Iowa saw some of the highest case numbers in a recent Cyclospora outbreak — a parasite that can cause a series of symptoms including severe intestinal issues.

Supermarket chain Hy-Vee, and other retailers, including Walmart and Aldi, recently pulled more than a dozen of their salad products from shelves because of a possible contamination.

As the cases of infection grew through the upper Midwest, Fresh Express announced that the U.S. Food and Drug Administration and the Centers for Disease Control and Prevention have expanded their investigation into the contamination of Cyclospora in the salad products.

As of June 26 — the last time the numbers were updated — there have been 208 laboratory-confirmed cases of Cyclospora infections in 8 Midwestern states, according to the Centers for Disease Control. 

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Both Iowa and Illinois had more than 56 confirmed cases, higher than any other state.

Data visualization by Eleanor Hildebrandt/The Daily Iowan

In addition to Hy-Vee’s bagged Garden Salad which was pulled initially, 12 other products were recently recalled on June 27 due to risk of Cyclospora infection, according to a press release from the company:

• Southwest Chopped Salad Kit
• Shredded Iceberg
• Veggie Deluxe Salad
• Greener Supreme Blend
• American Blend Salad
• Italian Blend Salad
• Coleslaw Mix
• Romaine Garden Salad
• Asian Chopped Salad Kit
• Sunflower Chopped Salad Kit
• Chipotle Cheddar Chopped Kit
• Avocado Ranch Chopped Kit

Anyone who has purchased these products is recommended to either return them for a refund or throw them away, according to the release.

Sam Jarvis, division manager in the Johnson County Department of Public Health, said Cyclospora is a small intestine parasite that is more prevalent in the summer months and is most commonly acquired through eating fresh greens.

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“[Cyclospora] is not uncommon… other neighboring states… Illinois, Kansas, Missouri, Minnesota, and Nebraska have also seen an increase in cases,” said Jarvis.

Christy Robie Williams, director of Muscatine County Public Health, said that though people of all ages are at risk for a Cyclospora infection, person-to-person transmission is extremely unlikely, and transmission is usually carried out by ingesting water or food that has been contaminated.

“[Cyclospora symptoms include] a watery diarrhea that can last anywhere between nine and 43 days if left untreated… loss of appetite, weight loss, other intestinal issues such as bloating, gassiness, stomach cramping… nausea and vomiting, tiredness, muscle-aches, and low-grade fevers,” Williams said.

Tina Potthoff, senior vice president of communications at Hy-Vee, said the coronavirus pandemic will have no effect on the recall process, and it will proceed smoothly despite these circumstances.

“When we received the notice from Fresh Express, we immediately pulled all potentially impacted salads that they produce from our shelves that same day,” Potthoff said.