Ongoing Cyclospora Outbreaks Expected to Persist
Federal health officials are concerned that cyclospora outbreaks, which lead to severe diarrhea, will likely continue throughout August as they investigate the food supply for sources of the infection.
The Centers for Disease Control and Prevention (CDC) has reported 1,645 confirmed cases of cyclospora, with 145 individuals hospitalized. Additionally, there’s a backlog of 5,100 cases needing further investigation, which includes interviews with those affected.
During a recent media briefing, Gwen Biggerstaff, the CDC’s deputy director for foodborne, waterborne, and environmental diseases, stated, “The actual number of infections is probably higher, as many people with milder symptoms recover.” She noted that this summer has seen an unusually high incidence of cyclosporiasis.
Health officials have linked outbreaks in Michigan, Ohio, West Virginia, and Kentucky, but they haven’t pinpointed a specific source yet. On Monday, Michigan officials identified lettuce as a “potential source” of the outbreak, while the investigation remains ongoing. Federal and state authorities are looking into whether lettuce served at Taco Bell in Michigan might be connected to these cases.
State reports suggest that the number of illnesses during this outbreak is significantly higher than what the CDC has documented, presumably due to reporting delays. As of Monday, Michigan officials indicated over 2,800 people had fallen ill.
Cyclosporiasis is an infection caused by the single-cell protozoan, cyclospora. It’s usually transferred through food or water that has been contaminated with feces. The infection tends to be more prevalent in warmer months, from May to August.
Tracking this parasite can be complicated, given its lengthy incubation period—anywhere from days to weeks before symptoms manifest. It often takes additional weeks for diagnosis and reporting, so patients may struggle to recall their meals from six to eight weeks prior.
Previous outbreaks have been traced back to items like bagged salads, herbs, raspberries, and lettuce. Some experts suggest that climate change could be increasing the prevalence of these infections, as warmer temperatures allow the parasite to thrive. Health officials recommend thoroughly washing fresh produce or cooking it when possible.
Donald Prater, acting deputy commissioner for food at the FDA, stated, “Cyclospora remains a challenging agent. Our outbreak investigation team is diligently following all leads from the CDC regarding various outbreak clusters.”
The Trump administration faced criticism for its handling of public health, particularly as expertise in foodborne illnesses has been vital during this outbreak. In the year leading up to the current issues, there was an $11.4 billion cut to state and local health departments and a significant reduction in the CDC’s FoodNet program, which monitored foodborne illness trends.
Biggerstaff mentioned that the CDC conducts weekly calls with states about the outbreak but did not confirm any deployment of staff. She did acknowledge that state budgets are often stretched thin. “States are usually under-resourced for foodborne outbreak response,” she said. “CDC is actively engaged.”
For years prior to these cuts, the CDC warned that comprehensive efforts were necessary to enhance food safety. They had also indicated a rise in cyclospora infections. A study from 2022 highlighted a staggering 443% increase in infections from 2016-2018 compared to 2021. However, later insights suggested this increase might be due to better detection rather than an actual rise in infections.
Biggerstaff encouraged the public to request a cyclospora test if they suspect an infection, noting that standard stool tests might not include it, requiring special testing. “I’m particularly concerned about the surveillance gap regarding individuals who don’t seek care or aren’t tested when they do,” she added.
