In June 2020 public health investigators in the United States announced an outbreak of Cyclospora infections linked to bagged salad mix produced by Fresh Express. A total of 701 outbreak associated cases were reported by 14 states. Illnesses started on dates ranging from May 11, 2020 to July 24, 2020. Thirty eight people were hospitalized. No deaths were reported.

The Public Health Agency of Canada also reported an outbreak of Cyclospora infections occurring in seven Canadian provinces. Exposure to certain Fresh Express brand salad products containing iceberg lettuce, carrots, and red cabbage, was identified as the likely source of cases in Canada. A total of 370 cases were identified. Ten people were hospitalized. There were no deaths.

The total number of outbreak associated cases in Canada and the United States was 1,071 with 48 hospitalizations.

Epidemiologic evidence indicates that bagged salad products produced by Fresh Express Streamwood, Illinois facility was the likely source of the outbreak. The salad products contained iceberg lettuce, red cabbage, and/or carrots. These salads were sold under the name of Fresh Express or the store brand labels ALDI Little Salad Bar, Giant Eagle, Hy-Vee, Jewel-Osco Signature Farms, ShopRite Wholesome Pantry, and Walmart Marketside. The contaminated bagged salad products that made people sick had "best before" dates up to and including July 14, 2020.

FDA's traceback investigation identified several farms that may have provided product used in the implicated Fresh Express bagged salads. In Florida, FDA analyzed water samples from 2 public access points along a regional water management canal (C-23) located west of Port St. Lucie, Florida. These samples tested positive for Cyclospora cayetanensis using FDA's validated testing method. FDA has been unable to determine if the Cyclospora detected in the canal water is a genetic match to clinical cases.