Tuesday, August 27, 2013

Cyclospora cases now over 600, Texas cases not linked to Taylor bagged salad

As of August 26th, CDC is reporting that there are 610 cases of Cyclospora infection in 22 states. While many of the illnesses in IA and NB were linked to bagged salad mix produced by Taylor Farms de Mexico, CDC indicates that a number of cases in Texas are unrelated to the cases in IA and NB, but rather originated with people eating at the same restaurant..

CDC is investigating the Texas cases as well as the cases seen in other states to see how any of them might be related and what might be the source (CDC release below).

The Taylor Farms facility in Mexico that was linked to the IA and NB cases has resumed production after undergoing an extensive FDA audit. (story and link below).


CDC News
Investigation of an Outbreak of Cyclosporiasis in the United States
http://www.cdc.gov/parasites/cyclosporiasis/outbreaks/investigation-2013.html

LAST UPDATED AUGUST 26, 2013 7:00 PM EDT
Case counts are updated Mondays, Wednesdays, and Fridays
On June 28, 2013, CDC was notified of 2 laboratory-confirmed cases of Cyclospora infection in Iowa residents who had become ill in June and did not have a history of international travel during the 14 days before the onset of illness. Since that date, CDC has been collaborating with public health officials in multiple states and the U.S. Food and Drug Administration (FDA) to investigate an outbreak of cyclosporiasis.

Highlights
Read the Advice to Consumers
Read the Guidance for Laboratories
Cyclospora cayetanensis is a single-celled parasite that causes an intestinal infection called cyclosporiasis.
As of August 23, 2013 (5pm EDT), CDC has been notified of 610 ill persons with Cyclospora infection from 22 states: Arkansas, California, Connecticut, Florida, Georgia, Illinois, Iowa, Kansas, Louisiana, Minnesota, Missouri, Nebraska, New Jersey, New Hampshire, New York (including New York City), Ohio, South Dakota, Tennessee, Texas, Virginia, Wisconsin, and Wyoming.
Most of the illness onset dates have ranged from mid-June through mid-July.
Among 581 ill persons with available information, 43 (7%) have reported being hospitalized. No deaths have been reported.
Public health officials in Iowa and Nebraska performed investigations within their states and concluded that restaurant-associated cases of Cyclospora infection in their states were linked to a salad mix produced by Taylor Farms de Mexico.
On August 12, 2013, Taylor Farms de Mexico informed FDA that the company had voluntarily suspended production and shipment of any salad mix, leafy green, or salad mix components from its operations in Mexico to the United States.
On August 25, 2013, Taylor Farms de Mexico, with FDA concurrence , resumed production and shipment of salad mix, leafy greens, and salad mix components to the United States.
Currently, CDC is collaborating with the Texas Department of Health and Human Services and local public health departments to investigate cases of cyclosporiasis reported among people in Texas.
The preliminary analysis of results from an investigation into a cluster of cases that ate at a Texas restaurant does not show a connection to Taylor Farms de Mexico. This investigation is ongoing.
Although the investigation of cases continues, available evidence suggests that not all of the cases of cyclosporiasis in the various states are directly related to each other.
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.
CDC will update the public as more information becomes available, including steps consumers can take to protect themselves. 

August 26, 2013
Investigation Update

Because many of the more recent cases have been reported from Texas, CDC is collaborating with the Texas Department of Health and Human Services and local public health departments to investigate cases of cyclosporiasis reported among people in Texas.

Public health investigators have interviewed ill people in Texas about their exposures during the 2 weeks before they became ill. These interviews have covered what food they ate and where they ate and purchased their food. On the basis of these interviews, investigators have identified a group (cluster) of ill people who reported eating at the same restaurant. A detailed investigation of this cluster is ongoing. This investigation includes listing the different ingredients in the food that was eaten. People who did not get sick but who also ate meals at the same restaurant on the same days as ill people are also being interviewed. The preliminary analysis of results from this ongoing cluster investigation in Texas does not show a connection to salad mix, leafy greens, and salad mix components produced at Taylor Farms de Mexico.

From August 11-19, 2013, FDA with the cooperation of Taylor Farms de Mexico and Mexican government authorities conducted a thorough environmental assessment at the firm’s processing facility. The team also assessed five farms identified through traceback information from the outbreak investigation. The team found that conditions and practices at these facilities at the time of the assessment were in accordance with known food safety protocols. On August 25, 2013, Taylor Farms de Mexico, with FDA concurrence , resumed production and shipment of salad mix, leafy greens, and salad mix components to the United States. The firm had voluntarily ceased production and shipment of these products on August 9, 2013.

The findings in Texas differ from those from earlier investigations in Iowa and Nebraska. In those states investigators linked cyclosporiasis cases acquired after eating in one of multiple restaurants to eating a bagged salad mix from Taylor Farms de Mexico. It is not unusual to recognize outbreaks that happen in the same season but are due to different foods. As in 2013 and in years past, most cases and outbreaks of cyclosporiasis in the United States are detected in spring and summer months. Not all cases during the same time of year are necessarily caused by the same exposure.

For example, during a several-month period in 1997, there were three separate and unrelated outbreaks of cyclosporiasis caused by different fresh produce items from various sources. Strong evidence from epidemiologic investigations led to the recognition that the outbreaks were separate and unrelated. Although the investigation of cases in 2013 is ongoing, available evidence suggests that not all of the cases of cyclosporiasis in the various states are directly related to each other. CDC continues to work with state and local partners and FDA to investigate clusters of illness, food exposures, and sources of food items.

Laboratory Update

No laboratory tests are available yet that can distinguish different strains of the parasite Cyclospora cayetanensis. CDC and other institutions are working on developing new molecular tools that could distinguish one strain from another. These tools would help public health investigators more quickly determine whether cases of Cyclospora infection are linked. These tools could also be useful for linking a possible source of infection to illnesses in people.

Case Count Update

 As of August 23, 2013 (5pm EDT), a total of 610 ill persons with Cyclospora infection have been reported from 22 states. Since the last update, 1 additional ill person was reported.

Ill persons range in age from less than one year to 92 years, with a median age of 51 years. 55 percent of ill persons are female. Among 581 ill persons for whom information is available, 43 (7%) have reported being hospitalized. No deaths have been reported.

Illnesses that occurred after July 17, 2013, might not yet have been reported because of the time it takes between when a person becomes ill and when the illness is reported. This could take up to 5 to 6 weeks.



Taylor Farms gets OK from FDA for full production at Mexico plant
The Packer
08/27/2013 10:27:00 AM
Coral Beach
http://www.thepacker.com/fruit-vegetable-news/Taylor-Farms-gets-OK-from-FDA-for-full-production-at-Mexico-plant-221327521.html

Taylor Farms has returned to full production at its San Miguel, Mexico, facility that was partially shut down Aug. 9 after foodservice salad mix from the plant was linked to cyclospora outbreaks in Iowa and Nebraska.
Officials are still trying to find the source of hundreds of cyclospora cases in 20 other states.

The reopening of the Mexico plant follows an inspection by the Food and Drug Administration, Mexican officials and almost 1,200 cyclospora tests by Taylor Farms that all showed negative results, according to Aug. 26 statements from the FDA and the Salinas, Calif.-based company. “The FDA has now completed its environmental assessment of Taylor Farms de Mexico, S. de R.L. de C.V. The assessment took place from Aug. 11-19 and included the facility’s processing operations and five associated farms,” according to a statement on the Taylor Farms website.

“We have been notified by the FDA that during their assessment, the FDA team found no indication of cyclospora and found that conditions and practices observed at these facilities at the time of the assessment were in accordance with known food safety protocols.” –

The FDA has consistently reported that Taylor Farms officials have cooperated fully with the investigation. Follow-up efforts at the Mexican fresh processing facility include what FDA describes as “a comprehensive cyclospora sampling program for leafy green and other products from their farms and processing facility in Mexico.” New testing protocols include sampling of products and water and continued monitoring of the sanitary conditions of the facilities, the FDA update said.

As of Aug. 23, the CDC reported 610 people with confirmed cyclospora infections in 22 states. No deaths have been reported, but 43 people have been admitted to hospitals. More than half of the cases are in Iowa, Nebraska and Texas, with those states reporting 156 cases, 86 cases and 258 cases respectively.

However, the CDC reports preliminary analysis of a “cluster of cases that are at a Texas restaurant does not show a connection to Taylor Farms de Mexico.” Iowa and Nebraska health officials linked illnesses in their states to salad mix at Red Lobster and Olive Garden restaurants that was supplied by the Taylor Farms de Mexico facility. “The findings in Texas differ from those from earlier investigations in Iowa and Nebraska,” according to the CDC update. “It is not unusual to recognize outbreaks that happen in the same season but are due to different foods. For example, during a several-month period in 1997, there were three separate and unrelated outbreaks of cyclosporiasis caused by different fresh produce items from various sources.” –
See more at: http://www.thepacker.com/fruit-vegetable-news/Taylor-Farms-gets-OK-from-FDA-for-full-production-at-Mexico-plant-221327521.html#sthash.k0D2DryD.dpuf









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