436 people sickened in outbreak linked to McDonald's salads

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The cyclospora infection is part of an ongoing outbreak that began in May.

The Food and Drug Administration investigation into the outbreak continues.

At least 20 people have been hospitalized and no deaths have been reported, according to the CDC. After stopping selling salads at 3,000 stores in Illinois, Indiana, Michigan, Ohio, Missouri, Iowa, Wisconsin, Minnesota, Nebraska, South Dakota, North Dakota, Montana and West Virginia, McDonald's has switched suppliers and resumed salad sales at those stores.

A total of 436 people have been sickened, the CDC said in its most recent update. Other common symptoms include loss of appetite, weight loss, stomach cramps/pain, bloating, increased gas, nausea, and fatigue. The illness is treated with antibiotics.

This isn't the first time this summer Americans have gotten ill from greens.

People who purchased salads while traveling through the Midwest from other states include residents of Tennessee and Virginia as well as the CT resident.

The FDA said an unused package of a Fresh Express salad mix of romaine lettuce and carrots that had been distributed to McDonald's tested positive for the presence of Cyclospora though it was past its July 19 expiration date.

This parasite may have also spread to meats sold in restaurants like Trader Joes, Walgreens and Kroger from July 18 to July 23, according to Business Insider and the United States Department of Agriculture.

"Epidemiologic evidence indicates that salads purchased from McDonald's restaurants are one likely source of these infections".

In the alert, the USDA said the issue was discovered when Indianapolis-based food distributor Caito Foods "received notification from their lettuce supplier, Fresh Express, that the chopped romaine that is used to manufacture some of their salads and wraps was being recalled".

Illnesses are usually reported within six weeks, so illnesses that started after June 21 may not be reported yet, the CDC said.