Tuesday, July 16, 2013

Cyclospora outbreak In IA and NE may be due to contaminated vegetables

Approximately 100 people have become ill from Cyclospora in Iowa and Nebraska.  Fresh vegetables are considered the likely source.

Cyclospora is a single cell parasite that infects the intestinal tract when oocysts are ingested.  According to the CDC website (http://www.cdc.gov/parasites/cyclosporiasis/gen_info/faqs.html), the symptoms are watery diarrhea (sometimes  explosive), loss of appetite, weight loss, stomach pain and bloating, increased gas and nausea.  If not treated, symptoms can last several days to over a month.  Patients will often have one or more relapses.  For immunocompromised individuals, symptoms can last much longer.

 Life cycle of Cyclospora cayetanensis

This parasite is more common in tropical and subtropical areas, but has been involved in outbreaks in the US, primarily through contaminated produce.  The last large outbreak was in 1996, when more than 850 become ill from eating contaminated raspberries.

Officials say vegetables likely cause of cyclospora outbreak -

See more at: http://www.thepacker.com/fruit-vegetable-news/Officials-think-fresh-veggies-likely-cause-of-cyclospora-outbreak-215584211.html#sthash.tkfOmaJX.dpuf
The Packer
07/15/2013 04:42:00 PMCoral Beach   

With more than 100 people in at least two states confirmed to have infections from the cyclospora parasite, public health officials investigating the outbreak suspect the culprit is some kind of fresh vegetable.

We are pretty sure it’s not fruit but a vegetable,” said Dr. Patricia Quinlisk, head epidemiologist and medical director for the Iowa Department of Health. “We are trying to correlate what the common source might be.”

Quinlisk said the first two cases were confirmed in Iowa in the last week of June. As of July 15, Iowa reported 71 cases and Nebraska health officials reported 30 cases in their state. She said a “couple of other states” are also investigating outbreaks of infections caused by the rare parasite. “One (state) has a lot of cases, but they haven’t gone public yet,” Quinlisk said July 15.

She said Iowa officials have been working with the Food and Drug Administration and the Centers for Disease Control and Prevention since the outbreak began. Officials at CDC confirmed they are assisting, but spokeswoman Sharon Hoskins said “Iowa and Nebraska are leading the investigation.” Symptoms usually begin about a week after exposure and can last more than 50 days in healthy people and up to a year in people with compromised immune systems, Quinlisk said. She said Iowa usually has one confirmed case annually, but there are possibly more because a specific lab test is required to detect the parasite.

The most recent widespread cyclospora outbreak in North America was in 1996 when more than 850 cases, mostly in 20 states in the U.S. but including some in Canada, were linked to imported raspberries from Guatemala, according to the CDC website. Fresh basil and lettuce have also been linked to U.S. outbreaks caused by the cyclospora parasite. -

Iowa Department of Public Health News Release
IDPH Cyclospora Outbreak Investigation Continues


The Iowa Department of Public Health, CDC and local public health agencies are investigating an outbreak of an intestinal illness caused by Cyclospora (a rare parasite). As of today, July 12, 45 cases of Cyclospora infections have been reported to IDPH; almost all have been identified through testing at the State Hygienic Lab (SHL), including:
Linn County - 21 cases
Fayette County - 3 cases
Polk County - 3 cases
O’Brien County - 3 cases
Dallas County - 2 cases
Mills County - 2 cases
Webster County - 2 cases
Des Moines County - 2 cases
Benton County - 1 case
Black Hawk County - 1 case
Buchanan - 1 case
Johnson County - 1 case
Pottawattamie County - 1 case
Van Buren County - 1 case
Woodbury - 1 case

Cyclosporiasis illness occurs when an individual consumes food or water contaminated with the parasite. Fresh fruits and vegetables are typically associated with Cyclospora outbreaks. While the source of this outbreak has not been determined, the investigation, which includes epidemiological interviews with those who have been ill, indicates fresh vegetables, not fruit, are implicated as a likely source.

Most people’s illness began in mid to late June and at least one person has been hospitalized. Many people report still being ill with diarrhea and some have had relapses. Specific treatment is available (but it is not typically used for more common diarrheal illnesses). Also, very specific laboratory testing (not commonly ordered) must be done to detect Cyclospora.

Additional cases have been identified in Nebraska and other Midwestern states. IDPH is coordinating the investigation with public health officials in those states. Washing fresh produce is recommended; however, it can be very difficult to wash Cyclospora off all types of produce.

Cyclosporiasis causes a watery diarrhea that lasts an average of 57 days if untreated. Other symptoms include:
Fatigue (severe tiredness)
Loss of appetite
Weight loss
Increased gas
Stomach cramps
Muscle aches
Low-grade fever

For more information, visit www.idph.state.ia.us/EHI/Issue.aspx?issue=Cyclospora Outbreak Investigation&pg=Investigation Home.

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