Iowa is part of a multistate outbreak of Cyclospora linked to pre-packaged veggie trays distributed by Del Monte Fresh Produce. The Food and Drug Administration announced on June 21 that laboratory testing confirmed a total of 144 people became ill from eating the products, primarily in Iowa, Indiana, Minnesota and Wisconsin.

Two cases in Michigan are part of this outbreak, but, because the trays were purchased in Wisconsin, they are attributed to the case count in that state.

Del Monte Fresh Produce recalled 6-ounce, 12-ounce and 28-ounce vegetable trays containing fresh broccoli, cauliflower, celery sticks, carrots and dill dip. The recall, issued on June 15, is for trays distributed to Kwik Trip, Kwik Star, Demond’s, Sentry, Potash, Meehan’s, Country Market, FoodMax Supermarket and Peapod stores in Illinois, Indiana, Iowa, Michigan, Minnesota and Wisconsin. The trays have a “Best If Enjoyed By” date of June 17, 2018, and include the following UPC codes displayed on the package label.

• Recalled 6 oz. Del Monte Fresh Produce veggie tray - UPC code 7 1752472715 2.
• Recalled 12 oz. Del Monte Fresh Produce veggie tray - UPC code 7 1752472518 9.
• Recalled 28 oz. Del Monte Fresh Produce veggie tray - UPC code 7 1752478604 3.

The FDA warned customers who purchased any of these products to throw them away and asked retailers to remove them from their shelves.

The Iowa Department of Public Health announced on June 13 that it is working with SHL, local public health partners, and the Iowa Department of Inspections and Appeals (IDIA) to investigate the increasing number of Cyclospora infections in Iowa.

Since the beginning of the year, 32 Cyclospora infections have been reported in nine Iowa counties: Clayton, Dallas, Floyd, Johnson, Linn, Mitchell, Polk, Story and Winneshiek. Some of the cases in northeastern Iowa are associated with the outbreak linked to the Del Monte veggie trays.

In its advisory, IDPH asked all laboratories with a positive patient test to send the specimen to SHL for additional typing and analysis.

According to Wade Aldous, director of the laboratory's Disease Control Division, the lab is performing food testing for IDIA, IDPH and Wisconsin Department of Health Services to help identify and confirm the sources of the outbreak.

Cyclosporiasis is an intestinal illness caused by the microscopic parasite Cyclospora cayetanensis. People may become infected by consuming food or water contaminated with the parasite.

Symptoms of Cyclospora infection include frequent watery diarrhea; loss of appetite and weight; cramping, bloating and/or increased gas; nausea (vomiting is less frequent); fatigue; and low-grade fever.