Cyclospora in Canada: PHAC and CFIA investigate

Posted on August 8, 2015 by Ben Chapman

According to the Public Health Agency of Canada, over 80 Canadians are ill with Cyclospora and the source isn’t known. It’s also not clear whether these illnesses are linked to the 350+ cases of Cyclospora in Texas and elsewhere.

Related, or maybe not, who can tell, cilantro produced in Puebla, Mexico was banned from the U.S. a couple of weeks ago – after hundreds of Cyclospora illnesses going back to 2012.

The Public Health Agency of Canada is collaborating with provincial public health partners, the Canadian Food Inspection Agency, and Health Canada to investigate 83 Canadian cases of Cyclospora infections in Ontario, British Columbia, Alberta, and Quebec. The source of this outbreak is not yet known, and the Agency and its partners continue to investigate.

In Canada, a total of 83 cases have been reported in British Columbia (3), Alberta (1), Ontario (74), and Quebec (5). Two cases have been hospitalized, and are recovered or recovering. No deaths have been reported. Individuals became sick between May 9 and July 18, 2015. To date, no source has been identified. The investigation is ongoing.

The Public Health Agency of Canada is leading the human health investigation of this outbreak and is in regular contact with its federal and provincial partners to monitor and take collaborative steps to address the outbreak. Health Canada provides food-related health risk assessments to determine if the presence of a certain substance or microorganism poses a health risk to consumers. The Canadian Food Inspection Agency (CFIA) conducts food safety investigations into the possible food source of an outbreak. The Government of Canada will continue to update Canadians as new information related to this investigation becomes available.

So many questions – are the Canadians coordinating with U.S. officials who are investigating american Cyclospora illnesses? Are Canadians still getting cilantro from Puebla, Mexico? This is a weird statement at the bottom of the press release:

To date, no multi-jurisdictional outbreaks have been linked to produce grown in Canada.

Cyclospora: Mexican cilantro contamination spurs partial U.S. import ban

Posted on July 27, 2015 by Douglas Powell

I try to grow my own cilantro, but the birds and cats and skinks find it yummy.

So there’s not much left.

And this is why I’m not a farmer.

As the Cyclospora count in Texas reached 203, some Mexican cilantro is being banned in the U.S. after health officials found human feces and toilet paper in growing fields from which herbs have been linked to hundreds of intestinal illnesses among Americans dating back to 2012.d

The Food and Drug Administration will detain Mexican cilantro at the border from April to August and won’t allow products from the state of Puebla, Mexico, into the U.S. without inspections and certification, according to an import ban dated Monday by the agency. Cilantro from other parts of Mexico will need documentation to prove the product isn’t from Puebla, about a two-hour drive southeast of Mexico City.

The cilantro is linked to outbreaks of cyclosporiasis, according to the alert. Last year, at

Since 2013, the FDA and Mexican authorities have inspected 11 farms and packing houses that produce cilantro from Puebla. At eight, health officials found bathrooms without soap, toilet paper or running water, in addition to the human feces and toilet paper in growing fields. Some had a complete lack of toilet facilities.

“Based on those joint investigations, FDA considers that the most likely routes of contamination of fresh cilantro are contact with the parasite shed from the intestinal tract of humans affecting the growing fields, harvesting, processing or packing activities or contamination with the parasite through contaminated irrigation water, contaminated crop protectant sprays, or contaminated wash waters,” the alert said.

A 2013 cyclosporiasis outbreak in 25 states was linked to Puebla cilantro as well as salad mix from Taylor Farms de Mexico that was sold to Olive Garden and Red Lobster, both then owned by Darden Restaurants Inc. The FDA and Mexican officials found conditions at Taylor Farms de Mexico in Guanajuato met food safety protocols, the FDA said.

Blame Mexico: 151 now sick in Texas Cyclospora outbreak, source unknown

Posted on July 12, 2015 by Douglas Powell

The Texas Department of State Health Services reports that a recent surge in reports of illnesses due to the parasite Cyclospora has prompted DSHS to investigate the infections in hopes of determining a common source. DSHS has received reports of 151 Cyclosporiasis cases from around Texas this year.

DSHS recommends thoroughly washing fresh produce, but that may not entirely eliminate the risk because Cyclospora can be difficult to wash off. Cooking will kill the parasite (but be wary of cross contamination).

Last year, Texas had 200 cases, some of which were associated with cilantro from the Puebla region in Mexico.

113 now sick in Texas Cyclospora outbreak; no food IDed yet

Posted on July 3, 2015 by Douglas Powell

A recent surge in reports of illnesses due to the parasite Cyclospora has prompted the Texas Department of State Health Services to investigate the infections in hopes of determining a common source.

DSHS has received reports of 113 Cyclosporiasis cases from around Texas this year, including 101 in the last two weeks.

DSHS recommends thoroughly washing fresh produce, but that may not entirely eliminate the risk because Cyclospora can be difficult to wash off. Cooking will kill the parasite.

Last year, Texas had 200 cases, some of which were associated with cilantro from the Puebla region in Mexico.

Cyclospora count in Texas rises to 78

Posted on July 1, 2015 by Douglas Powell

A recent surge in reports of illnesses due to the parasite Cyclospora has prompted DSHS to investigate the infections in hopes of determining a common source. DSHS has received reports of 90 Cyclosporiasis cases from around Texas this year, including 78 in the last two weeks.

DSHS recommends thoroughly washing fresh produce, but that may not entirely eliminate the risk because Cyclospora can be difficult to wash off. Cooking will kill the parasite.

But what about cross-contamination?

54 now sick: Cyclospora outbreak in Texas

Posted on June 24, 2015 by Douglas Powell

The Texas Department of State Health Services alerted health care providers this week to be on the lookout for cyclospora. The state’s count is at 54 cases.

The alert says reports of the illness have been high in Texas each of the past three summers. But state health department spokeswoman Carrie Williams says a surge like the one over the last week is unusual.

Williams says there are no known hospitalizations or deaths related to the illness.

42 sick: Cyclospora outbreak in Texas

Posted on June 23, 2015 by Douglas Powell

My aunt contracted Cyclospora from basil in Florida about a decade ago.

It’s not fun.

The Austin/Travis County Health and Human Services Department is investigating an outbreak of Cyclospora, an intestinal illness caused by a microscopic parasite.

As of today, the department has 15 confirmed and probable cases and 11 new cases that are currently under investigation. Within the past week, 42 cases of Cyclospora infection have been reported to the Texas Department of State Health Services.

Cyclospora is spread by people ingesting something – such as food or water – that was contaminated with feces (stool). Cyclospora needs time (days to weeks) after being passed in a bowel movement to become infectious for another person. Therefore, it is unlikely that Cyclospora is passed directly from one person to another.

In the United States, foodborne outbreaks of cyclosporiasis have been linked to various types of imported fresh produce including berries and leafy greens. At this time, no particular food item has been identified. It is recommended that residents thoroughly wash fresh produce.

Washing doesn’t do much.

Probably cilantro that sickened hundreds with cylospora in 2013; better detection needed

Posted on April 14, 2015 by Douglas Powell

The 2013 multistate outbreaks contributed to the largest annual number of reported US cases of cyclosporiasis since 1997. In this paper we focus on investigations in Texas.

We defined an outbreak-associated case as laboratory-confirmed cyclosporiasis in a person with illness onset between 1 June and 31 August 2013, with no history of international travel in the previous 14 days. Epidemiological, environmental, and traceback investigations were conducted.

Of the 631 cases reported in the multistate outbreaks, Texas reported the greatest number of cases, 270 (43%). More than 70 clusters were identified in Texas, four of which were further investigated. One restaurant-associated cluster of 25 case-patients was selected for a case-control study. Consumption of cilantro was most strongly associated with illness on meal date-matched analysis (matched odds ratio 19·8, 95% confidence interval 4·0–∞). All case-patients in the other three clusters investigated also ate cilantro. Traceback investigations converged on three suppliers in Puebla, Mexico.

Cilantro was the vehicle of infection in the four clusters investigated; the temporal association of these clusters with the large overall increase in cyclosporiasis cases in Texas suggests cilantro was the vehicle of infection for many other cases. However, the paucity of epidemiological and traceback information does not allow for a conclusive determination; moreover, molecular epidemiological tools for cyclosporiasis that could provide more definitive linkage between case clusters are needed.

2013 multistate outbreaks of Cyclospora cayetanensis infections associated with fresh produce: focus on the Texas investigations

Epidemiology and Infection [ahead of print]

Abanyie, R. R. Harvey, J. R. Harris, R. E. Weigand, L. Gual, M., Desvignes-Kendrick, K. Irvin, I Williams, R. L. Hall, B. Herwaldt, E. E. Gray, Y. Qvarnstrom, M. E. Wise, V. Cantu, P. T. Cantey, S. Bosch, A. J. Da Silva, A. Fields, H. Bishop, A. Wellman, J. Beal, N. Wilson, A. E. Fiore, R. Tauxe, S. Lance, L. Slutsker and M. Parise

http://journals.cambridge.org/action/displayAbstract?fromPage=online&aid=9644741&fileId=S0950268815000370

304 sick from Cyclospora in US, some linked to fresh cilantro from Puebla, Mexico

Posted on August 30, 2014 by Douglas Powell

The U.S. Centers for Disease Control and federal, state, and local public health partners are continuing surveillance to identify and interview additional ill persons and to identify sources of infection.

Cyclospora cayetanensis is a single-celled parasite that causes an intestinal infection called cyclosporiasis.
As of August 26, 2014 (5pm EDT), CDC had been notified of 304 ill persons with confirmed Cyclospora infection in 2014; of these, 207 ill persons from the following states had no history of international travel within two weeks before onset of illness: Arkansas, California, Connecticut, Florida, Illinois, Maine, Maryland, Massachusetts, Michigan, Minnesota, Montana, Nebraska, Pennsylvania, New Jersey, New York (and New York City), Texas, Virginia, Wisconsin, and Washington.

◦ Most (133; 64%) of the cases were reported from Texas.

◦ Most (133; 64%) of the cases were reported in July 2014.

◦ Most (176; 85%) of the illness onset dates occurred in June and July.

◦ Among 183 persons with available information, 7 (4%) have reported being hospitalized. No deaths have been reported.

◦ Among 204 persons with available information, ill persons range in age from 3 to 88 years, with a median age of 49 years.

◦ Among 204 persons with available information, 115 (56%) of ill persons are female.

To date, 133 ill persons with Cyclospora infection have been reported among Texas residents who did not travel outside of the country within the two weeks before becoming ill.

◦ Epidemiologic and traceback investigations conducted in Texas by state and local public health and regulatory officials and the FDA indicated that some illnesses among Texas residents were linked to fresh cilantro from Puebla, Mexico.

◦ Reported cases of cyclosporiasis in Texas have returned to baseline levels in August; therefore, it is likely that the outbreak has ended.

Investigations are ongoing in other states.

◦ To date, there is no evidence to suggest that any illnesses outside of Texas are linked to cilantro from Puebla, Mexico.

Consumers should continue to enjoy the health benefits of eating fresh fruits and vegetables as part of a well-balanced diet.
Consumers and retailers should always follow safe produce handling recommendations.

Cyclospora redux: Cilantro linked to 21 illnesses in Texas

Posted on August 28, 2014 by Ben Chapman

We eat a lot of cilantro in my house; whether in fresh salsa, guacamole or as an ingredient in tacos it’s a favorite.

I’m rethinking my love of the herb as it’s entering the raw sprouts realm.

After notable recalls in 2009, 2011 and a 2013 Cyclospora outbreak where the U.S. Food and Drug Administration and Centers for Disease Control and Prevention concluded that fresh cilantro grown in Puebla, Mexico was the source, cilantro is at it again.

According to NBCDFW a current outbreak of Cyclospora has been linked yet again to the fresh herb.

The Texas Department of State Health Services said Thursday the its investigation has linked the cases in four restaurants clusters to fresh cilantro from Puebla, Mexico.

Texas DSHS says a total of 21 people got sick and all of them reported eating food containing cilantro within two weeks of becoming ill.

The FDA and DSHS traced the cilantro from all four restaurants to Puebla, Mexico. While investigators could not find cilantro contaminated with cyclospora they say there’s a strong enough “epidemiological link” between the illnesses and the cilantro to draw the conclusion.

In October 2013, the Centers for Disease Control and Prevention also linked a cyclospora outbreak to cilantro from Puebla, Mexico.

The Texas DSHS reported a total of 166 confirmed cyclospora cases in the state, but only 126 cases were considered part of the outbreak.

Dallas County reported the majority of this year’s cases with 38, 19 cases were confirmed in Tarrant County and 12 in Collin County.

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