State Laws Obscure Source of Contaminated Salad Mix Linked to Cyclospora Outbreak, CDC Reports 400 Cases

The US Centers for Disease Control and Prevention (CDC) has now received reports of 400 cases of the intestinal illness cyclospora across 16 states and New York City, and public health officials in Iowa and Nebraska suspect prepackaged salad mix as the source of the outbreak -- but state investigators are prohibited from revealing the source or sources of the tainted salad because it is believed to now be out of the food supply chain.

The salad mix believed to be the source of the cyclospora was apparently an industrial standard variety common in many restaurants and grocery stores and made available through national distribution channels.

In Iowa alone, exposure to the unidentified mixture of iceberg and romaine lettuce, carrots and red cabbage could have occurred in at least 50 locations including more than 15 restaurants and 30 grocery stores, according to The Iowa Department of Public Health (IDPH).

"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," the IDPH said earlier this week.

Because it is believed that the contaminated salad mix is no longer in the food supply chain and no longer a public health threat -- either from having been consumed or thrown away -- both Iowa and Nebraska officials are restricted by law from revealing the source or sources of the tainted salad mix.

"There is no ongoing threat to the public health which would require the identification of a particular brand, store, or restaurant where the salad mixture was available," IDPH said in a statement.

"In addition, these sites could not have taken any action to prevent contamination of the mixture since it came prepackaged and ready-to-eat. If it had been determined the source of the outbreak was still in the food supply chain, or that a business was refusing to take some action necessary to protect the public's health, IDPH would inform Iowans about the exact product or source in order to protect their health. In such a case, a recall of the item would be facilitated by the FDA. Neither action was necessary in this outbreak."

The CDC and the Food and Drug Administration are still investigating the cyclospora outbreak, and while the number of cases reported continues to gradually increase, the worst appears to be over. As of Aug. 1, the IDPH discontinued daily updates of case counts and daily investigation status updates.

Cyclospora is a rare, lengthy intestinal illness caused by the microscopic parasite Cyclospora cayetanensis.

People may become infected with cyclospora after consuming food or water contaminated with the parasite, according to the CDC, which reports at least 22 people having been hospitalized for cyclospora infection in five states.

As of Aug 1., the CDC has been notified of 400 cases of Cyclospora infection from the following 17 health departments: Iowa (146), Texas (113), Nebraska (81), Florida (25), Wisconsin (9), New York City (5), Georgia (4), Illinois (4), Arkansas (2), Kansas (2), Louisiana(2), Missouri (2), Connecticut (1), Minnesota (1), New Jersey (1), New York (1), and Ohio (1).