More illnesses have been reported across the United States in two separate cyclospora outbreaks, federal health officials said Thursday.
Three people have been hospitalized, and no deaths are being reported.
As of July 13, McDonald's had chose to stop selling salads at restaurants in 14 states, according to the FDA. The FDA is working with McDonald's to identify the salad ingredients making people sick and to trace them through the supply chain. As of July 19, IL health officials had recorded 243 cases of cyclosporiasis, an intestinal illness caused by a microscopic parasite.
Links to the illness are now being investigated in nine states, including Illinois, Iowa, Kentucky, Minnesota, Missouri, Nebraska, Ohio, South Dakota and Wisconsin.
The outbreak, first reported in IL and Iowa, prompted the fast-food chain to temporarily stop selling salads at the restaurants identified as possible sites of contamination.
McDonald's has stopped selling those salads at some 3,000 restaurants, all located in Midwest states: Illinois, Iowa, Indiana, Wisconsin, Michigan, Ohio, Minnesota, Nebraska, North Dakota, South Dakota, Montana, West Virginia and Missouri.
The symptoms, which can begin a week or more after consuming the parasite, include diarrhea and frequent, sometimes explosive bowel movements, according to the US Centers for Disease Control and Prevention. Those infected can experience loss of appetite, weight loss, stomach cramps or pain, nausea, gas and fatigue.
The CDC says if you've eaten McDonald's salads in any of the above states, excluding Florida, to watch for symptoms. Vomiting, body aches, headache, fever, and other flu-like symptoms may be noted.
The FDA is advising that people showing symptoms of cyclosporiasis contact their health care providers immediately.
"McDonald's is committed to the highest standards of food safety and quality and we continue to cooperate and support regulatory and public health officials in their investigations", McDonald's said in a statement Friday.