Multistate Outbreak of Cyclosporiasis Linked to Del Monte Fresh Produce Vegetable Trays — United States, 2018: Final Update

Outbreak Summary – September 6, 2018

CDC, public health and regulatory officials in four states, and the FDA investigated a multistate outbreak of Cyclospora infections.

As of September 5, 2018, 250 people were infected with Cyclospora reported from 4 states. A list of the states and the number of cases in each can be found in the Case Count Maps page.

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.

Investigation Details

Epidemiologic evidence indicated that pre-packaged Del Monte Fresh Produce vegetable trays containing broccoli, cauliflower, carrots, and dill dip were the likely source of these infections.

In interviews, ill people answered questions about the foods they ate in the 2 weeks before they became ill. Ill people reported eating pre-packaged Del Monte Fresh Produce vegetable trays containing broccoli, cauliflower, carrots, and dill dip. Ill people reported buying pre-packaged Del Monte Fresh Produce vegetable trays containing broccoli, cauliflower, carrots, and dill dip in the Midwest. Most people reported buying the trays at Kwik Trip convenience stores

On June 15, 2018, Del Monte Fresh Produce recalledExternal 6 oz., 12 oz., and 28 oz. pre-packaged vegetable trays containing fresh broccoli, cauliflower, celery sticks, carrots, and dill dip. Recalled products were sold in clear, plastic clamshell containers.

As of September 5, 2018, this outbreak appears to be over.

July 19, 2018

As of July 19, 2018 (1pm EDT), a total of 237 laboratory-confirmed cases of Cyclospora infection were reported in people who consumed pre-packaged Del Monte Fresh Produce vegetable trays containing broccoli, cauliflower, carrots, and dill dip from 4 states. A list of the states and the number of cases reported from each state can be found on the Case Count Maps page.

The median illness onset date among patients is June 1, 2018 (range: May 14 to June 13). Ill people range in age from 13 to 79 years old, with a median age of 46. Fifty-three percent (53%) are female and 7 people have been hospitalized. No deaths have been reported.

Illnesses that began after June 7, 2018 might not have been reported yet due to the time it takes between when a person becomes ill and when the illness is reported.

July 12, 2018

As of July 12, 2018 (1pm EDT), a total of 227 laboratory-confirmed cases of Cyclospora infection were reported in people who consumed pre-packaged Del Monte Fresh Produce vegetable trays containing broccoli, cauliflower, carrots, and dill dip from 4 states. A list of the states and the number of cases reported from each state can be found on the Case Count Maps page.

The median illness onset date among patients is May 31, 2018 (range: May 14 to June 13). Ill people range in age from 13 to 79 years old, with a median age of 47. Fifty-three percent (53%) are female and 7 people have been hospitalized. No deaths have been reported.

Illnesses that began after May 31, 2018 might not have been reported yet due to the time it takes between when a person becomes ill and when the illness is reported.

July 5, 2018

As of July 5, 2018 (9am EDT), a total of 212 laboratory-confirmed cases of Cyclospora infection were reported in people who consumed pre-packaged Del Monte Fresh Produce vegetable trays containing broccoli, cauliflower, carrots, and dill dip from 4 states. A list of the states and the number of cases reported from each state can be found on the Case Count Maps page.

The median illness onset date among patients is May 31, 2018  (range: May 14 to June 13). Ill people range in age from 13 to 79 years old , with a median age of 47 . Fifty-four percent (54%) are female and 7  people have been hospitalized. No deaths have been reported.

Illnesses that began after May 24, 2018  might not have been reported yet due to the time it takes between when a person becomes ill and when the illness is reported.

June 28, 2018

As of June 28, 2018 (11am EDT), a total of 185 laboratory-confirmed cases of Cyclospora infection were reported in people who reportedly consumed pre-packaged Del Monte Fresh Produce vegetable trays containing broccoli, cauliflower, carrots, and dill dip from 4 states. A list of the states and the number of cases reported from each state can be found on the Case Count Maps page.

The median illness onset date among patients is May 31, 2018 (range: May 14 to June 9).  Ill people range in age from 13 to 79 years old, with a median age of 47. Fifty-seven percent (57%) are female and 7 people have been hospitalized. No deaths have been reported.

Illnesses that began after May 17, 2018 might not have been reported yet due to the time it takes between when a person becomes ill and when the illness is reported.

June 21, 2018

As of June 21, 2018 (11am EDT), a total of 144 laboratory-confirmed cases of Cyclospora infection were reported in people who reportedly consumed pre-packaged Del Monte Fresh Produce vegetable trays containing broccoli, cauliflower, carrots, and dill dip from 4 states. A list of the states and the number of cases reported from each state can be found on the Case Count Maps page.

The median illness onset date among patients is May 31, 2018 (range: May 14 to June 8). Ill people range in age from 20 to 79 years old, with a median age of 46. Fifty-nine percent (59%) are female and 6 people have been hospitalized. No deaths have been reported.

Illnesses that began after May 10, 2018 might not have been reported yet due to the time it takes between when a person becomes ill and when the illness is reported.

June 15, 2018

CDC, public health and regulatory officials in several states, and the U.S. Food and Drug Administration are investigating a multistate outbreak of Cyclospora infection.

As of June 15, 2018 (3pm EDT), a total of 78 laboratory-confirmed cases of Cyclospora infection were reported in people who reportedly consumed pre-packaged Del Monte Fresh Produce vegetable trays containing broccoli, cauliflower, carrots, and dill dip from 4 states. A list of the states and the number of cases reported from each state can be found on the Case Count Maps page.

All of the ill persons reported onset of illness on or after May 1, 2018. Ill people range in age from 20 to 79 years old, with a median age of 47. Sixty-seven percent (67%) are female and 4 people have been hospitalized. No deaths have been reported.

Illnesses that began after May 16, 2018 might not have been reported yet due to the time it takes between when a person becomes ill and when the illness is reported.

Investigation of the Outbreak

Epidemiologic evidence indicates that pre-packaged Del Monte Fresh Produce vegetable trays containing broccoli, cauliflower, carrots, and dill dip are the likely source of these infections.

Most ill people reported eating pre-packaged Del Monte Fresh Produce vegetable trays containing broccoli, cauliflower, carrots, and dill dip.

Most ill people reported buying pre-packaged Del Monte Fresh Produce vegetable trays containing broccoli, cauliflower, carrots, and dill dip in the Midwest. Most people reported buying the trays at Kwik Trip/Kwik Star convenience stores.

The investigation is ongoing to determine if there is a common supplier of the vegetable trays to stores where ill people shopped.