At least 80 Iowa cases have been confirmed in a Cyclospora outbreak linked to salads sold at McDonald’s restaurants in 15 states, primarily in the Midwest, the CDC reported on July 26.

The Iowa Department of Public Health (IDPH) first announced on July 12 that it was investigating 15 Iowa cases of Cyclospora infections. By July 19, that number had increased to more than 21 before jumping the following week to 80 cases in the state.

IDPH, SHL and the Iowa Department of Inspections and Appeals are working with the CDC and FDA on the outbreak that has sickened a total of 286 people as of July 26 in Ill., Ind., Iowa, Fla., Ky., Mich., Minn., Mo., Mont., Neb., N.D., Ohio, S.D., W.Va. and Wis.

Cyclospora cayetanensis is a single-celled parasite that causes the intestinal illness cyclosporiasis.

McDonald’s reported on July 13 that it had removed the salads in more than 3,000 locations.

In the past several years, several Cyclospora outbreaks have occurred in the U.S., especially during the summer months. These outbreaks and illnesses often occur as a result of eating contaminated fresh produce. Symptoms of Cyclospora infection include:

It may take a week or more after consuming contaminated product for symptoms to begin.

If you have any of these symptoms, see your health care provider who can specifically order Cyclospora parasite testing and provide appropriate treatment. IDPH and local health department personnel are continuing to conduct interviews with individuals who test positive for Cyclospora, and further cases may be identified.