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Neighbors Growing Together | Nov 23, 2017

Prepackaged salad mix implicated in recent cyclospora outbreak

By Iowa Department of Inspections and Appeals | Jul 31, 2013

DES MOINES — A prepackaged salad mix has been implicated as the source of the cyclospora outbreak that sickened more than 100 Iowans last month, the state’s top food inspector said Tuesday. Steven Mandernach, chief of the Food and Consumer Safety Bureau of the Iowa Department of Inspections and Appeals (DIA), said epidemiological data and food history interviews conducted with ill Iowans links a bagged salad mix with the food-borne illness.

“The evidence points to a salad mix containing iceberg and romaine lettuce, as well as carrots and red cabbage as the source of the outbreak reported in Iowa and Nebraska,” Mandernach said, adding: “Iowans should continue eating salads, as the implicated prepackaged mix is no longer in the state’s food supply chain.”

Once epidemiological results from the Iowa Department of Public Health (IDPH) was provided to DIA, the department’s food inspection staff traced potential products through the food distribution and production system. DIA’s investigation found an exposure to a common prepackaged salad mix from a single source in approximately 80 percent of the cases. “Additionally, food histories are challenging as individuals do not always remember the foods eaten during the past several weeks,” Mandernach added.

Compounding the state’s investigation was the fact that by the time the parasitic-induced illness was identified, most if not all of the suspect product was no longer on the shelves.

“Because it can take more than a week for the first symptoms to appear after ingesting the contaminated food, there wasn’t a product on the shelf to be examined for the parasite," Mandernach said. "As a result, most of the food-borne illness investigation focused on trying to trace-back suspected food products through the food chain."

The statewide investigation was conducted jointly by DIA, IDPH, the State Hygienic Laboratory (SHL), local health departments, and officials in Nebraska who were investigating a related outbreak. Despite the challenges of the investigation, Mandernach said a number of successes were also recognized, including the initial detection of the cyclospora by the SHL technicians.

“Additionally, the investigation was helped by the excellent communication and collaboration between the involved local, state, and federal agencies, and the cooperation of the public, medical providers, and the food industry,” he added.

Iowa’s public health and regulatory agencies have been working for several years on improving the investigation process for food-borne illness.

“We saw those efforts pay off during this investigation, as all the players worked together seamlessly to the betterment of the public,” the food inspector said.

Mandernach noted that Iowa received a three-year cooperative grant in 2012 from the FDA to establish a Food and Feed Rapid Response Team. The team includes not only those agencies involved in the cyclospora investigation, but integrates the Iowa Department of Agriculture and Land Stewardship (IDALS) and the FDA into the state’s investigative and response process.

“Our goal, when investigating a food-borne illness, is to as quickly as possible identify the source of the outbreak and stop the spread.

The Rapid Response Team assists in this effort by promoting coordination and communication among the various agencies, and making available dedicated staff that are focused on the early detection of potential food-borne illness,” he added.

The state will continue to work closely with local health departments, other states, and the Centers for Disease Control and prevention (CDC) and FDA as the investigation moves forward. For the latest cyclospora outbreak information, go to <http://www.idph.state.ia.us/EHI/Issue.aspx?issue=Cyclospora Outbreak Investigation>.

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