Health officials have linked a multistate cyclospora food poisoning outbreak to bagged salad products, which may have caused more than 200 illnesses nationwide in recent weeks.

The U.S. Centers for Disease Control and Prevention (CDC) announced a bagged salad Cyclospora outbreak last week, indicating that there have been at least 200 illnesses and more than 23 hospitalizations as of June 26, each involving individuals who became sick after consuming certain bagged salad products produced by Fresh Express.

Multiple recalls have now been issued for bagged salad sold at major retailers across the U.S., including ALDI and Walmart, after it was determined that the products may be contaminated with Cyclospora bacteria, which may cause severe intestinal illness that results in the need for hospitalization.

CDC and FDA officials have been working with state and local health departments to perform epidemiologic and traceback investigations, and have determined the outbreak likely originated from bagged salad mixes containing iceberg lettuce, carrots, and red cabbage produced by Fresh Express from certain growing regions.

Since May 11, illnesses have been reported in at least eight different states throughout the mid-west, including Arkansas, Illinois, Indiana, Iowa, Kansas, Michigan, Minnesota, Missouri, Nebraska, North Dakota, South Dakota, and Wisconsin.

The FDA has announced four separate bagged salad recalls linked to the outbreak, including 12-ounce and 24-ounce bags of Marketside brand Classic Iceberg Salad sold at Walmart stores in Iowa, Michigan, Minnesota, Nebraska, North Dakota, South Dakota, and Wisconsin, 12-ounce bags of Little Salad Bar brand Garden Salad sold at ALDI stores in Arkansas, Illinois, Indiana, Iowa, Michigan, Minnesota, Missouri, North Dakota, South Dakota and Wisconsin, 12-ounce bags of Hy-Vee brand Garden Salad sold at Hy-Vee stores in Illinois, Iowa, Kansas, Minnesota, Missouri, Nebraska, South Dakota, and Wisconsin, and 12-ounce bags of Jewel-Osco Signature Farms brand Garden Salad sold at Jewel-Osco stores in Illinois, Indiana, and Iowa.

Customers are being asked to stop consuming the recalled products immediately and to check your home for any of these recalled salads. Any remaining salad, even if some of it has been eaten and no one has gotten sick, should be thrown away.

Cyclospora illnesses are caused by Cyclospora cayetanensis, a single celled parasite, which causes an intestinal infections. It is spread through human waste and can cause symptoms like loss of appetite, weight loss, stomach cramps, nausea, and fatigue. In some cases, the symptoms may become severe and lead to vomiting, body aches, fever, and other flu-like symptoms.

While Cyclospora rarely leads to death, the infection can last for several days to a few months, often recurring after the patient seems better.

Consumers who have eaten the recalled products or have experienced symptoms of the illness are being encouraged to contact their healthcare provider right away, write down what you have eaten in the two weeks prior to symptoms appearing, and report your illness to the local health department.