The Washington Post reports that three people knowledgeable about the investigation say the Centers for Disease Control and Prevention (CDC) has identified cases of cyclosporiasis, the illness caused by Cyclospora, in Arkansas, Iowa, Missouri, Nebraska, New Hampshire, and North Carolina. The outbreak, tied to contaminated lettuce from Taylor Farms de Mexico, now affects 15 states. On July 17, Taylor Farms recalled its Mexican-grown iceberg lettuce.
As of yesterday, 10,468 laboratory-confirmed cases of domestically acquired cyclosporiasis have been reported to the CDC, and more than 12,555 cases are awaiting confirmation or further investigation. The illness causes watery diarrhea, stomach cramps, nausea, and bloating.
Two deaths in Michigan
Yesterday, Michigan, which has the highest number of Cyclospora cases, announced that two people had died.
“According to medical records, both individuals had significant underlying health conditions that may have been impacted by cyclosporiasis and dehydration. No addition information will be presented on these two cases,” the Michigan Department of Health and Human Services said. “Death resulting from cyclosporiasis is uncommon in the United States.”
As of July 30, Michigan reported 12,218 cases of cyclosporiasis, with 193 hospitalizations, according to its Department of Health and Human Services. Ohio has also experienced a high number of cases. The Toledo Lucas County Health Department has documented 3,148 cases in Northwest Ohio and 1,231 in Lucas County.
Outbreak could be slowing
Even though the number of cases continues to increase, experts say that it doesn’t mean that the outbreak is ongoing. There’s often a delay in reporting cyclosporiasis, because it takes one to two weeks for symptoms to start. Then people can wait seven to 10 days for test results confirming the diagnosis.
“We estimate a 6-week reporting lag between illness and onset and case reporting to the CDC,” the agency said on its website. “We anticipate that the case counts will continue to rise as data are received.”
The epidemic curve (epicurve), which the CDC published on July 24, shows where the outbreak might be headed.
“Because of the delay in reporting and processing of information, it could be still going on, and we’ll see the epicurve expanding,” said Craig Hedberg, PhD, professor of environmental health sciences in the School of Public Health at the University of Minnesota. “But if you look at the two outbreak peaks that are present, it would certainly be consistent with the main transmission event associated with (the outbreak having) worked its way through the system.”
Despite the expansion of the outbreak, most produce remains safe to eat. “As the outbreak evolves, as investigations occur, and specific products are identified as being a source for the outbreak, then I think it’s prudent to avoid consuming those,” Hedberg explained. “Fresh produce is an important part of our diets.”
