The U.S. Centers for Disease Control and Prevention said it has epidemiologically linked a “large” cyclosporiasis outbreak in at least four Midwest states — Michigan, Ohio, West Virginia and Kentucky — to a “likely common source.”
Gwen Biggerstaff, the deputy director of the CDC’s Division of Foodborne, Waterborne, and Environmental Diseases, said during a July 14 news conference that it remains unclear specifically what that common source might be.
“Right now we don’t have a specific source identified,” she said, adding that the agency is working closely with state and local health departments and the U.S. Food and Drug Administration to collect epidemiologic, trace-back and laboratory data “to triangulate when we might have a common signal across cases.”
In those four Midwest states, illnesses in 400 people have been connected, the CDC reported. All of the people sickened in those four states had symptoms beginning on or after June 22.
“FDA and CDC, of course, are working with our state partners,” said Donald Prater, the acting deputy commissioner for food at the U.S. Food and Drug Administration. “We are aware of the signal for lettuce … that’s being noted by our Michigan partners. What I can say at this point is that [we are] continuing our trace-back investigation on multiple produce items, including the lettuce.”
In all, the CDC has reported a total of 1,645 laboratory-confirmed cases and 141 hospitalizations nationally between May 1 and July 13 in 34 states.
Biggerstaff said hundreds of those cyclosporiasis cases and clusters of infections have yet to be epidemiologically linked but that the investigation continues.
“We want to be clear, the true number of infections is almost certainly higher than what’s reflected in these numbers because many people with mild illness recover without seeking medical care and are never tested,” Biggerstaff said.
“Historically, cyclosporiasis outbreaks have been associated with travel to other countries, but in the last few years, we have seen an … increasing number of cases tied to domestic and imported produce.”
Could it be lettuce, salad greens?
Cyclosporiasis is caused by a microscopic parasite that infects people when they eat food or drink water that’s been contaminated with fecal matter.
Michigan public health investigators say they are zeroing in on lettuce and other salad greens as potential sources of the outbreak of illness in the state.
“Although we do not have a definite product identified as the source of the outbreak, we want to let Michiganders know what we have learned so far so they can take steps to protect their families,” said Dr. Natasha Bagdasarian, the state’s chief medical executive, in a July 13 statement. “Early information has shown lettuce as a common product that regularly comes up during the investigation. We will continue to provide updates as we learn more.”
The Michigan Department of Health and Human Services reported 3,309 cases of cyclosporiasis as of 9:30 a.m. July 14.
Other types of food items cannot be completely ruled out, the state health department said, and no specific type of produce, grower or supplier has been identified as the source.
Biggerstaff did not respond to a question about whether lettuce or cilantro from Michigan Taco Bell restaurants may be a source. The fast-food chain stopped serving lettuce and cilantro amid the outbreak in at least some of its metro Detroit restaurants.
What is cyclosporiasis?
Cyclosporiasis is an illness caused by a tiny, single-celled parasite called cyclospora cayetanensis.
It is a protozoan parasite that is so small, it can only be seen with a microscope. It can infect humans when they eat food or drink water that has been contaminated with fecal matter. Fresh produce can carry the parasite when it is grown in fields irrigated with contaminated water.
The parasite survives for days to weeks in warm, wet environments and is notoriously difficult to eliminate. It can be difficult to wash off fresh produce and isn’t killed by common disinfection methods.
It generally does not spread directly from person to person.
In summer months, there are some local cases every year. Michigan typically has about 50 cases annually, the state health department reported.
In the past, outbreaks in the United States and Canada have been tied to bagged salad mixes and kits, such as precut lettuce blends with romaine, iceberg, red cabbage and carrots; fresh cilantro; basil; raspberries; snow peas, and green onions.
Among them were outbreaks identified:
How to protect yourself from cyclosporiasis
The Michigan Department of Health and Human Services suggests reducing the risk of cyclosporiasis infection by cooking leafy greens, cilantro, basil, green onions, snow peas and raspberries after carefully washing them under clean, running water. Heating food to 158 degrees or higher kills the parasite.
If you must eat raw, fresh produce, the health department suggests:
Contact Kristen Shamus: kshamus@freepress.com. Subscribe to the Detroit Free Press.
This article originally appeared on Detroit Free Press: CDC: ‘Large’ cyclosporiasis outbreak in 4 Midwest states are linked
Reporting by Kristen Jordan Shamus, Detroit Free Press / Detroit Free Press
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By Kristen Jordan Shamus, Detroit Free Press | USA TODAY Network
