People who consumed salads from McDonald’s restaurants continue to suffer from Cyclospora infections, the federal Centers for Disease Control and Prevention (CDC) in Atlanta reports.  As of Thursday (Aug. 23), CDC said there was a total of 507 laboratory-confirmed cases of Cyclospora infections in people who consumed salads from McDonald’s restaurants.

The cases were reported by 15 states and New York City.  Connecticut, New York City, Tennessee, and Virginia case-patients purchased McDonald’s salads while traveling in Illinois, and the Florida case-patient purchased a salad while traveling in Kentucky. A list of the states and the number of cases reported from each state can be found on the Case Count Maps page.

Illnesses started on or after May 20, 2018. The median illness onset date is June 29, 2018 (range: May 20 to July 21). Ill people range in age from 14 to 91 years old, with a median age of 52. Sixty-six percent (66 percent) are female. At least 24 people have been hospitalized. No deaths have been reported.

CDC reports that Illnesses that started after July 12, 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. For Cyclospora infections, this can take up to six weeks.

Investigation of the Outbreak

According to CDC’s epidemiologic evidence, salads purchased from McDonald’s restaurants are one “likely source” of these infections. The investigation is ongoing, and the U.S. Food and Drug Administration (FDA)  is working to determine the sources of the ingredients that were in common to the salads served at McDonald’s.

At the present time, there is no evidence to suggest that this cluster of illnesses is related to the  Cyclospora outbreak linked to Del Monte fresh produce vegetable trays.

Another 31 confirmed cases were added to the outbreak totals since CDC’s last report on Aug. 16. The number of states involved did not change.  

The public first learned of the outbreak on July 13.   On July 26, FDA  completed an analysis of an unused package of romaine lettuce and carrot mix distributed to McDonald’s by the Fresh Express processor in Streamwood, IL. 

The analysis confirmed the presence of Cyclospora in that mix. 

Cyclospora cayetanensis is a parasite composed of one cell, too small to be seen without a microscope. This parasite causes an intestinal infection called cyclosporiasis.

The time between becoming infected and becoming sick is usually about 1 week. Cyclospora infects the small intestine (bowel) and usually causes watery diarrhea, with frequent, sometimes explosive, bowel movements. Other common symptoms include loss of appetite, weight loss, stomach cramps/pain, bloating, increased gas, nausea, and fatigue. Vomiting, body aches, headache, fever, and other flu-like symptoms may be noted. Some people who are infected with Cyclospora do not have any symptoms.

If not treated, the illness may last from a few days to a month or longer. Symptoms may seem to go away and then return one or more times (relapse). It’s common to feel very tired.

Unrelated illnesses reported in New York State

Separately, the McDonald’s in Jamestown, NY is the center of a state and local investigation of multiple illnesses.   

According to the New York State Department of Health and Chautauqua County Health Department, 22 people became Ill between Aug. 4 and 21 with common symptoms of nausea, vomiting or diarrhea.   All reported eating various breakfast sandwiches from the Jamestown McDonald’s.

Tests to find out the cause of the illnesses are underway at the Wadsworth Center, New York State’s Public Health Laboratory in Albany,

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