Cyclospora Sources Still at Large

Cyclospora infection count reaches 500 as sources still unknown in most states

/ Author:  / Reviewed by: Robert Carlson, M.D Beth Bolt, RPh

(RxWiki News) Progress was made last week when officials pinned down a salad mix as the source of Cyclospora infections (called cyclosporiasis) in Iowa and Nebraska.

However, counts of infection from the foodborne parasite are growing across the US, leaving the source in 15 states still yet to be discovered.

According to the Centers for Disease Control and Prevention (CDC), 514 Cyclospora infections have now been reported across the US. Texas, which has reported 206 infections, has now jumped up the list to the state with the most cases of cyclosporiasis. 

"Wash fruits and vegetables before eating."

Last week, the US Food and Drug Administration (FDA) reported that outbreaks in Iowa and Nebraska were connected to salad mixes produced by a company called Taylor Farms de Mexico and sold in Darden Restaurants including Olive Garden and Red Lobster.

"The Iowa Department of Inspections and Appeals (DIA) and the Nebraska Department of Health and Human Services have announced that they believe the contaminated salad is no longer in the food supply in those states," the FDA reported.

However, counts of cyclosporiasis across the US have continued to rise, with 17 states reporting a total of 514 cases as of August 8. The infections have caused 30 hospitalizations and zero deaths. 

Texas, with its 206 reported cases, has now surpassed Iowa (153 cases) as the state with the most Cyclospora infections. 

According to the CDC, symptoms of cyclosporiasis, which can include watery diarrhea, stomach cramps and fatigue, typically take about a week after the infection occurs to develop. The symptoms can last anywhere from a few days to more than a month.

In an interview with the CBS News Dallas Fort Worth affiliate, Chris Van Deusen, Assistant Press Officer with the Texas Department of State Health Services, cited this delay between infection and illness as part of the problem in tracking the source. 

Not only do the symptoms take a while to show up, but often they are mild and may not be enough to urge the patient to visit the doctor, until time passes and they continue to reoccur. 

“We are asking people to think back, ‘What did you eat? Two, three, four weeks ago?’' said Van Deusen. "It’s not as easy for people to answer that. Frankly, it just takes some’s a lot of shoe leather detective work."

Van Deusen did note that though Texas' case numbers have increased, things seem to be improving. 

“Of the illnesses that have been reported to us, the last onset date was in late June. We haven’t seen any more recent," Van Deusen said.

However, this doesn't mean the state is necessarily in the clear. "Our peak was several weeks ago, so it may be that we are on the down slope of this or it may be that we are going to get more cases reported,” Van Deusen told CBS.

The CDC described the investigation into the current Cyclospora outbreak as "ongoing and collaborative" as officials across the nation try to hunt down the source or sources in the remaining 15 states reporting infections. 

In the meantime, the CDC noted that previous Cyclospora outbreaks have involved various types of fresh produce. People are encouraged to wash fresh produce carefully before eating. 

Review Date: 
August 9, 2013
Last Updated:
August 12, 2013