis. According to the U.S. Centers for Disease Control and Prevention, the illness is usually not life threatening. Symptoms of cyclosporiasis may include: watery diarrhea (most common), loss of appetite, weight loss, cramping, bloating, increased gas, nausea and fatigue. Other symptoms that may occur but are less common include vomiting and low-grade fever.
Of course it’s small. So are the trillion of microorganisms inside each of us.
Cyclospora has been on the public radar since at least 1996.
Cyclosporiasis is an intestinal illness caused by consumption of foods, mainly fresh produce, that are contaminated with Cyclospora. The FDA has been working to help prevent contaminated product from reaching consumers, gathering the scientific knowledge that will help to better detect the parasite in food and the environment, and gathering data to better understand how food is contaminated by the parasite and help prevent contamination in the future. We’re also sharing what we know with stakeholders in the public and private sectors.
Because several past outbreaks have been associated with fresh herbs, the FDA has been conducting surveillance sampling of fresh cilantro, parsley and basil. A quarterly update on this food surveillance study was released today. As this effort continues, our goal is to collect enough samples to provide a precise estimate of the prevalence of contamination of Cyclospora in our food supply, enabling us to better understand our vulnerability to Cyclospora contamination.
The FDA is also acting on what we already know about where Cyclospora is found and how contamination can be prevented.
In 2019, 10% of the Cyclospora infections reported between May and August were linked to a multi-state outbreak associated with fresh imported basil that started in mid-June and was declared over in October. FDA increased its screening at the border of basil exported by the company tied to the outbreak before the company voluntarily recalled its product and ceased shipping while corrective measures were implemented.
The FDA is also tracking contamination in domestically-grown produce. The first confirmed evidence of Cyclospora in domestically grown produce was detected in 2018 in cilantro, a finding not associated with an outbreak of illnesses. As with bacterial pathogens, if the parasite is found on produce, the FDA follows up with inspections and sampling, working with the business to take the actions needed to protect public health.
The FDA has been reaching out to farmers to increase awareness of Cyclospora and actions that can be taken on the farm to reduce the likelihood of contamination. For example, ways to control sources of contamination include proper use, maintenance and cleaning of toilet and handwashing facilities. We created education and outreach materials for farmers, including the Cyclosporiasis and Fresh Produce Fact Sheet.
In late 2014, the FDA’s Center for Food Safety and Applied Nutrition established a Foodborne Parasitology Research Program, and in collaboration with the CDC, has been sequencing the genomes of several different strains of C. cayetanensis, enabling the development of genetic typing methods. In 2016, we created a genome database named “CycloTrakr” to be used as a public repository of genomic data at the National Center for Biotechnology Information (NCBI). This is an important first step towards the goal of linking, in real-time, the genetic fingerprints of Cyclospora in contaminated food and sick people to pinpoint the source of the outbreaks.
The agency has also pioneered ways to detect the parasite, developing and validating new methods to test for Cyclospora in produce and water. The first of these new methods was used for the first time in 2018 to confirm the presence of the parasite in a salad mix product tied to an outbreak that sickened hundreds of people.
In July 2019, the FDA made its second major advance in Cyclospora detection, completing studies that resulted in a novel, validated method to test agricultural water for the presence of the parasite. Water used on farms is a potential source of the contaminants that cause foodborne illnesses. Analysts from FDA laboratories are being trained in the use of this method for regulatory testing.
While cyclosporiasis cases are reported year-round in the United States, cyclosporiasis acquired in the United States (i.e., “domestically acquired”, or cases of cyclosporiasis that are not associated with travel to a country that is considered endemic for Cyclospora) is most common during the spring and summer months. The exact timing and duration of U.S. cyclosporiasis seasons can vary, but reports tend to increase starting in May. In previous years the reported number of cases peaked between June and July, although activity can last as late as September. The overall health impact (e.g., number of infections or hospitalizations) and the number of identified clusters of cases (i.e., cases that can be linked to a common exposure) also vary from season-to-season.
The number of reported cases of domestically acquired cyclosporiasishas increased from the previous month and remains elevated in the United States since May 1, 2019.
As of August 28, 2019, 1,696 laboratory-confirmed cases of cyclosporiasis were reported to CDC by 33 states, District of Columbia and New York City in people who became ill since May 1, 2019 and who had no history of international travel during the 14-day period before illness onset.
The median illness onset date was June 29, 2019 (range: May 1–August 13, 2019).
At least 92 people were hospitalized; no deaths were reported.
At this time, multiple clusters of cases associated with different restaurants or events are being investigated by state public health authorities, CDC, and FDA.
Many cases of cyclosporiasis could not be directly linked to an outbreak, in part because of the lack of validated molecular typing tools for C. cayetanensis.
The U.S. Centers for Disease Control (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 fresh basil from Siga Logistics de RL de CV of Morelos, Mexico.
CDC is advising that consumers do not eat or serve any fresh basil from Siga Logistics de RL de CV of Morelos, Mexico. This investigation is ongoing and the advice will be updated when more information is available.
Consumers who have fresh basil from Siga Logistics de RL de CV of Morelos, Mexico, in their homes should not eat it. Throw the basil away, even if some has been eaten and no one has gotten sick.
Do not eat salads or other dishes that include fresh basil from Siga Logistics de RL de CV of Morelos, Mexico. This includes dishes garnished or prepared with fresh basil from Siga Logistics de RL de CV of Morelos, Mexico, such as salads or fresh pesto.
If you aren’t sure the fresh basil you bought is from Siga Logistics de RL de CV of Morelos, Mexico, you can ask the place of purchase. When in doubt, don’t eat the fresh basil. Throw it out.
Wash and sanitize places where fresh basil was stored: countertops and refrigerator drawers or shelves.
The FDA strongly advises importers, suppliers, and distributors, as well as restaurants, retailers, and other food service providers to not sell, serve or distribute fresh basil imported from Siga Logistics de RL de CV located in Morelos, Mexico. If you are uncertain of the source, do not sell, serve or distribute the fresh imported basil.
Two hundred and five people with laboratory-confirmed Cyclosporainfections and who reported eating fresh basil have been reported from 11 states; exposures occurred at restaurants in 5 states (Florida, Minnesota, New York, Ohio, and Wisconsin).
Illnesses started on dates ranging from June 10, 2019 to July 18, 2019.
Five people have been hospitalized. No deaths attributed to Cyclospora have been reported in this outbreak.
Epidemiologic evidence and early product distribution information indicate that fresh basil from Siga Logistics de RL de CV of Morelos, Mexico is a likely source of this outbreak.
2019 Outbreak of Cyclospora infections linked to fresh basil from Mexico
Bethany Bump of the Times Union writes that New York state and local health departments are investigating an outbreak of cyclosporiasis in the Capital Region.
The gastrointestinal illness, which can spread through contaminated food and water, has been confirmed in 11 people so far.
Symptoms began around mid-June, and several of the patients reported eating at the Italian American Community Center in Albany, Prime Life Restaurant at the Beltrone Senior Living Community Center in Colonie, and a private buffet held at Union College in Schenectady, state health officials said.
While cyclosporiasis is endemic in some areas of the world, outbreaks in the U.S. are often associated with imported fresh produce that have been contaminated with a fecal parasite known as Cyclospora cayetanensis.
State health officials say there is no indication that the parasite was spread by poor food handling or preparation at local establishments, which are cooperating with the investigation. Instead, contamination often occurs prior to arrival at food distribution centers and restaurants, they said, and is not easily removed by standard rinsing.
Additional dining establishments may be identified as the investigation continues, they added.
The recall announced by Shenandoah Growers’ last week involves a couple of brands also in November’s massive recall, which was ignited by Florida Department of Agriculture testing. This product pull, according to the company-written, FDA-posted recall notice, followed FDA testing in Miami of basil grown at Puerto Vallarta Herbs SAS farms in Colombia.
