The CDC has increased the case count for an outbreak of Cyclospora parasitic infections linked to iceberg lettuce by several thousand.
As of Aug. 5 the confirmed case count was 6,358 with 278 hospitalizations. That is up from 1,947 that the Centers for Disease Control and Prevention had been reporting for the past week. The patients had symptom onset from June 21 through July 30.
The outbreak spans 15 states: Arkansas, Iowa, Nebraska, New Hampshire, North Carolina, Missouri Illinois, Indiana, Kansas, Kentucky, Michigan, Ohio, Oklahoma, Pennsylvania and West Virginia.
Investigators at the Food and Drug Administration have linked the outbreak to iceberg lettuce imported from Central Mexico by Taylor Farms. The Salinas, CA, company issued a recall for its iceberg lettuce products on July 17, well past the window of when the lettuce would have begun making people sick.
The CDC reports that the recalled lettuce constituted multiple lots and was distributed and sold in at least 27 states to foodservice providers, consumers, restaurants and retailers, including Taco Bell locations and Marketside-brand products at Walmart stores. Taco Bell stopped using Taylor Farms iceberg lettuce before the recall. Sysco, the country’s largest foodservice provider, has stopped buying iceberg lettuce from Taylor Farms and from Mexico, according to the company’s CEO.
Michigan’s health department was the first entity to report a cyclospora outbreak and that state’s count now stands at 12,218 with 193 reported patients indicating they had been hospitalized. Two patients in Michigan have died. The Michigan officials said some of the outbreak patients reporting eating at Taco Bell before becoming sick, but it is not known how many of the total number of patients are included in the iceberg lettuce outbreak.
The CDC reports that it is tracking several other Cyclospora outbreaks, with 10,468 laboratory-confirmed cases and another 12,255 that are awaiting further investigation.
The agency expects the cases counts in all of the outbreaks to continue to increase because it can take six weeks for patients to be added to the federal case count. This is because of the time it takes for confirmation testing and the time lag between that testing and when officials report their findings to the CDC.
Also, the CDC estimates that for every confirmed Cyclospora infection there can be up to 83 patients who go undetected. This is because some patients do not seek medical attention and others are not specifically tested for Cyclospora infection.
About Cyclospora
Anyone who has developed symptoms of Cyclospora infection, and has reason to believe they have been exposed to the parasite, should seek medical attention. Specific tests are required and antibiotics are used to fight the parasite.
Cyclospora infection can cause severe abdominal pain, explosive diarrhea, nausea, vomiting, body aches, and fatigue. Symptoms can develop between two and 14 days after exposure. Though symptoms can be severe enough to send people to the hospital, it’s rare for people to die from Cyclospora infections.
Symptoms can last for a month or more and can reoccur for several more months if not treated.
Cyclospora is a type of protozoa, which is a single-celled organism. It is transmitted when people somehow ingest contaminated feces, typically through contaminated food or water. It can be spread only through human waste, unlike E. coli and salmonella, which can also be spread from animal fecal matter.
Previous U.S. outbreaks of cyclosporiasis have been linked to various types of fresh produce, including lettuce, basil, cilantro, mesclun lettuce, raspberries, and snow peas.
Food safety experts say there’s no evidence that washing the produce will remove the parasite because it becomes embedded in the flesh of the produce.