Multistate US Cyclospora spike tops 200 cases

The Center for Infectious Disease Research and Policy at the University of Minnesota reports that several states noted Cyclospora infections over the past week, pushing the total to 202, and health officials are still on the hunt for a common food source for some of the infections.

love.boat.cyclosporaThe US Centers for Disease Control and Prevention (CDC) said 202 cases have been reported as of today, an increase of 77 from the past week. More than half of the cases were in Texas, which saw its total grow by 49 cases over the past week, to 110.

Six more states reported illnesses, raising the number of affected states from 13 to 19, with New York City also reporting cases. The latest states to report cases are California, Michigan, Minnesota, Ohio, Virginia, and Wisconsin.

Last week the CDC said outbreak investigations were under way in Texas, Maine, and Massachusetts and that federal officials were assisting state partners in their investigations.

Foodborne Cyclospora outbreaks have been reported in the United States since the mid 1990s and have been linked to many kinds of imported fresh produce, including raspberries, basil, snow peas, and mesclun.

125 now sick in multi-state Cyclospora investigation

The Center for Infectious Disease Research and Policy is reporting that U.S. federal health officials have joined with officials in 13 states to investigate a spike in Cyclospora illnesses, with 125 confirmed or probable cases reported and no specific food item implicated so far.

love.boat.cyclosporaTexas health officials have been investigating a recent surge of infections, and an outbreak investigation is underway in Maine, with Massachusetts also probing an increase in lab-confirmed cyclosporiasis cases, the CDC said in an e-mail to CIDRAP News. As of today, it said, those 3 states, 10 others, and New York City have reported cases. The other states are Connecticut, Florida, Georgia, Illinois, Maryland, Montana, New Jersey, New York, Oregon, and Tennessee.

News of a multistate increase in Cyclospora illnesses follows the recent launch of the investigation in Texas. Over the last months the Texas Department of State Health Services (TDSHS) has learned of 61 cases around the state, which prompted a recent alert to Texas healthcare providers. No common source has been identified.

Cyclospora surge in Texas

Tarrant County Public Health issued a warning Monday about an outbreak of Cyclosporiasis.

pesto.basil.cyclosporaPrior to this month, there were just eight cases reported in the State of Texas, and Tarrant County had seen just one.

But there are now 69 Cyclosporiasis cases in Texas, nine of them in Tarrant County.

So far, health officials have not found the source of the outbreak. They are asking health care providers to test patients who have intestinal issues lasting more than a few days.

Tarrant County Public Health says past outbreaks in the U.S. have been linked to imported fresh produce, including fresh cilantro, pre-packaged salad mix, raspberries, basil, snow peas, and mesclun lettuce.

643 sick in separate cyclospora outbreaks

In 2005, my aunt was part of a cyclospora outbreak linked to fresh basil that struck at least 300 in Florida.

Cyclospora is miserable, until a correct diagnosis comes along and cilantro.slugs.powell.10appropriate anti-parasitics prescribed.

But cyclospora outbreaks keep popping up, year after year.

The U.S. Food and Drug Administration and Centers for Disease Control and Prevention have concluded the 2013 outbreaks were at least two different sources: fresh cilantro grown in Puebla, Mexico, felled some of those in Texas, while salad mix supplied by Taylor Farms de Mexico, S. de R.L. de C.V.,   to Olive Garden and Red Lobster restaurants, both owned by Darden Restaurants, was linked to those sick in Iowa and Nebraska.

As of September 20, 2013, CDC has been notified of 643 cases of Cyclospora infection from 25 states:  Arkansas,  California, Connecticut, Florida, Georgia, Illinois, Iowa , Kansas, Louisiana, Masssachusetts, Michigan, Minnesota, Missouri, Nebraska , New Hampshire, New Jersey, New York (including New York City), Ohio, Pennsylvania, South Dakota, Tennessee, Texas , Virginia, Wisconsin , and Wyoming. 

Cyclospora, bad advice and vasectomies

After walking Sorenne to school this morning – as I do – I dropped by my local fruit and veg monger where we chatted about kids, Screen-Shot-2013-08-05-at-8.53.06-AM-230x300partners and vasectomies.

As I do.

We compared stories.

Then we got into cyclospora.

Chapman put out an infosheet, but what strikes me, and my fruit and veg monger, is the amount of terrible advice: you’re not going to wash this stuff off, and if you succeed, you’re going to cross-contaminate your food service or home kitchen (cyclospora is a parasite, not a virus, news outlets).

Food safety starts on the farm.

Investigators and regulators – take us to the farm.

Iowa, Nebraska link cyclospora outbreaks to packaged salads

I don’t know what it is about some folks from Minnesota; they take any opportunity to lecture the rest of the country – and world – about how they should better investigate foodborne illness.

Amy was born in Albert Lea and I get the same attitude, about spongebob_oil_colbert_may3_103111-300x234other things.

Seriously, it’s not like you grew up with Wayne Gretzky.

But, they’re probably right.

Except this time the real culprit may be the leafy greens cone of silence.

The on-going cyclospora outbreak that has sickened almost 400 Americans in 15 states has been linked by Iowa and Nebraska to “a nationally distributed packaged salad mix.”

Can I buy that at retail? Good branding.

“Our investigation implicated prepackaged, prewashed, salad mix as the cause of this outbreak,” said Nebraska’s chief medical officer, Joseph Acierno, in the online update.

Both Iowa and Nebraska officials said in the online updates that the salad mix contained iceberg and romaine lettuce, carrots and red cabbage, though neither state would name the brand or the lettuce_skull__e_coli__O145_1_story1-300x225producer of the bagged salad mix — and they would not say whether it was an imported or domestic product.

But it wasn’t yet clear whether the packaged salad was linked to other infections in other states, officials with the Food and Drug Administration and the Centers for Disease Control and Prevention said.

106 sick; Cyclospora outbreak grows in Midwest

Iowa health officials said today 71 people across the state have been sickened by a parasite called Cyclospora that is associated with
diarhhea.kennycontaminated fruits and vegetables. An additional 35 people are reported sick in Nebraska.

Authorities suspect that whatever vegetables caused the problem probably have already been sold and consumed or thrown out.

45 now sick in Iowa-based Cyclospora outbreak; veggies suspected?

Authorities suspect that fresh vegetables are the source of a rare parasite sickening dozens of Iowans.

The Iowa Department of Public Health reported this morning that 45 cyclospora infections have been confirmed in the state in the past few pesto.basil.cyclosporaweeks. 

That’s up from 22 cases earlier this week.

Only 10 such cases had been reported in the state in the past 20 years.
The parasite is usually transmitted by tainted produce or water. It can cause weeks of severe diarrhea.

Federal experts are helping to trace the cause. Officials are urging everyone to wash their produce carefully … though they note that Cyclospora can be difficult to wash off.

Investigators who interviewed the patients believe the outbreak started in tainted vegetables, not fruit. 

7 sick from Cyclospora in Iowa

On July 7, 1997, a company physician reported to the Alexandria Department of Health (ADOH) that most of the employees who attended a corporate luncheon on June 26 at the company’s branch in Fairfax, Virginia, had developed gastrointestinal illness.

On July 11, the health department was notified that a stool specimen from one of the employees who attended the luncheon basil.salmonellawas positive for Cyclospora oocysts. Many others tested positive. It was subsequently revealed in a July 19, 1997, Washington Post story citing local health department officials that basil and pesto from four Sutton Place Gourmet stores around Washington D.C. was the source of cyclospora for 126 people who attended at least 19 separate events where Sutton Place basil products were served, from small dinner parties and baby showers to corporate gatherings. Of the 126, 30 members of the National Symphony Orchestra became sick after they ate box lunches provided by Sutton Place at Wolf Trap Farm Park.

In May 2001, 17 people in British Columbia were sickened with cyclospora associated with basil from Thailand.

In 2005, 300 people in Florida were sickened with cyclospora from fresh basil.

My aunt was part of that outbreak.

Beginning with California strawberry growers wrongly fingered as the source of a 1996 cyclospora outbreak that sickened over 1,000 people across North America (the culprit was Guatemalan pesto.basil.cyclosporaraspberries) through to several outbreaks on an Australian cruise ship that sickened at least 314 in 2010, cyclospora keeps popping up.

Today it was Iowa, where consumers are being urged to carefully wash their produce as public health officials hunt for the source of a parasite that has caused severe diarrhea in at least seven Iowans.

The cyclospora infections have been confirmed in five counties in the past two weeks, the Iowa Department of Public Health reported Wednesday. Only 10 such cases had been reported in the state in the previous 20 years.

Dr. Patricia Quinlisk, the department’s medical director said while many previous Iowa cases have involved people who picked up the parasite while traveling to other countries, that doesn’t appear to be the source of this outbreak. “It looks like they got it here,” Quinlisk said.

The epidemiologist said previous U.S. outbreaks have been traced to fresh produce, such as raspberries, basil, snow peas, and mesclun lettuce. She urged the public to carefully wash produce before consuming it.

Washing produce will do little. And good luck washing that pesto from food service.