The Centers for Disease Control and Prevention has reportedly widened its investigation into what is believed to be the largest documented cyclosporiasis outbreak, adding more states to the growing multistate public health alert, including Arkansas and Missouri.
Arkansas health officials confirmed the state’s inclusion in the CDC’s expanding cyclosporiasis outbreak probe. “Arkansas is one of the states the CDC is adding to the multi-state outbreak for cyclosporiasis,” a spokesperson for the state health department told the Guardian.
Missouri’s health department also acknowledged that the state is part of the wider investigation, with a spokesperson telling the Guardian that Missouri is involved in the “multistate outbreak”.
The reported expansion of the outbreak investigation also reaches Iowa, Nebraska, New Hampshire and North Carolina, according to the Washington Post.
In New Hampshire, health officials said they have identified residents who were exposed to recalled lettuce connected to the outbreak. A spokesperson for the New Hampshire Department of Health and Human Services told the Guardian: “New Hampshire DHHS has identified residents exposed to recalled lettuce and has launched a cyclosporiasis webpage that includes information on infections linked to recalled food. The DHHS cyclosporiasis webpage related to the multistate outbreak is updated each Tuesday by 12.00pm.”
The Guardian has sought comment from the CDC, as well as health departments in Iowa, Nebraska and North Carolina.
By 28 July, the CDC had logged 6,707 laboratory-confirmed cyclosporiasis infections, with roughly 11,500 additional suspected cases still awaiting verification. Since May, illnesses have been reported across 45 states, though the majority of suspected infections have been centered in Michigan and Ohio.
Cyclosporiasis is a foodborne illness caused by Cyclospora cayetanensis, a microscopic parasite. The infection can trigger a range of symptoms, including diarrhea, loss of appetite, bloating, severe fatigue, low-grade fever, stomach cramps, nausea and vomiting.
Cyclosporiasis spreads through the fecal-oral route, most commonly by consuming contaminated food or water. Symptoms typically begin about a week after infection, and without treatment can last anywhere from a few days to a month or longer, according to the CDC. Those with symptoms are advised to stay well hydrated.
Although the Food and Drug Administration is still investigating six cyclosporiasis outbreaks, it has identified iceberg lettuce produced by Taylor Farms de Mexico as the source of one outbreak. In response, Taylor Farms voluntarily recalled lettuce distributed to restaurants in 27 states and grocery stores in 15 states.
On 24 July, the CDC announced that the outbreak linked to iceberg lettuce had expanded to four additional states – Illinois, Kansas, Oklahoma and Pennsylvania. As of that date, illnesses associated with the outbreak had been reported in nine states: Illinois, Indiana, Kansas, Kentucky, Michigan, Ohio, Oklahoma, Pennsylvania and West Virginia.
Michigan – the state hardest hit by the outbreak, with health officials reporting 11,234 outbreak-linked cases – on Monday reported the first two US deaths linked to the disease since the outbreak began.
The CDC has warned the public to not eat recalled Taylor Farms iceberg lettuce, and to contact healthcare providers if cyclosporiasis symptoms are experienced.
