A Gastrointestinal Outbreak Spreading in Multiple States
A troublesome gastrointestinal illness is rapidly spreading across several states, with over 700 confirmed cases in Michigan in recent weeks. Testing for cyclosporiasis, a pathogen typically linked to contaminated fresh produce, is in high demand. So many people are experiencing severe diarrhea and painful abdominal cramps that many laboratories are struggling to keep up with the influx of patients.
The exact source of these illnesses remains unclear, although the Food and Drug Administration is investigating the situation. Dr. Anurag Malani, vice chief of staff at Trinity Health Ann Arbor, speculated that cases in Michigan could reach 1,000, noting that there are likely many more undiagnosed cases out there.
In an effort to identify potential food sources, health officials are examining grocery shopping lists, according to Dr. Natasha Bagdasarian, Michigan’s chief medical executive. Recently, cases surged to 708 within about ten days, which is quite alarming compared to the usual 40 to 50 cases reported annually.
Cyclosporiasis cases often see a rise during the summer months, particularly between May and August, as noted by the Centers for Disease Control and Prevention. While most cases are found in southeastern Michigan, other states like Ohio, North Carolina, Illinois, and New Jersey have also reported illnesses.
The FDA and CDC are monitoring the outbreak, though an FDA spokesperson indicated it’s too early to classify the current situation as “definitively unusual” until the investigation concludes. Cyclosporiasis, triggered by a microscopic parasite called cyclospora, is predominantly associated with fresh produce. Previous outbreaks have linked it to items like raspberries and contaminated salads.
Symptoms of the illness can include severe, watery diarrhea, flatulence, stomach cramps, nausea, and loss of appetite. The CDC recently reported 145 cyclosporiasis cases across 17 states from early May through mid-June, although many cases likely went unreported.
Interestingly, a CDC representative stated that there is no evidence of a single, large-scale outbreak tying cases together at this moment. However, some experts have raised concerns about the CDC scaling back its tracking of cyclospora, hinting that it could hinder the ability to respond to outbreaks effectively.
Dr. Brian Kaminski from ProMedica Health System mentioned that the cases in Michigan and Ohio look to be part of a larger “epidemic cluster.” He pointed out that the rise in persistent diarrhea cases suggested something significant was occurring. As of Monday, ProMedica had recorded 411 cases.
Unlike norovirus, which is highly contagious and usually resolves in a few days, cyclosporiasis is not spread from person to person. If untreated, it can linger for weeks. Treatment typically involves an antibiotic known as Bactrim, but some patients have required hospitalization due to dehydration. Fortunately, no deaths have been reported.
Dr. Matthew Sims, director of infectious diseases research at Corewell Health in Royal Oak, Michigan, raised an important question: Are these cases all interconnected, or are there several separate outbreaks? One complicating factor in investigations is that symptoms can take one to two weeks to appear after exposure to contaminated food.
Health officials are diligently asking affected individuals where they’ve dined or shopped recently and what they purchased. Meanwhile, testing capabilities in some regions are reportedly being tested. Initial turnaround times for results were about a day, but now it’s taking two to three days. If delays persist, doctors might need to treat patients based on symptoms rather than waiting for lab results.
Staying Safe from Cyclospora
Washing produce can minimize risks but doesn’t completely eliminate them, as the cyclospora parasite tends to cling tightly to food. Michigan health officials suggest consumers buy whole heads of lettuce and peel away the outer leaves before washing to reduce contamination risks. Raspberries, in particular, are tricky due to their tiny hairs that harbor the parasite.
Freezing may kill the parasite, but it’s not guaranteed. Cooking food remains the most reliable method to eliminate the risk.
