Fresh Express, a California produce company owned by Chiquita Brands, is linked to an outbreak that sickened nearly 400 people in 15 states who ate salads from McDonalds.

Health officials have confirmed 395 cases of cyclospora infection from salad mixes sold at the fast-food chain, the U.S. Food and Drug Administration said in an updat late Thursday. Of those stricken, 16 were hospitalized.

Fresh Express, based in Salinas, California, supplied bagged salad mixes likely tainted with cyclospora to McDonalds franchises in the Midwest, the FDA said. After reports of intestinal illnesses surfaced, the fast-food chain in July halted salad sales at 3,000 franchises and switched its supplier.

Federal safety officials issued a public health alert earlier this week about salads and wraps distributed nationwide by Caito Foods in Indianapolis, Indiana, and containing chopped romaine lettuce recalled by Fresh Express. Retailers including Kroger, Trader Joes and Walgreens sold the possibly tainted products, all of which had July expiration dates.

In foods tainted by fecal matter, cyclospora can cause diarrhea, stomach cramps, nausea, fatigue, body aches and fever a week or more after someone consumes food or liquid contaminated with the parasite.

Caito Foods also recently drew unwanted attention in a multi-state salmonella outbreak tied to recalled pre-cut melon that sickened 77 people in nine states.

Chiquita Brands did not respond to requests for comment.

"Fresh Express products subject to recall had already passed the use-thru date of July 24 and were not marked or labeled for retail sale," a spokesperson emailed, adding the company is working with health officials and hopes "a definitive source is found soon."

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