Multistate product traceforward investigation to link imported romaine lettuce to a US cyclosporiasis outbreak – Nebraska, Texas, and Florida, June–August 2013

@article{Buss2015MultistatePT,
  title={Multistate product traceforward investigation to link imported romaine lettuce to a US cyclosporiasis outbreak – Nebraska, Texas, and Florida, June–August 2013},
  author={Bryan F. Buss and M V Joshi and Jamie Dement and Venessa Cantu and Thomas J. Safranek},
  journal={Epidemiology and Infection},
  year={2015},
  volume={144},
  pages={2709 - 2718}
}
SUMMARY During June–August 2013, 25 US states reported 631 cyclosporiasis cases including Nebraska and Iowa where a regional investigation implicated common-source imported salad mix served in two chain restaurants. At least two common-origin growing fields were likely sources of contaminated romaine lettuce. Using producer- and distributor-provided data, we conducted a grower-specific traceforward investigation to reveal exposures of ill US residents elsewhere who reported symptom onset during… 

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An investigation into a cyclosporiasis outbreak conducted in Nebraska, Iowa, and neighbouring states found a single production lot code of salad mix supplied by both a common producer and distributor was linked to the majority of confirmed cases in persons reporting regional chain A/B exposure.

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