Almost 7,000 individuals across the country might be affected by cyclosporiasis, a foodborne illness that leads to weeks of severe diarrhea, according to the Centers for Disease Control and Prevention (CDC) on Tuesday. The majority of these cases, about 3,309, are reported in Michigan.
In a health alert, the CDC noted that 1,645 people have contracted cyclosporiasis nationwide, marking it as one of the largest outbreaks of foodborne illness in recent years. They are urging healthcare providers to be vigilant for symptoms like watery diarrhea, nausea, and bloating.
Additionally, there are approximately 5,100 cases still being investigated.
“This season, we’re observing an unusually high count of cyclosporiasis cases,” said Gwen Biggerstaff, deputy director of the CDC’s Division of Foodborne, Waterborne, and Environmental Diseases, during a media call. Typically, there are about 2,700 cases annually, especially during summer.
Since the illnesses were initially reported in May, the CDC has confirmed 141 hospitalizations but thankfully no fatalities.
Over the past two weeks, the number of cases has surged, with clusters being reported in at least 30 states besides Michigan. The national totals may not reflect the actual situation since each case must be verified by the CDC.
People testing positive range in age from 2 to 95, with women making up over half of the cases at 56%. All individuals began showing symptoms starting June 22, and none had traveled outside the U.S.
Lettuce and Salad Greens Identified as Potential Sources
While Michigan is facing the brunt of the outbreak, the CDC indicated on Tuesday that multiple outbreaks from different origins are likely taking place simultaneously. The CDC suspects that around 400 cases across four states—Kentucky, Michigan, Ohio, and West Virginia—may be interconnected.
Biggerstaff mentioned that these cases could be linked as a single multistate outbreak but clarified that many other cases are not part of this group, and further investigations are ongoing.
Officials in Michigan have preliminarily identified lettuce and salad greens as possible sources based on interviews with over 1,000 infected individuals.
Yet, as of now, no specific product, retailer, or distributor has been definitively tied to the current outbreak, and there have been no product recalls.
Biggerstaff also mentioned that more cases are likely to arise through August.
Kelly Leahy, 56, from Charlotte, North Carolina, tested positive for cyclosporiasis after two weeks of being ill. She described feeling dehydrated and light-headed, adding, “It’s not a quick bug to shake off.”
Shortly after her positive test, a health department representative reached out to inquire about her diet before she fell ill, but Leahy found it difficult to provide specific details.
The parasite’s incubation can take up to two weeks, meaning the cause of her illness likely dates back to a month earlier.
The Food and Drug Administration (FDA), which usually handles food investigations and recalls in tandem with the CDC, has yet to pinpoint a specific source or supplier of the potentially contaminated produce. Donald Prater, the FDA’s acting deputy commissioner for food, noted that their investigation into several produce items, including lettuce, is ongoing.
A spokesperson for Taco Bell announced on Tuesday that they’ve “voluntarily and temporarily removed limited ingredients” from some locations as a precaution, clarifying that public health officials have not linked the chain to the outbreak.
Understanding Cyclosporiasis
Cyclosporiasis is a foodborne illness caused by the cyclospora parasite, which can spread from contaminated water or improper food handling, particularly affecting products like lettuce.
While not as commonly seen in the U.S. compared to outbreaks involving salmonella, norovirus, or E. coli, previous instances of cyclosporiasis have been associated with items like raspberries, pre-packaged salads, cilantro, and other produce. Symptoms can take up to two weeks to appear, often starting with fatigue and loss of appetite, escalating to severe diarrhea.
Treatment typically involves the antibiotic Bactrim, and if left untreated, symptoms may persist for weeks.
Tara Rabin, a former FDA spokesperson who focused on food safety, mentioned that it may still be early to identify the exact sources of these outbreaks. She explained, “Science takes time, and there may be delays in connecting products to the cases.”
Dr. Natasha Bagdasarian, Michigan’s chief medical executive, commented that the outbreak’s source is probably broader than a single establishment or supplier, indicating that contamination likely occurs at the growing or processing level.
Given the lengthy investigation process, it is possible that contaminated produce may already be off the shelves. This doesn’t imply that the outbreaks have necessarily concluded.
Bagdasarian pointed out two peaks of cases observed—one around June 25 and another around July 7—suggesting that at least two batches of contaminated produce could be involved.
Nevertheless, she noted a consistent increase in case numbers.
How to Reduce the Risk of Infection
Removing cyclospora from produce can be quite challenging. The CDC advises washing fresh produce thoroughly under clean running water before consumption.
Soaking in vinegar or using commercial vegetable washes are not sufficient to eliminate the parasites; they require scrubbing or peeling off the outer layers.
The Michigan Department of Health and Human Services recommends peeling fruits and vegetables post-washing, as the parasites tend to remain on the outer surfaces, and pre-washed products might not guarantee safety.
Ultimately, cooking food is the only way to ensure the parasite is killed before eating.
