The total number of laboratory-confirmed parasite infections has risen to 641 people in 11 states, according to the U.S. Centers for Disease Control and Prevention (CDC).

The states include Georgia, Illinois, Iowa, Kansas, Minnesota, Missouri, Nebraska, North Dakota, Pennsylvania, South Dakota and Wisconsin. The illnesses started on dates ranging from May 11 to July 5.

At least 37 people have been hospitalized and multiple lawsuits have been filed by people who fell ill.

Last month, Fresh Express recalled dozens of bagged salad items with a product code beginning with Z178 or a lower number. The “best buy” dates run through July 14.

All of the salads are long past their use-by dates, but Cyclospora infection symptoms can take several weeks to appear — and some people have no symptoms, particularly in the early stages.

Cyclospora is a parasite that spreads in feces and is found in tropical and subtropical countries. People who eat contaminated food or water can experience months of diarrhea and other symptoms.

The salads were sold at ALDI, Giant Eagle, Hy-Vee, Jewel Osco, ShopRite, and Walmart stores in 31 states and Washington, D.C. For a complete list of recalled salads, please visit the FDA outbreak investigation.

Source: FDA: More than 600 sickened by parasite in bagged salad mixes

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