The U.S. Centers for Disease Control report 436 confirmed cases of cyclospora infections after eating salads from McDonald's. Twenty people have been hospitalized. The CDC says the outbreak began in May. Affected regions are Iowa, Illinois, Indiana, Kentucky, Minnesota, Montana, Nebraska, Ohio, South Dakota and Wisconsin. The outbreak has been traced to salad ingredients from Fresh Express and McDonald's said it has pulled the mix from its restaurants.

From the CDC:

  • Cyclospora is a type of microscopic parasite. People can become infected with Cyclospora by consuming food or water contaminated with the parasite.

  • Unlike other foodborne pathogens, Cyclospora is not transmitted directly from one person to another (e.g., by ill food handlers).

  • Most people infected with Cyclospora develop diarrhea, but other symptoms can occur, including weight loss, loss of appetite, bloating, increased gas, nausea, fatigue, vomiting, fever, and abdominal cramps.

  • These symptoms begin on average a week (range: 2 days to ≥2 weeks) after ingesting the parasite. In some people, diarrhea may be so severe that they need to be hospitalized.

  • If untreated, symptoms can persist for several weeks or a month or more.

  • Anyone can be infected with Cyclospora.

  • Talk to your doctor if you have symptoms of a Cyclospora infection and report your illness to your local health department.